Employee Accommodation Request Forms
If you believe you need a workplace accommodation because of a personal medical condition, disability, or pregnancy, please review and complete the following:
- Procedure and Practice Guide (PDF) (Word version)
- Employee Accommodation Request Form (Submit Online)
- Healthcare Provider Cover Letter (PDF)
- Employee Accommodation Medical Certification Form (PDF)
You can request to have the paperwork mailed to you by contacting the University ADA Coordinators via email at email@example.com or by phone at 512-471-1849.
Submit Accommodation Paperwork
- Via email at: firstname.lastname@example.org
- By fax at: 512-471-8180 or 512-475-7730
Overview of the University Employee Accommodation Request Process
The University of Texas at Austin (University) is required by law to provide reasonable accommodations to qualified employees with disabilities in accordance with the Americans with Disabilities Act, as amended (ADA) and to employees experiencing limitations associated with pregnancy, childbirth, or related conditions under the Pregnant Workers Fairness Act (PWFA). The University’s ADA Coordinators are charged with coordinating the University’s compliance with the employment provisions of the ADA and the PWFA. The determination of reasonable accommodations is a collaborative and interactive process between the University ADA Coordinators, the employee seeking accommodations, the employee’s supervisor, and/or other appropriate personnel (e.g., Human Resources or Leave Management) as needed.
Having a medical condition alone is not enough to make someone eligible for accommodation under the ADA. Under the ADA, an individual with a disability is someone with a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment. To have an “actual” disability (or to have a “record of” a disability) an individual must be (or have been) substantially limited in performing a major life activity as compared to most people in the general population. Documentation from an individual’s healthcare provider is necessary to assess the functional limitations associated with one’s disability and what accommodations are appropriate. ADA related medical files are kept separate and apart from the location of personnel files, and access is limited to those personnel involved in the implementation of workplace accommodations.
The PWFA requires employers to provide reasonable accommodations to a worker’s known limitations related to pregnancy, childbirth, or related medical conditions. While most accommodations under the PWFA can be managed at the departmental level, the ADA Coordinators are available to facilitate the process when situations are more complex. Documentation from an individual’s healthcare provider is necessary in these situations to assess the limitations associated with one’s condition(s) and what accommodations are appropriate.
Initiating the Accommodation Process
Employees seeking workplace accommodation(s) are responsible for initiating contact with and requesting information regarding accommodations. Employees interested in workplace accommodations can call or email the University ADA Coordinators to request the paperwork to start the accommodation process.
An employee may request a reasonable accommodation at any time, either orally or in writing. A request does not have to include any specific words, such as “reasonable accommodation,” “disability,” or “Americans with Disabilities Act.” A request is any communication in which an individual asks or states they need the University to provide or to change something because of a medical condition. A supervisor, manager, or the University ADA Coordinators will ask an individual whether they are requesting a reasonable accommodation if the nature of the initial communication is unclear. Supervisors who receive a request for accommodation should refer the employee to the University ADA Coordinators, and notify that office of such referral via email at email@example.com.
Employees may initially consult with the University ADA Coordinators without first informing their supervisor. Supervisors are part of the process and will be brought into the discussion after the employee has met with the University ADA Coordinators. It is important to note that in having this discussion, the University ADA Coordinators do not share the medical diagnosis or disability documentation with the supervisor, but rather maintains the focus on the limitations of the condition(s) and suggested accommodations.
Processing the Request
When an employee indicates there is a need for an accommodation, the University ADA Coordinators will provide the individual with the necessary paperwork to be completed. University employees can also access and print the necessary paperwork for an accommodation by visiting the Accommodation Request Forms page. To determine whether an employee is eligible for accommodations under the ADA or PWFA, they will need to provide written documentation from their licensed health care provider concerning their condition(s).
After receiving the documentation from the employee’s health care provider, the University ADA Coordinators will review the medical information to determine its adequacy. If the information provided is incomplete, unclear, or inconsistent, the University ADA Coordinators may request that the employee obtain additional or clarifying information from their healthcare provider.
The University ADA Coordinators have the authority to obtain, at departmental expense, an independent medical opinion concerning the impairment for which an employee seeks an accommodation.
Once an employee has submitted their completed paperwork, the University ADA Coordinators will reach out to schedule a time to meet. Communication is a priority throughout the entire process, but particularly when the specific limitation, problem, or barrier is unclear; when an effective accommodation is not obvious; or when the parties are considering different forms of reasonable accommodation. After meeting with an employee, the University ADA Coordinators will reach out to the employee’s supervisor to discuss the accommodations being requested and explore the feasibility of their implementation.
Texas Senate Bill 212
Beginning January 1, 2020, Texas Senate Bill 212 requires all employees of Texas universities to report any information to the Title IX Office regarding sexual harassment, sexual assault, dating violence and stalking that is disclosed to them. The University ADA Coordinators must report any Title IX related incidents that are disclosed in writing, discussion, or one-on-one. Before talking with the University ADA Coordinators, or with any staff member about a Title IX related incident, be sure to ask whether they are a responsible employee. For more information about reporting options and resources, visit http://www.titleix.utexas.edu/, contact the Title IX Office via email at firstname.lastname@example.org, or call 512-471-0419.
The Family Medical Leave Act (FMLA) provides eligible employees of covered employers with job-protected leave for qualifying family and medical reasons and requires continuation of their group health benefits under the same conditions as if they had not taken leave. FMLA leave may be unpaid or used at the same time as employer-provided paid leave. Employees are eligible if they work for a covered employer for at least 12 months and have at least 1,250 hours of service with the employer during the 12 months before their FMLA leave starts.
The Sick Leave Pool (SLP) is a reserve of sick time off hours donated by employees to provide eligible employees with paid sick time off for catastrophic medical conditions. Employees suffering from a catastrophic condition, or who have an *immediate family member suffering from a catastrophic condition and are appointed to work at least 20 hours per week for at least 4.5 months are eligible to apply for SLP hours. Eligible employees must exhaust all their own paid time off prior to applying for and receiving a SLP award. Students in positions where student status is a requirement for employment are not eligible.
For more information about FMLA and/or SLP, please contact Leave Management at HRS-LM@austin.utexas.edu or by phone at (512) 475-8099.
The Employee Assistance Program (EAP) provides employees with counseling and consultation services. EAP services are confidential, and you can speak with them during work hours. For more information, contact EAP at email@example.com or by phone at 512-471-3366.