New Hampshire Request for Accommodation under the ADA

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Multi-State
Control #:
US-293EM
Format:
Word; 
Rich Text
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Description

This form is used by an employee to request an accommodation under the ADA.

How to fill out Request For Accommodation Under The ADA?

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FAQ

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.

Sample Accommodation Request LetterIdentify yourself as a person with a disability.State that you are requesting accommodations under the ADA (or the Rehabilitation Act of 1973 if you are a federal employee)Identify your specific problematic job tasks.Identify your accommodation ideas.More items...

Under Title I of the Americans with Disabilities Act (ADA), a reasonable accommodation is a modification or adjustment to a job, the work environment, or the way things are usually done during the hiring process.

An individual meets the Americans with Disabilities with Act definition act of disability that would qualify them for reasonable accommodations if they have a physical or mental impairment that substantially limits one or more major life activities (sometimes referred to in the regulations as an actual disability)

REASONABLE ACCOMMODATION RELATED TO THE BENEFITS AND PRIVILEGES OF EMPLOYMENT. The ADA requires employers to provide reasonable accommodations so that employees with disabilities can enjoy the "benefits and privileges of employment" equal to those enjoyed by similarly-situated employees without disabilities.

Wheelchair use:Installing a ramp to make a workplace wheelchair-accessible.Modifying a restroom so a worker with disabilities can use it.Changing the layout of cubicles to provide enough room for a wheelchair to pass.Providing a raised or adjustable desk so that a wheelchair can be used in place of a chair.

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."

(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.

I request you to kindly give me accommodation. It is very hard for me to stay in hotels or hostels. (Cordially describe your requirements). I shall be really thankful to you if you provide me accommodation considering my issue.

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New Hampshire Request for Accommodation under the ADA