Letter Template — Client Disability Claims / Short-term Leave (Narrative — use cautiously)
Audience: Associates (contractors)
Note: This is an example template only. Each associate authors and signs their own letters within their scope of practice.
Use cautiously. This version is more narrative/interpretive. Please avoid overreaching beyond scope (e.g., causal statements, diagnostic certainty) and prefer the DEFAULT template unless there is a clear reason not to.
To Whom It May Concern,
Re: Short term leave from work for (the client) ______
I am writing to inform you that I have spoken with ______ in counselling for ______ (how much time) and I have taken the time to evaluate their symptoms and their present circumstances. ______ (the client) reports that they are experiencing symptoms consistent with ______. (Depression, anxiety, burnout, whichever it is…) appears to have been triggered by recent events beyond their control in their family life combined with challenges in their personal life.
(The client) is attending therapy ______ (frequency) to learn to process and deal with the impact of difficult past events in their life, so that they can cope better and respond to difficulties presenting themselves in their current situation.
In order to have time to recuperate and learn new skills, it would be helpful for (the client) to have a short period away from work so that they can focus on recovery and then return to work better equipped to meet the challenges of their job. Given that their performance at work is suffering, it seems prudent to allow (the client) to step back and recover. Because the nature of their work as a ______ requires them to respond to the mental and emotional needs of others as well as the demands of a complex organization, it is reasonable in my opinion that their recent struggle to perform and/or feel confident at work could be attributable to their current state of mental health.
I have confidence that (the client) is working to overcome this situation and is doing everything in their own power to improve their situation and the ______ symptoms that have been bothering them lately.
If there is anything else I can do, please let me know.
Kind regards,
Signature: ______
Name: ______
Credentials / Registration #: ______
Phone: ______
Email: ______