Disability Accommodation Request Letter (ADA)

Formal request for reasonable accommodation under the Americans with Disabilities Act — work, school, or housing.

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Jordan Alex Taylor
482 Elm Street, Apt 3B, Portland, OR 97214
Phone: +1 503 555 0118
Email: jordan.taylor@example.com

Date: May 4, 2026

Acme Corporation — Human Resources Department
Attn: Priya Patel, Director of HR
1200 Industrial Way, Portland, OR 97214

Re:  Request for Reasonable Accommodation
     Context:  Employment (ADA Title I)

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Dear Priya Patel, Director of HR,

I am formally requesting a reasonable accommodation under the Americans with Disabilities Act (ADA, 42 U.S.C. §§12101 et seq.) and any applicable state law. This letter initiates the interactive process required by the ADA.

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DISABILITY (limited disclosure)

I have a chronic medical condition (rheumatoid arthritis) that limits one or more major life activities, including walking, standing for extended periods, and grasping/typing. I have provided supporting documentation from my treating rheumatologist (attached). I am not asking for personal medical detail beyond what is necessary to support the requested accommodation.

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LIMITATIONS IN THIS CONTEXT

In my current role as a software engineer, I am required to type for extended periods. RA flares cause significant hand and wrist pain after 30-45 minutes of continuous typing, reducing my output and (when prolonged) requiring me to stop work for the day. Standing for over 30 minutes triggers knee swelling and pain.

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ACCOMMODATIONS REQUESTED

1. Ergonomic workstation: split keyboard, vertical mouse, and adjustable monitor stand provided by the employer.
2. Sit-stand desk to allow position changes throughout the day.
3. Flexibility to take 5-10 minute movement breaks every hour during flare periods (without docking break time from PTO).
4. Permission to work from home up to 2 days per week during flare periods (full-time WFH not requested).
5. Voice-to-text software (Dragon Professional or similar) for note-taking and longer-form writing.

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DOCUMENTATION OFFERED

Letter from Dr. Asha Park, MD, rheumatologist, OHSU — attached. Letter confirms diagnosis of rheumatoid arthritis (without disclosing specific medication regimen or other unrelated medical detail), confirms the functional limitations described above, and supports the recommended accommodations.

I am willing to provide additional documentation reasonably necessary to support the request, but I respectfully ask that requests for medical information be limited to what is necessary to evaluate the accommodation, consistent with the ADA's confidentiality and minimum-necessary principles (29 CFR §1630.14).

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COST AND HARDSHIP CONSIDERATIONS

The requested accommodations are commercially available and modest in cost: ergonomic equipment $400-1,200 one-time, voice-to-text software $200/year. Sit-stand desks are standard at most modern employers. Hourly movement breaks and 2 WFH days/week have minimal direct cost and significant productivity benefit during flare periods.

The ADA defines undue hardship as significant difficulty or expense, considering employer size, financial resources, and the nature of the operation. Requested accommodations of the type listed above are routinely granted by employers of comparable size and are not generally considered undue hardships.

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INTERACTIVE PROCESS

Yes — I welcome an interactive discussion of accommodations

I propose we schedule a meeting (in person, by phone, or by video) within 10 business days to discuss the request. If alternative accommodations would meet my limitations equally well, I am open to discussing them.

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CONFIDENTIALITY

I request that:

  (a) The information disclosed in this letter and any supporting medical documentation be kept confidential consistent with 29 CFR §1630.14, in a separate file from my general personnel/student/tenant file.

  (b) Disclosure be limited to those with a need to know to evaluate or implement the accommodation (HR, supervisor where necessary for implementation).

  (c) No medical detail be disclosed to colleagues or peers.

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I look forward to a prompt response. Please direct correspondence to the contact information above.

Thank you,


_______________________________            Date: ____________________
Jordan Alex Taylor

Attachments:
  • Treating provider's supporting letter
  • Job description / curriculum / lease (relevant context document)

About this template

A reasonable-accommodation request under the Americans with Disabilities Act (ADA) initiates the interactive process — a federally-required dialogue between the requester and the employer, school, public entity, or housing provider to identify accommodations that allow the person to perform essential functions or access services. The request does not need to be in writing or use the words "ADA" or "accommodation" to trigger the obligation, but a written request creates a clear record of when the obligation began and what was asked. The four ADA contexts are Title I (employment, 15+ employees), Title II (state/local government), Title III (public accommodations — businesses open to the public), and the related Section 504 of the Rehabilitation Act and Fair Housing Act for federally-funded entities and housing. The successful request demonstrates four things: (1) a covered disability under the broad ADA definition (impairment that substantially limits a major life activity, broadly construed since the ADA Amendments Act of 2008), (2) functional limitations in the specific context, (3) specific accommodations that would address the limitations, and (4) why those accommodations are reasonable (commercially available, comparable to what others in the workplace have, low cost relative to operation). The requester is not obligated to disclose the diagnosis itself in detail — disclosing the functional limitations and providing supporting medical documentation is generally sufficient. Employers have an obligation to engage in good faith and to grant accommodations that are reasonable unless they cause "undue hardship," a high standard considering employer size and resources. Failure to engage in the interactive process is itself an ADA violation in many circuits, even if the underlying accommodation request is later determined to be unreasonable. Disputes proceed through internal HR/grievance channels, then EEOC complaint (employment), DOJ complaint (Titles II and III), or HUD complaint (housing).

When to use it

  • Employee with a disability requesting workplace adjustments.
  • Student with a disability requesting academic accommodations.
  • Tenant with a disability requesting housing modifications or assistance-animal accommodation.
  • Customer / patron requesting accommodation at a business open to the public.
  • After an informal request for accommodation has been ignored or denied.

What to include

  • Concise disability description (sufficient, not more than necessary).
  • Functional limitations in the specific context.
  • Specific accommodations requested.
  • Documentation from a treating provider.
  • Cost / hardship analysis.
  • Confidentiality request and offer of interactive process.

Frequently asked

Generally no — you must disclose enough about the disability and its functional limitations to support the requested accommodation, but you typically do not need to provide the specific diagnosis. Some employers ask for diagnosis through a medical-inquiry process; the ADA permits limited inquiry as part of the interactive process, but employers cannot demand more medical detail than is necessary. You can have your treating provider write the letter focused on functional limitations rather than diagnosis.
⚠ Legal disclaimer. ADA case law is extensive and context-specific. Title I (employment) cases proceed through the EEOC; Title II and III (public services and accommodations) through the DOJ; Section 504 and Fair Housing Act through HUD or relevant federal agency. State laws often provide broader protection than the ADA (California FEHA, New York City Human Rights Law, others). Deadlines for EEOC complaints (180 days, or 300 days in deferral states) are firm. For complex situations — especially where retaliation, denial of essential-function accommodations, or constructive discharge is involved — consult a disability-rights or employment attorney. Many take cases on contingency; non-profit organisations (Disability Rights Education and Defense Fund, ACLU) provide free or low-cost help.

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