Confirmation Of Request For Reasonable Accommodation (Page 3 of 4) in pdf

Confirmation Of Request For Reasonable Accommodation Page 3

DENIAL OF REASONABLE ACCOMMODATION REQUEST (Continued)

6. If you are dissatisfied with the decision to deny your request for accommodation, you

have the following appeal rights:

a. Request reconsideration from either the decision maker denying the request or the

next level supervisor above the decision maker. Your request for reconsideration

must be made within 5 business days from the date you received this form notifying

you that your request has been denied, and/or

b. Contact the Office of Civil Rights (OCR) within 45 calendar days from the date you

received this notice informing you that your request has been denied to:

 Seek redress through an agency approved informal dispute resolution process

(e.g. Alternative Dispute Resolution) and/or

 File a formal EEO complaint with OCR

c. For a collective bargaining claim, file a written grievance in accordance with the

provisions of the Collective Bargaining Agreement, or

d. Initiate an appeal to the Merit Systems Protection Board within 30 days of an

appealable adverse action as defined in 5 C.F.R. § 1201.3.

Name of Deciding Official

Signature of Deciding Official

Date Reasonable Accommodation is denied

EEOC Form 557a (2/01)

Confirmation Of Request For Reasonable Accommodation Page 3