Important notice: Legal Momentum has developed this sample demand letter as a model that may be useful for
individuals seeking to enforce their legal rights. However, because laws and legal procedures frequently change and
are subject to differing interpretations, Legal Momentum cannot ensure that the information in this letter is current,
nor be responsible for any use to which it is put. Before relying on this information, you are advised to consult an
attorney or appropriate agency about your legal rights in your particular situation. If you need assistance in finding a
lawyer, contact Legal Momentum, the bar association in your state, your local legal services office, domestic or
sexual violence coalition, or service provider.
Sample Letter Challenging a Firing or Other Job Action Under the Family and Medical Leave Act
(FMLA)
What rights does this letter assert? This letter is drafted to challenge a firing for absences or assert
other rights under the Family and Medical Leave Act (FMLA). For more information about the FMLA,
see Legal Momentum’s “Know Your Rights: Medical Leave for Survivors and Family Members.” This
letter may also be a helpful model for asserting rights under a state or local medical leave law or similar
provisions in a personnel policy or collective bargaining agreement. There are also state and local laws
that provide time off specifically to victims of domestic or sexual violence to address a range of issues
related to the violence. For more information on these laws, see Legal Momentum’s State Law Guide
“Time Off from Work for Victims of Domestic or Sexual Violence” or our sample letter asking for time
off under those laws.
What employers are covered by the law? FMLA applies to employers anywhere in the United States.
The employer must have at least fifty employees at your workplace or within 75 miles of your workplace.
To be protected by the law, you must have worked for your employer for at least a year and have worked
at least 1,250 hours (an average of 25 hours per week) in the year before you ask for leave.
Whom should you send your letter to? You should send the letter to your supervisor, human resources
representative, or someone else with authority to make accommodations for you, give you time off, or
make decisions regarding your employment.
How should you deliver the letter? You may hand deliver the letter or you may mail it. If you mail the
letter, it’s a good idea to mail it certified with return receipt requested or by an express mail service that
can give you a record of receipt.
What records should you keep? You should keep a copy of the letter you send and record of how and
when you delivered it. You should keep a copy of any written response you receive. If a representative of
your employer talks to you about your letter, you should take notes on this conversation (either during the
conversation or immediately after the conversation) and keep a copy of these notes. Your notes should be
as detailed as possible. They should include the date of any conversation, what you said, what your
employer said, and the date that you wrote up the notes. Also, if you feel like you are being discriminated
against at work because of your request for leave or your serious health condition, you should keep
records of exactly what happened (including notes on specific words said to you, if possible).
Are there risks to sending a letter? Yes, sometimes employers respond to a request for time off or a complaint
about a job action by firing or otherwise retaliating against the employee (if you have not already been fired).
This is usually illegal. However enforcing the law might be too difficult or time consuming an option for you
right now. It might be more important to know you can keep a steady paycheck right now. Additionally, if
disclose you are a survivor of domestic violence, sexual assault, or stalking to anyone at work, this information
may not kept confidential. Also, your employer might pressure you to take certain actions to address the
situation (such as get a protective order), which may not be right for you at this time.