Reasonable Accommodation Based on Disability
The Americans with Disabilities Act of 1990 (ADA) makes it unlawful to discriminate in employment against a qualified individual with a disability. To be protected under the ADA, an individual must have, have a record of, or be regarded as having a substantial (as opposed to a minor) impairment. A substantial impairment is one that significantly limits or restricts a major life activity.
This form is designed to assist employees in requesting a reasonable accommodation. What is a reasonable accommodation? A reasonable accommodation is any change or adjustment to a job or work environment that does not cause an undue hardship on the department or unit and which permits a qualified applicant or employee with a disability to participate in the job application process, to
perform the essential functions of a job, or to enjoy benefits and privileges of employment equal to those enjoyed by employees without disabilities. For example, a reasonable accommodation may include providing or modifying equipment or devices, job restructuring, allowing part-time or modified work schedules, reassigning an individual, adjusting or modifying examinations, modifying training materials or policies, providing readers and interpreters or making the workplace readily accessible to and usable by people with disabilities.
Instructions
This form must be completed whenever an employee or applicant requests an accommodation, or it is apparent that a reasonable accommodation may enable an individual with a disability to perform the essential duties of a position or participate in the employment process. Copies of the completed form should be forwarded to the ADA Office (EHS Building 179 Newell Drive). If you require any assistance in completing this form, call 392-7056(V), 846-1046 (TDD). Click here for a copy of the Reasonable Accommodation Based on Disability Request Form