Americans with Disabilities Act (ADA)

Employee Accommodation Request Checklist

The Employee Accommodation Request Checklist is to aid supervisors when an employee is communicating the presence of a disability and/or requesting an a accommodation.

Step 1:
(Without assuring the employee that an accommodation will be granted or discussing the accommodation in any detail…direct your employee to schedule an appointment with a Benefits Specialist in the Human Resources department)

The Benefits Specialist will explain the ADA process and provide the employee with the required documents for completion, they are as follows:

1) The Americans with Disabilities (ADA) forms, which include:
  • Employee Request for Accommodation Form
  • Medical Professional’s Documentation of Disability
  • Accommodation Evaluation Form

2) Review the written job description

Step 2:
The employee must complete the Employee Request for Accommodation form and have a medical professional complete the Medical Professional’s Documentation of Disability form.
Step 3:
All documents must be completed and submitted to the Benefits Specialist.  The Benefits Specialist will determine if the employee has a qualifying disability by evaluating the Medical Professional’s Documentation of Disability form
Step 4:
The Benefits Specialist will compare the Medical Professional’s Documentation of Disability form and the employee's job description.
Step 5:
The Human Resources Benefits Specialist and the supervisor will discuss the request, evaluate the requested accommodations and determine if the requested accommodation is reasonable, and propose alternatives.  Once an agreement has been made, the Accommodation Evaluation Form will be completed by the Benefits Specialist and will need to be signed by both the employee and supervisor.
If you have questions about the Americans with Disabilities Act (ADA) or need assistance with the accommodation request process for an employee, contact Human Resources, All other inquires should contact the Office of Disability Services.

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