Template: Filing a Wage Claim with the DOL — What to Include and Deadlines to Watch

Facing unpaid wages? Start here — fast, practical steps to file a DOL wage claim and collect back pay

If your employer shorted your pay, you're not alone. Wage disputes are common, confusing, and time-sensitive. This guide gives you a fill-in-the-blank wage claim template, a clear evidence checklist, sample language to send employers and the U.S. Department of Labor (DOL), and the deadlines you must watch in 2026.

Most important facts up front (inverted pyramid)

• File as soon as you can. Under the Fair Labor Standards Act (FLSA) most claims are limited to 2 years; willful violations reach back 3 years (29 U.S.C. §255).
• Gather evidence now. Pay stubs, time records, emails, calendar entries and witness names make investigations faster and more likely to succeed.
• Use the DOL Wage and Hour Division (WHD) for federal wage disputes (overtime, minimum wage, off-the-clock work). State labor agencies handle state-law claims and sometimes shorter deadlines.
• No filing fee. Filing a complaint with the DOL is free; the WHD will investigate and may seek back wages and liquidated damages on your behalf.

2025–2026 context: why now matters

Enforcement activity by the DOL's Wage and Hour Division has been prominent in late 2025 and into 2026. For example, a federal consent judgment entered Dec. 4, 2025 required North Central Health Care to pay $162,486 in back wages and liquidated damages after an investigation found unrecorded off-the-clock work. That case highlights two trends you should know:

• DOL investigations increasingly focus on timekeeping and off-the-clock work.
• WHD outcomes can include back wages plus liquidated damages equal to back wages for FLSA violations.

These trends mean documented evidence of hours and communications is especially powerful in 2026.

Step-by-step: How to file a wage claim with the DOL (quick action plan)

1. Step 1 — Collect core evidence (1–3 days).
   • Pay stubs and direct deposit records.
   • Timecards, punch logs, shift schedules, and calendar entries.
   • Emails, texts, or chat messages showing hours worked or pay discussions.
   • Wage notices, offer letters, job descriptions showing exempt/nonexempt status.
   • Witness names and short statements (coworker confirmations of hours).
2. Step 2 — Do a simple calculation of unpaid wages (same day).

   Calculate alleged unpaid wages and overtime. Example: if you worked 50 hours in a week and your regular rate is $15/hour, overtime = 10 hours × $22.50 = $225 for that week. Do this for each pay period you claim.

3. Step 3 — Send a short demand letter to your employer (optional but recommended).

   Give the employer 7–14 days to respond. Use the sample demand language below. This can prompt a quick voluntary fix and preserves evidence of your attempt to resolve the dispute.

4. Step 4 — File with the DOL WHD or your state labor agency.

   File online or contact your local WHD office. Include your evidence checklist and a clear timeline of unpaid hours. The WHD investigates violations of federal law; state agencies address state-law claims and may accept parallel complaints.

5. Step 5 — Cooperate during the investigation.

   Provide documents quickly, give accurate dates, and be available for interviews. WHD often attempts conciliation before litigation; be prepared to accept a settlement or seek private counsel if needed.

6. Step 6 — Track deadlines and consider private action.

   If the WHD closes your complaint without relief, you can file a private lawsuit. Remember FLSA statute of limitations (2 or 3 years). For state claims, confirm the state statute of limitations — many are 2–3 years, but some are shorter.

Fill-in-the-blank: DOL wage claim template (use in your complaint or as a cover letter)

Copy this template into a document or the WHD complaint intake form. Replace bracketed text with your details.

Worker name: [Your full legal name]

Contact: [Phone] • [Email] • [Mailing address]

Employer name: [Company name as on paystubs]

Employer address (payroll or HQ): [Address]

Employment dates: [Start date] — [End date or “Present”]

Job title(s): [Your title(s)]

Pay arrangement: [Hourly/salary/commission] • [Rate or salary]

Type of claim: Overtime / Minimum wage / Unpaid wages / Off-the-clock work / Misclassified employee

Summary of claim (one sentence): From [date] to [date], I was not paid for [number] hours of work per week; my regular rate was [$/hr]; unpaid overtime is [$/hr].

Detailed timeline and totals (short bullets):

• [Week of MM/DD/YYYY] — Worked [total hours], paid for [hours paid], unpaid difference [hours × rate = $].
• [Repeat for each representative week or attach spreadsheet].

Key evidence attached: Pay stubs (attached), timecards (attached), email proving work outside paid hours (attached), witness statements (attached).

Relief sought: Payment of back wages ($[total alleged]), liquidated damages (if applicable), and any other relief WHD deems appropriate.

Signed: [Your name] • [Date]

Sample employer demand letter (fill in and send before filing)

Send by email and certified mail when possible. Keep proof of delivery.

[Date]

[Employer name and HR contact]

Re: Request for payment of unpaid wages — [Your name]

Dear [HR or Manager name],

I worked as [job title] at [location] from [start date] to [end date or present]. I have reviewed my pay records and believe I have not been compensated for [describe: overtime hours/off-the-clock hours/missed wages] for the period [dates].

Summary of unpaid wages: [brief bullet list with dates and amounts]. Total unpaid: $[total].

Please investigate and pay the unpaid wages within 10 business days. If we cannot resolve this, I will file a complaint with the U.S. Department of Labor and pursue all available remedies.

Sincerely,

[Your name] • [Phone] • [Email]

Evidence checklist — items that strengthen your case

• Pay records: Pay stubs, direct deposit notices, W-2s, or 1099s.
• Time records: Timecards, punch logs, scheduling apps, Google/Outlook calendar entries.
• Communications: Texts, emails, Slack/Teams messages showing you worked or were asked to work off the clock.
• Payroll policies: Employee handbook excerpts, job postings, offer letters describing compensation.
• Work product proof: Files you produced, timestamps on reports, screenshots of work done outside paid hours.
• Witnesses: Coworker names and short written statements confirming hours worked.
• Calculations: A spreadsheet or summary that shows claimed unpaid wages and overtime math.

How to calculate back wages and overtime — quick how-to

FLSA overtime basic rule: nonexempt employees get time-and-a-half for hours worked over 40 in a workweek. Simple calculation steps:

1. Confirm whether you’re nonexempt (hourly workers typically are; salaried workers may be exempt if they meet strict duties tests).
2. Compute your regular hourly rate: weekly earnings ÷ hours worked that week (include nondiscretionary bonuses).
3. Overtime rate = regular rate × 1.5.
4. Overtime due that week = overtime rate × overtime hours (hours over 40).
5. Repeat for each week and add totals. If employer failed to pay any hours at all, include straight-time unpaid hours as well.

Example: You earned $600 for a week and worked 50 hours. Regular rate = $600 ÷ 50 = $12. Overtime rate = $18. Overtime owed = 10 × $18 = $180. If employer paid only $600, additional unpaid is $180.

Deadlines to watch (what you must not miss)

• Federal FLSA statute of limitations: 2 years from the date wages were due; extends to 3 years for willful violations (29 U.S.C. §255). File complaints promptly to preserve rights.
• DOL complaint timing: The WHD accepts complaints without a strict filing fee or rigid deadline, but evidence and witnesses grow stale — file early.
• State deadlines: Vary by state. Some state wage acts have shorter statutes (e.g., 1–3 years). Check your state labor agency for exact time limits.
• Document retention: Keep all records for at least 3–4 years or until your claim is resolved.

What to expect after filing with DOL

1. Intake & initial review: WHD will contact you for more information.
2. Investigation: Investigator requests employer records; this can take weeks to months.
3. Conciliation: WHD often tries to resolve through conciliation. Employers may voluntarily pay back wages.
4. Referral & litigation: If conciliation fails, WHD may refer the case to the Solicitor of Labor or the U.S. Attorney for litigation.
5. Outcome: Back wages, liquidated damages (often equal to back wages under FLSA), or a negotiated settlement. Example: Dec. 4, 2025 consent judgment required $162,486 in back wages and liquidated damages for 68 employees.

Common pitfalls and advanced tips (2026 strategies)

• Don’t delay gathering digital evidence: In 2026, employers increasingly use digital scheduling and messaging; preserve screenshots, export chat logs, and download calendar entries immediately.
• Document attempts to resolve: Keep copies of your demand letter and any HR responses — they show you tried to fix the problem first.
• Beware of misclassification: Employers still misclassify workers as independent contractors in 2026. If you were controlled in hours, tasks and reporting, you may be an employee under FLSA tests.
• Consider joining co-worker claims: WHD often handles group investigations efficiently when multiple employees report similar violations. See resources on coordinated claims and workplace organizing.
• Get legal help when required: If the amount is large or employer threatens retaliation, consult an employment lawyer experienced in wage claims.

Sample follow-up message to a WHD investigator

Subject: Follow-up — Case Intake for [Your name] / Employer: [Company]

Dear Investigator [Last name],

Thank you for opening an intake for my complaint. Attached are paystubs (MM/YYYY–MM/YYYY), a spreadsheet of unpaid hours, and two witness statements. I am available for a call most weekdays after 4 p.m. My preferred contact is [phone/email]. Please let me know if you need additional documentation.

Sincerely,

[Your name]

If WHD closes the case without relief — next steps

• Request a closing letter that explains the basis — it helps your private suit or appeal.
• Consider filing a private lawsuit within the FLSA statute of limitations (2 or 3 years). A lawyer can advise whether to pursue liquidated damages.
• File a state agency claim if state law gives stronger protection or longer recovery periods.

Trusted resources and where to file

• U.S. Department of Labor, Wage and Hour Division (WHD): https://www.dol.gov/agencies/whd — start here to find local offices and the complaint form.
• FLSA statute (for limitations): 29 U.S.C. §255 — consult an attorney for legal interpretation.
• State labor agency: Check your state’s Department of Labor website for parallel filing options and state statutes of limitation.
• Recent case example: North Central Health Care consent judgment (Dec. 4, 2025) — news summary: https://www.insurancejournal.com/news/midwest/2026/01/16/854694.htm

Actionable takeaways — what to do today

• Download and complete the fill-in-the-blank DOL template above and your evidence checklist.
• Send a short demand letter to your employer and set a 10-day response deadline.
• File a complaint with WHD if the employer does not resolve the issue.
• Preserve all documents and get witness contact information now.

Final note on safety and retaliation

Federal law prohibits retaliation for filing a wage claim. Keep records of adverse actions (discipline, changes to schedule, termination) and report them. If you fear retaliation, contact WHD and consider consulting an attorney immediately.

Call to action

Start your claim now: copy the templates above into a document, attach your evidence checklist, and file with the DOL Wage and Hour Division at their website or your local office. If your case involves large unpaid sums, repeated violations, or employer threats, contact a labor attorney for a free consultation.

Need the printable template and a sample spreadsheet? Download, fill in, and keep a dated copy before you file. The faster you act, the stronger your claim.

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