(Provided with permission from Disability Rights CA)
Sample Letter to Request Reasonable Accommodations During the COVID-19 Pandemic
This sample letter can be used to ask your employer or prospective workplace for reasonable accommodations you need in the hiring process or for your job.
[Date]
Dear [Employer]:
I am writing to request [a] reasonable accommodation[s] for my disability/disabilities. I [am an employee of/am applying for a position at] [Public Entity]. I am also [subject to a stay-at-home order / at higher risk for COVID-19 complications because of my disability]. Because of my disability, I need to take extra care to protect myself from COVID-19. I need the following accommodations: [list accommodations]. My [physician/psychiatrist/psychologist/therapist/social worker/occupational therapist /other individual (describe)] has deemed these accommodations/modifications necessary in light of my disability. Please see the attached letter from [doctor or professional’s name]. Additionally, please see the [federal, state or local] order requiring me to shelter-in-place during the COVID-19 pandemic. Federal and state law require that employers accommodate employees and applicants who have disabilities. Please respond to this request by [date]. Feel free to contact me at [your phone number and/or e-mail address] if you have any questions. Thank you.
Sincerely,
[Your name]
[Your address]
Sample letter to Work from Home During the COVID-19 Pandemic
This sample letter can be used to ask your employer or prospective workplace for reasonable accommodations to work from home during the COVID-19 pandemic.
[Date]
Dear [Employer]:
I am writing to request a reasonable accommodation for my disability to work from home during the COVID-19 pandemic.
I am a [job position] at [work location]. Federal and state law require employers to accommodate employees and applicants with disabilities. Because of my disability, I am in a higher risk group for contracting and/or experiencing severe or even fatal symptoms from COVID-19. For this reason, I must limit contact with others during this pandemic as much as possible.
I am able to perform the essential job duties of my position with a work from home reasonable accommodation.
I need the following equipment in order to work from home effectively [list accommodations].
[If you can get a doctor’s note that supports your request, then include:
My medical care provider has deemed it necessary to work at home instead of my usual work location.]
Please respond to this request by [date].
Sincerely,
[Your name]
[Your phone number and e-mail address]
Sample Letter to Request Paid Leave During the COVID-19 Pandemic
This sample letter will help you request paid leave if you qualify under the Family First Coronavirus Response Act.
[Date]
Dear [Employer]:
I am writing to request paid leave to care for [myself/someone I care for]. I am [(1) subject to an isolation or quarantine order from the government; (2) subject to an isolation or quarantine order from my doctor; (3) experiencing COVID-19 symptoms; (4) caring for an individual who is subject to a stay-at-home order; and/or (5) caring for a child whose school or daycare is closed due to the COVID-19 pandemic]. Please see the attached [letter from doctor or professional’s name/federal, state or local ordinance that requires me to isolate and quarantine]. Because [Employer] has less than 500 employees, I believe I am entitled to paid leave under the Family First Coronavirus Response Act. Please respond to this request by [date]. Feel free to contact me at [your phone number and/or e-mail address] if you have any questions. Thank you.
Sincerely,
[Your name]
[Your address]
Additional Resources
Working during COVID-19 – learn more about COVID-19 accommodations.
Community living and accessibility during COVID-19.
EEOC guidelines on the ADA in the workplace during the COVID-19 Pandemic.