Medical Leave of Absence Example Letters

Mary Gormandy White
Leave of Absence Letter Sample

If you need to take an extended period of time off for work for medical reasons, it's a good idea to submit a formal letter of request to your employer. Before writing your letter, make sure you are aware of company policies regarding medical leave and find out whether or not your employer is covered under the Family Medical Leave Act (FMLA).

Sample Letters for Medical Leave Requests

The three most common reasons to submit a letter to request a medical leave of absence are the need for surgery, diagnosis of a serious illness, or diagnosis with a chronic condition that may require intermittent leave. The sample letters below can be downloaded and customized using Adobe, then printed out and signed.

Medical Leave of Absence Request: Surgery

Medical Leave of Absence Request: Serious Illness

Medical Leave of Absence Request: Intermittent Leave

Tips for Requesting Medical Leave

Be sure that you know and follow your company's policies regarding leave requests and be sure that you follow the requirements to the letter. Most companies have specific guidelines that employees must follow when requesting leave. Look in your employee handbook for your company's policies or ask your human resources representative for information.

It's advisable to begin the process of requesting approval for medical leave as soon as you know that you need time off from work for a qualified situation. Most companies request 30 days advance notice when it is practical. The fact that you are writing a letter of request will not excuse you from following official company procedure. Do not assume that your request has been approved simply because you submitted a letter.

Be prepared to complete official FMLA forms to request leave and for medical certification if you are eligible for this type of leave and if your company is covered by the law. See to learn more about FMLA eligibility and requirements. Even if your company is not obligated to provide you with leave under FMLA, your request may be granted if doing so is practical for the organization.

Reasonable Accommodation Considerations

If the reason you need leave is protected as a disability under the Americans with Disabilities Act or Americans with Disabilities Amendments Act, you may be able to request leave as a reasonable accommodation for your disability. If your company is not covered under FMLA and does not grant medical leave as a matter of policy, your initial request can be for a reasonable accommodation. If your company does provide FMLA or policy-based leave, but you need more time off for your health condition, requesting extended leave as a reasonable accommodation may be a good option for you. Learn more about disability rights and laws at

Medical Leave of Absence Example Letters