South Carolina 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

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 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...

1) Decisions regarding reasonable accommodations for job applicants must be made by the individual or individuals designated to do so by the head of that OA.

The following are suggestions about how to request and negotiate an accommodation in the workplace:Decide how you are going to make your request.Decide who you are going to ask.Explain why you need an accommodation and give your accommodation ideas.Follow-up as needed.Monitor the accommodation.

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.

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.

The most widely requested form JAN offers is the Sample Medical Inquiry Form in Response to an Accommodation Request. This form is commonly used to obtain information from a healthcare provider to substantiate that an employee has a medical impairment, associated limitations, and requires accommodation under the ADA.

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."

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.

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.

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South Carolina Reasonable Accommodation Request Form