PRACTICAL GUIDANCE FOR

MEDICAL PROFESSIONALS:

HELPING PATIENTS WRITE EFFECTIVE

ACCOMMODATION REQUEST LETTERS

Fact Sheet Series
2

JAN’S ACCOMMODATION FACT SHEET SERIES

PRACTICAL GUIDANCE FOR MEDICAL PROFESSIONALS

HELPING PATIENTS WRITE EFFECTIVE ACCOMMODATION REQUEST LETTERS

Under the Americans with Disabilities Act (ADA), covered employers must provide

reasonable accommodations for employees with disabilities. However, before an

employer has any obligation to provide an accommodation, an employee must make an

accommodation request and if asked, provide appropriate documentation. Medical

professionals can play a key role in the success of workplace accommodations for their

patients with disabilities by helping them write effective accommodation request letters

and providing sufficient medical documentation. The following discusses what

information might be included in an accommodation request letter and related medical

documentation.

Using Letterhead

Employers tend to place more value on medical documentation that is on professional

letterhead and in some cases, employers will not even accept medical documentation

unless it is on letterhead. To save time and help insure that medical documentation is

sufficient, accommodation request letters should be done on letterhead.

Documenting Disability

Under the ADA, when an employee requests an accommodation and the disability is not

known or obvious, employers can require medical documentation that the disability

exists. The ADA contains a specific definition of disability: an impairment that

substantially limits one or more major life activities. Therefore, when documenting that a

patient has a disability, medical professionals may want to use the ADA’s specific

language so the information will be helpful for employers.

The first piece of information to include is the patient’s diagnosed impairment. If the

patient is hesitant to provide the diagnosis, a more general statement about the medical

condition may suffice, but if the employer insists on having the diagnosis it should be

provided or the documentation may be considered insufficient. According to the Equal

Employment Opportunity Commission (EEOC), documentation is insufficient if it does

not specify the existence of an ADA disability and explain the need for reasonable

accommodation.

The next piece of information to include when documenting disability under the ADA is

information about what major life activity the impairment substantially limits. There are

two categories of major life activities. The first includes, but is not limited to, caring for

oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing,

lifting, bending, speaking, breathing, learning, reading, concentrating, thinking,

communicating, and working.

The second category of major life activities is major bodily functions, which includes but

is not limited to, functions of the immune system, normal cell growth, digestive, bowel,
3

bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive

functions.

Once a disability is established, employers have an obligation to accommodate any

limitations resulting from the disability, even limitations that are not substantial. One

important thing to remember is that the major life activity that establishes that a patient

has a disability is not necessarily the same major life activity that is affecting the patient

at work and for which the accommodation is needed.

Providing Accommodation Information

Under the ADA, employers are responsible for coming up with and providing effective

accommodations. However, employers do not always know what accommodations

might work so it may be helpful to provide any accommodation ideas that the medical

professional and patient have. In addition to accommodation ideas, this part of the letter

should include information about what limitations are causing the patient’s work-related

problems and what those problems are. The goal here is to help the employer

understand the problem and start exploring solutions. Here are a few examples:

Example A: Because of Patient X’s depression and associated concentration problems,

she is having difficulty completing reports on time. One accommodation that might be

helpful is to reduce distractions in her workspace. This could be done by moving her to

a private office or providing a headset with white noise.

Example B: Because of Patient X’s rotator cuff injury and his associated limitations of

lifting no more than 25 pounds, pushing/pulling no more than 50 pounds, and no

overhead work, he is having difficulty moving some of the boxes in the warehouse.

Accommodations that might be helpful include a height-adjustable lifting device, a small

lightweight ladder, and help moving some of the heavier boxes.

Example C: Because of Patient X’s progressive vision loss and associated blurred

vision, she is having difficulty reading her computer screen and paper copies of reports.

One accommodation that might be useful for her computer access is screen reading

software. For reading paper copies, a stand magnifier that magnifies four times the

regular print may work for now, but because the vision loss is progressive, a better

option might be to scan in documents so Patient X can read reports on her computer.

Offering to Follow Up

In the final section of an accommodation request letter, medical professionals should

offer to address any specific questions the employer has about the employee’s

accommodation needs and to discuss other accommodation options if needed. When

making an accommodation request, employees want to be careful not to lock

themselves into only one accommodation solution because if the employer cannot

provide that accommodation, the employer may conclude that an employee is no longer

qualified. This final part of the letter helps address this issue by leaving open the door

for additional discussion.
4

Accommodation Request Letter

Letterhead

Dear Employer Name

I am treating Patient Name for diagnosed impairment, which causes substantial

limitations in the major life activity(s) of major life activity or activities impacted by the

diagnosed impairment.

Because of Patient Name's diagnosed impairment and associated limitation, he/she has

difficulty work-related problem and needs an accommodation. Patient Name and I

discussed the situation and came up with the following accommodation ideas:

List accommodation ideas here, and briefly explain how each will address the workrelated problem.

If these accommodations cannot be provided, please let Patient Name know so we can

discuss alternatives.

Sincerely,

Medical Professional’s Signature

Medical Professional's Name

Updated 12/22/10.
5

This document was developed by the Job Accommodation Network, funded by a

contract agreement from the U.S. Department of Labor, Office of Disability Employment

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the

position or policy of the U.S. Department of Labor. Nor does mention of trade names,

commercial products, or organizations imply endorsement by the U.S. Department of

Labor.