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Medical Opinions for Federal Disability Accommodations

Informational overview of a limited, case-by-case service.

This page provides general information about medical opinions used in support of federal disability accommodation requests. It is intended for veterans who already have service-connected medical conditions and who have been asked by a federal agency to submit medical documentation addressing functional limitations and accommodation needs. 

This service is not related to VA disability ratings, compensation claims, or appeals.

Federal Disability Accommodations Intake

When These Medical Opinions Are requested

Veterans employed by, or applying to, federal agencies are sometimes required to provide medical documentation to support a reasonable accommodation request. Agencies may ask for clarification regarding: 


  • The existence of a medical condition
  • Functional imitations related to essential job duties
  • Whether a requested accommodation is medically reasonable


In many cases, treating clinicians are unable or unwilling to provide this type of documentation, particularly when occupational or functional analysis is required.

The Role of Occupational Medicine

Physicians trained in occupational and environmental medicine focus on the intersection of health and work. This includes evaluating how medical conditions may affect functional capacity, work activities, and symptom management in occupational settings.


Medical opinions in this context typically address:


  • Functional impact of a medical condition
  • Work-related limitations from a medical standpoint
  • Medical rationale for why certain accommodations may reduce symptom exacerbation


These opinions are medical in nature and are not determinations of employment eligibility or legal entitlement.

Scope of the Medical Opinion

When offered, these medical opinions are limited to:


  • Review of relevant medical records and history
  • Evaluation of reported functional limitations
  • Medical reasoning regarding accommodation requests


They do NOT include:


  • Fitness-for-duty evaluations
  • Employment clearance or disqualification decisions
  • Legal determinations under the ADA or Rehabilitation Act
  • Advocacy or guarantees regarding agency decisions


Final accommodation determinations are made solely by the requesting agency.


Eligibility and Case Selection

This specialty nexus letter service is provided on a case-by-case basis and only in select circumstances.


In general, inquiries must meet the following criteria:


  • The condition is already service-connected
  • A federal agency has specifically requested medical documentation
  • The request is focused on functional limitations or accommodations, not disability ratings


Not all requests are appropriate for this type of medical opinion.

Medical Review Modality

Medical opinions are based on a review of available records (e.g. Functional Capacity Evaluation), written documentation, and other materials provided by the Veteran. In some cases, a telehealth consultation may be conducted if clinically appropriate; in those cases, the Veteran must be physically located within the state of Washington. The method of review is determined on a case-by-case basis based on the nature of the request.

Important Clarification

This specialty nexus letter service:

  • Is not a substitute for ongoing clinical care
  • Is not an expert witness service
  • Does not guarantee approval of any accommodation request


The medical opinion in this specialty nexus letter reflects clinical judgment based on available information at the time of review.

Inquiries

Veterans who have been asked by a federal agency to submit medical documentation for an accommodation request may complete our Federal Disability Accommodations Intake Form. The information will be reviewed by our licensed MD physician and occupational medicine specialist to determine whether their case is appropriate for review.

Federal Disability Accommodation Intake

Medical opinions are provided independently and in accordance with professional medical standards. Services are limited in scope and offered selectively.


Accommodation opinions are medical assessments of functional limitations and do not constitute treatment, employment determinations, or legal advice. 


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