Note: Each Mission Area/Agency has their own processes and procedures for obtaining and submitting documentation pertaining to a request for a Reasonable Accommodation or Personal Assistance Services. For forms specific to a Mission Area/Agency, contact the respective Reasonable Accommodation Coordinator (RAC) or visit their website for details. Additionally, employees should provide medical documentation to the RAC only.
An employee or applicant may be asked to complete the following forms to assist in the process and for record keeping purposes:
- AD Form 1163, Confirmation of Request for Reasonable Accommodation
- Disabled Parking Permit (HQ Complex only)*
- Limited Release of Medical Documentation*
- Medical Documentation Request Form*
- Medical Checklist* (completed by an appropriate medical or healthcare professional) or submit medical documentation from the medical or healthcare professional that addresses only the disability or medical condition related to the reasonable accommodation. Since this may vary by Mission Area/Agency, the employee/applicant should contact the Mission Area/Agency or Staff Office RAC.
- SF-256, Self-Identification of Disability (PDF, 63 KB)
* These documents can be obtained from your Mission Area/Agency or Staff Office RAC.
Authorities, Regulations, and Policy Statements
- Departmental Regulation 4300-008, Reasonable Accommodations and Personal Assistance Services
- Departmental Manual 4300-002, Reasonable Accommodation Procedures
- Rehabilitation Act of 1973, as amended
- Americans with Disabilities Act of 1990, as amended
- Executive Order 13164, Requiring Federal Agencies to Establish Procedures to Facilitate the Provision of Reasonable Accommodation (PDF, 327 KB)
- Civil Rights Act of 1991
- Architectural Barriers Act
- EEOC Regulation 29 CFR Part 1630. Regulations to Implement the Equal Employment Provisions of The Americans With Disabilities Act
- EEOC Regulation 29 CFR Part 1614.203. Rehabilitation Act (PDF, 144 KB)
- USDA Anti-Harassment Policy
- USDA Civil Rights Policy Statement
- Non-Discrimination Policy Statement
Resources
- Departmental Regulation 4300-008, Reasonable Accommodations and Personal Assistance Services
- Departmental Manual 4300-002, Reasonable Accommodation Procedures
- Federal Relay Service
(800) 877-8339 (Voice/TTY/Spanish) - USDA Target Center
202-720-2600 (Voice/TTY) - EEOC Questions and Answers on the Final Rule Implementing the ADA Amendments Act of 2008
- Equal Employment Opportunity Commission Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA
- Equal Employment Opportunity Commission Questions & Answers: Federal Agencies’ Obligation to Provide Personal Assistance Services Under Section 501 of the Rehabilitation Act
- Applying Performance and Conduct Standards to Employees with Disabilities
- Understanding Your Employment Rights under the Americans with Disabilities Act (ADA): A Guide for Veterans
- Veterans and Americans with Disabilities Act (ADA): A Guide for Employers
- National PTSD Center
- Job Accommodation Network (JAN)
1-800-526-7234 (Voice)
1-877-781-9403 (TTY) - Searchable Online Accommodation Resources
- Personal Assistance Services (PAS) in the Workplace
- Employers Practical Guide to Reasonable Accommodation Under the ADA
- Computer/Electronic Accommodations Program
Reasonable Accommodation and Personal Assistance Service Forms
[Hyperlinks will be provided when forms are given AD-numbers and uploaded.]