Checklist: Disability Evaluations

The following checklist was developed by David K. Fram, Director of EEO and ADA Training, National Employment Law Institute. It provides the most important questions to ask and information to be gathered when an allegation of disability discrimination arises.

Does the individual have an impairment? Yes No

If yes, what is the impairment?

Discuss evidence of the impairment.

Is a major life activity affected by the impairment? Yes No

If yes, what is the major life activity?

Walking

Speaking

Breathing

Hearing

Seeing

Thinking

Sitting

Standing

Reaching

Interacting with Others

Learning

Performing Manual Tasks

Caring for Oneself

Concentrating

Lifting

Sleeping

Working

Other (Describe)

Does the impairment substantially limit the major life activity? Yes No

Discuss how the individual is substantially limited in the major life activity identified above. If the major life activity is "working," identify the class of jobs or broad range of jobs that the individual cannot perform because of the impairment.

If yes:

Does the individual have a record of impairment? Yes No

If yes, what is the impairment?

Discuss evidence of the impairment.

Was a major life activity affected by the impairment? Yes No

If yes, what was the major life activity?

Walking

Speaking

Breathing

Hearing

Seeing

Thinking

Sitting

Standing

Reaching

Interacting with Others

Learning

Performing Manual Tasks

Caring for Oneself

Concentrating

Lifting

Sleeping

Working

Other (Describe)

Did the impairment substantially limit the major life activity? Yes No

Discuss how the individual is substantially limited in the major life activity identified above. If the major life activity is "working," identify the class of jobs or broad range of jobs that the individual cannot perform because of the impairment.

If yes:

Does the individual claim to be "regarded as" having an impairment? Yes No

If yes, what is the impairment? ------------

Does the person claim to be "regarding as" affected in a major life activity because of the impairment? Yes No

If yes, what was the major life activity?

Walking

Speaking

Breathing

Hearing

Seeing

Thinking

Sitting

Standing

Reaching

Interacting with Others

Learning

Performing Manual Tasks

Caring for Oneself

Concentrating

Lifting

Sleeping

Working

Other (Describe)

Does the individual claim to be "regarded as" substantially limited in the major life activity? Yes No

Discuss why the individual claims to be "regarded as" "substantially limited" in the major life activity identified above. If the major life activity is "working," identify the class of jobs or broad range of jobs that the individual cannot perform because of the impairment.