FMLA Leave Requests

Continuous FMLA Leave for a Major Depressive Episode

A fully-written letter you can copy or download. Below the letter we explain why it is written the way it is, the mistakes most people make, and the legal authorities the language invokes.

The letter

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To: HR at [Employer Name]
From: [Your Full Name]
Date: [Today's Date]
Subject: Request for Continuous FMLA Leave

Dear [HR Contact Name],

I am writing to request continuous leave under the Family and Medical Leave Act beginning [Start Date]. I have a serious health condition that requires ongoing treatment by a healthcare provider, and my clinician has recommended that I take a leave of absence.

I have worked at [Employer Name] since [Start Month, Year] and have worked at least 1,250 hours in the past twelve months, so I am eligible for up to twelve weeks of FMLA leave.

My clinician expects the leave to last approximately [Number] weeks, through [Estimated End Date]. That estimate may be adjusted as treatment progresses, and the WH-380-E certification will reflect any updated timeline. During my leave I will be in structured treatment, such as [an intensive outpatient program / a partial hospitalization program / psychiatric medication stabilization / individual therapy]. I do not expect to be able to perform the essential functions of my job during that period.

Please send me the WH-380-E certification form within five business days so my provider can complete it. I would also appreciate written confirmation of:

1. My eligibility for FMLA leave.
2. The start and end dates of my twelve-week entitlement.
3. Which method the company uses to calculate the twelve-month period (calendar year, rolling forward, or rolling backward).
4. How my group health insurance will continue during leave, and how I should pay my share of premiums.
5. Whether accrued paid time off will be substituted for unpaid leave automatically, or whether I can choose.

I am not disclosing my specific diagnosis in this letter. My understanding is that the certification form does not require one. Please keep any medical records in a confidential file separate from my personnel file.

I plan to return to my position following treatment and am prepared to provide a fitness-for-duty certification if one is required.

Thank you for processing this promptly.

Sincerely,

[Your Full Name]
[Your Work Email]
[Your Phone Number]

Replace every bracketed prompt with your own information before sending. Everything in brackets is for you. Everything outside brackets is the letter.

Before you send this

Many employers do not handle FMLA paperwork themselves. They hand it off to a third-party administrator, usually called a TPA. A TPA is a leave-management vendor, like Sedgwick, Unum, Lincoln, or The Hartford, that your employer pays to process claims. TPAs have an incentive to close claims quickly, and they use a predictable set of tactics to push employees into giving up more than the law actually requires. Watch for these:

Blanket HIPAA authorization forms. These are not required for FMLA. The WH-380-E certification is. A broad HIPAA release can pull therapy notes, substance use records, and unrelated medical history into a corporate vendor's database.
Demands for records beyond the WH-380-E. The law limits what your employer or its TPA can require to what is necessary to determine FMLA eligibility. You are not obligated to provide a full chart.
Artificial delays that trip deadlines. If the TPA says your certification is incomplete, they must tell you in writing exactly what is missing and give you seven calendar days to fix it. Silence is not a legal denial.
Direct calls to your healthcare provider. TPA claim examiners cannot call your provider for general information. Contact for clarification must be routed through a healthcare professional designated by the employer.
Pressure to use an Employee Assistance Program (EAP) instead of accommodations. An EAP is a short-term counseling benefit your employer funds, usually limited to three to eight sessions. An EAP referral is not a response to an ADA accommodation request, and engaging with the EAP can muddy your record.

Watch out for the sign-up process. HR typically sends you to a TPA website to register and "start your claim." Those sign-up flows are where most of the traps live: pre-checked HIPAA authorization boxes, fields asking you to enter your diagnosis, current medications, symptoms, or the contact information for your treating providers. None of that is required to open an FMLA claim. Fill in only the administrative fields (name, employee ID, employer, dates) and leave clinical fields blank.

If the portal will not let you proceed without medical entries, or if anything about the process feels coercive, raise the concern in writing. A short email to HR and the TPA is enough: say that the portal appears to be asking for information that goes beyond what the FMLA certification requires, that you understand the employer's information rights are limited to what is necessary to determine FMLA eligibility, and that you would like to submit your certification through an alternative channel (email or fax to the TPA directly, with your provider sending the completed WH-380-E to that address). Wait for a written response. Only use the alternative if HR or the TPA agrees. Putting the concern in writing either gets you the alternative or creates a paper trail that protects you if the claim is later denied or delayed.

If any of this is happening, read Protecting Your Medical Records, FMLA and HIPAA Privacy Rights, or use the letter that limits records release to a TPA. If you need to talk to someone free of charge, see our list of free legal helplines and crisis lines.

When to use this letter

You are in an active depressive episode that requires you to step away from work entirely, likely for several weeks. Your provider has recommended intensive outpatient treatment, a partial hospitalization program, or inpatient care. You need continuous (not intermittent) leave.

Continuous FMLA leave is used when you cannot work at all for a defined period, typically because of an intensive treatment program or a severe episode of incapacity. The letter below is appropriate when your clinician has told you that you need weeks off, not occasional days.

You do not need to wait until you are in crisis to send this. FMLA protects the leave your provider says you need, whether that is a two-week leave to stabilize medication or a twelve-week leave for a partial hospitalization program followed by outpatient therapy.

Why the letter is written this way

Each paragraph is doing specific legal work.

01
Why give a specific start date
Unlike an intermittent request where 'when' is episodic, continuous leave has a defined beginning. Setting the start date in writing prevents later disputes about whether the leave actually began or whether you were still 'expected to work' in the first days of treatment.
02
Why ask which 12-month method the employer uses
Under 29 C.F.R. § 825.200, employers can choose from four methods of calculating the 12-month FMLA period. Which one applies changes how much leave you have available today. If the employer has not chosen a method in advance, the method most favorable to the employee applies. Asking in writing forces them to commit to one.
03
Why ask about paid time off substitution
29 C.F.R. § 825.207 allows employers to require you to use accrued PTO during FMLA leave, or to let you choose. Clarifying this in writing prevents an HR person from quietly burning your PTO without telling you and leaving you with no paid buffer when you return.
04
Why mention fitness-for-duty
Under 29 C.F.R. § 825.312, employers can require a fitness-for-duty certification before you return from continuous leave, but only if they gave you written notice of that requirement at the start. Signaling that you are willing to provide one forecloses an employer from later inventing a new return-to-work hurdle.
05
Why keep the diagnosis private in writing
Continuous leave for a depressive episode can involve stigma. Once a written disclosure exists, it can travel through HR, a TPA, or a future background check. Your clinician's certification stays with HR in a confidential file. Your letter should not add diagnostic detail.

Don't do this

The mistakes that undo the letter.

01Telling your supervisor the specific diagnosis while keeping HR vague. Supervisors talk. If you write 'major depressive disorder' anywhere in a document that ends up in a personnel review, it can be used against you.
02Starting leave before paperwork is filed. Employers can retroactively designate leave as FMLA (29 C.F.R. § 825.301), but if the paperwork is incomplete they can also deny FMLA protection for the early days.
03Not asking about health insurance. Under 29 U.S.C. § 2614(c), your group health benefits must continue, but you still owe your share of premiums. Failure to pay can end coverage even while you are on protected leave.
04Accepting a verbal 'take as long as you need.' This is exactly the pattern the court flagged as FMLA interference in Donovan v. Nappi Distributors (D. Me. 2023). Informal permission is not FMLA protection.
05Leaving out the estimated return date. An open-ended 'indefinite leave' is harder to administer and gives the employer grounds to argue the leave is not FMLA-compatible. Your provider can adjust the timeline later.

Legal authorities cited

The language invokes real regulations.

29 U.S.C. § 2612(a)(1): 12 weeks of FMLA leave per 12-month period
29 U.S.C. § 2614(c): Continuation of group health benefits
29 C.F.R. § 825.113: Definition of serious health condition
29 C.F.R. § 825.200: Methods of calculating the 12-month period
29 C.F.R. § 825.207: Substitution of paid leave
29 C.F.R. § 825.305: Certification timing
29 C.F.R. § 825.312: Fitness-for-duty certification

Keep reading

Where to go next.

LeaveRights es una herramienta educativa gratuita y no proporciona asesoramiento legal. No se recopilan ni almacenan datos. La información proporcionada es solo para orientación general. Consulte a un abogado laboral calificado para obtener asesoramiento específico a su situación.

Each paragraph is doing specific legal work.

Why give a specific start date

Why ask which 12-month method the employer uses

Why ask about paid time off substitution

Why mention fitness-for-duty

Why keep the diagnosis private in writing

The mistakes that undo the letter.

The language invokes real regulations.

Where to go next.