Date of Verification:
DSM IV Diagnosis:
Qualifying Formulas (Multiple Testing Required)
____ UNCP aptitude-achievement discrepancy regression formula
____ 15 pt or > discrepancy between verbal/performance WA1S-R
*Major Life Activity with which this condition interferes:
___ Manual tasks ___ Walking ___ Talking ___ Seeing ___ Hearing ___ Breathing ___ Learning
___ Speaking ___ Sleeping ___ Lifting ___ Bending ___ Concentration ___ Thinking ___ Communicating
___ Reading ___ Working ___ Immunity ___ Digestion ___ Cell Growth ___ Bladder ___Neurological
__Brain Function ___ Respiratory ___ Endocrine ___ Circulation ___ Reproduction ___ Episodic Conditions
___ Reading ___ Other
____ Easily Distracted
____ Poor Concentration
___ Difficulty Focusing for Extended periods of time ___ Difficulty Formulating and executing plan of action
___ Abstract Thinking
____ Extended test time (1.5X/2X)
____ Alternate Chair/Table ___ ___ Notetaking
____ Taped text books
____ Computer/Word Processing
____ Extended Time Assign. Completion
___ Tape Recorder
___ Non-distracting test environment
___ Excessive Absences
___ Preferential Seating
___ Campus Access
University of North Carolina at Pembroke
FACULTY and STAFF ACCOMMODATION UNDER
UNCP will adhere to all applicable federal and state laws, regulations, and guidelines with respect to providing reasonable accommodations as required to afford equal employment opportunity to qualified individuals with disabilities. The University will provide reasonable accommodations to qualified individuals with disabilities who are employees or applicants for employment. The purpose of such accommodation is to allow individuals to perform the duties associated with their positions.
The purpose of this document is to describe the procedure by which disability-related accommodations can be requested by current or potential members of the faculty and staff. A brief overview of definitions is followed by description of policies and procedures.
The following definitions and explanations may help faculty and staff members and their departments in consideration of accommodation requests.
1. A qualified individual with a disability is a person who, with or without reasonable accommodation, can perform the essential functions of the employment position.
2. Reasonable accommodations are modifications that facilitate performance of the essential functions of a job by a qualified individual with a disability. Examples include, but are not limited to, making facilities accessible, adjusting work schedules, restructuring jobs, providing assistive devices or equipment, providing readers or interpreters, and modifying work sites.
3. A job function may be considered essential for any of several reasons, including but not limited to the following: (a) the reason the position exists is to perform the function, (b) there are a limited number of available employees among whom the performance of that job function can be distributed, and/or (c) the function may be highly specialized so that the incumbent in the position is hired for his or her expertise or ability to perform the particular function (e.g., teach a particular required course). Some of the factors that may be considered in determining whether a job function is essential include the amount and or percent of time spent performing the function and the consequences of not requiring an individual to perform the function.
4. Undue hardship includes any action that is excessively costly, extensive, or disruptive. Administrative units are not required to make accommodations that would impose an undue hardship on them.
POLICIES AND PROCEDURES
Many accommodation requests are simple and straightforward and have little impact on department functioning. For example, a person with back pain may request a better chair for his/her computer work station, an individual with carpal tunnel syndrome may ask for a wrist rest for his/her computer, or a faculty member with a mild hearing loss might request a volume device for the telephone. Other requests may be more complex and have more impact on the functioning of the unit. For example, a faculty member who acquired a disability might request an extension of the tenure clock, or modifications to an office or laboratory. A staff member may become disabled and require re-assignment of non-essential duties.
FORMAL PROCEDURES TO REQUEST ACCOMMODATIONS
A faculty or staff member who needs a modified work environment as the result of a temporary or permanent disability is required to arrange accommodations through the ADA Coordinator’s office. (DSS office, DF Lowry, Room 107, 910-521-6695)
FORMAL PROCEDURES TO REQUEST ACCOMMODATIONS
The formal procedures to request accommodation shall be used to resolve accommodation issues.
1. To initiate a formal request for disability accommodation, the employee should provide a written request for an accommodation to the ADA Coordinator office.
2. If disability-related documentation is considered necessary by the department, it is the responsibility of the employee to make the initial request to the health care provider(s) (e.g., medical or rehabilitation professionals) for written verification of the need for a disability accommodation. The letter to the health care provider(s) should communicate the requirements of the position as understood by both the department’s supervisor, and ask the health care provider(s) whether and how (i.e., with what accommodations) the employee can meet these responsibilities. The letter should request that the health care provider(s) reveal only such information about the disability as is necessary to answer the questions posed.
3. If the reply from the health care provider(s) does (do) not, in the opinion of the ADA Coordinator, include enough information to enable the ADA Coordinator to make an informed decision about accommodations, the ADA Coordinator may compose a follow-up letter seeking clarification and additional information.
7. Requests should not be denied or modified without prior consultation with the ADA Coordinator.
8. If the Vice Chancellor denies a request, or does not propose an accommodation that the employee regards as reasonable, the employee may file a grievance with the ADA Coordinator.
9. In the event that a request for accommodation in the form of a tenure clock extension is denied or modified, the decision may be appealed to the Chancellor through the ADA Coordinator.
10. The ADA Coordinator, the Vice Chancellor, or any University Committee, and all other involved university personnel must make every effort to keep accommodation requests and related information confidential.