ESS-C-185 Job Accommodation Form (Rev 2022-09-09)

Form Number: 


The EC will complete the Job Accommodation Form when the individual first begins a job, at each milestone, and for any job replacements. The Job Accommodation Form will be submitted for payment with the required documentation for each milestone or service and a copy will be retained in the individual's case file. For information about Job Accommodations contact the DRS Counselor and/or use the Jan Network at


File Origination or Revision Date: 

Rev 2022-09-09