Arizona Request for Medical Status Evaluation Under ADA

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Multi-State
Control #:
US-315EM
Format:
Word; 
Rich Text
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Description

This form is submitted to an employee\'s physician in order for him or her to describe the diagnosis of the employee for purposes of certification.
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  • Preview Request for Medical Status Evaluation Under ADA
  • Preview Request for Medical Status Evaluation Under ADA
  • Preview Request for Medical Status Evaluation Under ADA
  • Preview Request for Medical Status Evaluation Under ADA
  • Preview Request for Medical Status Evaluation Under ADA

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FAQ

An employer may ask if you can perform the essential functions of the job, with or without accommodations, but it is against the law to directly ask if you have any disabilities. Instead, it is up to you, the employee, whether or not to give this information.

The Equal Employment Opportunity Commission (EEOC) is the federal agency that enforces the ADA. The Arizona attorney general's office has a Civil Rights Division (ACRD) that enforces the state employment discrimination law.

There are various reasons why an employer may choose to deny an accommodation request made under the ADA. It is possible that by asking about your employer's reasons, you might be empowered to change the outcome of the situation.

The Americans with Disabilities Act of 1990 (ADA) is a federal civil rights law that prohibits discrimination against individuals with disabilities in every day activities, including medical services.

Under the ADA , you have a disability if you have a physical or mental impairment that substantially limits a major life activity. The ADA also protects you if you have a history of such a disability, or if an employer believes that you have such a disability, even if you don't.

The ADA requires employers to treat any medical information obtained from a disability-related inquiry or medical examination (including medical information from voluntary health or wellness programs (9)), as well as any medical information voluntarily disclosed by an employee, as a confidential medical record.

The ADA requires employers to keep confidential the medical information of applicants and employees, but only if they solicit the information through a medical inquiry or medical exam.

With limited exceptions, the ADA requires employers to keep confidential any medical information they learn about any applicant or employee. Medical information includes not only a diagnosis or treatments, but also the fact that an individual has requested or is receiving a reasonable accommodation.

An individual with epilepsy, paralysis, a substantial hearing or visual impairment, mental retardation, or a learning disability would be covered, but an individual with a minor, nonchronic condition of short duration, such as a sprain, infection, or broken limb, generally would not be covered.

A violation can occur when job postings discourage individuals with disabilities from applying, exclude them, or deny a qualified individual employment because of their disability. It is an ADA violation for any employer to demote, terminate, harass, or fail to provide reasonable accommodations to disabled employees.

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Arizona Request for Medical Status Evaluation Under ADA