The Veterans Health Administration (VHA) Medical Center Director failed to meet reasonable accommodations (RA) confidentiality requirements by disclosing an employee’s confidential medical information to unauthorized VA managers, medical staff, and other employees. In addition, the Director improperly appointed herself Designated Management Official (DMO), substituted her medical judgment for that of an employee’s physicians, delayed accommodating the employee while gathering additional, unnecessary medical information, and neglected to provide the employee avenues of redress when she denied the employee’s RA request. Further, the VHA Medical Center Equal Employment Opportunity (EEO) Program Manager and Local Reasonable Accommodations Coordinator (LRAC) failed to implement the 2008 Americans with Disabilities Act Amendments and subsequent Equal Employment Opportunity Commission (EEOC) guidance, after receiving directions from VA’s Office of Diversity and Inclusion. The LRAC violated confidentiality requirements when she consulted VHA physicians and revealed the nature of the employee’s condition to the DMO and others and failed to follow VA policy when she composed an RA denial letter without providing avenues of redress for the VA employee. Further, a Regional Counsel Staff Attorney failed to provide proper advice to the LRAC concerning the employee’s prospective RA, as she told the LRAC that RA guidelines did not recognize the employee’s medical condition as a disability.