ADA State Accessibility Grievance Form

DAS Home / Director's Office / ADA Task Force / ADA State Accessibility Grievance Form

 

Grievance Procedure

The Grievance Procedure is established to meet the requirements of the Americans with Disabilities Act of 1990 (“ADA”). It may be used by anyone who wishes to file a complaint alleging discrimination on the basis of disability in the provision of services, activities, programs, or benefits by the State of Nebraska.

Filing a Complaint

The complaint should be in writing and contain as much information as possible about the alleged discrimination such as name, address, phone number of complainant and location, date, and description of the problem. The form below is the preferred method of receiving a complaint.

Submit your grievance form online to the Nebraska ADA Coordinator as soon as possible but no later than 60 days after the alleged violation:


Problem Information Please check the box(es) next to the type of access problem you have experienced. An access problem includes having difficulty using a State-owned facility or part of a facility or being unable to use a facility or part of a facility. Check all of the following that apply:

Resolving Your Complaint For each box checked above, describe the problem, including specific location or website; the State Agency, Board or Commission; and, program or service.

Grievance Process
Within 20 calendar days after receipt of the complaint, the ADA Coordinator will discuss with you the complaint and possible resolutions.

Appealing the Decision
If the response by the ADA Coordinator or their designee does not satisfactorily resolve the issue, the complainant and/or his/her designee may appeal the decision in writing within 30 calendar days after receipt of the response to the Nebraska ADA Task Force.

The complainant and/or his/her designee must state why they are appealing the ADA Coordinator’s decision. Within 20 calendar days after receipt of the appeal, the Nebraska ADA Task Force will meet in person, via phone, or through other electronic means with the complainant and the affected State Agency, Board or Commission in order to discuss the complaint and possible resolutions.

Within 20 calendar days after this meeting, the Nebraska ADA Task Force will respond in writing, or in a format accessible to the complainant, with the final resolution of the complaint. All written complaints received by the ADA Coordinator or their designee, appeals to the Nebraska ADA Task Force, and responses from these two offices will be a public record and retained by the State of Nebraska for at least three years.