# How to request an ADA accommodation in residency: a checklist Practical Guidance · Published 2026-07-16 · Resident Help **Short answer:** Make the request in writing, to the office your institution's accommodation policy names, and keep the date. Say that you are requesting an accommodation and what change you need. Take part in the interactive process, ask for a written determination listing each accommodation, who is responsible, and when it starts, and confirm it reached your program and is actually in place. The request you make in writing is the one that counts. Accommodations generally apply going forward. That makes two things matter more than anything else: asking early, and asking in writing, so the date is never in dispute. This checklist covers the process, not whether you have a disability or a claim. Those questions go to counsel. Use the checklist, then tell us where you are in the process: [start a confidential intake](https://www.residenthelp.org/intake). ## Before you ask - Find your institution's accommodation policy and the office it names. - Learn who your HR and GME contacts are. See [who to contact above your program director](https://www.residenthelp.org/blog/who-to-contact-above-your-residency-program-director). - Decide what change you need: to a schedule, a task, equipment, an exam, or the way something is customarily done. ## Making the request - Put it in writing, to the named office, and keep the date. - Say that you are requesting an accommodation, and describe the change you need. Plain language is enough. - Keep the medical detail for the documentation the office requests, not for your program. - Keep a copy outside your institutional account. ## The interactive process - Expect a conversation about what you need and what will work. Take part, and follow up in writing after each meeting. - Provide the documentation the office reasonably asks for. - Ask what will happen next, and when. ## The determination - Ask for a written determination. - Check that it lists each accommodation, who is responsible for it, and when it starts. - Ask whether it has been sent to your program. - If anything was denied, check that the denial describes what you actually asked for. If not, see [accommodation denied for something you never asked for](https://www.residenthelp.org/blog/residency-accommodation-denied-not-what-you-asked). ## After approval - Write down the first day each accommodation is actually in place. - If one is not in place, ask in writing when it will start. See [approved but not provided](https://www.residenthelp.org/blog/residency-accommodations-approved-not-provided). - If you are on a remediation plan, ask that it account for the accommodations. - Ask who has seen your accommodation file. It should be kept separate from your training file. ## One honest limit Accommodations usually work going forward. They rarely erase concerns raised before you asked, which is why asking early matters. The Job Accommodation Network offers free, confidential guidance on accommodation options. ## If this is happening to you Tell us where you are in the process and what has happened since you asked. We will review your situation confidentially and point you to the right next step: [start a confidential intake](https://www.residenthelp.org/intake). Resident Help is not a law firm, and submitting an intake does not create an attorney-client relationship. If your situation needs a lawyer, we will tell you and help you find one. ## Common questions ### How do I request an ADA accommodation in residency? Find your institution's accommodation policy and the office it names, often HR or a disability or employee accommodation office. Send a written request that says you are asking for an accommodation and what change you need. Keep a copy and the date. ### Do I have to use the words reasonable accommodation? No. EEOC guidance says a request can be made in plain language. Putting it in writing, and saying clearly that you are asking for a change at work because of a medical condition, makes the date and the request easy to prove. ### Do I have to tell my program director my diagnosis? Accommodation requests usually go through HR or a designated office, which may ask for documentation. Your program generally needs to know what the accommodation is, not your diagnosis. Ask who will see your documentation. ### When should I request an accommodation in residency? As early as possible. Accommodations generally apply going forward and rarely erase performance concerns raised before the request, so the request date matters. ## Sources - U.S. Equal Employment Opportunity Commission, Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA, https://www.eeoc.gov/laws/guidance/enforcement-guidance-reasonable-accommodation-and-undue-hardship-under-ada - Job Accommodation Network, https://askjan.org/ - Accreditation Council for Graduate Medical Education, Institutional Requirements, 2025, https://www.acgme.org/globalassets/pfassets/programrequirements/2025-reformatted-requirements/institutionalrequirements_2025_reformatted.pdf This post is general information and not legal advice. Institutional policies and board rules change, so confirm the version in force on your dates. ## Related guidance - [Residency accommodations approved but not provided: what to check](https://www.residenthelp.org/blog/residency-accommodations-approved-not-provided): Many residents do the hard part of the accommodation process. They ask, provide documentation, and receive an approval letter. Then nothing on the schedule changes. Approved is not the same as provided. - [Residency accommodation denied for something you never asked for](https://www.residenthelp.org/blog/residency-accommodation-denied-not-what-you-asked): Sometimes an accommodation denial answers a different request than the one the resident made. Correcting the record in writing, promptly, and restating the request in terms that answer the stated objection is often the most useful next step. - [Who to contact above your residency program director](https://www.residenthelp.org/blog/who-to-contact-above-your-residency-program-director): A concern raised verbally, or emailed to the wrong person, can leave no record and get no reply. Every accredited sponsoring institution has offices above the program director. Learn who they are before you need them. - [FMLA and medical leave in residency: what protects you](https://www.residenthelp.org/blog/fmla-medical-leave-residency): Residents have leave protections from three places: the federal FMLA, the ACGME's institutional leave requirements, and their specialty board's rules. They overlap but are not the same, and the gaps between them are where problems start. ## Start here - [Questions residents ask, answered](https://www.residenthelp.org/faq): Short answers to every question our guides cover, from resignation offers and appeal deadlines to accommodations and visas. - [Know your rights as a resident](https://www.residenthelp.org/rights): What your program owes you under ACGME requirements, what federal law protects, and the first 72 hours. - [Court decisions on resident dismissal and probation](https://www.residenthelp.org/cases): Published opinions every resident should know before a probation, dismissal, or forced-leave decision. - [The free Residency Record](https://www.residenthelp.org/record): The documents every resident should keep, the dates that decide non-renewal, and a private place for both. --- Source: https://www.residenthelp.org/blog/how-to-request-accommodation-in-residency Publisher: Resident Help (https://www.residenthelp.org) This website provides general information and is not legal advice. Using this site or submitting a form does not create an attorney client relationship.