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Sample Letters To Request An Accommodation

A Request to Work at Home

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January 18, 2010

Barry Shulman, HR Manager
Shulman's Manufacturing
123 Elm Street
Main Town, U.S.A. 55555

Dear Mr. Shulman:

Although I may not look it, I am disabled as described in the Americans with Disabilities Act. Attached is a letter from Susan Rice, M.D. confirming my disability.

My medical condition is causing me extreme fatigue which is only made worse by the commute which is over 45 minutes each way. The commute interferes with my energy level while I work and leaves me exhausted by the time I return home.

If I can find some relief form this fatigue, I am sure I can continue to perform all the essential functions of my position.

One way to get the relief would be for me to work at home two days a week, perhaps Monday and Tuesday when we don't have a lot of meetings. Working at home I'd still be able to handle phone calls, do computer work, stay in touch with staff through telephone and e-mail and (describe the parts of the job you can do at home.) The three days I would be in the office I would be able to do all my regular tasks, focusing on the parts that must be done here at the office.

The cost would be minimal. I could take home one of those computers that no one is using. I would need a modem, and a dedicated phone line. The total cost to set up would be about $100 and the cost per month would only be $30.

If you have an alternative idea for an accommodation, I would welcome it.

Could I please have your response as soon as possible?

Very truly yours,


Hanako Hankermeyer


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