Kansas 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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  • Preview Reasonable Accommodation Request Form
  • Preview Reasonable Accommodation Request Form
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FAQ

Re: Request for Reasonable Accommodation for (Your Name)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.

How To Request AccommodationsKeep it simple. You can tell your employer that you need an adjustment or change because of a medical condition.Put it in writing.Talk to the right people.How it works: an example.Finding help.

I would like to request accommodations for your class. I have copied my coordinator (name) and have attached my verification letter. I would like to set up a time to discuss this information with you to determine how we can implement accommodations. Please let me know your convenient time.

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.

In your reasonable accommodation letter, you should provide all the information your employer will need to begin the accommodation process, including what your disability is, how it affects you, which aspects of your job might require modification, and proposed accommodations.

Dear Employee Name: On Date, you informed Name and Title of your medical condition and requested a job accommodation to be able to perform your job functions. Company Name complies with the Americans with Disabilities Act (ADA), and we want to support you in continuing to perform your job duties.

Employees are responsible for preventing impairment or engaging in behavior that puts themselves or co-workers at risk. An employee suspected of being under the influence of illegal substances can be required to submit to drug testing. A disabled employee can be relieved from his job duties if drug tests are positive.

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."

Employers are required to provide reasonable accommodation only for the physical or mental limitations of a qualified individual with a disability of which they are aware. Generally, it is the responsibility of the employee to inform the employer that an accommodation is needed.

The only statutory limitation on an employer's obligation to provide "reasonable accommodation" is that no such change or modification is required if it would cause "undue hardship" to the employer.

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Kansas Reasonable Accommodation Request Form