Under the guidelines of the American with Disabilities Act (ADA), departments are required to complete an essential function analysis when a request for accommodation is made. Departments are encouraged to complete the analysis prior to advertising vacant positions and use the information in the interviewing process. Additionally, departments are encouraged to use an essential function analysis to conduct staff training and performance evaluations.

INSTRUCTIONS: Complete sections 1- 10. Questions about this form may be directed to Human Resource Services at (575) 646-8000.

Section 1: Information about the position
Department/ Division: / Job Location:
Job Title: Grade: FTE: / Classification: Faculty Exempt Non-exempt
Work schedule
No. of days per week: From: To:
Work Hours: From: To: / Shift Work
On-call
Required overtime
Competing Demands
Other
A specific job description exists for this position Yes (please attach job description) No (please complete Section 2)
Section 2: Essential Job Functions (List 5 to 8 specific primary/essential functions and check one justification code and one accountability code)
Justification codes: 1) Position exists to perform function 2) Proportion of time spent performing the function3)Frequency duty is performed 4) Highly skilled duty 5) Consequence of error 6) Limited staff to perform function
Accountability codes (check all that apply): A) Life, B) Injury, C) Monetary, D) Property, E) Inconvenience.
Essential Functions / Justification / Accountability
1 / 2 / 3 / 4 / 5 / 6 / A / B / C / D / E
Section 3: Mental Functions (Check one)
Frequency / Not Required / Less than 25% / 25 to 49% / 50 to 74% / 75% or more
Comparing – Judging the readily observable functional, structural, or compositional characteristics (whether similar to or divergent from obvious standards) of data, people, or things.
Computing – Performing arithmetic operations and reporting on and/or carrying out a prescribed action in relation to them.
Compiling – Gathering, collating, or classifying information about data, people or things. Reporting and/or carrying out a prescribed action in relation to the evaluation is frequently involved.
Analyzing – Examining and evaluating data. Presenting alternative actions in relation to the evaluation is frequently involved.
Coordinating – Determining time, place, and sequence of operations or action to be taken on the basis or analysis of data. May include prioritizing multiple responsibilities and/or accomplishing them simultaneously.
Synthesizing – To combine or integrate data to discover facts and/or develop knowledge or creative concepts and/or interpretations.
Negotiating - Exchanging ideas, information, and opinions with others to formulate policies and programs and/or jointly arrive at decided, conclusions, solutions, or solve disputes.
Communicating – Talking with and/or listening and/or signaling people to convey or exchange information; includes giving/receiving assignments and or/directions.
Instructing – Teaching subject matter to others or training others through explanation, demonstration, and supervised practice; or making recommendations on the basis of technical disciplines.
Interpersonal skills/behaviors – Dealing with individuals with a range of moods and behaviors in a tactful, congenial, personal manner so as not to alienate or antagonize them.
Section 4: Physical Demands (Check one)
Frequency / Not Required / Less than 25% / 25 to 49% / 50 to 74% / 75% or more
Sitting - is a rest position supported by the buttocks or thighs where the torso is more or less upright.
Standing – is a position in which the body is held upright and supported only by the feet,
Walking – Moving about on foot.
Climbing – Ascending or descending ladders, stairs, ramps, and the like, using the feet and legs and/or hands and arms.
Balancing – Maintaining body equilibrium to prevent falling on narrow, slippery or erratically moving surfaces, or maintaining body equilibrium when performing feats of agility.
Stooping – Bending body downward and forward. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.
Kneeling, Crouching, and Crawling - Bending legs at knees to come to rest on knee or knees; bending downward and forward by bending legs and spine; moving about on hands and knees or hands and feet.
Reaching – Extending hand(s) and arm(s) in any direction.
Handling, Fingering, and Feeling - Seizing, holding, grasping, turning, or otherwise working with hand or hands; picking, pinching, or otherwise working primarily with fingers rather than with the whole hand or arm as in handling; perceiving attributes of objects, such as size, shape, temperature, or texture, by touching with skin, particularly that of fingertips.
Hearing – Perceiving the nature of sounds. Used for those activities which require ability to receive detailed information through oral communications, and to make fine discriminations in sounds, such as when making fine adjustments on running engines.
Control of others – Seizing, holding, controlling, and/or otherwise subduing, violent, assaultive, or physically threatening persons to defend one’s self or prevent injury. Body strength and agility of all four limbs is necessary.
Section 5: Visual (Check one)
Frequency / Not Required / Less than 25% / 25 to 49% / 50 to 74% / 75% or more
Near Acuity - Clarity of vision at 20 inches or less
Far Acuity – Clarity of vision at 20 feet or more
Depth Perception – Three dimensional vision
Accommodation – Adjustment of eyes to bring things into clear focus. Close work.
Color Vision – Ability to identify and distinguish colors.
Section 6: Weight (Check all that apply)
Lifting - Raising or lowering an object fromone level to another.
Carrying - Transporting an object, usually holding it in the hands or arms or on the shoulder.
Pushing - Using upper extremities to press against with steady force inorder to thrust forward, downward or outward.
Pulling - Using upper extremities to exert force in order to draw, drag, haul or tug objects in a sustained motion.
Frequency / Not Required / Less than 25% / 25 to 49% / 50 to 74% / 75% or more
 Lifting  Carrying  Pushing  Pulling - Up to 10 pounds
 Lifting  Carrying  Pushing  Pulling - Up to 25 pounds
 Lifting  Carrying  Pushing  Pulling - Up to 50 pounds
 Lifting  Carrying  Pushing  Pulling - Up to 100 pounds
 Lifting  Carrying  Pushing  Pulling - More than 100 pounds
Section 7: Environmental Conditions (Check one)
Frequency / Not Required / Less than 25% / 25 to 49% / 50 to 74% / 75% or more
Exposure to Extreme Weather – Exposure to hot, cold, wet, humid, or windy conditions caused by the weather.
Extreme Cold Non-Weather Related – Exposure to non-weather related cold temperatures.
Extreme Heat Non-Weather Related – Exposure to non-weather related hot temperatures.
Wet and/or Humid – Contact with water or other liquids; or exposure to non-weather related humid conditions.
Atmospheric Conditions – Exposure to conditions such as fumes, noxious odors, dusts, mists, gases, and poor ventilation that affect the respiratory system, eyes or the skin.
Hazards – Exposure to situations with a definite risk of bodily injury, such as, proximity to moving mechanical parts, electrical current, working on scaffolding and high places, explosives, radiations, chemicals.
Vibration – Exposure to a shaking object or surface. This factor is rated important when vibration causes a strain on the body or extremities.
Confined/Restricted Working Environment – Work is performed in a closed or locked facility providing safety and security for clients or fellow workers.
Section 8: Noise (Check one)
Frequency / Not Required / Less than 25% / 25 to 49% / 50 to 74% / 75% or more
Very Quiet (forest trail, isolation booth for hearing test)
Quiet (library, private office)
Loud Noise (lawn mowing or large earth moving equipment)
Very Loud Noise (jack hammer work)
Section 9: Additional information
Are there aspects of the job that can be modified?
Temporarily: Yes No Permanently: Yes No
Explain:
List all machines, tools, equipment and work aides used:
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Section 10: Preparer’s information
Name
Department / Job Title
Signature Date

Rev. 9.7.11 1

Compensation Services