Why this matters
Severe illness and hospitalization are recognized examples of “reasonable cause” that can justify IRS penalty relief when they prevent a taxpayer from filing or paying on time. A well-prepared packet increases the chance the IRS will grant abatement. In my practice working with clients on tax resolution, clear chronology and relevant medical records are the items that most often change an outcome.
Step-by-step preparation checklist
- Check the IRS notice first — follow its instructions
- Use the contact address or phone number on the IRS notice or the online message in your IRS online account. The notice will list which penalties were assessed and where to respond.
- Create a concise reasonable-cause letter
- Open with the tax year(s), tax form (for example, Form 1040), and the penalty type (failure-to-file or failure-to-pay). State that you are requesting penalty abatement due to severe illness or hospitalization and summarize the timeline in 2–3 sentences.
- Provide a clear chronology of events (dates of illness onset, hospitalization admission and discharge, surgeries or treatments, and any follow-up incapacitation). Include dates when you normally file/pay and when the missed filing/payment occurred.
- Close with a respectful request for abatement and list of enclosed documents.
- Assemble supporting documentation (what to include)
- Hospital admission and discharge summaries with dates and physician name(s).
- Operative reports, emergency-room records, doctor’s notes, and medication or treatment logs that show incapacity.
- Proof of dates you were medically unable to manage affairs (bedridden notes, home health visits, skilled nursing documentation).
- Copies of medical bills or insurance documents if they corroborate dates.
- If someone else handled affairs (power of attorney, caregiver), include a signed statement and their contact information.
Documentation tips
- Provide copies, not originals, and keep a complete copy for your records.
- Redact unrelated protected health information (PHI) before sending if you want to limit exposure — but don’t remove the dates, provider names, or diagnosis codes that prove incapacity.
- If records are limited, a signed and dated statement from the treating physician describing the incapacity period is helpful.
How to submit the request
- Respond to the IRS notice using the return address or instructions on the notice. If you don’t have a notice, mail your packet to the IRS address for correspondence shown on their website or use the IRS secure message in your online account when applicable.
- You can also authorize a tax pro (CAF number) to contact the IRS on your behalf by submitting Form 2848 (Power of Attorney).
What to expect (timing and outcome)
- Response times vary; many cases are resolved within 30–90 days but complex reviews may take longer. Keep copies of everything and note the date you mailed the packet.
- The IRS evaluates each case on the facts and whether the illness made compliance impossible or significantly more difficult. If abatement is denied, appeal options include requesting a Collection Due Process hearing or contacting the Taxpayer Advocate Service if the delay causes a hardship (see below).
Sample content and drafting tips
- Be specific and factual. Avoid emotional language; present dates and facts. Example sentence: “I was admitted to General Hospital on March 24, 2024, with acute appendicitis and discharged March 31, 2024; records attached.”
- Tie the medical facts to the missed tax action: explain why hospitalization prevented filing (e.g., surgery, prolonged recovery, cognitive impairment, inability to access records).
- Cite that you are requesting relief under the IRS reasonable cause standard (IRS guidance evaluates facts and circumstances) to frame the request professionally [see IRS guidance].
Common mistakes to avoid
- Sending vague statements without dates or medical specifics.
- Over-sharing irrelevant medical history — include only what establishes the time and severity of incapacity.
- Mailing to the wrong IRS address; always use the address on the notice or the one for correspondence on IRS.gov.
When to escalate or seek additional help
- If you don’t get a response in a reasonable time or your request is denied, you may file an appeal or request assistance from the Taxpayer Advocate Service (TAS) if the problem causes financial hardship or systemic delays (Taxpayer Advocate Service: https://www.taxpayeradvocate.irs.gov/).
- If collection actions (levies, liens) begin, contact a tax professional immediately and consider filing an appeal while pursuing abatement.
Related resources on FinHelp
- For evidence that strengthens a claim, see How to Ask the IRS for a Penalty Abatement: Evidence That Works: https://finhelp.io/glossary/how-to-ask-the-irs-for-a-penalty-abatement-evidence-that-works/
- For a practical letter you can adapt, see Preparing a Reasonable Cause Letter for Penalty Abatement: Sample Template: https://finhelp.io/glossary/preparing-a-reasonable-cause-letter-for-penalty-abatement-sample-template/
- For a focused list of documents, see Preparing a Penalty Abatement Request: Documentation to Include: https://finhelp.io/glossary/preparing-a-penalty-abatement-request-documentation-to-include/
Authoritative sources
- IRS — Penalty relief and reasonable cause guidance: https://www.irs.gov/individuals/penalty-abatement (consult the page for requirements and submission instructions).
Professional note and disclaimer
In my 15 years of tax and financial advising I’ve seen that clear timelines and corroborating medical records are the most persuasive elements of a reasonable-cause packet. This article is educational and not a substitute for personalized tax advice. Consult a CPA or tax resolution specialist for help preparing and submitting an abatement request tailored to your situation.
