ADA Accommodation Requests

Flexible Schedule for Therapy

A fully-written letter you can copy or download. Below the letter we explain why it is written the way it is, the mistakes most people make, and the legal authorities the language invokes.

The letter

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To: HR at [Employer Name]
From: [Your Full Name]
Date: [Today's Date]
Subject: Request for a Flexible Schedule as a Reasonable Accommodation

Dear [HR Contact Name],

I am writing to request a flexible schedule as a reasonable accommodation under the Americans with Disabilities Act. I can perform all the essential functions of my job as [Your Job Title]. I am not requesting leave. I am asking for a schedule modification to protect a recurring clinical appointment. Please consider this a request to begin the interactive process.

I have a standing therapy appointment on [Day of Week] from [Start Time] to [End Time]. Missing or rescheduling on short notice is not clinically advisable and would disrupt the continuity of care.

The accommodations I am asking for are:

1. Permission to leave for, attend, and return from the standing appointment each week, with any time off the clock made up earlier or later the same day, or during the rest of the workweek.
2. Excluding the standing appointment window from routine internal meeting scheduling. If a one-time urgent meeting must fall in that window, I will join remotely where possible, or reschedule the appointment with my clinician's prior agreement.
3. Written confirmation that using this accommodation will not count against attendance, punctuality, or reliability in any performance review.

This is not a request for FMLA leave and does not require me to use PTO.

I am happy to provide a letter from my clinician describing the medical need for consistent appointment timing.

I understand you can choose among accommodations that work. If a different structure produces the same outcome (one consistent, uninterrupted weekly appointment), I am open to discussing it.

Please confirm receipt and propose a meeting within ten business days.

Thank you,

[Your Full Name]
[Your Work Email]
[Your Phone Number]

Replace every bracketed prompt with your own information before sending. Everything in brackets is for you. Everything outside brackets is the letter.

Before you send this

Many employers do not handle FMLA paperwork themselves. They hand it off to a third-party administrator, usually called a TPA. A TPA is a leave-management vendor, like Sedgwick, Unum, Lincoln, or The Hartford, that your employer pays to process claims. TPAs have an incentive to close claims quickly, and they use a predictable set of tactics to push employees into giving up more than the law actually requires. Watch for these:

Blanket HIPAA authorization forms. These are not required for FMLA. The WH-380-E certification is. A broad HIPAA release can pull therapy notes, substance use records, and unrelated medical history into a corporate vendor's database.
Demands for records beyond the WH-380-E. The law limits what your employer or its TPA can require to what is necessary to determine FMLA eligibility. You are not obligated to provide a full chart.
Artificial delays that trip deadlines. If the TPA says your certification is incomplete, they must tell you in writing exactly what is missing and give you seven calendar days to fix it. Silence is not a legal denial.
Direct calls to your healthcare provider. TPA claim examiners cannot call your provider for general information. Contact for clarification must be routed through a healthcare professional designated by the employer.
Pressure to use an Employee Assistance Program (EAP) instead of accommodations. An EAP is a short-term counseling benefit your employer funds, usually limited to three to eight sessions. An EAP referral is not a response to an ADA accommodation request, and engaging with the EAP can muddy your record.

Watch out for the sign-up process. HR typically sends you to a TPA website to register and "start your claim." Those sign-up flows are where most of the traps live: pre-checked HIPAA authorization boxes, fields asking you to enter your diagnosis, current medications, symptoms, or the contact information for your treating providers. None of that is required to open an FMLA claim. Fill in only the administrative fields (name, employee ID, employer, dates) and leave clinical fields blank.

If the portal will not let you proceed without medical entries, or if anything about the process feels coercive, raise the concern in writing. A short email to HR and the TPA is enough: say that the portal appears to be asking for information that goes beyond what the FMLA certification requires, that you understand the employer's information rights are limited to what is necessary to determine FMLA eligibility, and that you would like to submit your certification through an alternative channel (email or fax to the TPA directly, with your provider sending the completed WH-380-E to that address). Wait for a written response. Only use the alternative if HR or the TPA agrees. Putting the concern in writing either gets you the alternative or creates a paper trail that protects you if the claim is later denied or delayed.

If any of this is happening, read Protecting Your Medical Records, FMLA and HIPAA Privacy Rights, or use the letter that limits records release to a TPA. If you need to talk to someone free of charge, see our list of free legal helplines and crisis lines.

Before you edit it

Keep these lines.

Change the tone, the names, and the details to fit your situation. These particular sentences are doing the legal work, and the letter gets weaker without them.

I am not requesting leave. I am asking for a schedule modification to protect a recurring clinical appointment.
Load-bearing. A modified schedule is a listed form of reasonable accommodation under 42 U.S.C. 12111(9)(B). Framing this as leave invites the employer to charge the time against FMLA entitlement or PTO when neither is necessary.
I can perform all the essential functions of my job as [Your Job Title].
The qualified-individual anchor. Keep it, and keep it near the top.
Written confirmation that using this accommodation will not count against attendance, punctuality, or reliability in any performance review.
This is the sentence that protects you a year from now. Accommodations that are formally granted and then quietly counted against you in a review are the most common way this goes wrong, and it is very hard to prove after the fact without something in writing.
If a different structure produces the same outcome (one consistent, uninterrupted weekly appointment), I am open to discussing it.
Names the outcome rather than the mechanism. It gives the employer room to solve the problem its own way, which makes agreement more likely and refusal harder to justify.

When to use this letter

You are in ongoing therapy and need your weekly appointment time protected. You do not need leave. You need schedule flexibility so a standing appointment can happen without your job being at risk every week.

Therapy works best with a consistent provider and a consistent appointment time. Rescheduling on short notice is often clinically problematic. This letter reframes that as a concrete schedule accommodation your employer can either approve or counter-propose.

Many people default to using PTO or burning intermittent FMLA on therapy appointments. That works, but it depletes a finite resource. A flexible schedule as an ADA accommodation is a better structural fix because it does not consume leave.

How to send it

Email to HR with your supervisor copied only if your workplace routes scheduling through them. Save a dated copy. If the appointment time is already on your calendar, leave it there.

Why the letter is written this way

Each paragraph is doing specific legal work.

01
Why distinguish this from FMLA leave
If this request is processed as intermittent FMLA instead of an accommodation, it consumes your 12-week allotment. Saying plainly 'I am not requesting leave' pushes HR to route it to the ADA track, where it costs you nothing.
02
Why emphasize clinical continuity
Generic 'therapy appointment' requests often get rescheduled. Explaining that clinical continuity is part of the treatment plan shifts the employer's decision frame from 'a preference' to 'a medical necessity.' Most HR departments will approve once the clinical reasoning is clear.
03
Why ask for written exclusion of the window from meeting scheduling
Without this, your team will routinely book over your appointment and you will have to decline. Declining a meeting to attend a medical appointment can quietly affect performance reviews. Getting the window formally excluded solves this structurally.
04
Why ask for confirmation that the accommodation will not affect ratings
Attendance, punctuality, and 'being a team player' are common informal criteria that can be used to downgrade a performance review for an accommodated employee. A written confirmation neutralizes this.
05
Why cite § 1630.2(o)(2)(ii) specifically
This provision explicitly identifies 'modified work schedules' as a reasonable accommodation. Citing it directly signals that you have read the regulation and forestalls an argument that schedule changes are not 'real' accommodations.

Don't do this

The mistakes that undo the letter.

01Describing the content of therapy in the letter (specific modalities, what you discuss). The employer has no right to know what happens in the appointment.
02Asking for 'flexibility in general.' Without a specific window, the employer has nothing to protect and no way to administer the accommodation.
03Using PTO for therapy when you could use an ADA accommodation. Once PTO is gone, so is your buffer for vacation, illness, and family needs.
04Submitting the request to your supervisor without a copy to HR. Supervisors often grant informal flexibility that evaporates when a new supervisor arrives.
05Not preserving the response. If approval comes by email, save it. If it comes verbally, follow up with a written confirmation within 24 hours.

What happens next

The replies you should expect.

Approved informally, with nothing in writing: Send a short confirming email summarizing what was agreed and asking them to correct anything you got wrong. An unanswered summary email is far better evidence than a remembered conversation.
You are told to use PTO for the appointments: Push back in writing. A schedule adjustment where you make up the time is not leave, and requiring you to spend paid time off on an accommodation is worth naming as a question rather than accepting silently.
Meetings keep getting scheduled in the protected window: Document each instance with dates. A granted accommodation that is routinely overridden is functionally a denial, and the pattern is the evidence.
You are asked for proof of every appointment: Ongoing attendance proof is not typically part of the accommodation. Offer a single letter from your clinician confirming the standing appointment and its clinical necessity instead of a running log.

Legal authorities cited

The language invokes real regulations.

42 U.S.C. § 12112: ADA Title I discrimination prohibition
29 C.F.R. § 1630.2(o)(2)(ii): Modified work schedule as reasonable accommodation
29 C.F.R. § 1630.2(o)(3): Interactive process
29 C.F.R. § 1630.9: Effective accommodations
29 C.F.R. § 1630.14(c): Medical documentation
EEOC Enforcement Guidance No. 915.002: Reasonable accommodation guidance

Keep reading

Where to go next.

LeaveRights is a free educational tool and does not provide legal advice. No data is collected or stored. Information provided is for general guidance only. Consult a qualified employment attorney for advice specific to your situation.

Keep these lines.

Each paragraph is doing specific legal work.

Why distinguish this from FMLA leave

Why emphasize clinical continuity

Why ask for written exclusion of the window from meeting scheduling

Why ask for confirmation that the accommodation will not affect ratings

Why cite § 1630.2(o)(2)(ii) specifically

The mistakes that undo the letter.

The replies you should expect.

The language invokes real regulations.

Where to go next.