Draft Sorn Nm12905-1

NM12905-1

System name:

Department of the Navy (DON) Reasonable Accommodation Records

System location:

Space and Naval Warfare Command (SPAWAR), 1325 10^th Street, SE, Building 196, Washington DC 20374-7000 and organizational elements of the DON. Official mailing addresses are published in the Standard Navy Distribution List available as an appendix to the Navy's compilation of systems of records notices and may be obtained from the System Manager.

Categories of individuals covered by the system:

Civilian employees, contractors, and applicants for employment with the DON.

Categories of records in the system:

Name; unit identification code; command; occupational series; grade and pay plan; job title; operating division/function; home, office, and/or other address; telephone and fax numbers; email address; physical or mental impairment; limitation(s) to Major Life Activities; disability or medical condition; whether an individual has a record of a disability and/or is regarded as having a disability; position description and essential functions of the position; information relating to an individual's ability to satisfactorily perform the functions of the position; medical documentation/information, correspondence, supporting documents, writings, recordings, pictures or electronic media relating to the request for reasonable accommodation (RA); RA requested and implemented; estimated and actual cost of the RA; vendor(s) name supplying the RA; provider(s) name of the RA; payment source(s) for the RA; results of reassignments and job search efforts; requests for reconsideration of the agency’s RA determinations; events and dates of actions taken; case number; and deciding official's, health care practitioner’s, social worker’s, rehabilitation counselor’s and/or other individuals involved in the reasonable accommodation process name, title, telephone number, email address, fax number, address, and signature.

Authority for maintenance of the system:

10 U.S.C. 5013, Secretary of the Navy; 10 U.S.C. 5041, Headquarters, Marine Corps; 29 U.S.C. 701, Rehabilitation Act of 1973, Sections 501 and 505; 42 U.S.C. 12101, Americans with Disabilities Act of 1990, Titles I and V; 29 Code of Federal Regulations (CFR) Part 1630, Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities Act; Executive Order 13163, Increasing the Opportunity for Individuals with Disabilities to Be Employed in the Federal Government; and Executive Order 13164, Requiring Federal Agencies to Establish Procedures to Facilitate the Provision of Reasonable Accommodation.

Purpose(s):

To track, monitor, review, and process requests for reasonable accommodations.

Routine uses of records maintained in the system, including categories of users and the purposes of such uses:

In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, these records or information contained therein may specifically be disclosed outside the Department of Defense (DoD) as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:

 
To officials and employees of the Equal Employment Opportunity Commission and/or other appropriate third party responsible for adjudicating any cases that may result from a reasonable accommodation request.

The DoD Blanket Routine Uses set forth at the beginning of DON’s compilation of system of records notices may apply to this system.

NOTE: This system of records contains individually identifiable health information. The DoD Health Information Privacy Regulation (DoD 6025.18-R) issued pursuant to the Health Insurance Portability and Accountability Act of 1996, applies to most such health information. DoD 6025.18-R may place additional procedural requirements on the uses and disclosures of such information beyond those found in the Privacy Act of 1974 or mentioned in this system of records notice.

Policies and practices for storing, retrieving, accessing, retaining, and disposing of records in the system:

Storage:

Paper records and electronic storage media.

Retrievability:

Name or case number.

Safeguards:

Access to specific case files is restricted to individuals having a need to know to perform their official duties. Case records are maintained in locked security containers.

Access to electronic records will be limited to users based on their area of responsibility and need to know. Users will not be able to view records outside their user privileges. Electronic records are controlled by limiting physical access to terminals and by the use of passwords.  Work areas are sight controlled during normal duty hours. 

Retention and disposal:

Destroy three years after employee separation from the agency or three years after all administrative or judicial proceedings are concluded, whichever is later.

Destroy three years after an applicant’s unsuccessful application for employment with the agency or three years after all administrative or judicial proceedings are concluded, whichever is later.

System manager(s) and address:

Policy Official: Program Director, DON Office of Equal Employment Opportunity (EEO) and Diversity Management, 614 Sicard Street, SE, Suite 100, Washington Navy Yard, DC 20374-5072.

Paper Record Holder:

Commanding Officer of the activity/command in question. Official mailing addresses are published in the Standard Navy Distribution List available as an appendix to the Navy's compilation of systems of records notices and may be obtained from the System Manager.

Electronic Record Holder:

Office of Civilian Human Resources (OCHR), 614 Sicard Street, SE, Suite 100, Washington Navy Yard, DC 20374-5072.

Notification procedures:

Individuals seeking to determine whether information about themselves is contained in this system should address written inquiries to Program Director, DON Office of EEO and Diversity Management, 614 Sicard Street, SE, Suite 100, Washington Navy Yard, DC 20374-5072 or the record holder (Commanding Officer of the activity in question). Official mailing addresses for record holders are published as an appendix to the Navy’s compilation of system of records notices.

The request should be signed and include the individual’s full name, complete mailing address, and proof of identity, photo identification, or a notarized statement or an unsworn declaration in accordance with 28 U.S.C. 1746, in the following format:

If executed outside the United States:  I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.  Executed on (date).  (Signature).

If executed within the United States, its territories, possessions, or commonwealths:  I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct.  Executed on (date).  (Signature).

The system manager may require an original signature or a notarized signature as a means of proving the identity of the individual requesting access to the records.

Record access procedures:

Individuals seeking to determine whether information about themselves is contained in this system should address written inquiries to Program Director, DON Office of EEO and Diversity Management, 614 Sicard Street, SE, Suite 100, Washington Navy Yard, DC 20374-5072 or the record holder (Commanding Officer of the activity in question). Official mailing addresses for record holders are published in the Standard Navy Distribution List that is available as an appendix to the Navy’s compilation of system of records notices.

The request should be signed and include the individual’s full name, complete mailing address, and proof of identity, photo identification, or a notarized statement or an unsworn declaration in accordance with 28 U.S.C. 1746, in the following format:

If executed outside the United States: I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.  Executed on (date).  (Signature).

If executed within the United States, its territories, possessions, or commonwealths:  I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct.  Executed on (date).  (Signature).

The system manager may require an original signature or a notarized signature as a means of proving the identity of the individual requesting access to the records.

Contesting record procedures:

The DON's rules for accessing records and for contesting contents and appealing initial agency determinations are published in Secretary of the Navy Instruction 5211.5; 32 CFR part 701; or may be obtained from the system manager.

Record source categories:

Information in the file is obtained from DON civilian employees, contractors, applicants for employment with the DON, health care providers, agency officials, other government agencies and other organizations with pertinent and relevant information or documents.

Exemptions claimed for the system:

None.