Government Employee Reasonable Accommodation Request
Category: Employment and Social Security
Updated:
Editable request describing a disability-related workplace barrier, practical accommodation options and the response sought from a government establishment.
Government Employee Reasonable Accommodation Request For an employee of a Government establishment seeking assessment of reasonable accommodation under the RPwD framework. Private-sector and education contexts need their own applicable assessment. Date: [date] To The Competent Officer or Grievance Redressal Officer [Government establishment and office] Employee name, designation and safe contact: [enter details] Work location and duties affected: [enter details] Barrier experienced in the work environment: [describe functional impact] Accommodation requested and proposed start or review date: [enter details] Sir or Madam I request consideration of the reasonable accommodation described below so that I can perform the relevant duties on an equal basis. I have identified the functional barrier and proposed practical options.
I am available to discuss workable arrangements and any limited supporting material genuinely needed to assess this request. 1. Barrier and duties affected: [provide specific examples]. 2. Proposed modification, assistive support or accessible arrangement: [enter details]. 3. Alternative options and a suitable review date: [enter details]. 4. Please provide a written response and identify the officer handling the request. Enclosures Relevant supporting material necessary for assessment Any earlier request or response Avoid unrelated medical history and limit disclosure to the purpose Signature: ____________________ Name: [name] Place: [place] How to use this template This page is guidance for the person preparing the document. Remove it from the submission copy after adapting the draft. Do not send unfilled placeholders or invented facts.
RPwD Act section 20 specifically addresses non-discrimination and reasonable accommodation in Government employment; assess the full applicable framework. Describe the barrier and practical solution rather than assuming a particular diagnosis automatically requires one fixed arrangement. Use a confidential official channel and ask how supporting medical or disability information will be handled. The request is an editable aid, not a determination of the employer obligations or an automatic approval. This is an original LawSphereX editable aid based on the references below. It is not a government-issued form, certification, legal opinion or promise that a request will be accepted. Where an authority prescribes a form, use that current form. Official references India Code Rights of Persons with Disabilities Act https://www. indiacode. nic.
in/bitstream/123456789/9320/1/disabilitiesacta2016-49. pdf Department of Empowerment of Persons with Disabilities Acts and Rules https://depwd. gov. in/en/acts/ Sources checked on 6 November 2026. Recheck the current authority requirements before submission or reliance.