California Reasonable Accommodation Request Form

State:
Multi-State
Control #:
US-216EM
Format:
Word; 
Rich Text
Instant download

Description

This form may be used to assist a company in determining to what extent a reasonable accommodation is required.
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How to fill out Reasonable Accommodation Request Form?

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FAQ

MC-410 Request for Accommodations by Persons with Disabilities and Response.

A reasonable accommodation is any change to the application or hiring process, to the job, to the way the job is done, or the work environment that allows a person with a disability who is qualified for the job to perform the essential functions of that job and enjoy equal employment opportunities.

If your employer cannot give you work that meets the work restrictions, the claims administrator must pay temporary total disability benefits (see Chapter 5). If you have questions or need help, use the resources in Chapter 10. Don't delay, because there are deadlines for taking action to protect your rights.

4. What accommodations are not considered reasonable? Reasonable accommodation does not include removing essential job functions, creating new jobs, and providing personal need items such as eye glasses and mobility aids.

What types of accommodations are generally considered reasonable?Change job tasks.Provide reserved parking.Improve accessibility in a work area.Change the presentation of tests and training materials.Provide or adjust a product, equipment, or software.Allow a flexible work schedule.More items...

The obligation to provide WRP ends when one of the following occurs: The employee is able to return to their regular job or a permanent new position. The job is changed to eliminate the MSD hazard or reduce it to the extent that it does not pose a risk of harm to the injured employee.

What are Common Work Restrictions? Restrictions can take place in many forms. There are physical work restrictions, emotional work restrictions and atmospheric limitations. Physical Work Restrictions are those that limit one's ability to perform physical work.

Unreasonable accommodations alter requirements that are essential to the program of instruction or to meet licensing prerequisites, cause fundamental alteration in the nature of the program, impose undue financial or administrative burden, or pose an appreciable threat to personal or public safety.

You may make this request initially to whomever you are most comfortable with. Make your request in writing and use the phrase: I am requesting a reasonable accommodation under the ADA. This helps create a clear record of your request and helps your employer know that your request should be taken seriously.

The Supreme Court of Canada has ruled that an employer has a legal duty to take reasonable steps, in policies or conditions of work, to accommodate an employee's individual needs.

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California Reasonable Accommodation Request Form