Kansas ADA Medical Documentation for Use by Medical Practitioner

State:
Multi-State
Control #:
US-AHI-209
Format:
Word
Instant download

Description

This AHI form is to be used by an employer who has hired a disabled employee. This form must be sent to the employees medical physician. This from includes the employees job description and functions preformed by the employee.
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  • Preview ADA Medical Documentation for Use by Medical Practitioner
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How to fill out ADA Medical Documentation For Use By Medical Practitioner?

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FAQ

Title I (Employment) Equal Employment Opportunity for Individuals with Disabilities.Title II (State and Local Government) Nondiscrimination on the Basis of Disability in State and Local Government Services.Title III (Public Accommodations)

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.

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.

Have an equal opportunity to be promoted once they are working; have equal access to benefits and privileges of employment that are offered to other employees, such as employer-provided health insurance or training; and. must not be harassed because of their disability.

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...

I have been working in (Branch) since (Duration) holding employee ID (Employee ID). Through this letter, I would request you to kindly provide me with accommodation. I, on // (Date) got transferred to (Branch Address) branch and have no place to reside at.

First, you have to prove that you have a disability under the Americans with Disabilities Act.By showing you have a physical impairment that substantially limits a major life activity;By showing that you have a record of a physical impairment; or.By showing that you are regarded as having a physical impairment.

The ADA is divided into five titles:Employment (Title I)Public Services (Title II)Public Accommodations (Title III)Telecommunications (Title IV)Miscellaneous (Title V)

Titles of the ADATitle Iemployment.Title IIpublic entities (and public transportation)Title IIIpublic accommodations (and commercial facilities)Title IVtelecommunications.Title V miscellaneous provisions.

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Kansas ADA Medical Documentation for Use by Medical Practitioner