Job Accommodation Network
The Americans with Disabilities Act of 1990 (ADA) requires employers to provide reasonable accommodations for qualified employees with disabilities, unless such accommodations pose an undue hardship (e.g., too costly, too extensive, too substantial, too disruptive). In general, the employee with a disability is responsible for letting the employer know that an accommodation is needed to perform essential job functions or to receive equal benefits and privileges of employment. Employers are not required to provide accommodations if they are not aware of the need.
According to the Equal Employment Opportunity Commission (EEOC), the federal agency charged with enforcing the ADA, an accommodation request does not have to be in writing and the ADA does not include specific guidelines or forms for requesting reasonable accommodation. However, some employers find it useful to document accommodation requests and want to have a standard form for employees to use when requesting accommodations. For these employers, JAN developed a sample accommodation request form. Please note that this sample is to be used as a guide only and is not legal advice. If legal advice is needed, contact a legal service.
Download (.doc) Sample Reasonable Accommodation Request Form for Employers
For information about medical documentation in response to an accommodation request, visit Medical Inquiry in Response to an Accommodation Request at http://www.jan.wvu.edu/media/medical.htm.
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