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A brief statement of the doctors credentials and history of treating the employee. The employees diagnosis, including how the condition would manifest if left untreated. (This information is necessary to allow the employer to determine whether the employee has a disability under the ADA.)
A request for reasonable accommodation can be denied if the individual requesting the accommodation is not qualified individual with a disability or if providing the requested accommodation would cause an undue hardship to the Agency or a Direct Threat.
Content to consider in body of letter: 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.
Dear [Insert employers name here]: I am writing this letter to submit a request for accommodations in the workplace. I have pain in my lower back. Sitting or standing for long periods of time in the same position is causing increased pain and is decreasing my mobility.
Examples of Reasonable Accommodations Reasonable accommodations may include, but are not limited to: Job restructuring such as altering when and/or how an essential function of a job is performed or reallocating marginal job functions that an employee is unable to perform because of a disability.

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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.
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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