Not legal advise..I've had to request accomadations through my employer. Not for speaking but other mental processing. I started with my PCP who then made referrals to the appropriate specialists. It took a couple years for them to sign off saying that it's permanent or will last longer than a year. Also the limitations were first determined by me, what I felt I was able to do. The PCP or specialist reviewed this against their assessment and either endorsed it or made recommendation to alter. The accommodations I had already discussed with employer, and then refined those measures when the doctors signed the form. Took about two years to have an official accommodation on file, though supervisor basically had an unofficial one with me while it was all in work.