Sample FMLA Complaint

When employees need to take time off of work because of a medical condition for themselves or for a child, spouse or parent, the Family Medical Leave Act (FMLA) offers up to 12 unpaid weeks of protected unpaid leave.

An employer is covered by FMLA guidelines if it employs more than 50 people in the company. Smaller companies may not be covered by FMLA but they could be governed by local and state medical leave guidelines. All government agencies at the local, state and federal level are covered by FMLA guidelines along with elementary and secondary school employees.

Employees must have worked for 12 months with their employer (though not necessarily continuously) with 1250 hours of work completed in the past 12 months prior to taking the leave. The employer must also have more than 50 employees in a 75-mile radius of the workplace. If you meet all of those criteria, then you would qualify for FMLA leave.

How To File A Report

If you have been denied FMLA leave but believe that you are eligible to receive it, you can file a claim with the United States Department of Labor’s Wage and Hour Division (WHD), or you can file a private lawsuit.

Your complaint can be filed at a local WHD branch in person, or you can file online, over the phone or by mail.

There is no benefit to one option over the other, though it can be easier to receive monetary damages through a private lawsuit. In either case, retaining an employment attorney is a good idea so that you have an expert working on your behalf.

What To Include In Your Complaint

When you file your complaint, you need to provide as much information as possible to support your claim that you were denied FMLA leave.

Here is some of the basic information you should include when filing your complaint:

  • Your name, address and phone number where you can be contacted
  • The name of your employer and the location. If you work for a large corporation then be sure to list the home office as well as the location where you worked.
  • Contact information for your company
  • Your manager’s name, or the name of the owner
  • The details of your FMLA leave request and the circumstances that led to your complaint.

Sample Complaint

Here is an example of what your sample FMLA complaint letter should look like:

John Q Adams

1234 Main St.

Anytown, USA



To the Wage and Hour Division:

I am writing with regard to a request for FMLA leave that was denied by my employer. I believe that I qualify for leave and my employer is refusing to grant my request.

I am currently employed by Home Hardware (123 First St, Anytown, USA; 123-555-6677) and when my mother became ill I requested time off to care for her during her recovery from a stroke. I provided notice to my supervisor, Arthur Pennywise, on August 27 after she became ill on August 25. Mr. Pennywise said that I have not worked enough hours to qualify for FMLA leave but according to my records I do indeed qualify.

As a result of my inability to receive FMLA leave I have had to pay for someone to care for my mother while I am at work at a total cost of $1250.23 so far. As my mother still requires care, I would like for my FMLA leave to be activated so that I can care for her myself.

I am happy to provide any additional information you need to review my case.

Thank you.

John Q. Adams

Getting Help From An Employment Law Attorney

The rules governing FMLA leave are straightforward, and if you and your employer both meet the guidelines then there should be no confusion as to whether or not you qualify. However, as with most laws there can be confusion, misunderstandings or outright lack of adherence to the rules. That is when hiring an employment law attorney can be very helpful.

If you need to file an FMLA complaint against your employer, hiring a lawyer will not guarantee that you win your claim but it will greatly increase your chances for success. An experienced employment attorney understands the documentation and evidence needed to file a claim, and a lawyer will also understand how to obtain damages and remedies you are entitled to under FMLA rights.

Most employment law attorneys will work on a contingency fee basis, so you will not have to pay in advance and you only pay if you win your case.