How to Fill Out and Submit the Sedgwick Accommodation Request Form

If your employer uses Sedgwick as its third-party administrator, you submit a Sedgwick accommodation request form through the mySedgwick portal rather than negotiating directly with HR. The request has three working parts: your identifying and job information, a clear description of the workplace change you need, and a healthcare provider statement documenting your functional limitations. Get those three right and the file moves. Leave any of them vague and it comes back for clarification.

The process runs on the Americans with Disabilities Act, which requires covered employers to provide reasonable accommodations to qualified employees with disabilities unless doing so would create an undue hardship.¹ Sedgwick administers that duty on the employer’s behalf, so exact portal branding and contact numbers differ by company, but the substantive fields are the same everywhere.

What to Have Ready Before You Open the Form

Pull these together first so the request routes correctly on the first pass:

Your company-issued employee ID.
Your direct supervisor’s name, title, and email.
A copy or summary of your job description, including physical demands such as lifting, standing time, or travel.
Any existing Sedgwick claim number, such as an open short-term disability or workers’ compensation claim, so the administrator can connect the files.

The single most important piece of preparation is not a document. It is a clear list of your functional limitations. “I have a herniated disc” gives the case manager nothing to act on. “I cannot sit for more than 30 minutes without pain and cannot lift more than ten pounds” tells them exactly which workplace barriers to address. Walk through a typical workday and note every task your condition makes difficult or impossible. That specificity is what drives the rest of the process.

Where to Find the Form

Most employers direct workers to login.mysedgwick.com and issue login credentials through HR or the benefits department. Some companies instead route the accommodation request through their own intranet or an internal HR portal that connects to Sedgwick behind the scenes. If you cannot find the entry point, call Sedgwick’s accommodation service center. The specific phone number, hours, and fax number are set by your employer, so check your employee handbook or benefits materials rather than assuming a general contact line.

Once you are logged in, choose the option to open a new accommodation request. Fax and email submission is available under most employer setups if you cannot use the portal. Paper submissions by mail are slower and less common.

Filling Out the Request Fields

After the identification fields, the form moves to its substantive sections. The central field is usually labeled something like “Requested Accommodation.” Be concrete. “An ergonomic keyboard and a sit-stand desk converter” or “a modified schedule starting at 10 a.m. to accommodate morning medical treatments” is far more useful than “help with my workstation.”

A separate field asks how long you expect to need the accommodation. If your condition is temporary, give a specific recovery timeline. If it is permanent, say so. Leaving duration blank or vague is one of the most common reasons forms get sent back.

You do not have to identify the perfect accommodation on your own. Under EEOC guidance, you only need to describe the problems your condition creates at work; your employer and Sedgwick are then responsible for working with you to find an effective solution.² Having a specific request ready still tends to speed things up.

To qualify for any accommodation, you must be able to perform the essential functions of your job with or without it. Essential functions are the fundamental duties of the position. An employer does not have to accommodate tasks that are not essential.³

The Healthcare Provider Statement

Nearly every Sedgwick accommodation request requires a Healthcare Provider Statement, sometimes called a medical certification. Your doctor completes it and it has to cover three things: the diagnosis, the expected duration of the impairment, and the specific physical or cognitive restrictions that affect your job duties.

Vague notes sink requests. “Patient has back problems and needs accommodation” is not enough. Ask your provider to use precise, measurable language: “Patient cannot stand for more than 15 consecutive minutes,” “Patient requires a 10-minute rest break every two hours,” or “Patient cannot lift more than five pounds overhead.” That level of detail lets Sedgwick match your restrictions against the physical demands of your job.

It is your responsibility to get the form to your doctor and make sure it comes back on time. Give the provider a copy of your job description if you can, so they understand which duties they are writing about. If the medical documentation comes in incomplete, Sedgwick or your employer may ask you for more information before contacting the provider directly. Under the ADA, an employer can reach out to your healthcare provider for clarification, but only with your written consent and only about functional limitations relevant to your job.

Some physicians charge an administrative fee for completing workplace forms. Fees vary and are generally the employee’s responsibility, so ask the office before you schedule the appointment.

Submitting and What Happens Next

After every field is complete and the healthcare provider statement is attached, submit through the mySedgwick portal. Keep copies of everything and note the submission date.

A designated case manager then reviews the file to confirm all pieces are present. If anything is missing, they will contact you. There is no federal deadline for how quickly your employer must respond, but EEOC guidance states the response should be “expeditious” and that unnecessary delays can themselves violate the ADA.² If weeks pass without word, follow up with your case manager through the portal or by phone.

The Interactive Process

Submitting the form starts what the EEOC calls the interactive process, an informal conversation between you, your employer, and Sedgwick to identify an effective accommodation. In clear cases there may be little discussion. In more complex ones, your employer may ask about your limitations, suggest alternatives, or ask for additional medical input.²

This is where most requests actually get shaped. Respond promptly to the case manager’s messages and keep a written record of every conversation.

One point that catches people off guard: your employer does not have to provide the specific accommodation you asked for. If two or more options would effectively address your limitations, the employer can choose the less expensive or less burdensome one.² It has to be effective, meaning it actually lets you perform the essential functions of your job, but effective is not the same as preferred. If you ask for a private office and your employer offers noise-canceling headphones plus a white-noise machine that solves the same concentration problem, that alternative can satisfy the law. Describing your functional limitation clearly on the form, rather than fixating on one solution, tends to open up more workable options.

If Your Request Is Denied

An employer can legally deny an accommodation if it would cause an undue hardship, defined by the ADA as significant difficulty or expense.¹ The determination has to be individualized, weighing the cost of the accommodation, the employer’s overall resources, the size and structure of the business, and the operational impact. Coworkers complaining about “special treatment” does not count.

Ask for any denial in writing with specific reasons. Some employers have a formal internal appeal, often submitted to HR or an accommodation appeals committee; check your handbook. If no formal process exists, you can request reconsideration in writing to your manager and HR.

If internal channels do not resolve it, you can file a charge of disability discrimination with the EEOC. The deadline is 180 calendar days from the date the discrimination occurred, extended to 300 days if a state or local agency enforces a similar law. Weekends and holidays count, though if the deadline falls on one, you have until the next business day. Filing an internal grievance does not pause the EEOC clock, so do not wait for the company process to finish if your filing deadline is approaching.⁴ Federal employees follow a separate process and must contact their agency’s EEO counselor within 45 days.

Confidentiality of the Medical Information You Submit

Everything medical you submit through the accommodation process is a confidential medical record under the ADA. Your employer must store it separately from your general personnel file, and access is limited to authorized personnel with a legitimate business need, such as designated HR staff. The rule applies to both paper and electronic records.

If You Are Also on FMLA Leave

If you are returning from FMLA leave, or currently on leave for a serious health condition, you may also be entitled to an ADA accommodation. The two laws run on separate tracks, and complying with one does not automatically satisfy the other. An employee who has exhausted all 12 weeks of FMLA leave may still be entitled to additional unpaid leave as a reasonable accommodation, and the fact that the leave exceeds 12 weeks is not on its own enough to prove undue hardship. Starting the Sedgwick accommodation request while you are still on leave, rather than waiting until your first day back, gives everyone more time to work out a solution before you return.

1
Office of the Law Revision Counsel. 42 USC 12112 – Discrimination
2
U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA
3
U.S. Equal Employment Opportunity Commission. The ADA – Your Employment Rights as an Individual With a Disability
4
U.S. Equal Employment Opportunity Commission. Time Limits For Filing A Charge