Right to Use Paid Sick Leave Letter to Employer (Free Template + State Tiers)

[Your Full Name]
  [Address]
  [City, State ZIP]
  [Phone] [Email]

  [Date]

  [Employer Legal Name — Human Resources]
  [Employer Address]

  cc: [Direct supervisor, payroll]

  Sent via certified mail, return receipt requested
  (Copy also emailed to HR contact)

  Re: Demand to Use Accrued Paid Sick Leave / Notice of Protected Sick-Leave Rights

  To Human Resources:

  I am writing about my accrued paid sick leave. [Choose the situation that applies and strike the others:]
    • I requested to use accrued paid sick leave on [date(s)] and the request was denied or discouraged.
    • I used accrued paid sick leave on [date(s)] and have since been [disciplined / written up / docked points under an attendance policy / threatened with termination / demoted / had hours cut].
    • I am giving advance notice that I intend to use accrued paid sick leave for [date(s) / the period of] [a foreseeable medical appointment / treatment / a family member's care], as the law and/or company policy permits.

  Relevant facts:
    • Date of hire: [Date]
    • Average hours worked per week: [Number]
    • Accrued, unused paid sick leave as of [date]: [Number] hours
    • Source of that balance: [pay stub dated (date) / HRIS export / company policy accrual schedule]
    • Reason for use (you are not required to disclose a diagnosis): [my own illness / injury / health condition; preventive care; care for a family member; or a reason protected under my state's statute]

  Legal basis:

  [Pick the tier that applies to your state — strike the others.]

    [TIER A — My state has a paid-sick-leave statute (statutory right to USE + anti-retaliation)]
    Under [Cal. Lab. Code §§ 246, 246.5 / Wash. Rev. Code § 49.46.210 / Colo. Rev. Stat. § 8-13.3-403 & -404 / N.Y. Labor Law § 196-b / N.J.S.A. 34:11D-2 & -3 / Ariz. Rev. Stat. § 23-372 & -373 / Mass. Gen. Laws c. 149 § 148C], I have accrued paid sick leave that I am legally entitled to use for the reasons set out in the statute, including my own or a family member's illness, injury, health condition, or preventive care. The same statute makes it unlawful to deny me the right to use that leave, or to discharge, threaten, demote, discipline, or otherwise retaliate against me for using it [Cal. Lab. Code § 246.5(c) / Wash. Rev. Code § 49.46.210(4) / Colo. Rev. Stat. § 8-13.3-407 / N.Y. Labor Law § 196-b(7) / N.J.S.A. 34:11D-4 / Ariz. Rev. Stat. § 23-364(B) / Mass. Gen. Laws c. 149 § 148C(h)–(i)]. My employer may not count protected sick-leave absences against me under any attendance or "points" policy.

    [TIER B — No state statute, but my employer's written policy promises paid sick leave]
    My state does not have a paid-sick-leave statute, but [Employer]'s written policy [quoted at Section X of the Handbook, attached] grants paid sick leave and sets the terms for using it. That written promise is an enforceable term of my employment, and the company must honor its own policy. Denying me leave the policy grants me, or punishing me for using it, is a breach of that policy and may give rise to a wage claim if the leave functions as promised paid time.

    [OPTIONAL — Federal-contractor employees only]
    If I am employed on a covered federal contract, Executive Order 13706 and 29 C.F.R. Part 13 independently require my employer to provide paid sick leave (accrued at 1 hour per 30 hours worked, up to 56 hours per year), enforceable through the U.S. Department of Labor.

  Demand:

  [Choose what fits your situation:]
    1. Approve my use of [Number] hours of accrued paid sick leave for [date(s)], paid at my regular rate.
    2. Reverse the [discipline / write-up / attendance points / other adverse action] taken against me for using protected sick leave, and confirm in writing that it has been removed from my record.
    3. Confirm in writing my current accrued paid-sick-leave balance and that I will not be retaliated against for using it.

  Please respond within [14] days of receipt of this letter.

  [Optional — only if your EMPLOYER'S POLICY promises a payout of unused sick leave at separation:]
    Note: I understand state law generally does not require unused sick leave to be paid out at separation. I am making this payout request solely because [Employer]'s written policy [Section X, attached] promises payout of accrued, unused sick leave. On that basis I request payment of [Number] hours × $[Rate] = $[Amount].

  If this is not resolved, I intend to pursue:
    • A complaint with the [state labor agency / wage-and-hour division] for denial of sick leave and/or retaliation;
    • Any remedies the statute provides, including reinstatement, back pay, and statutory penalties [where the law provides them];
    • The rebuttable presumption of retaliation that applies where adverse action follows my protected leave [California: within 30 days, Lab. Code § 246.5(c)(2); Arizona / New Jersey: within 90 days, Ariz. Rev. Stat. § 23-364(B) / N.J.S.A. 34:11D-4].

  I would prefer to resolve this directly and continue doing my job. Please confirm in writing.

  Sincerely,

  [Your Signature]
  [Your Printed Name]

  Enclosures: [pay stub or HRIS export showing accrued sick-leave balance; relevant pages of the employee handbook / sick-leave policy; any write-up or attendance-point notice; written denial of leave if any]