Privacy Issues in the Community College Workplace

A PPENDIX Q

R EQUEST FOR D OCTOR TO P ROVIDE F ITNESS FOR D UTY E XAM

Re: Request for Fitness-For-Duty Assessment

Dear Dr. [to come]:

Pursuant to the Americans With Disabilities Act- ADA (42 U.S.C. §§ 12101, et seq.) and the Fair Employment and Housing Act - FEHA (Government Code § 12940), the [employer] requests you to examine whether [employee] is fit for duty as a [job classification] for [employer]. The [employer] has a duty to accommodate employees who are disabled within the meaning of the ADA and FEHA and who can perform the essential job duties of their positions with or without reasonable accommodation. The purpose of this letter is to request you to assist the [employer] in determining whether [employee] is disabled. Enclosed is the job description for the [job title] classification. Please make your assessment based upon the job duties listed in the job description and pursuant to the ADA and FEHA requirements. To that end, please respond only to the following questions. The [employer] seeks only information regarding [employee's] functional limitations, if any, that may entitle [him or her] to leave from work or that may limit [his or her] fitness to perform [his or her] present employment. Do not provide any information regarding medical cause or medical history. Your discussion should be limited to the employee’s limitations or need for accommodations, if any, that you may identify. 1. Does [employee] have a [mental impairment or physical impairment] that limits [his or her] ability to engage in a major life activity, such as the ability to work, care for [himself or herself], perform manual tasks, walk, see, hear, eat, sleep, or engage in social activities? A condition can be said to "limit" one, under the FEHA amendments that went into effect on January 1, 2001, if the condition makes the achievement of the major life activity more difficult. 2. If the answer to question number one is yes, does the impairment currently affect [employee]'s ability to perform the essential functions of [job title] as described in the attached job description? 3. If the answer to question number two is yes, is there an accommodation(s) that can be made that would enable [employee] to perform his essential job functions? Please identify the accommodation(s). 4. Does [employee's] continued assignment to the job of [job title] pose a significant current risk of substantial harm to the health and safety of the employee or others?

Privacy Issues in the Community College Workplace ©2019 (c) Liebert Cassidy Whitmore 231