Business

Accommodating your employees: Easy ways to comply with the Americans with Disabilities Act

Making your office suitable for workers with disabilities can be inexpensive and less complicated than you think.

By Mike Norbut — Posted March 7, 2005

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Most doctors are familiar with the Americans with Disabilities Act because of how it applies to their patients. Some offices have exam tables with adjustable heights, while others have wide doors and hallways to be more accessible to people in wheelchairs.

Accommodating employees with disabilities, however, is not a scenario for which physicians are as widely prepared. Those who do not have an employee with either a physical or mental disability, might never have been forced to know the different rules that apply to those workers.

There could be a time, though, when you need to help a capable employee who has been injured or diagnosed with a debilitating disease. Or you might want to protect yourself from future liability, by being prepared to hire a person with a disability. Most accommodations are fairly inexpensive, and can go a long way to preserving a harmonious office environment.

According to the U.S. Census Bureau, there are nearly 50 million Americans older than 5 who have a disability, so the odds are pretty good that you eventually could have the opportunity to employ a worker who is disabled. The spectrum, of course, is wide, to the point that you might not even know some of your current employees are technically disabled.

Just as some disabilities can be difficult to define, the ADA itself is a challenging law with many wrinkles best left for legal experts to interpret. For example, a person would not be deemed disabled if he or she is using a medical aid to perform the appropriate job functions, said Rachel Steely, a partner in the labor and employment section of Gardere Wynne Sewell LLP, a law firm based in Houston. A person who is legally blind but wears corrective lenses, or someone who has bipolar disorder but is on medication, would not qualify under the act, she said.

"The employee has to be able to perform the essential job functions, with or without help," Steely said. "The U.S. Supreme Court said it will take into account remedial measures that can bring you back" to a level of being able to perform the job.

The federal law applies to businesses with 15 or more employees, so many small practices do not fall under the ADA's purview. Some states, however, have laws that could apply different standards in terms of the number of employees.

Physician offices can offer a unique challenge because of their often vague leadership hierarchies. The lines defining employer and employee can sometimes be blurred, said Patricia Haas, an employment and labor attorney with the Cleveland office of McDonald Hopkins Co., LPA.

"Some physicians may be considered shareholders," Haas said. "Can they hire or fire? Who sets the rules and regulations of the other individuals? Sometimes there are no definitive answers."

Physicians also might want to be involved in the diagnosis of an employee's ailment, but the sense of medical altruism could result in a human resources blunder, attorneys said. The employing physician needs to rely on the treating physician's diagnosis and evaluation of job capabilities the way any manager with no medical background would.

For example, if an otolaryngologist has an employee who claims to have a sinus problem and needs to move his or her desk away from the file room, the doctor has to resist the urge to examine that person to gauge the veracity of the story, Steely said.

"You should send a list of essential job duties to the treating physicians and ask what accommodations are needed to allow the person to perform," Steely said. "Physicians [who are also the employers] can't make the call themselves. This protects them as employers, by having the treating physician saying this is what [the employee] can or can't do."

Simple and affordable

Considering how affordable and simple many accommodations are, it's often easier to just make the proper changes in the office than to try to gamble with legal interpretations, experts said.

New buildings or older structures that have undergone at least a 25% renovation would need to conform to ADA requirements, but there are probably many dated buildings that have not seen much renovation over the years, said Tim Schmida, an architect with Burt Hill Kosar Rittelmann Associates, based in Butler, Pa., near Pittsburgh.

"But if you're a physician, and I'm in a wheelchair and I can't get into the bathroom in your office, I could become a disgruntled [job] applicant," he said.

Actions such as replacing doorknobs with handles or using a horizontal rather than vertical file system can be all the reasonable accommodations needed to help an employee with a disability perform his or her tasks.

Some changes, such as adding grab bars over the toilet or lowering light switches in employee areas, are visually obvious, but there are more subtle changes to make as well, such as scheduling breaks for employees with mental disabilities or changing job descriptions to better utilize everyone's talents.

For David Steiman, MD, a cardiologist in Plantation, Fla., and his wife and office manager, Laura Prado, the accommodations made for a mentally disabled employee are largely in planning and preparation.

Once a week, a 42-year-old woman with Smith-Magenis syndrome, a rare developmental disability, goes to Dr. Steiman's office for one of the highlights of her week: her job.

As parents of a child with autism, Dr. Steiman and his wife realize the difficulties facing people with disabilities, and carving out a job for someone who can contribute is one way they can help. What they get in return, however, is a dependable, fiercely loyal, conscientious worker who deeply values her job, and the accommodations required to employ her were not costly or onerous.

"I don't think it required extraordinary means," Dr. Steiman said. "The main thing is laying out the tasks for her. She's very task-oriented."

As a part-time employee in the practice, the woman handles administrative duties such as filing and mailing insurance claims, and as the practice grows, Dr. Steiman expects more work to be available for her.

"In many ways, a physician's office is a good environment for people with disabilities," Dr. Steiman said. "It's a small business, a family-type atmosphere. We look forward to seeing her every week."

Health care a prime market

Organizations that help to place people with disabilities in jobs have identified the health care industry as one that already is seeing and will continue to see a shortage of labor. Disabled workers organizations are establishing training programs to assist employees in preparing for some of these specific jobs.

"Some advantages to that type of work situation [are that] you have better pay because it's a white-collar environment and it's good career experience," said Sheila Fesko, PhD, project coordinator for the National Center on Workforce and Disability/Adult, part of the Institute for Community Inclusion, a program funded by the U.S. Dept. of Labor. "With a doctor's office, there's a real customer-service dimension, so we'd be looking for someone who likes dealing with people."

There are incentives and tax credits available for businesses that employ people with disabilities, geared to fund on-the-job training for the individuals, Dr. Fesko said.

While training the people might take a little more time, the accommodations necessary to employ someone with a disability often require little more than some understanding.

"A lot of times it's just reorganizing the way certain tasks are done," Dr. Fesko said. "It's flexible schedules and work assignments.

"It's like family and work: You just offer a little more flexibility."

Back to top


ADDITIONAL INFORMATION

Making accommodations

Many physical modifications to the office work environment are easy and inexpensive. Here are some examples:

  • Install horizontal file cabinets to make records more accessible.
  • Use a color-coded system for filing to aid a learning-disabled employee with poor reading skills.
  • Put handles on doors instead of knobs to make them easier to open for those with physical disabilities.
  • Lower light switches for employees who use a wheelchair.
  • Adjust the height of coat racks and hooks for employees who use a wheelchair.
  • Add grab bars over toilets for both employees and patients with physical disabilities.
  • Use hearing/visual impaired technology for phones to aid an employee who might not be able to see a blinking light to know which phone line is ringing.
  • Have proper chairs or adjustable desks to accommodate employees in wheelchairs or with physical disabilities.
  • Schedule breaks and have a designated break room where people with mental disabilities can go at regular intervals to relax and focus.

Back to top


Do's and don'ts

When working with an employee with disabilities, there are several things to keep in mind, both in terms of etiquette and office protocol:

Don't

  • Don't refer to the person as "handicapped." The proper terminology is "person with disabilities."
  • When interviewing a candidate, don't make your first question about the accommodations the employee would need if hired. There will be time to ask that, but your first questions should focus on the tasks of the position.
  • If an employee becomes disabled, don't examine him or her yourself to determine the extent of the disability. For the sake of liability, leave recommendations about job functions to the employee's treating physician.

Do

  • Offer assistance to the employee, but don't start helping without asking first. The employee might decline your offer.
  • Treat all devices that assist a person with a disability as personal property. Don't move a wheelchair or crutches that are in the way, and don't use them as a prop.
  • Interact with a person with a disability as if he or she weren't disabled. Use a normal speaking tone, offer to shake hands and treat adults like adults.

Sources: Labor attorneys and the National Center on Workforce and Disability/Adult

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn