MEMORANDUM
TO: (1) ____________________________
FROM: (2) ____________________________
RE: Request for Reasonable Accommodation
DATE: (3) ________________________
This is a request for reasonable accommodation under the Americans with Disabilities Act (ADA) and the California Fair Employment and Housing Act (FEHA). If you are not the appropriate person to receive this request, please notify me immediately, and forward this letter on to the person who handles requests for reasonable accommodation.
I am a person with a “disability” under the ADA and the FEHA. [My condition is (4) _________________.] Due to my disability, I need (5) _______________________________________________.
According to the ADA and the federal Equal Employment Opportunity Commission (EEOC), communication access is a form of reasonable accommodation. See 42 U.S.C. § 12111(9)(B), EEOC Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act (Oct. 17, 2002), and EEOC Factsheet, Questions and Answers About Blindness and Vision Impairments in the Workplace and the Americans with Disabilities Act (Jan. 11, 2011), all available at www.eeoc.gov. The EEOC has also recognized that modifications related to mobility (such as the use of canes and guide dogs) and transportation may be reasonable accommodations for blind and visually impaired workers. See Questions and Answers About Blindness and Vision Impairments in the Workplace.
Please let me know if you require reasonable medical documentation of my condition, or if you wish to propose alternative accommodations to those I have requested. I am available and eager to engage in the interactive process with you.
Thank you.
(1) Name of Human Resources director, supervisor, program director, or another manager
(2) Your name
(3) Today’s date
(4) Optional: State the name or a description of your condition using language you feel comfortable with.
(5) Explain what form of accommodation you are requesting, such as: “documents in a format accessible with text-to-speech software.”
Accommodations for blind and visually impaired individuals include:
- documents in alternative formats such as Braille, enlarged print, or digital files;
- written minutes or notes summarizing meetings;
- text-to-speech software such as JAWS;
- computer equipment such as CCTV or a computer screen magnifier for enlarging documents and visual materials;
- schedule changes to permit travel by public transportation or in some cases a driver;
- The use of a cane or service animal at work;
- another accommodation.