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An employee tells her supervisor on a Saturday shift that she is pregnant and worried about lifting. By Monday, the question is on your desk: what do you have to do, how fast, and are you allowed to ask for a doctor's note? The PWFA interactive process addresses the first two questions, while the regulation's limits on supporting documentation address the third. Most requests should close in one short conversation; the ones that go wrong usually involve delay, paperwork the employer had no right to demand, or no record of what was discussed.
This guide covers the steps, when documentation may be requested, and a request log you can adapt. For the law's overall scope, start with our Pregnant Workers Fairness Act Employer Guide.
What Is Fixed by Statute and What Comes from the Regulation?
Some of what follows is in the statute. Some is in the EEOC regulation, which the agency plans to revise. Know which is which before building a policy around it.
| Rule | Source | How stable? |
|---|---|---|
| Duty to accommodate known limitations unless there is undue hardship | Statute, 42 U.S.C. § 2000gg-1(1) | Stable |
| The interactive process "will typically be used" to find an accommodation | Statute, 42 U.S.C. § 2000gg(7) | Stable |
| No requiring an employee to accept an accommodation not arrived at through the interactive process | Statute, 42 U.S.C. § 2000gg-1(2) | Stable |
| Limits on disability-related inquiries and medical confidentiality | ADA statute, 42 U.S.C. § 12112(d), applied to PWFA requests | Stable |
| Definition of the interactive process; "no rigid steps" | Regulation, 29 C.F.R. § 1636.3(k) | May change |
| Limits on supporting documentation and self-confirmation | Regulation, 29 C.F.R. § 1636.3(l) | May change |
| Unnecessary-delay factors and interim accommodation as a factor | Regulation, 29 C.F.R. § 1636.4(a)(1) | May change |
Status as checked on October 4, 2026. The regulation took effect June 18, 2024, and its text has not been amended. Louisiana v. EEOC (W.D. La., May 2025) vacated the part of the rule treating elective abortion as a "related medical condition" and did not reach the interactive-process or documentation provisions. Texas v. Bondi, a challenge to the statute's enactment concerning the State of Texas as an employer, is being reheard by the full Fifth Circuit. The EEOC's regulatory agenda projects a proposed revision of Part 1636 for November 2026. Check FederalRegister.gov for the proposed rule and the Fifth Circuit for a decision. A proposal changes nothing until a final rule takes effect, so follow the current regulation.
The PWFA Interactive Process, Step by Step
The regulation defines the interactive process as an informal exchange and says "there are no rigid steps that must be followed." The EEOC expects most requests to be resolved in one conversation or a short email exchange. The steps below are a working sequence for HR, not a mandatory checklist.
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Recognize and Log the Request
A request exists when the employee—or a representative, such as a family member or health care provider—tells a supervisor, manager, or HR that she needs a change at work because of a condition related to pregnancy, childbirth, or a related medical condition. The request can be oral and needs no form or particular words. See PWFA Known Limitations and How to Recognize a Request.
Log the date, who received the request, and what was said. You may offer a request form, but it cannot be a condition of starting the process.
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Put an Interim Accommodation in Place Where Needed
If the need is immediate—for example, chemical exposure, lifting, or heat—or the answer will take time, offer an interim accommodation that keeps the employee working. The guidance calls this a best practice, and it may count in the employer's favor if delay is later challenged.
Leave is the exception. It does not count as an interim accommodation that excuses delay unless the employee selects or requests it. The guidance warns that imposing unpaid leave while a request is pending, when paid work was available, may be retaliation.
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Talk to the Employee
Identify the limitation and the change needed if either is unclear, and ask what the employee would prefer. Avoid probing for a diagnosis: a request does not have to identify a medical condition, and questions about past accommodations or preexisting conditions are generally impermissible disability-related inquiries in this context.
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Decide Whether Documentation Is Needed at All
Usually it is not. The next section explains when documentation may be requested. Make this an HR decision, not a supervisor's.
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Evaluate Options, Including Temporary Suspension of an Essential Function
Consider the essential functions, effective accommodation options, and the employee's preference. If the employee temporarily cannot perform an essential function, the PWFA requires you to consider suspending it. See Reasonable Accommodations Under the PWFA. If you believe a request cannot be granted, review PWFA Undue Hardship and Denial before anyone says no.
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Decide, Confirm in Writing, and Implement
Where more than one accommodation would be effective, the employee's preference gets primary consideration, but the employer chooses among effective options. The employer may not impose a change the employee did not ask for without going through the process. The EEOC's example is a server who asks for extra breaks and is moved to host shifts instead.
Confirm the decision in writing: what was approved, the start date, the review date, and who to contact if it stops working.
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Follow Up
Needs can change during and after pregnancy, so set a review date. If you already have enough information about a limitation, including an episodic one, you may not ask for new documentation each time it recurs.
Timing: No Fixed Deadline, but Delay Can Be a Violation
Neither the statute nor the regulation sets a specific number of days. Instead, unnecessary delay may be a failure to accommodate even if the accommodation is eventually provided. Factors include the reason for and length of the delay, how long the accommodation is needed, each side's contribution, whether the accommodation was simple or complex, and whether an interim accommodation that kept the employee working was offered.
For the four simple modifications—water, extra restroom breaks, sitting or standing, and breaks to eat and drink—the regulation says delay "will virtually always result in a finding of unnecessary delay."
Internal targets, such as acknowledging a request within one or two business days, are sensible company standards, not legal deadlines. Allow time when documentation is properly requested: the guidance notes that appointments early in pregnancy can be hard to get, and that this does not mean the employee is refusing to participate.
Supporting Documentation: When You May Ask and What You May Ask For
The statute says nothing about medical documentation. The rules below come from 29 C.F.R. § 1636.3(l) and could change with the regulation. The ADA's limits on medical inquiries are statutory and would remain.
When It Is Not Reasonable to Ask
An employer is never required to seek documentation. It may do so only when reasonable under the circumstances to determine whether the employee has a limitation and needs a change at work because of it. The regulation gives five examples of when asking is not reasonable:
- Obvious. The limitation and the needed change are obvious, and the employee self-confirms. The guidance example is an obviously pregnant employee asking for a different-size uniform.
- Already known. The employer already has sufficient information, such as an earlier note covering a lifting restriction for a stated period.
- The four simple modifications. The employee is pregnant, self-confirms, and asks for water, additional restroom breaks, sitting or standing as needed, or breaks to eat and drink.
- Lactation. The request concerns a time or place to pump, other pumping-related modifications, or nursing during work hours when the child is nearby, and the employee self-confirms.
- Your own policy. Employees without PWFA limitations can get the same change without documentation under your policies or practices.
"Predictable assessments" is the regulation's label for the four modifications in the undue-hardship analysis; the documentation rule simply borrows the list.
Self-Confirmation
Self-confirmation is a simple statement confirming the limitation and the change needed. It can be made in any manner, including in the same conversation as the request. The employer may not require a specific format, wording, or form.
What You May Request When Asking Is Reasonable
When it is reasonable to ask—for example, when an employee seeks suspension of an essential function for a condition that is not obvious—the employer is limited to "reasonable documentation": the minimum sufficient to:
- Confirm the physical or mental condition;
- Confirm that it is related to, affected by, or arising out of pregnancy, childbirth, or related medical conditions; and
- Describe the change at work that is needed. The guidance adds that an estimate of expected duration may be included.
No diagnosis is required; "fatigue" or "a lifting restriction" is enough.
| You may | You may not |
|---|---|
| Require that documentation come from a health care provider. The regulation lists doctors, midwives, nurses, doulas, lactation consultants, physical therapists, and others, including telehealth providers. | Require that the provider be the one treating the condition. |
| Offer an optional form. | Require a specific form, or reuse an ADA or FMLA form that asks about "impairments," "major life activities," or a "serious health condition." |
| Ask for the expected duration of the restriction. | Require an examination by a provider the employer chooses. |
| Ask only about the non-obvious part of a request. | Require confirmation of pregnancy by a specific test, or seek the complete medical record. |
| Give the employee sufficient time to obtain documentation. | Deny or stall the accommodation for missing documentation you had no basis to request. |
Over-asking has two consequences. Missing documentation cannot justify a denial or delay unless the request was reasonable and limited, and the employee had sufficient time. The guidance also says seeking more than the regulation allows may itself violate the anti-retaliation and coercion provision, 42 U.S.C. § 2000gg-2(f). A blanket policy requiring a medical note for every accommodation request is the EEOC's own example.
Confidentiality of Medical Information
PWFA records follow the ADA confidentiality rule, not HIPAA, which generally governs health plans and providers rather than an employer's personnel records. Under 29 C.F.R. § 1630.14 and the PWFA guidance:
- Keep medical information in a separate medical file, apart from the personnel file.
- Treat pregnancy, recent pregnancy, a related condition, and the existence of a PWFA accommodation as medical information.
- Tell supervisors only the necessary restrictions and accommodations. Other recognized exceptions include first-aid and safety personnel, government investigators, and workers' compensation and insurance uses.
- Do not explain a coworker's accommodation to the team.
Request Log and Decision Record Template
Adapt this template to your systems. Keep it in the confidential medical file. Fields marked with an asterisk are filled in only where applicable.
| Field | Entry |
|---|---|
| Employee, position, location | |
| Date and time received; received by; how communicated | |
| Request in the employee's words; change requested; expected duration | |
| Self-confirmation received (date, manner) | |
| Interim accommodation offered (what, date); if leave, did the employee request it? | |
| Documentation requested? Basis under § 1636.3(l), what was asked, date, time allowed | |
| Interactive-process contacts (dates, options discussed, employee preference) | |
| Essential function affected? Temporary suspension considered? | |
| Decision (approved, alternative, partial, denied); decision maker | |
| If alternative or denial: reasons, undue-hardship analysis, alternatives offered* | |
| Written confirmation sent; supervisor told restrictions only (dates) | |
| Start date; review date; follow-up notes | |
| Other laws considered (ADA, FMLA, state law, PUMP Act) |
Example entry (fictional): "March 3, request received orally by shift lead J. Ortiz: employee is pregnant and needs to avoid lifting cases over 20 pounds. Interim: returns desk, same day, employee agreed. March 4, HR call; employee prefers a lift assist on her own line. Documentation requested (weight limit and duration only), 14 days allowed, interim continues. March 9, midwife's note received. March 10, approved: lift assist and team lift over 20 pounds through expected due date; review June 1."
Under the EEOC's recordkeeping rule, 29 C.F.R. § 1602.14, requests for reasonable accommodation are personnel records that must be kept for one year from the record or the action, whichever is later. All relevant records must be preserved once a charge is filed until final disposition.
Writing the Process into Policy
A PWFA accommodation policy should say who can receive a request; that no form or medical note is needed to start; that the four simple modifications are approved on the spot; that only HR may request documentation or deny a request; and that retaliation is prohibited.
A single intake path for PWFA, ADA, and leave requests works well because one request can trigger several laws. See our PWFA, ADA, and FMLA Guide, the ADA Interactive Process Guide, and ADA Accommodation Request Form and Documentation. Where both the PWFA and ADA could apply to documentation, the guidance says to use the rule that is less demanding for the employee.
State and local laws may add notice or documentation rules. Check each state where you have employees. The Leave and Accommodation Management seminar works through medical inquiries, the interactive process, and documentation across the PWFA, ADA, FMLA, and state laws using scenarios.
Frequently Asked Questions
Is the interactive process required under the PWFA?
The statute says it will "typically be used." The EEOC guidance says failing to engage is not by itself a violation, but the employer may be liable if the employee goes without an accommodation that was available without undue hardship. An employee's refusal to participate can justify not providing an accommodation.
Can an employer require a doctor's note for a PWFA accommodation?
Only when it is reasonable under the circumstances, and then only the minimum needed to confirm the limitation, its connection to pregnancy or childbirth, and the change needed. It is not reasonable to request documentation for the four simple modifications when the employee is pregnant and self-confirms, for obvious needs, for most pumping requests, or when the employer already has the information.
How long does an employer have to respond to a PWFA request?
There is no fixed number of days. The regulation looks at whether delay was unnecessary and says delay in providing the four simple modifications will virtually always be found unnecessary. Offering an interim accommodation that keeps the employee working reduces the risk.
Will these documentation rules change?
They might. The documentation rules come from the regulation, not the statute, and the EEOC has a proposed revision of the regulation on its agenda. Until a final rule takes effect, the current text applies. Check for a published proposed or final rule.
The Bottom Line
Run the PWFA interactive process as a fast, documented conversation: log the request, provide an interim accommodation if the need is immediate, ask for documentation only when the regulation allows it and only for the minimum, confirm the decision in writing, and keep medical details out of the personnel file. The statutory duties are stable; the documentation limits are regulatory and worth rechecking when the rule is revised.
Next steps: give supervisors the PWFA Guide for Managers, run the PWFA Compliance Checklist against your forms, and keep the PWFA FAQs handy. For the full picture across leave laws, see the Leave and Accommodation Management Guide, and consider the Leave and Accommodation Management seminar if your team handles requests where the PWFA, ADA, FMLA, and state law overlap. This article is general education, not legal advice.
