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Request to your employer for reasonable adjustments (Northern Ireland)
Northern Ireland · in English · for employees
€2.00This document is sold blank, to print and complete by hand.
Made for use in Northern Ireland
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For a worker in Northern Ireland with a disability or long-term health condition who needs changes at work — equipment, hours, duties, the workplace, how meetings are run: a letter asking the employer to make reasonable adjustments under the Disability Discrimination Act 1995, which still applies in Northern Ireland, describing the difficulty at work (not a diagnosis) and the changes asked for, and offering a meeting or an occupational health referral. Access to Work (NI) can also help. Sold blank, to complete by hand, as it holds health data.
- Made for use in Northern Ireland
- Last updated October 29, 2026
- Document in English
Where a UK document reproduces the words of legislation or of a government publication — UK, Scottish or Northern Irish — it contains public sector information licensed under the Open Government Licence v3.0.
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When to use this document
- You have a long-term health condition and need different equipment at work in Northern Ireland.
- After time off ill you want to return to work on shorter hours for a while.
- Your workplace is not set up for your disability and you want changes made.
- You want to ask your employer in writing for reasonable adjustments.
What you fill in
The details the document asks for.
- Employee
- Employee's address
- Town or city
- Employee's postcode
- Date
- Person at your employer you are writing to, as you would greet them (e.g. Priya Patel)
- Employer
- Employer's postal address (street and number, postcode and town on separate lines)
- The difficulty you have at work (its effect; you need not name a diagnosis)
- Adjustments requested
- Anything else you want to add (optional)
Common questions
- When must an employer in Northern Ireland make reasonable adjustments?
- When a worker or job applicant is disabled under the Disability Discrimination Act 1995 — which still applies in Northern Ireland, where Great Britain has the Equality Act 2010 — because a physical or mental impairment has a substantial and long-term adverse effect on normal day-to-day activities, and the employer knows, or could reasonably be expected to know, of it. The employer must take the steps that are reasonable to remove the disadvantage. nidirect explains disability rights at work free.
- What is Access to Work in Northern Ireland, and does it replace the employer's duty?
- Access to Work (NI) is a free scheme run by the Department for Communities that can pay for practical support at work — special equipment, a support worker, help with travel to work — beyond what is reasonable for the employer to provide. You apply through an Employment Service Adviser at your Jobs & Benefits office; nidirect explains how. It is separate from Great Britain's scheme and does not replace the employer's duty to make the adjustments that are reasonable for it to make.
- What can I do in Northern Ireland if an employer refuses reasonable adjustments?
- Ask for the reasons in writing and raise a formal grievance. The Equality Commission for Northern Ireland gives free advice on disability discrimination, and the Labour Relations Agency's helpline is free too. A failure to make reasonable adjustments is disability discrimination under the Disability Discrimination Act 1995: an industrial tribunal claim, after early conciliation with the Labour Relations Agency, must generally start within three months of the failure. Keep a record of what you asked for and when.
How you can sign this document
- Print it and sign by hand. The signature lines in the document are left blank on purpose — sign on them in ink.
- Sign it yourself with a qualified electronic signature. If you already hold a QES — Evrotrust, B-Trust, StampIT, ZealiD or any qualified provider on the EU Trusted List, on a card, a USB token, in a mobile app or in the cloud — our signing guide explains step by step how to sign this exact file without invalidating it. Step-by-step help, and a way to check it worked
DocMuse sells documents, not legal advice. Acceptance always depends on the recipient's rules and your local law.
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