Sample letter requesting work accommodation
Mr. / Ms. ______ (Name of human resources or manager here)
Dear Mr. / Ms. _______:
I have worked at _________________ (company name) as a ___________________ (position or position in “_____ department” if appropriate) since ______________ (approximate date of hire). I am experiencing the following difficulties in performing my job because of my disability: _______________________.
I am writing to request that you ______________________ (state requested accommodation) because it will___________________________ (how it will help you do your job) as a reasonable accommodation. I have a disability as defined by the Americans with Disabilities Act, and I need this accommodation to successfully perform my job. If you have alternative suggestions regarding reasonable accommodations, please share them with me so we can work together to find a workable and effective accommodation.
For more information about my rights and your responsibilities under the Americans with Disabilities Act, you can contact the Job Accommodation Network at 1-800-526-7234, the Southeast ADA Center at 1-800-949-4232, or the Equal Employment Opportunity Commission at 1-800-669-4000. The Job Accommodation Network also provides examples of possible reasonable accommodations for different disabilities.
If you have any questions about my request you can contact me in writing or by phone. However, I would appreciate a written response to this request within two weeks of the date of this letter. Thank you very much.
Your full address
Your phone number