Tag Archives: Temporary Disability Leave Sample

short term disability leave of absence

Here are easy formats of disability leave by employee. Everyone can change according to need.

Short Term Disability Leave of Absence


The Director,

Firm Chemical Pvt Ltd.

Subject: short term disability leave from work

Dear Sir,

With due respect, it is stated that I work in HR department of this firm from past 4 years. My stay here has always been refreshing with my workaholic and fun loving team. I have never taken an off from firm without notifying. I have always been very vigilant and punctual employee. Unfortunately, recently I have had a terrible accident due to which my leg has been fractured and doctors has advised me to take complete rest for at least three months. It is not a slight dysfunction but major one with a lot of leg pain due to inflammation in bones. Please permit my request.

Yours Sincerely,

HR Officer

Temporary Disability Leave Request

Respected Sir,

This letter is being written to you to bring this in your kind information that I need temporary disability leave from work. I fell from the stairs and have excruciating pain in my back. Doctors have diagnosed as slight disintegrated spinal cord and inflammation has also been detected. I am in no condition to come to work and perform my best. I cannot sit straight. This is my request to you to please permit my leave and give me off for 4 weeks so I can get into my healthy shape as soon as possible. Thank you.

Yours Truly,


Temporary Disability Leave Sample

Respected Madam,

It is brought to your kind notice that I have had dreadful accident last night. My car got hit by a tremendous truck and it got flipped once. I have sustained some major vulnerable injuries which cannot go away or heal overnight. My joints have been disoriented. I need surgical procedures and after that even, I won’t be able to come to work. I need leave for 5 weeks, it will be considered as my temporary
disability leave quota. I will attach note of my physician with this application. I will inform my supervisor about my condition regularly and will be back to work as I get recovered. Thanking you in anticipation.

Yours Faithful,

George Robert