Medical Leave Application Letter



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How to write a Medical Leave Application response to a leave request from employee? An easy way to start completing your response is to download this example Medical Leave Application Response Letter template now!

At some point during an employees' career, you may need to accept a request for leave of absence from your work, due to a variety of reasons, for example: personal or health-related issues, birth or adoption of a son or daughter, a break caused by excessive work-related stress, inevitable loss of a person close to you or maybe just a strong desire to travel the world by the employee.

Important to know: Other than for leaves covered by Family and/or Medical Leave Act (FMLA), military duty, jury duty, and some other particular circumstances, an employer or boss is not required to approve such a request for leave, nor is the company required to provide paid personal leave.

We provide this response to personal leave request template to help professionalize the way you are responding to such requests. Our business and legal templates are regularly screened and used by professionals. If time or quality is of the essence, this ready-made letter can help you to save time and to focus on the topics that really matter!

Medical Leave Application Letter sample content:
To Employee Name, Employee Address, Dear employee,
Your upcoming [leave of absence or reduced work schedule, whichever is applicable] may qualify as a Family/Medical Leave under Administrative Policy 08-03. I have enclosed a copy of “Your Rights and Obligations under the Federal Family and Medical Leave Act of 1993 (FMLA) and City and Borough of Juneau Administrative Policy, Family/Medical Leave” for your review. You should also refer to the applicable portions of your collective bargaining agreement if you are a represented employee.
Several other important forms are also enclosed: the Leave of Absence and Benefits Election Request Form; the Medical Certification Form; your job description to include the Physical, Environmental and Mental Demands of your position; and the Return to Work Certification form.
At this time we are provisionally designating your [anticipated time off or reduced work schedule] as Family/Medical Leave effective [date]. As of this date, you have (xx) hours of accrued personal leave. Your absence for family/medical leave will be deduced from your available leave balance. Please complete the enclosed Leave of Absence Request form, and return it as soon as possible.
Please complete the employee sections of the Medical Certification Form and provide it to your health care provider to complete the remainder of the Medical Certification Form. You should also provide your health care provider a copy of your job description. Approval of your leave of absence is contingent upon receipt of medical certification, which must be completed and returned to me within 15 calendar days of the date of this letter, [put due date here]. Failure to provide required medical certification may result in delay or denial of leave.
If you have any questions, please feel free to contact me directly. I will be available on phone: [T+00000000] and email: [[email protected]] in case of any query.
Looking forward to your reply,
Yours sincerely,

Using this leave request response letter template guarantees you will save time, cost and efforts! Completing documents has never been easier!

Download this Medical Leave Application Letter template and send it to your employee today.




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Nothing on this site shall be considered legal advice and no attorney-client relationship is established.


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