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GR 33 Request for Reasonable Accommodation

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Plaintiff's First Set of Interrogatories and Notice of Service of Discovery

Name of Petitioner/Plaintiff

Address of Petitioner/Plaintiff

City, State, Zip

Phone

IN THE SUPERIOR COURT FOR

COUNTY, STATE OF WASHINGTON

,Petitioner/Plaintiff

Vs.

,Respondent/Defendant

PLAINTIFF'S FIRST SET OF INTERROGATORIES PROPOUNDED TO THE DEFENDANT WITH REQUEST FOR PRODUCTION

CASE NO.

COMES NOW ("Plaintiff") and propounds the following interrogatories to ("Defendant") pursuant to Washington Rules, and other applicable provisions of said Rules, and gives notice that each and every interrogatory or section thereof is to be answered separately, in writing, under oath of the aforesaid Defendant within the legal number of days of the date of service hereof, and further gives notice that these interrogatories and request for production of documents and things are deemed to be continuing, and, that if different or additional information is received by Defendant after answers hereto are submitted and filed, same is to be provided to this Plaintiff in writing. Production requests are also made pursuant to the rules of Washington. Plaintiff requests that Production of documents be made on the same date as the date Answers to Interrogatories are due and shall be made to Plaintiff at the following address:

INTERROGATORY NO. 1

State your full name, social security number, date of birth, residence address, and telephone number.

INTERROGATORY NO. 2

INTERROGATORY NO. 4

State your total income to date since , and attach to your answers copies of your last five paycheck stubs.

INTERROGATORY NO. 5

INTERROGATORY NO. 6

INTERROGATORY NO. 7

INTERROGATORY NO. 8

INTERROGATORY NO. 9

INTERROGATORY NO. 10

INTERROGATORY NO. 11

INTERROGATORY NO. 12

INTERROGATORY NO. 13

INTERROGATORY NO. 14

INTERROGATORY NO. 15

INTERROGATORY NO. 16

INTERROGATORY NO. 17

INTERROGATORY NO. 18

INTERROGATORY NO. 19

INTERROGATORY NO. 20

INTERROGATORY NO. 21

INTERROGATORY NO. 22

INTERROGATORY NO. 23

INTERROGATORY NO. 24

INTERROGATORY NO. 25

INTERROGATORY NO. 26

INTERROGATORY NO. 27

Have you read the answers to each and every one of the above interrogatories and requests for production of documents and things, and do you state that the answers thereto are true, complete, responsive and correct?

INTERROGATORY NO. 28

If, at any time between this date and the date of the trial of this cause, you come into possession of information which would properly have to be disclosed, will you disclose such newly discovered information to Plaintiff within fifteen days or prior to trial, whichever is first?

Respectfully submitted,

Signature of Plaintiff

NAME:

CERTIFICATE OF SERVICE

I, the undersigned, , Plaintiff, do hereby certify that I have this day mailed, by United States mail, postage prepaid, a true and correct copy of the above and foregoing Plaintiff's First Set of Interrogatories to Defendant at:

Name of Defendant

Address

DATED, this the day of

, 20

Signature

Signature of Plaintiff

Notice of Service of Discovery

TO: All Counsel of Record:

Notice is hereby given that Plaintiffs have this date served in the above entitled action:

PLAINTIFF'S FIRST SET OF INTERROGATORIES PROPOUNDED TO THE DEFENDANT WITH REQUEST FOR PRODUCTION

The undersigned retains the originals of the above papers as custodian thereof pursuant to Court Rules.

DATED:

Respectfully Submitted,

By:

Signature of Plaintiff

Certificate of Service

I, , Plaintiff in the above referenced civil action, do hereby certify that I have this day caused to be delivered, via United States Postal Service, first class postage prepaid, a true and correct copy of the above and foregoing document to:

Defendants Name

Address

THIS the day of , 20.

Signature

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What the GR 33 Request for Reasonable Accommodation is

The GR 33 Request for Reasonable Accommodation is a written request used by employees, applicants, students, or service recipients to ask an employer or covered entity to modify policies, provide equipment, or adjust workplace conditions because of a disability. The form documents the accommodation sought, supporting facts and medical information where required, and creates a record for the interactive process under federal disability law such as the Americans with Disabilities Act (42 U.S.C. §12101 et seq.) and Section 504 of the Rehabilitation Act. The form may be adapted for agency or institutional procedures while preserving core elements: requester identity, functional limitations, and the accommodation requested.

Why documenting accommodation requests matters

A clear GR 33 request creates a durable record to support the interactive process, helps employers evaluate reasonable options, and reduces dispute risk by documenting dates, proposed solutions, and supporting evidence under ADA and Section 504.

Why documenting accommodation requests matters

Who typically completes and reviews this form

Several roles interact with a GR 33 request from submission through resolution.

  • Employees and applicants: Individuals with disabilities or their representatives who need workplace or academic adjustments.
  • HR and disability coordinators: Human resources, benefits, or disability services staff who assess requests and coordinate solutions.
  • Supervisors and managers: Operational reviewers who provide job-essential information and implement practical accommodations.

Clear role separation and timely communication among these parties support a lawful and effective accommodation process.

Key sections every professional GR 33 should include

A well-structured GR 33 captures requester data, the specific limitation, the accommodation sought, supporting documentation, an interactive-process log, and a decision or implementation plan.

Requester Info

Full legal name, job title or program, employer or institution name, contact information, and preferred method for follow-up and notices.

Nature of Disability

Concise description of the functional limitation(s) that affect essential duties or access; avoid unnecessary medical detail while explaining the limitation.

Accommodation Requested

Specific accommodations requested (equipment, schedule changes, leave, modified duties) with rationale linking the request to the functional limitation.

Supporting Documentation

Provider statements, medical records, or assessments that clarify functional limits and the need or expected duration of the accommodation.

Interactive Process Notes

Log of communications, alternative options considered, and decisions made to show a good-faith, individualized assessment by the employer.

Decision & Implementation

Outcome, effective date, responsible implementer, review date, and any monitoring or modification plan to track effectiveness.

Essential data elements to capture securely

Full name: Legal name of requester
Contact: Phone and email
Employer: Organization or department
Requested change: Brief accommodation summary
Documentation: Type and provider
Decision date: Implementation date

Step-by-step: submitting a GR 33 request

Use these sequential steps to prepare, submit, and track a GR 33 request.

  • 01
    Gather information: Collect job description, limitation summary, and supporting medical documentation.
  • 02
    Complete form: Fill all required fields and attach documents in specified formats.
  • 03
    Submit to HR: Send to designated HR/disability contact or upload per policy.
  • 04
    Engage interactive process: Participate in follow-up discussions and agree next steps in writing.

Configuring an online GR 33 workflow

When moving this form online, configure authentication, attachments, notifications, and retention to match policy and privacy rules.

Field Configuration
Authentication method Email + SMS code
Attachment types allowed PDF, DOCX; max 10 MB
Notifications Notify HR and supervisor
Audit trail Enable timestamps and IP logging

Where to send the completed GR 33

Routing depends on employer or institution structure; use the official submission channels to ensure timely review.

  • HR or Benefits: Primary recipient for workplace accommodations
  • Disability Services: Campus or agency unit for student requests
  • EEO Office: For complaints or complex cases
  • Third-party reviewer: Use only when policy specifies external medical review

Digital submission and e-signature requirements

Electronic handling should preserve security, access, and legal validity while meeting privacy obligations.

  • File formats: PDF and DOCX preferred
  • Authentication: Email + SMS or stronger
  • Audit and retention: Maintain tamper-evident audit trail

Ensure any eSignature vendor supports required protections (BAA when PHI is involved) and provides access for records requests.

Typical timelines and response expectations

Timelines vary by employer but the interactive process should proceed without undue delay; record key target dates for accountability.

Acknowledgement:

Acknowledge receipt within 5 business days

Initial review:

Begin interactive discussion within 15 calendar days

Decision timeframe:

Aim to decide within 30 calendar days

Implementation window:

Implement accommodation as agreed or mutually extended

Appeal period:

Follow employer policy, often 30 days

Common pitfalls to avoid

  • Incomplete requests that omit the functional limitation or the specific accommodation leave reviewers unable to evaluate feasibility.
  • Overly broad medical disclosures may violate privacy; supply only information necessary to establish functional limitations and need.
  • Failure to participate in the interactive process or to respond to follow-up questions can lead to delays or denial.
  • Using unsigned or undated forms, or mismatched names, risks administrative rejection and procedural delays.

Risks and legal consequences of mishandled requests

Discrimination claim: Potential ADA litigation
Regulatory fines: Agency enforcement actions
HIPAA exposure: Unauthorized PHI disclosure
Operational disruption: Delayed accommodations impacting performance
Recordkeeping gaps: Lost audit trail and defensibility
Denial appeal: Costs and time for reconsideration

Typical eSignature vendor comparison for processing GR 33 requests

Vendor selection should prioritize secure storage, audit trails, HIPAA support where applicable, and reasonable pricing; signNow appears first for comparison.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day trial Check vendor Check vendor Check vendor Check vendor
Bulk Send Yes Yes Yes Yes Varies
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA) Check vendor Check vendor Check vendor Check vendor

Frequently asked questions about the GR 33 Request for Reasonable Accommodation

Answers to common questions cover documentation, timing, e-signatures, privacy, and next steps after a decision.


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