Policy DE006: ADA/504 Requesting a Reasonable Accommodation
Recommended for Approval by:

Amy E. Salsgiver
Amy E. Salsgiver, Executive Director of Equity and Title IX

Approved by:
Dr. Dale-Elizabeth Pehrsson, President
Effective Date: 2/10/2023

A. Intent

In accordance with the Americans with Disabilities Act of 1990 (“ADA”), the Pennsylvania
Human Relations Act, and Pennsylvania Western University policies and practices,
Pennsylvania Western University is prohibited from discriminating in employment against
qualified individuals with disabilities on the basis of disability. It is the policy of
Pennsylvania Western University of Pennsylvania to provide reasonable accommodations in
compliance with federal and state law.
B. Definition(s)
1. A Reasonable Accommodation is a modification or adjustment to a job, the work
environment, or the way things are usually done that enables a qualified individual with a
disability to enjoy an equal employment opportunity.
2. An Equal Employment Opportunity means an opportunity to attain the same level of
performance or to enjoy equal benefits and privileges of employment as are available to an
average similarly-situated employee without a disability.
C. Policy
The ADA requires reasonable accommodation to ensure equal opportunity in the application process,
to enable a qualified individual with a disability to perform the essential functions of a job, and to
enable an employee with a disability to enjoy equal benefits and privileges of employment.

It is the responsibility of individual applicants and employees to disclose a disability or
medical condition and request an accommodation. It is also the responsibility of individual
employees to provide documentation of their disability (from an appropriately licensed
professional) and to demonstrate how the disability limits their ability to complete the

essential functions of their job. Medical documentation will be kept confidential and in a file
separate from the employee’s personnel file.
D. Procedure(s)
To request an accommodation, please refer to the attached form. Questions about completing the
form should be directed to the Office of Equity and Title IX, asalsgiver@pennwest.edu, 423 Becht Hall
Clarion Campus, 814-393-2109.
Once a completed request for an accommodation is received, the University engages in an interactive
process with an employee and their supervisor to identify the most appropriate accommodation(s) in a
given situation. Accommodations are made on a case by case basis, taking into account the type and
severity of the disability and the specific job requirements involved.
If the employee disagrees with the accommodation selected or has been denied an accommodation to
which the employee believes they are entitled under federal or state law, the employee may appeal the
decision to the Office of Human Resources, Dixon Hall, 250 University Avenue, California Campus,
within 10 working days of the date of the decision.
E. Related policies
DE002: Non-Discrimination Policy and Procedures
F. Contact Information
Amy Salsgiver – Executive Director of Equity and Title IX
Email: asalsgiver@pennwest.edu
Phone: 814-393-2109
Address: 423 Becht Hall, Clarion, PA
G. Policy Review Schedule
Reviewed every two years or as needed.

Appendix A – Reasonable Accommodation Request Form, Release of Medical Information Statement,
Medical Certification Form