Accommodations for Employees: What They Are, What They Do, and How to Start the Conversation

Honestly, if a medical issue is affecting your ability to do your job, you do not have to figure everything out on your own. You can ask for help and start a conversation about whether a workplace accommodation might make things more manageable.

The likelihood that someone will need or use a workplace accommodation during their working career is higher than many people realize. In JAN’s survey of employers who contacted the service during 2019–2024, 66% of the 2,069 respondents who rated effectiveness said accommodations were either very effective or extremely effective, and 61% of the 1,425 respondents providing cost information reported that accommodations cost nothing to implement.⁴ The point is not that every request will look the same. The point is that accommodations can be a normal part of making work accessible.

It is okay not to know exactly what to do. The process can be complex, and it can feel overwhelming when you are also dealing with medical concerns. If you are covered by the ADA and meet its requirements, you may have rights to a reasonable accommodation. There are no awards for people who refuse help.

What an accommodation is

• An accommodation is a change to the way work is done, the work environment, or the way a job is structured.
• It is intended to help a qualified employee with a disability perform the essential functions of the position or access the same workplace opportunities as other employees.
• It may involve changes to scheduling, equipment, communication, the physical workspace, or how certain tasks are completed.
• The goal is to address a work-related limitation so you can perform the essential functions of your job.

What an accommodation is not

• It is not a favor.
• It is not a guarantee that you will receive the exact arrangement you request.
• It does not generally remove the essential functions of your job.
• It does not necessarily reduce your overall job duties or excuse you from performing the core responsibilities of your role.
• It is not always the exact solution your medical provider recommends.

Your medical provider and your employer have different roles in this process. Your treating professional can explain your medical limitations, how they affect you, and why a particular adjustment may help. Your employer will look at your job description and the actual requirements of the position to identify its essential functions.

Together, you and the employer may need to clarify which tasks are difficult, what limitation is creating the barrier, and whether there are changes that would help you perform the essential functions. Under the ADA, the discussion may include whether the adjustment is effective and whether providing it would create undue hardship. An employer may choose a different effective reasonable accommodation; it generally does not have to provide the employee’s preferred option if another accommodation would be effective.¹

That means “my doctor recommended this” matters. It does not automatically mean every item on the note must be approved exactly as written. Your provider may recommend limits or possible changes based on your health. Your employer must consider those limitations in the context of the essential functions of your specific job. The purpose is not to eliminate the essential functions, but to determine whether there is a reasonable way to help you meet them.

What to do if you think you need an accommodation

1. Identify the work-related barrier. Start with the task, schedule, environment, or workplace practice that is creating a problem. For example, “Standing at the counter for an entire shift increases my symptoms” gives the conversation somewhere to go.
2. Tell your employer that you need a change because of a medical condition or disability. You can make the request in ordinary language, and it does not initially have to be in writing. For example: “Because of my medical condition, I’m having trouble with this task, and I’d like to discuss an adjustment.” A written follow-up can still help keep everyone clear.¹
3. Start with the right person. You can usually begin with your supervisor, HR department, or the person your workplace designates to handle accommodation requests. Explain the work-related barrier, identify the task or condition that is difficult, and ask to discuss possible accommodations.
4. You do not have to disclose every detail to your supervisor. You generally do not need to share your entire diagnosis with your manager. Your employer may request limited, job-related medical information when the disability or need for accommodation is not obvious, but that does not mean everyone at work is entitled to your private medical history. Information obtained in connection with an accommodation generally should be kept confidential and shared only with people who need it for limited work-related reasons.
5. Ask your treating professional for useful information. Bring a specific example of what you do, when the barrier occurs, and what happens. Ask which limitations and possible changes are medically appropriate. Your provider can describe what you can and cannot do medically; your employer will evaluate that information alongside the essential functions of the job.
6. Use resources if you are not sure what to request. Visit the Job Accommodation Network at AskJAN.org. Its resources organize possibilities by disability, limitation, and work situation. JAN offers free, confidential guidance; it does not approve your employer’s accommodation or decide a legal claim.⁴
7. Keep the conversation focused on the actual problem. You do not need to arrive with the perfect solution. The goal is to identify the limitation, understand the essential job function involved, and discuss effective options.
8. Follow up after an option is offered. Ask how it will work, when it starts, and how you will review whether it helps. If it does not address the barrier, explain why and ask to revisit the discussion. Participation works both ways.

More resources for your toolbox

• The U.S. Equal Employment Opportunity Commission: Visit EEOC.gov for information about the ADA, reasonable accommodations, medical inquiries, confidentiality, retaliation, and how to file a charge if you believe your rights may have been violated.
• The Department of Labor: Visit DOL.gov for information about workplace rights, leave, wage and hour rules, and other employment protections. Depending on your situation, the Family and Medical Leave Act may provide job-protected leave for qualifying employees and medical conditions.
• Your state or local vocational rehabilitation agency: These agencies may offer employment counseling, assistive technology information, training, or other services for people with disabilities. Search online for your state’s vocational rehabilitation office.
• Your employee handbook, benefits portal, or union contract: These may explain who handles accommodation requests, how to request leave, what short-term or long-term disability benefits are available, and whether there are internal appeal or grievance procedures.
• A disability rights organization or legal aid office: Disability Rights organizations, legal aid programs, bar association referral services, and employment attorneys may be able to explain your options. Ask about cost before agreeing to representation.
• A trusted support person: If you are comfortable doing so, a family member, advocate, union representative, or trusted friend can help you prepare questions, organize documents, or remember what was discussed. Ask your employer whether another person may attend a meeting.

When using online resources, look for information from government agencies, established disability rights organizations, or recognized professional organizations. Be cautious with websites that promise a guaranteed result, ask for large upfront payments, or encourage you to exaggerate your limitations. Keep copies of anything you submit, including requests, medical forms, emails, job descriptions, and written responses.

Employees are often concerned about bringing up medical issues at work, and that concern is understandable. You may worry about being judged, treated differently, or seen as less reliable. You may also be tempted to keep pushing through until the problem affects your attendance, work quality, or performance. But trying to “white-knuckle” a medical issue at work can make the situation harder for everyone and may allow a manageable limitation to turn into a performance problem.

Employers have responsibilities under the law. Depending on the circumstances, an employer may need to engage in an interactive process, consider reasonable accommodations, protect confidential medical information, avoid discrimination and retaliation, and provide leave or other benefits when an employee qualifies. Employers do not have to provide every requested change, remove essential job functions, or create an accommodation that causes undue hardship. They do have to take a good-faith look at the situation rather than dismissing the concern, making assumptions, or punishing someone for asking about support.

You should also review and use the benefits available through your workplace. Depending on your situation, those may include health insurance, paid sick time, employee assistance programs, short-term or long-term disability benefits, leave programs, flexible scheduling, telework options, or other wellness and support resources. Benefits are part of your compensation and are there to be used when you qualify. Using them is not a personal failure, and asking for help is not a lack of commitment to your job.

There are no awards for not speaking up for yourself. Raising a concern early may help you and your employer identify a workable solution before the issue becomes more serious.

Questions to discuss with your medical provider

Before an appointment, write down the work tasks that are difficult and what happens when you try to perform them. You may want to ask:

• Which specific activities should I avoid, limit, or modify?
• How long can I sit, stand, walk, lift, bend, reach, type, concentrate, or work without a break?
• Do my symptoms vary during the day or from one day to another?
• Would a predictable schedule, flexible start time, additional breaks, remote work, reduced distractions, or a quieter workspace help medically?
• Would assistive equipment, ergonomic changes, written instructions, captioning, or another communication method help?
• Is the limitation temporary, recurring, or expected to be ongoing?
• When should the restrictions or accommodation be reviewed?
• What information can you provide about my functional limitations without disclosing unnecessary private details?
• Can you explain how the recommended change relates to my ability to perform specific work tasks?

Ask your provider to describe functional limitations and medically supported workplace changes rather than simply writing “unable to work” unless that is truly the medical conclusion. A useful note may identify the relevant limitation, the activities affected, the recommended duration, and whether the restriction is absolute or whether another arrangement may be possible. Your provider should not guess about the essential functions of your job, so bring a job description or a clear list of your duties if you have one.

You can also ask whether your provider recommends a follow-up appointment, whether symptoms should be tracked, and what warning signs require medical attention. Do not change treatment or ignore medical advice just to meet workplace expectations.

What if your manager notices or someone tells your manager that you have a medical condition?

A manager may notice that you are struggling, or someone else may tell the manager that you have a medical condition. That does not automatically give the manager every detail about your health. It also does not mean you have to begin explaining your entire medical history in the hallway.

If the manager has reason to believe that a medical condition may be affecting your work, the manager should respond appropriately and respectfully. Depending on the circumstances, that may include asking whether you need support, directing you to HR or the designated accommodation contact, and limiting the sharing of medical information to those with a legitimate need to know. The manager should not gossip, make assumptions, retaliate, or treat you differently simply because of a medical condition.

If the need for an accommodation is obvious, the employer may need to consider reasonable accommodation even if you do not use formal legal language. If the manager is unsure whether you need a workplace change, the manager can ask a limited question about whether you need assistance or should connect with HR. The employer may also begin discussing accommodation when it becomes aware of information suggesting that a medical condition may be affecting the employee’s ability to work, but the scope and timing of that discussion depend on the circumstances. It should not demand unnecessary medical details or make decisions based on stereotypes.

You can still say: “I’m dealing with a medical issue, and I would like to talk with HR about whether an accommodation may help.” That is enough to start the conversation.

From the toolbox:

• Write down the task, the limitation, and one question.
• Save links to reliable resources.
• Gather your job description and workplace policies.
• Review the benefits available to you.
• Make a short list of what you want to ask your medical provider.

Congratulations on taking this step. Asking for help is not easy, but you can do hard things. You do not have to become an accommodation expert before asking for support. You do need to help the conversation find the actual problem.

Accommodations 101 Series