A medical leave of absence letter is a formal letter that is written by an employee to his or her employer to request needed time off work for medical reasons. Even if the employee has spoken to their supervisor or management about the need for medical leave, they should also send a formal letter.

It will most likely be included in the employee’s file, so it should be clear and professional. If the employee does not plan to return to work, they should write a resignation letter and not ask for medical leave.

Company’s Policies For Medical Leave

The first thing the employee should do is find out the company’s policies for medical leave and whether the company is covered by the Family Medical Leave Act (FMLA). 

The FMLA protects employee’s jobs for up to 12 weeks during a one year period. Only companies that have 50 employees or more are accountable to FMLA. The human resources department will have this information. If the employee is requesting leave under the FMLA, there will be certain forms that need to also be completed.

Reason For Requesting Medical Leave

The reason for requesting medical leave must be a valid reason according to the company rules. There may also be a time frame to submit a medical leave letter. 

The employee should also ascertain to whom the letter should be addressed. If suitable, the letter can also mention any paid leave or vacation time that may be incorporated in the medical leave.

The most common reasons an employee may need medical leave are for:

• Surgery
• The diagnosis of a serious illness
• A chronic condition that requires intermittent leave
• An accident that has debilitated the employee for some time
• Spouse or child medical needs

Most companies require the letter to contain the following information:

 A formal request
• The reason for the request
• The amount of leave required with a return date if possible
• A doctor’s letter included with the leave letter
• What will be done with the employees work while he or she is gone

If the request is for surgery, the employee should also include the type of surgery and the date on which it will take place. If it is not possible to give an exact date when the employee will return to work, an approximate date should be given. 

For example, if the surgery requires 60 days of recovery, the employee can say they will return about 60 days after the surgery.

The name of the coworker who will take the responsibilities of the employee should also be given as well as a phone number where the employee can be reached in case their advice or help is needed at work. 

This shows initiative on the part of the employee and takes the responsibility off the employer for covering the absent employees work. If some work can be done from home, this should also be mentioned. The employee should keep in close communication with their supervisor during their medical leave to update them about their recovery progress. 

Below are sample medical leave of absence letters. Certified mail should be used to send the letter in order for the employee to have proof that they sent the letter within the prescribed time. If there are any documents enclosed such as a letter from a doctor or medical records, only copies should be sent and never original documents.

Sample 1 – Medical Leave Of Absence Letter

Janet Gibson
1416 Action Street
Berkeley, CA, 94703

May 13, 2019

Larry Elton 
HR Manager
Big Company
2600 Flake Street
Berkeley, CA, 94703

RE: Requesting Medical Leave of Absence

Dear Mr. Elton, 

This letter is to formally request leave of absence for medical reasons. I will be having a hysterectomy on 06/01/2019 and will not be able to work for 90 days. I plan to return to work on DATE if the recovery goes well.

I have included a letter from my surgeon that states the need for surgery and the date of the surgery. If any other medical records are required, I will be happy to supply them.

Kim Brown in my department will take responsibility for my clients, and I will be available by phone to give any assistance I can be reach at or at 555-123-4567. 

I greatly appreciate your kind consideration in granting me this leave. 


Janet Gibson
List of enclosures

Sample 2 – Medical Leave Of Absence Letter

Sonny Hill
1400 Jackson Road
San Jose, CA, 94704

May 13, 2019

Sandy Jones
HR Manager
XYZ Company
2600 Lucky Street
San Jose, CA, 94704

RE: Requesting Medical Leave of Absence

Dear Ms. Jones, 

As you may already know, my young daughter is having some serious health problems. Although she’s seen a number of different health care providers and endured many tests to address the problem, she unfortunately needs surgery. 

She requires a serious neuro-based type of surgery and therefore I will need to be at her side and care for her for a number of weeks while she recovers. I am sorry to say that I need the full 12 weeks that are allowed under the FMLA policy. 

Her doctor has already filled out the request from that I obtained from the human resources department. Because I respect the company I work for and am trying to be as fair as possible, 

I am giving you a full month’s notice so you’ll have enough time to make adequate arrangements to cover my position while I’m away. My daughter’s surgery is scheduled for June 22, 2019. I intend to work up until the previous Friday on June 19 to ensure that my job is covered. 

I am more than willing to train someone to do my job or wrap up any business matters if you like. I expect to return on Monday, September 14, 2019. As of right now, these are the anticipated dates for her surgery and my time of leave. 

If anything changes I will let you know immediately. Hopefully I can return before September 14 if all goes better than expected and retain my current position in the company. 

I truly appreciate your consideration and understanding concerning this sensitive matter. I respect both you and the company and feel it’s been an honor to work here over the past 12 years. Again, thank you for understanding. If you have any questions or concerns, I intend to be here every day until June 19 to talk with you.


Sonny Hill
List of enclosures

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  2. Writing a Compelling Request Letter for Paternity Leave
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  4. Writing a Formal Leave of Absence Request Letter
  5. Writing a Vacation Request Letter (with Sample)