This document is a resource for healthcare providers. It explains what types of information might be helpful to support a patient’s request for reasonable accommodations at work. 

Under the Americans with Disabilities Act (ADA), employers must provide reasonable accommodations to employees with disabilities. 

When an employee requests a reasonable accommodation, the employer may ask for medical documentation to confirm that the employee:

• Has a disability, and
• Needs an accommodation.

It is important that this documentation includes enough information to support the employee’s request. 

The ADA defines disability as an impairment that substantially limits one or more major life activities. It can be helpful to use the same language that the ADA uses about disability in medical documentation.

The most effective documentation:

• Explains how the patient’s disability affects them at work; and
• Suggests accommodations that may help.

Documenting Disability

It is a best practice to include a medical statement about how the patient’s disability impacts them at work. 

Next, it is best to include information about what major life activity or activities the patient’s disability impacts. The ADA defines and provides examples of major life activities. 

Here are some examples of major life activities: 

• Breathing
• Bending
• Caring for oneself
• Communicating
• Concentrating
• Eating
• Hearing
• Learning
• Lifting
• Performing manual tasks
• Reading
• Seeing
• Speaking
• Standing
• Thinking
• Walking

Major life activities also include major bodily functions, such as:

• Immune function
• Digestive function
• Bowel or bladder function
• Neurological function
• Respiratory function
• Circulatory function
• Endocrine function

Impact on Work and Accommodation Ideas

Employers must provide reasonable accommodations that an employee needs to perform the essential functions of their job. 

Medical documentation should explain that the patient has a disability and how the patient’s disability affects them at work. This helps employers understand the problem and work with the employee to find solutions.

It is also a best practice to suggest accommodations that could be helpful. Possible accommodations may include: 

• Changes to communication (such as giving instructions in writing).
• Changes to testing requirements, training materials, or workplace policies.
• Job restructuring (removing a less important task from your job).
• New or adjusted equipment (such as screen readers or adjustable chairs).
• Part-time or flexible work schedules.
• Qualified readers or interpreters (ASL interpreters for important meetings).
• Reassignment to an open job you qualify for (usually only if no other accommodation works).
• Taking time off from work (unpaid leave in addition to FMLA or sick leave).
• Working from home.

Here are some examples of what that may look like:

Example 1: Patient A has ADHD. This can cause difficulty with concentration when there are distractions around. Patient A’s cubicle is located near the entrance, where there is a high volume of foot traffic. Because of her the distractions, Patient A is having difficulty completing reports on time. One accommodation that may be helpful is to reduce distractions in her workplace. This could be done by moving her to a private office or providing a noise-cancelling headset.

Example 2: Patient B has progressive vision loss. This can make his computer screen inaccessible. Some accommodations that may be helpful are screen magnifying software or screen reading software. This would allow Patient B to read his computer screen more clearly.

Example 3: Patient C has Crohn’s Disease which affects the bowel function. Patient C may need to use the restroom suddenly. It would be a helpful accommodation to place Patient C’s desk close to a restroom. Patient C would also benefit from the ability to quietly leave meetings when needed to use the restroom.

Additional Notes

It is a best practice to put the documentation on the healthcare provider’s letterhead. Employers tend to place more value on documentation that is on professional letterhead. Sometimes employers will not accept medical documentation that is not on letterhead. 

The medical documentation letter should let the employer know that the employee is open to more discussion offer to discussion if their requested accommodation is not available.

Sample Letter: Medical Documentation for a Reasonable Accommodation

LETTERHEAD

[DATE]

Re: Medical Documentation for (Patient Name) Reasonable Accommodation Request

Dear (Employer Name),

I am treating (Patient Name), who has a disability that causes substantial limitations in the major life activities of (major life activities impacted).

Due to (Patient Name)’s disability and the impact it has on (major life activities impacted), (Patient Name) is requesting a reasonable accommodation to help with (work related problem).

I have spoken with (Patient Name) about accommodations and we came up with the following ideas:

(List accommodation ideas and briefly explain how each accommodation would help the patient or address the work-related problem).

Please let (Patient Name) know if you have any questions about (her/his/their) request for reasonable accommodation. In the event that these accommodations cannot be provided, please let (Patient Name) know so we can discuss alternatives.

Sincerely,
(Medical Professional’s Signature)
(Medical Professional Name)