Special Conditions Letter - Sample
The sample letter below is an example of how to inform Social Security about Special Conditions.
Please customize the letter so it accurately represents the employee’s situation. Bold text is intended to be replaced with the employee’s personal information.
Note: Employment Support Providers may want to consider writing this letter on their agency’s letterhead.
To Whom It May Concern:
This letter is to inform you about Special Conditions for Employee’s Full Name, SSN.
Employee name is currently employed number hours per week as a Job Title at Employer name.
Employee name receives on average 10 hours per week of direct, on-site support from a Job Coach. This direct support is viewed as being ongoing and necessary for Employee name to be successful at their job. The job coach is funded by a third-party.
Included with this letter is a record of the support hours provided. (Optional but helpful.)
Thank you for your consideration. If you have any questions, please feel free to contact me.
Sincerely,
Author’s name
Title
Phone number
Email address