Kentucky & Ohio · Employee resource
FMLA request checklist and sample email
When you need medical leave, the paperwork should not be another source of stress. Use this checklist to explain what you need, track important dates, and keep a clear record.
This guide is for employees in Kentucky and Ohio. For eligibility, job protection, denied leave, or retaliation, see our FMLA and medical leave rights page.
Request
Explain the need for leave and the expected timing. Follow your employer’s call-in and leave-request procedures.
Track
Keep the forms, deadlines, and instructions together. Follow up promptly if something is missing.
Keep
Save your request, delivery confirmation, and the employer’s written response.
Before you request leave
FMLA eligibility usually requires at least 12 months with a covered employer, 1,250 hours worked in the preceding 12 months, and a worksite with at least 50 employees within 75 miles. Special rules can apply. You can ask HR to confirm eligibility without having every answer yourself.
- Identify the reason: your own serious health condition, care for a qualifying family member, a new child, or another qualifying reason.
- Estimate the timing: the first day, likely length, and whether you need a continuous block, occasional absences, or a reduced schedule.
- Check the process: find the correct HR contact, leave administrator, portal, and call-in requirements.
Give notice promptly. When the need is foreseeable, give at least 30 days’ notice if possible and practical. Otherwise, notify your employer as soon as possible and practical. An email does not replace required call-in procedures unless the employer permits that.
Adapt this to your situation
Sample FMLA request email
Replace the brackets with accurate facts. Include enough information to explain why the leave may qualify. A vague “I am sick” message may not be enough. Send medical paperwork through the employer’s designated process rather than copying a large group.
Subject: Request for family or medical leave beginning [date]
Hello [HR or leave administrator],
I need time away from work beginning [date] because [briefly explain the qualifying need, such as surgery and recovery that will prevent you from working, or care for a parent with a serious health condition].
I expect to need [continuous leave through an estimated date / intermittent absences or a reduced schedule, with the expected frequency and duration if known]. These dates are estimates, and I will update you if they change.
Please evaluate my eligibility for FMLA leave and send the required notices, forms, deadlines, and submission instructions. Please also explain how I should report absences, how paid leave may apply, and how to continue my health coverage during leave.
Please confirm receipt and let me know if you need more information.
Thank you,
[Your name] [Preferred contact information]This is a starting point, not an approval or a substitute for required forms. Follow up on questions from the employer.
After you send the request
- Confirm receipt. Keep a copy of the email or portal submission and note who received it.
- Calendar the paperwork deadline. If medical certification is required, you generally must receive at least 15 calendar days to provide it. If you cannot meet the deadline despite diligent, good-faith efforts, tell the employer promptly and explain why.
- Track corrections. If certification is incomplete or insufficient, keep the written explanation of what is missing and the deadline to fix it.
- Keep the decision. Save eligibility, rights-and-responsibilities, and designation notices, along with any denial and explanation.
- Continue required updates. Follow applicable absence-reporting rules and communicate changes in your expected return date.
Questions worth asking HR
- Am I eligible? If not, what requirement is missing?
- Who receives the certification, and when is it due?
- Will paid time off run at the same time as FMLA?
- How do I pay my share of health insurance premiums?
- How do I report intermittent absences and track remaining leave?
- Are there return-to-work requirements I should know now?
Common questions about requesting FMLA
Do I have to use the words “FMLA”?
Not for your first request for a qualifying reason. You must give enough information for the employer to recognize that FMLA may apply. For later absences tied to an approved reason, refer to that reason or FMLA rather than simply saying you are sick.
Does the email guarantee that my leave is protected?
No. Eligibility, employer coverage, the reason for leave, notice, and required certification matter. Keep following the process and ask for a written explanation if leave is denied.
Does FMLA mean I will be paid?
FMLA itself does not require paid leave. Employer-provided paid leave may run at the same time. Ask how your pay, benefits, and available leave will be handled before assuming they continue unchanged.
What if I need time off but do not qualify for FMLA?
Ask about employer leave policies and other protections. A disability accommodation or pregnancy accommodation may be relevant. Lack of FMLA eligibility does not answer every question about your rights.
Denied leave or punished for asking?
Save the request, the response, and any attendance points or discipline. Thompson Legal represents individuals in employment matters in Kentucky and Ohio. We never represent employers or government.
Official guidance and further reading
- U.S. Department of Labor: FMLA eligibility and counting leave
- U.S. Department of Labor: employee notice requirements
- U.S. Department of Labor: medical certification
Published by Thompson Legal LLC. Updated November 10, 2026. General information, not legal advice for a particular situation. Reading or using this template does not create an attorney-client relationship.