Reasonable Accommodation Request Form

State:
Multi-State
Control #:
US-216EM
Format:
Word; 
Rich Text
Instant download

Definition and meaning

The Reasonable Accommodation Request Form is designed to assist employers in evaluating the needs of employees who have disabilities. This form is pivotal in determining whether specific adjustments or modifications can be made to work environments or job responsibilities to help disabled employees perform their essential job functions effectively and safely.

How to complete a form

Filling out the Reasonable Accommodation Request Form involves several key steps:

  • Section I: This section is to be completed by the employee requesting the accommodation. The employee must provide their name, job title, and contact details, along with a date and signature.
  • Request details: Employees should articulate their specific limitations, how these limitations affect their job duties, and suggest potential accommodations that could assist them.
  • Section II: This section is for the employer's review and confirmation that the employee has signed the form.
  • Section III: Human Resources will use the information to decide on the accommodation request.

Make sure to maintain confidentiality throughout this process.

Who should use this form

This form should be used by employees who have a disability and are seeking modifications to their workplace environment or job duties to enable them to perform their roles more effectively. Employers are also encouraged to familiarize themselves with this form to ensure compliance with legal requirements and to promote an inclusive workplace.

Key components of the form

The Reasonable Accommodation Request Form consists of three main sections:

  • Section I: Employee details, including their request for accommodation and permission to consult health professionals.
  • Section II: Employer validation of the employee's request, including checks for necessary signatures and completion of analysis forms.
  • Section III: Human Resources documentation and determination based on input from health care professionals.

Benefits of using this form online

Completing the Reasonable Accommodation Request Form online offers several advantages:

  • Accessibility: Users can access the form from any device with internet capabilities, ensuring ease of use.
  • Efficiency: Submission and processing times are reduced since forms can be sent directly to Human Resources electronically.
  • Confidentiality: Online submissions can be more secure when managed through dedicated systems designed to protect employee information.

Common mistakes to avoid when using this form

When filling out the Reasonable Accommodation Request Form, employees should avoid the following errors:

  • Failing to provide complete and accurate information in all required fields.
  • Not signing the form, which can result in delays or denials of the accommodation request.
  • Exceeding the limits of the form – for example, using too many additional sheets without clear context.

What to expect during the accommodation process

Once the Reasonable Accommodation Request Form is submitted, employees can expect the following:

  • Review by HR: Human Resources will evaluate the request and may consult health care professionals.
  • Decision notification: Employees will be informed whether their request has been approved or denied, along with the reasons for the decision.
  • Implementation: If approved, the employer will work with the employee to implement the agreed accommodation in a timely manner.
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FAQ

Dear So-and-So, I am writing to request a reasonable accommodation as a person with disabilities. I am requesting this accommodation so that I will have equal opportunity to participate in your housing.

Your name and position. The date. Information about your disability. A request for accommodation. Accommodation ideas. Medical information.

____________________________________________________________________ Provide the name, address, telephone and fax numbers of your health care provider. The provider may receive a request from us for information regarding your impairment/disability and recommendations for accommodations.

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. Request your employer's accommodation ideas.

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.

Providing an assistant as needed may be a reasonable accommodation for a person with a disability, if this does not impose an undue hardship. Examples include: An assistant may be needed to retrieve items on shelves, file, or selectively assist a person with quadriplegia with other clerical duties.

Your name and position. The date. Information about your disability. A request for accommodation. Accommodation ideas. Medical information.

Step One: Determine whether an individual has a disability and meets minimum qualification standards. Step Two: Determine the essential functions of the job. Step Three: Identify the abilities and limitations of the individual. Step Four: Identify potential accommodations.

Identify 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.

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Reasonable Accommodation Request Form