Employee accommodation form 2025

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Sufficient medical documentation should describe the nature, severity, and duration of the impairment, the activity or activities that the impairment limits, the extent to which the impairment limits the employees ability to perform the activity or activities, and should also substantiate why the requested reasonable
The first step in the reasonable accommodation process is disclosure of a disability, as employers are only required to accommodate disabilities of which they are aware.
Statements, records or letters from a Federal Government agency that issues or provides disability benefits. Statements, records or letters from a State Vocational Rehabilitation Agency counselor. Certification from a private Vocational Rehabilitation or other Counselor that issues or provides disability benefits.
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.
Reasonable medical documentation states that an employee has a physical or mental condition that limits a major life activity, and describes why the employee or applicant needs an accommodation to have an equal opportunity to: Participate in the application process or be considered for the job; Perform job duties; or.
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If your employer doesnt have a form, you can write a letter (or email) that clearly states your request and the medical condition that it is related to. The Job Accommodation Network (JAN) recommends that you include the following in your letter: Identify yourself as a person with a disability.

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