Medical Leave Application: Format, Required Certificates, Sample Letters

Medical Leave applications fail more often than any other category because the supporting documentation is treated as an afterthought. The application is filed with a hastily-obtained certificate that does not specify the period or the diagnosis, and the establishment section returns it for resubmission. By that time the employee has already been absent on what becomes unauthorised leave.

The three documents that matter

• The leave application itself — specifying the period, the leave account to debit (HPL commuted, EL, or EOL), and the address during leave.
• The medical certificate — from a registered medical practitioner, naming the patient, the period of advised rest with start and end dates, and the diagnosis (or at minimum, the broad category of illness).
• The fitness certificate — from the same treating doctor, dated on or around the joining date, certifying that the employee is fit to resume duty. This is submitted on the day of return.

The standard format

Subject: Application for Medical Leave from [start date] to [end date]

Sir,

I request grant of [N] days of Medical Leave from [start date] to [end date] (both days inclusive) on account of [diagnosis/condition]. The medical certificate from Dr [name], [hospital/clinic] dated [date] is enclosed.

The leave may kindly be debited from my [Half Pay Leave account, commuted to leave on full pay on medical grounds / Earned Leave account, since HPL is exhausted].

During the period, I shall be at [home address] under treatment, available on mobile [number].

Yours faithfully,
[Signature, Name, Designation, Date]

Enclosure: Medical certificate.