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Click ‘Get Form’ to open the reasonable accommodation form in the editor.
Begin by entering your name in the 'Name of Client or Applicant' field. Ensure that all information is printed clearly.
Fill in your 'Case Number' and 'Social Security Number' accurately to avoid any processing delays.
Provide your current address and telephone numbers for both work and home, ensuring they are up-to-date.
In the section asking for DHS services, list any services you are requesting or currently receiving that require accommodation.
Specify the disability that needs to be accommodated in the designated field.
Clearly state your requested accommodation in the appropriate section, providing as much detail as necessary.
Indicate whether medical documentation is attached. If not, provide a brief reason in the space provided.
Sign and date the form at the bottom. Ensure all signatures required are completed before submission.

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Why would a reasonable accommodation be denied?

If the employee or applicant fails to provide documentation or information where it has been properly requested, the deciding official may deny a reasonable accommodation request. The deciding official must consult with the EOUSA GCO to determine whether additional medical or other information is needed.

What qualifies for reasonable accommodation?

Examples of reasonable accommodations include providing interpreters, readers, or other personal assistance; modifying job duties; restructuring work sites; providing flexible work schedules or work sites (i.e. telework) and providing accessible technology or other workplace adaptive equipment.

How to get a reasonable accommodation from a doctor?

Your doctor will want you to sign a consent form, allowing the doctor to provide details about your medical condition that would otherwise have to be kept confidential. Once youve given your consent, the doctor should write a brief letter explaining your condition and suggesting possible accommodations.

How do you write a reasonable accommodation request?

Requesting an Accommodation The requesting employee submits their request for reasonable accommodation through the DOL Accommodates system, providing all the information requested.

What documentation is needed for a reasonable accommodation?

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

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