Get OPM SF 256 2010

Every precaution is taken to ensure that the information provided by each employee is kept in the strictest confidence. ENTER CODE HERE Targeted Disabilities or Serious Health Conditions 02- Developmental Disability for example autism spectrum disorder 03- Traumatic Brain Injury 19- Deaf or serious difficulty hearing benefiting from for example American Sign Language CART hearing aids a cochlear implant and/or other supports 20- Blind or serious difficulty seeing even when wearing glasses 31- Missing extremities arm leg hand and/or foot 40- Significant mobility impairment benefiting from the utilization of a wheelchair scooter walker leg brace s and/or other supports 60- Partial or complete paralysis any cause 82- Epilepsy or other seizure disorders 90- Intellectual disability 91- Significant Psychiatric Disorder for example bipolar disorder schizophrenia PTSD or major depression 92- Dwarfism disfigurements caused by burns wounds accidents or congenital disorders Other Options 01 - I do not wish to identify my disability or serious health condition. 05 - I do not have a disability or serious health condition. 06 - I have a disability or serious health condition but it is not listed on this form. U.S. Office of Personnel Management Other Disabilities or Serious Health Conditions 13- Speech impairment 41- Spinal abnormalities for example spina bifida or scoliosis 44- Non-paralytic orthopedic impairments for example chronic pain stiffness weakness in bones or joints some loss of ability to use part or parts of the body 51- HIV Positive/AIDS 52- Morbid obesity 59- Nervous system disorder for example migraine headaches Parkinson s disease or multiple sclerosis 80- Cardiovascular or heart disease 81 Depression anxiety disorder or other psychiatric disorder 83- Blood diseases for example sickle cell anemia hemophilia 84- Diabetes 85- Orthopedic impairments or osteo-arthritis 86- Pulmonary or respiratory conditions for example tuberculosis asthma emphysema 87- Kidney dysfunction 88- Cancer Present or past history 94- Learning disability or attention deficit/hyperactivity disorder ADD/ADHD 95- Gastrointestinal disorders for example Crohn s Disease irritable bowel syndrome colitis celiac disease dysphexia 96- Autoimmune disorder for example lupus fibromyalgia rheumatoid arthritis 97- Liver disease for example hepatitis or cirrhosis 98- History of alcoholism or history of drug addiction but not currently using illegal drugs 99- Endocrine disorder for example thyroid dysfunction Page 1 of 2 SF 256 Revised Previous editions not usable Definition An individual with a disability A person who 1 has a physical or mental impairment which substantially limits one or more major life activities 2 has a record of such an impairment or 3 is regarded as having such an impairment. This definition is provided by the Rehabilitation Act of 1973 as amended 29 U.S.C. 701 et seq. government to establish programs that will facilitate the hiring placement and advancement of individuals with disabilities. While selfidentification is voluntary your cooperation in providing accurate information is critical to these efforts. Every precaution is taken to ensure that the information provided by each employee is kept in the strictest confidence. ENTER CODE HERE Targeted Disabilities or Serious Health Conditions 02- Developmental Disability for example autism spectrum disorder 03- Traumatic Brain Injury 19- Deaf or serious difficulty hearing benefiting from for example American Sign Language CART hearing aids a cochlear implant and/or other supports 20- Blind or serious difficulty seeing even when wearing glasses 31- Missing extremities arm leg hand and/or foot 40- Significant mobility impairment benefiting from the utilization of a wheelchair scooter walker leg brace s and/or other supports 60- Partial or complete paralysis any cause 82- Epilepsy or other seizure disorders 90- Intellectual disability 91- Significant Psychiatric Disorder for example bipolar disorder schizophrenia PTSD or major depression 92- Dwarfism disfigurements caused by burns wounds accidents or congenital disorders Other Options 01 - I do not wish to identify my disability or serious health condition. 05 - I do not have a disability or serious health condition. 06 - I have a disability or serious health condition but it is not listed on this form. U.S. Office of Personnel Management Other Disabilities or Serious Health Conditions 13- Speech impairment 41- Spinal abnormalities for example spina bifida or scoliosis 44- Non-paralytic orthopedic impairments for example chronic pain stiffness weakness in bones or joints some loss of ability to use part or parts of the body 51- HIV Positive/AIDS 52- Morbid obesity 59- Nervous system disorder for example migraine headaches Parkinson s disease or multiple sclerosis 80- Cardiovascular or heart disease 81 Depression anxiety disorder or other psychiatric disorder 83- Blood diseases for example sickle cell anemia hemophilia 84- Diabetes 85- Orthopedic impairments or osteo-arthritis 86- Pulmonary or respiratory conditions for example tuberculosis asthma emphysema 87- Kidney dysfunction 88- Cancer Present or past history 94- Learning disability or attention deficit/hyperactivity disorder ADD/ADHD 95- Gastrointestinal disorders for example Crohn s Disease irritable bowel syndrome colitis celiac disease dysphexia 96- Autoimmune disorder for example lupus fibromyalgia rheumatoid arthritis 97- Liver disease for example hepatitis or cirrhosis 98- History of alcoholism or history of drug addiction but not currently using illegal drugs 99- Endocrine disorder for example thyroid dysfunction Page 1 of 2 SF 256 Revised Previous editions not usable Definition An individual with a disability A person who 1 has a physical or mental impairment which substantially limits one or more major life activities 2 has a record of such an impairment or 3 is regarded as having such an impairment. ENTER CODE HERE Targeted Disabilities or Serious Health Conditions 02- Developmental Disability for example autism spectrum disorder 03- Traumatic Brain Injury 19- Deaf or serious difficulty hearing benefiting from for example American Sign Language CART hearing aids a cochlear implant and/or other supports 20- Blind or serious difficulty seeing even when wearing glasses 31- Missing extremities arm leg hand and/or foot 40- Significant mobility impairment benefiting from the utilization of a wheelchair scooter walker leg brace s and/or other supports 60- Partial or complete paralysis any cause 82- Epilepsy or other seizure disorders 90- Intellectual disability 91- Significant Psychiatric Disorder for example bipolar disorder schizophrenia PTSD or major depression 92- Dwarfism disfigurements caused by burns wounds accidents or congenital disorders Other Options 01 - I do not wish to identify my disability or serious health condition. 05 - I do not have a disability or serious health condition. 06 - I have a disability or serious health condition but it is not listed on this form. U.S. Office of Personnel Management Other Disabilities or Serious Health Conditions 13- Speech impairment 41- Spinal abnormalities for example spina bifida or scoliosis 44- Non-paralytic orthopedic impairments for example chronic pain stiffness weakness in bones or joints some loss of ability to use part or parts of the body 51- HIV Positive/AIDS 52- Morbid obesity 59- Nervous system disorder for example migraine headaches Parkinson s disease or multiple sclerosis 80- Cardiovascular or heart disease 81 Depression anxiety disorder or other psychiatric disorder 83- Blood diseases for example sickle cell anemia hemophilia 84- Diabetes 85- Orthopedic impairments or osteo-arthritis 86- Pulmonary or respiratory conditions for example tuberculosis asthma emphysema 87- Kidney dysfunction 88- Cancer Present or past history 94- Learning disability or attention deficit/hyperactivity disorder ADD/ADHD 95- Gastrointestinal disorders for example Crohn s Disease irritable bowel syndrome colitis celiac disease dysphexia 96- Autoimmune disorder for example lupus fibromyalgia rheumatoid arthritis 97- Liver disease for example hepatitis or cirrhosis 98- History of alcoholism or history of drug addiction but not currently using illegal drugs 99- Endocrine disorder for example thyroid dysfunction Page 1 of 2 SF 256 Revised Previous editions not usable Definition An individual with a disability A person who 1 has a physical or mental impairment which substantially limits one or more major life activities 2 has a record of such an impairment or 3 is regarded as having such an impairment. This definition is provided by the Rehabilitation Act of 1973 as amended 29 U.S.C. 701 et seq. government to establish programs that will facilitate the hiring placement and advancement of individuals with disabilities. One method for determining agency progress in fulfilling these requirements is through the production of reports at certain intervals showing for example the number of employees with disabilities who are hired promoted trained or reassigned over a given time period the percentage of employees with disabilities in the work force and in various grades and occupations etc. Such reports bring to the attention of agency top management OPM and the Congress the progress or any deficiencies within specific agencies or the Federal government as a whole in the hiring placement and advancement of individuals with disabilities. .