Visit this seminar's website at http://www.accc.uic.edu/seminars/acrobat/

For users of screen readers, there are two options to read PDF files: the Make Accessible plugin for Acrobat is a separate download from the Adobe website that allows tagging a PDF file to allow a screen reader to determine the proper reading sequence. This also enables reflowing a PDF for portable devices with their small screen sizes. PDFmaker for MS Office 2000/XP (but not for Office 97) automatically creates tagged PDF files (leave Page labels turned off!).
The other option is the PDF-to-HTML converter at the Access Adobe website. Go there and check this out - you find it under Related Links for this seminar. Older PDF documents (version 3 and older) do not work well with this and should be converted. There are other possible problems due to complex layouts - see the accessibility handout.