Voluntary Self-Identification of Disability
If the company you are applying to has to comply with government reporting you may see the Voluntary Self-Identification of Disability form page before OR after you submit the application form.
Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever has a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.
How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history of record of such an impairment or medical condition.
Disabilities include, but are not limited to:
- Blindness
- Deafness
- Cancer
- Diabetes
- Epilepsy
- Autism
- Cerebral palsy
- HIV/AIDS
- Schizophrenia
- Muscular dystrophy
- Bipolar disorder
- Major depression
- Multiple sclerosis (MS)
- Missing limbs or partially missing limbs
- Post-traumatic stress disorder (PTSD)
- Obsessive compulsive disorder
- Impairments requiring the use of a wheelchair
- Intellectual disability (previously called mental retardation)
You can select a response from the following options:
- Yes, I have a disability (or previously had a disability)
- No, I don’t have a disability
- I don’t wish to answer
Any information you submit is considered private and confidential and is kept separate from your employment application.
Responding to these questions is voluntary, and is used for reporting purposes only. This form may also be provided to you if you are hired.
Also see: Affirmative Action Questions, Veteran Status Pre-Offer Solicitation