As the number of students with disabilities attending college in the United States continues to rise, the workload of Disability Support Services (DSS) offices has also increased. No study to date has examined the primary method (e.g., individual office member, accommodations committee) for reviewing disability accommodation requests. The purpose of the current investigation was to determine the prevalence and preference of review processes for accommodation requests at postsecondary institutions in the U.S. A total of 98 DSS professionals from U.S. institutions participated in an online survey. The findings indicate the majority of accommodation requests are reviewed by a single individual within the DSS office. This study indicated that 59% of requests were reviewed by the DSS director/coordinator and 21% were reviewed by a single DSS staff member. DSS offices that served fewer than 250 students were more likely to use directors/coordinators as reviewers, while offices that assisted more than 250 students were more likely to use department/office staff members. The majority of respondents were satisfied with their current review process and noted efficiency as the primary advantage of having a single individual review accommodation requests. Respondents who indicated they were dissatisfied noted the single reviewer process may contribute to employee burnout.