New York 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

Essentially any chronic condition which significantly limits a bodily function is going to qualify, and cognitive thinking and concentration are bodily functions. In most cases, chronic stress and anxiety disorders are covered by the ADA.

To be protected under the ADA, an individual must have a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment; or being regarded as having a substantial impairment.

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.

According to the EEOC, there is no specific amount of time that employers have to respond to an accommodation request, but they should respond as quickly as possible. Unnecessary delays in responding or implementing an accommodation can result in a violation of the ADA.

Definition of "disability" in the NYCHRL. (i) "Disability" means "any physical, medical, mental or psychological impairment, or a history or record of such impairment." Section 8-102(16).

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...

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.

Requests for reasonable accommodations may be made orally or in writing. The person seeking the accommodation does not have to state that they have a disability or use the phrase reasonable accommodation; they only have to notify a staff person that they need a change or adjustment for a medical reason.

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New York Reasonable Accommodation Request Form