District of Columbia 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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FAQ

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.

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...

According to the Equal Employment Opportunity Commission (EEOC), when an individual decides to request an accommodation, the individual or his/her representative must let the employer know that s/he needs an adjustment or change at work for a reason related to a medical condition.

Examples of accommodations include:sign language interpreters for students who are deaf;computer text-to-speech computer-based systems for students with visual impairments or Dyslexia;extended time for students with fine motor limitations, visual impairments, or learning disabilities;More items...?

According to the EEOC, you only have to let your employer know that you need an adjustment or change at work for a reason related to a medical condition. You can use "plain English" to make your request and you do not have to mention the ADA or use the phrase "reasonable accommodation."

Steps for Requesting AccommodationsComplete a Getting Started Form. This basic form consists of contact information and five brief questions.Provide DSS with current disability related documentation.Meet with DSS for an intake appointment.Request Your Accommodations Each Term.

Dear Mr./Ms. (Contact at Human Resources Department): I work at (Company Name) as a (Your Job Title) and have been in this position since (Date). I am writing to request that you provide (list accommodation needed here) as a reasonable accommodation under the ADA.

Examples of reasonable accommodations include making existing facilities accessible; job restructuring; part-time or modified work schedules; acquiring or modifying equipment; changing tests, training materials, or policies; providing qualified readers or interpreters; and reassignment to a vacant position.

Steps for Requesting AccommodationsComplete a Getting Started Form. This basic form consists of contact information and five brief questions.Provide DSS with current disability related documentation.Meet with DSS for an intake appointment.Request Your Accommodations Each Term.

How to Handle an Employee's Request for an ADA AccommodationStep 1: Determine Whether the Employer Is Covered by the ADA.Step 2: Ensure a Policy and Procedure Exist for Handling Accommodation Requests.Step 3: Determine Whether the Employee with a Disability Is "Qualified"Step 4: Initiate the Interactive Process.More items...

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District of Columbia Reasonable Accommodation Request Form