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DISABILITY QUESTIONNAIRE(EMPLOYMENT CASES)Pa lm Bea ch Co unty Office of Eq ua l Op po rtunity th 301 North Olive Avenue, 10 Floor West Palm Beach, FL 33401 Telephone: (561) 3554883 / FAX: (561) 3554932
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How to fill out disability questionnaire employment cases

01
Read all instructions carefully before starting.
02
Gather all relevant medical documents and information.
03
Complete personal information section accurately.
04
Detail your disability and how it affects your ability to work.
05
Provide specific examples of your limitations and challenges.
06
Fill out employment history accurately, including accommodations you've needed.
07
Review your answers for clarity and completeness.
08
Sign and date the questionnaire before submission.

Who needs disability questionnaire employment cases?

01
Individuals applying for disability benefits.
02
Employees seeking accommodations at work due to disabilities.
03
Job seekers with disabilities who need to disclose their condition.
04
Employers who need to understand the impact of an employee's disability.
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A disability questionnaire in employment cases is a form used to gather information about an employee's medical condition and the impact it has on their ability to perform work-related tasks.
Employees applying for disability benefits or accommodations related to their employment are typically required to file a disability questionnaire.
To fill out a disability questionnaire, individuals typically need to provide personal information, details about their medical condition, how it affects their work, and any reasonable accommodations they are seeking.
The purpose of the disability questionnaire is to assess an employee's eligibility for disability benefits and to assist employers in determining appropriate accommodations.
The questionnaire must report personal identification information, medical history, specific disabilities, the nature of any limitations, and any prior accommodations sought or received.
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