General tips re: physician letters for reasonable accommodations in housing contexts

  • Look at two sample letters you can use.
  • Your letter must be on official stationery (otherwise it may be assumed to be forged). It must include your personal contact information. If the housing provider wants to follow up with you, it should not be a matter of central switchboards and generic voicemails.
  • Start with who you are, what kind of medical professional you are, and your relation to the person with a disability. Unless you have known the patient for only a very short time, state how long you have known the patient.
  • Be as specific as possible about as much as you can (see below).
  • There are three big things you are trying to communicate here: i) that there is a person in the household who has a disability, ii) that this disability, in the context of the current situation, requiresthe specific accommodation(s) you are requesting, and iii) that the person reading this letter should care about this situation and actually do something about it.
  • With that in mind, describe the disability as much as you can (caveat: see note below about whether or not to mention the specific disability) so that it is clear that it is a disability. Educate them about the condition and then give the facts pertaining to this particular person's experience with the disease (i.e. hospitalizations/etc.) to contextualize it and raise their sympathy. Remember that the definition of disability is relatively broad in many housing contexts. One general idea to have in mind is a condition that affects a major life function—that can be thinking, decision-making, and other mental functions as well as walking, breathing, climbing stairs, etc.
  • Then describe various ways in which a housing situation can exacerbate and/or be very difficult for a person with this condition generally, this person specifically (see sample), and how an improvement in the housing situation would improve the patient’s health.
  • Then, and of critical importance, provide the specific ask(s), making clear that each is necessary and explaining why each is necessary (see sample).
  • [optional]: Finally, if relevant/you have these facts, you can give additional facts about this particular living situation. For example, you might add the fact that the current place has dust and an old carpet that are harming the kid’s breathing and making a pain episode more likely.


regarding disclosing the specific disability: You are not legally required to disclose the disability. That is good thing in cases where someone is and/or feels particularly stigmatized by the relevant disability or perceived disability. However, there are two catches to this to consider. First, if you are not going to disclose, then it is harder to craft a persuasive letter—you will have to make sure to walk through how the undisclosed disability requires the specific accommodations you are requesting, but doing so without disclosing (or practically disclosing) takes time. Again, it can be worth it and important in certain cases, but bear the added difficulty in mind. Second, stigma is one side of a double-edged sword, with the other side being sympathy. At the end of the day, if you can get the administrator reading your letter to be sympathetic, then you are much more likely to yield effective (let alone any) action. Generating this sympathy without disclosing/describing the disability can make this more difficult. With all that in mind, I generally end up disclosing and then going into a lot of specifics. You should of course have a conversation about all this (pros/cons/etc.) with the family if you are thinking of disclosing.

New England Pediatric Sickle Cell Consortium, in collaboration with Rajan Sonik, Equal Justice Fellow, Massachusetts Law Reform Institute