# Work Remotely To Whom It May Concern, I am writing to request a reasonable accommodation for my patient, [NAME], who has been diagnosed with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). This condition significantly impacts their ability to perform essential job functions in a traditional office setting. **Diagnosed Medical Condition:** My patient has been diagnosed with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a chronic, multisystem disease characterized by severe fatigue, post-exertional malaise (PEM), unrefreshing sleep, cognitive impairment, and orthostatic intolerance. **Major Life Activities Affected:** ME/CFS affects several major life activities, including: - **Orthostatic Intolerance:** Difficulty remaining upright, which can lead to dizziness, lightheadedness, and fainting. - **Post-Exertional Malaise (PEM):** A significant worsening of symptoms following physical or mental exertion, often lasting for days or weeks. - **Cognitive Impairment:** Problems with memory, attention, and information processing, often referred to as "brain fog". - **Sleep Disturbances:** Unrefreshing sleep and other sleep-related issues. **Functional Limitations:** The functional limitations imposed by ME/CFS include the need to pace physical, cognitive, sensory, social, and orthostatic exertion with breaks in between activities. Without these mitigating measures, the patient would experience periodic worsening of symptoms (PEM), requiring them to call off work frequently if forced to go into the office. **Impact on Job Performance:** The patient is able to perform job duties if allowed to pace as much as possible. This involves staying home to reduce the exertion associated with travel, social exertion, and reduced ability to rest as needed in the office. If required to go into the office, the likelihood of missing work increases significantly due to the exacerbation of symptoms and the need for extended recovery periods. **Reasonable Accommodation Request:** Given the nature of ME/CFS and its impact on my patient's ability to perform essential job functions, I am requesting that [NAME] be allowed to work from home. This accommodation is necessary to manage their symptoms effectively and maintain their productivity. Working from home will enable my patient to: - Avoid the physical strain and orthostatic challenges associated with commuting and prolonged periods of being upright. - Manage their energy levels more effectively, reducing the risk of post-exertional malaise. - Create a controlled environment that minimizes cognitive overload and allows for necessary rest periods. According to the American Academy of Psychiatry and the Law, reasonable accommodations under the ADA/ADAAA include modifications to the work environment or work schedule that enable an individual with a disability to perform essential job functions. Allowing my patient to work from home is a reasonable accommodation that will not impose an undue hardship on the employer and will enable my patient to continue contributing effectively to their role. Thank you for your consideration of this request. Please feel free to contact me if you require any further information. Sincerely, Katelynn Brown, MD