If anxiety, depression or ADHD makes part of your job harder, you can ask your employer for a reasonable accommodation: a change to how, when or where you work, such as a modified schedule around therapy appointments, a quieter workspace, written instructions or remote work. Under the Americans with Disabilities Act, the employer must provide an effective accommodation unless it would cause significant difficulty or expense, and it may ask for a letter from your clinician, but in New York City it generally cannot demand your specific diagnosis.
New York City's Human Rights Law is broader than the federal law in two ways that matter here: it covers smaller employers, and it requires a good-faith "cooperative dialogue" that ends in a written decision. This article explains both laws, gives accommodation examples by symptom, and shows what a useful clinician letter contains. It is general information, not legal advice.
Which law applies to you
| Americans with Disabilities Act (federal) | NYC Human Rights Law | |
|---|---|---|
| Employers covered | 15 or more employees for 20 or more weeks in the current or preceding year | Four or more persons employed, or one or more domestic workers |
| Definition of disability | An impairment that substantially limits a major life activity; the EEOC says major depression, PTSD, bipolar disorder, schizophrenia and OCD should easily qualify | Any physical, medical, mental or psychological impairment, or a history of one, with no "substantial limitation" requirement |
| Process | The employer may ask about your condition and limits once you request an accommodation | A good-faith written or oral cooperative dialogue, ending in a written final determination |
| Diagnosis | A general description, such as "anxiety disorder," may be enough | The employer cannot require the specific diagnosis unless it is necessary to decide the accommodation |
| Where to complain | EEOC, generally within 180 days, or 300 days where a state or local law also applies | NYC Commission on Human Rights, within one year of the last discriminatory act |
If you work in New York City for an employer with at least four people, the city law usually gives you more. If you work elsewhere, the federal law sets the floor, and state law may add protections; an employment lawyer can tell you which applies to your workplace.
What counts as a reasonable accommodation
The ADA's definition is broad. It includes job restructuring, part-time or modified schedules, reassignment to a vacant position, equipment, changes to policies and similar adjustments. The EEOC's mental health guidance gives examples that fit common situations: altered break and work schedules (for instance, scheduling work around therapy appointments), quiet office space, changes in supervisory methods, specific shift assignments and permission to work from home.
Leave can be an accommodation too. Even if you are not eligible for FMLA, or have used it up, the EEOC says unpaid leave may be a reasonable accommodation when it would help you get back to performing your job's essential functions. An employer also generally cannot insist that you return with no medical restrictions at all if you can do the job with or without a reasonable accommodation; the EEOC says that kind of "100% healed" rule violates the ADA unless the needed accommodation would cause undue hardship.
Two limits apply. The accommodation has to be reasonable, and the employer does not have to provide one that would cause undue hardship, meaning significant difficulty or expense. And if more than one accommodation would work, the employer can choose which one to give you. That is why it helps to describe the problem clearly and suggest more than one solution.
Accommodation ideas by symptom
The Job Accommodation Network (JAN), a free technical assistance service on the ADA and job accommodations, organizes ideas by the limitation they address rather than by diagnosis. The table below draws on its pages for anxiety, depression and ADHD.
| Limitation at work | Examples from JAN's lists |
|---|---|
| Concentration and focus | Noise-canceling headsets or white noise, uninterrupted work time, a flexible schedule, telework, written instructions, task separation |
| Time management and organization | Calendars and planners, checklists, reminders, a task flow chart, job coaches, adjusted supervisory methods |
| Stress intolerance | A modified break schedule, one-on-one communication, positive and supervisory feedback, a support person, telework |
| Fatigue and low stamina | Periodic rest breaks, task rotation, a flexible schedule, telework |
| Medical treatment and medication | A flexible schedule, telework, a rest area or private space, medication reminders |
| Sleep problems | A flexible schedule, a modified break schedule, periodic rest breaks |
| Hyperactivity and impulsivity (ADHD) | Structured breaks as a physical outlet, a private workspace, reviewing the conduct policy with the employee, adjusting supervision |
| Emotional regulation | Counseling or the employee assistance program, a support person, supervisory methods, reassignment |
For ADHD in particular, JAN's key suggestions include a quiet work space, uninterrupted work time, minimizing marginal functions so you can focus on essential duties, a mentor, to-do lists and meetings to discuss expectations. Executive-function coaching outside work can complement these; ADHD coaching vs therapy explains what coaching can and cannot do.
How to ask
You can ask at any time, and you do not need to have a specific accommodation in mind. Tell a supervisor, human resources or another appropriate person that you need a change at work because of a medical condition. Your employer may ask you to put the request in writing. Even where it is not required, a short written request creates a record of the date and what you asked for.
- Name the problem in work terms. "Open-plan noise makes it hard to sustain focus on detailed analysis" is more useful than a diagnosis.
- Propose one or two solutions, and say you are open to alternatives.
- Say that your clinician can provide supporting documentation if needed.
- Ask for a response, and in New York City, a written final determination.
- Keep copies of everything, including dates of conversations.
In New York City, the employer's duty to start a cooperative dialogue can arise even without a formal request, if it knew or should have known you might need an accommodation. Failing to engage in that dialogue is an independent violation of the city law, and so is failing to provide the written final determination.
Deciding when and how much to disclose
Disclosure is a decision, not an obligation. In most situations you can keep a mental health condition private, and an employer can ask medical questions of a current employee only in limited situations, such as when you request an accommodation or when there is objective evidence that you cannot do the job or pose a safety risk. Asking for an accommodation does mean saying that a medical condition is involved, but it does not mean sharing everything.
Timing matters in practice. Requests made early, before missed deadlines and poor reviews accumulate, tend to be simpler conversations than requests made in the middle of a performance improvement plan. If problems at work have already started, you can still ask; say plainly that you believe a medical condition is contributing and that you want to discuss changes that would help you meet expectations.
Decide in advance who needs to know what:
- Your manager usually needs to know only what will change (hours, format of instructions, location), not why.
- Human resources or the person handling accommodations may need the clinician's letter.
- Coworkers need to know nothing medical; the employer must keep your medical information confidential, even from them.
Under the NYC guidance, an employer should not demand a particular form or type of documentation, and if what you provide seems insufficient, it should ask for more information rather than deny the request outright. If HR sends you a generic medical questionnaire that asks for far more than your limits and the accommodation, it is reasonable to ask which items are actually needed.
What your clinician's letter should and should not say
The EEOC says an employer may ask you to describe your condition generally and how it affects your work, and may ask for a letter from your health care provider documenting that you have a mental health condition. The NYC Commission's guidance limits documentation to what substantiates the disability, identifies the functional limitation and explains how the accommodation addresses it, and says an employer may not ask for unrelated documentation such as complete medical records.
| Include | Leave out |
|---|---|
| That you are under the clinician's care for a condition that is a disability | Your full history, therapy content or session notes |
| The specific functional limits at work (concentration, stamina, attendance for treatment) | Unrelated diagnoses |
| How each requested accommodation addresses those limits | Medication names and doses, unless directly relevant |
| Expected duration, or when the clinician will reassess | Opinions about your manager or workplace conflicts |
| The diagnosis in general terms only if you have agreed to share it | Anything you have not reviewed and agreed to release |
Your employer must keep medical information it receives confidential, even from coworkers. Ask to see the letter before it goes out. A short, specific letter is usually more persuasive than a long one, and it shares less of your private information.
A worked example
Consider a hypothetical analyst at a 30-person Manhattan firm who is being treated for depression and has started a medication change. Mornings are the hardest part of the day, she has a weekly therapy appointment at 9 a.m., and she struggles to follow long verbal briefings.
- She emails HR asking to shift her hours later on therapy days and to receive assignments in writing, noting that her psychiatrist can confirm the need.
- HR asks for documentation. Her psychiatrist writes that she is in active treatment for a condition that limits morning concentration, that a later start one day a week accommodates treatment, and that written instructions address a temporary difficulty retaining verbal information; it will be reassessed in three months.
- Because her employer has more than four employees and she works in New York City, the city law applies. HR meets with her, agrees to the schedule change, offers recorded briefings instead of written summaries, and sends a written final determination listing both.
The employer chose a different form of the second accommodation, which it may do if it is effective. If it does not work, she can return to the dialogue.
Reviewing accommodations over time
Mental health conditions change, and accommodations should change with them. A later start time that made sense during a medication adjustment may not be needed six months later, while a new role may create needs the old arrangement did not cover. Build a review point into the request, such as "reassess in three months," so neither side treats a temporary fix as permanent or forgets to revisit it.
Under the New York City law, a cooperative dialogue is the place to raise these changes, and the obligation can be triggered again whenever the employer has notice that you may need something different. Keep a brief log of what is working and what is not. Specific observations, such as "written task lists cut rework on reports," make the next conversation shorter and help your clinician update any documentation.
If the request is denied or ignored
Ask for the reason in writing, and ask whether another accommodation would work. Harassment because of a disability and retaliation for asserting your rights are both prohibited under the ADA. If the problem continues, the filing deadlines are short: generally 180 days for an EEOC charge, or 300 days where a state or local law also applies, and one year for a complaint to the NYC Commission on Human Rights. An employment lawyer can advise on which route fits your case.
When the problem is time away rather than changes at work, see FMLA leave for mental health and New York short-term disability. If you are coming back after time off, returning to work after a mental health leave covers phased returns.
Treatment and accommodation work together
Accommodations reduce friction at work; they do not replace treatment. If symptoms are steadily getting worse despite reasonable changes, that is a signal to review the care plan with your clinician, not just to ask for more accommodations. The practice's articles on depression versus burnout and CBT for burnout and high-achiever stress may help you sort out what is going on. Adult ADHD treatment options compared covers the treatment side for ADHD.
At this practice, ongoing care includes psychiatric evaluation and medication management, psychotherapy including CBT and DBT, and coaching, and ADHD treatment plans may include executive-function coaching. If you think you will need an accommodation letter, mention it on the free discovery call. The guide to choosing psychiatric care explains the other steps.
If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room.
Frequently asked questions
Do I have to tell my employer I have a mental health condition?
In most situations, no. The EEOC says you can usually keep your condition private. But if you want an accommodation, you will need to say you have a medical condition that requires a change at work, and your employer may ask for documentation.
Is ADHD a disability under the ADA?
It can be. The question under federal law is whether it substantially limits a major life activity such as concentrating, thinking or working. Under the New York City Human Rights Law, any mental or psychological impairment counts, with no substantial-limitation test.
Can my employer contact my psychiatrist directly?
Not without your permission. You provide the documentation, and you decide whether to sign a release allowing the employer to talk to your clinician. If documentation is insufficient, the NYC Commission's guidance says the employer should ask for more information rather than deny the request.
Can I ask for permanent remote work as an accommodation?
You can ask. Telework appears in the EEOC's examples and JAN's lists. Whether it is reasonable depends on the job's essential functions and whether another effective accommodation exists; the employer can choose among effective options.
What if my employer has fewer than 15 employees?
The ADA does not apply, but the NYC Human Rights Law covers employers with four or more employees, or one or more domestic workers, in New York City. Outside the city, ask an employment lawyer about state law.
Will an accommodation letter go into my personnel file?
The EEOC says employers must keep medical information confidential, even from coworkers. Ask HR how it stores medical documentation; it is typically kept separate from the general personnel file.
Sources
- Depression, PTSD, & Other Mental Health Conditions in the Workplace: Your Legal Rights. U.S. Equal Employment Opportunity Commission, 2016. eeoc.gov
- 42 U.S. Code 12111 Definitions (ADA Title I). Legal Information Institute, Cornell Law School, 2026. law.cornell.edu
- Anxiety Disorder: accommodation ideas. Job Accommodation Network (JAN), 2026. askjan.org
- Depression: accommodation ideas. Job Accommodation Network (JAN), 2026. askjan.org
- Attention Deficit/Hyperactivity Disorder (ADHD): accommodation ideas. Job Accommodation Network (JAN), 2026. askjan.org
- Legal Enforcement Guidance on Discrimination on the Basis of Disability. New York City Commission on Human Rights, 2026. nyc.gov
- The Law (NYC Human Rights Law overview). New York City Commission on Human Rights, 2026. nyc.gov
- Employer-Provided Leave and the Americans with Disabilities Act. U.S. Equal Employment Opportunity Commission, 2016. eeoc.gov
Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.
The information provided on this blog is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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