ENews: Volume 12, Issue 2, Second Quarter, 2014
The JAN E-News is a quarterly online newsletter. Its purpose is to keep subscribers informed about low-cost and innovative accommodation approaches; the latest trends in assistive technologies; announcements of upcoming JAN presentations, media events, trainings, and Webcasts; and legislative and policy updates promoting the employment success of people with disabilities.
An e-mail announcement is sent to an opt-in list when a new issue is available. Please use the links at the end of this document to subscribe or unsubscribe.
Applying the ADA in a Global Economy
Job Application/Interview Stage Dos and Don’ts
- Implementing a Workplace Fragrance Policy as an Accommodation
- Addressing Accommodation Needs Specific to Gastrointestinal Disorders
- April Was National Donate Life Month
- Autism Awareness
- JAN Blog Growing
- JAN Releases New Resources
- JAN Exhibit and Training Schedule
- Subscribe to JAN Newsletter
- Applying the ADA in a Global Economy
- Job Application/Interview Stage Dos and Don’ts
- Implementing a Workplace Fragrance Policy as an Accommodation
- Addressing Accommodation Needs Specific to Gastrointestinal Disorders
- April Was National Donate Life Month
- Autism Awareness
- JAN Blog Growing
- JAN Releases New Resources
- JAN Exhibit and Training Schedule
- Subscribe to JAN Newsletter
These days, the U.S. economy is part of a larger, global economy so it is not unusual for U.S. companies and U.S. citizens to work in foreign countries, nor is it unusual for foreign companies to operate in the United States. As a result, one of the questions that arises is: when do U.S. laws apply to employees who work overseas or who work in the United States for a foreign employer? Of course at JAN the law we get the most questions about is the Americans with Disabilities Act (ADA). Luckily, the Equal Employment Opportunity Commission (EEOC) has published guidance on this issue. This guidance is aptly called: Enforcement Guidance on Application of Title VII and the Americans with Disabilities Act to Conduct Overseas and to Foreign Employers Discriminating in the United States. Here’s a summary of what it says:
- Working in a Foreign Country: To determine whether the ADA applies to employment in foreign countries, you must look at both the employee and the employer. The employee must be a U.S. citizen; foreign employees working in foreign countries have no protection under the ADA. In addition, the employer must be a covered entity (at least 15 employees) and must be of American nationality or, if foreign, controlled by an employer of American nationality. There is one exception called the “foreign laws defense.” All this defense means is that American employers do not have to violate the laws of the foreign country in which the workplace is located in order to comply with the ADA. So, to quote the EEOC, generally “American workers employed by U.S. companies overseas enjoy the same broad protections as workers in the U.S. That means protection under the anti-discrimination laws travels with the employee, so long as the employee is a U.S. citizen working for a U.S. company.”
- Foreign Employers in the United States: On the other hand, the ADA applies to foreign companies with 15 or more employees operating within the United States regardless of an employee’s nationality. However, in some cases coverage is limited by a treaty or international agreement between the United States and the home country of the foreign employer.
For more information, see JAN's Consultants' Corner titled Does the ADA Apply to Foreign Employment?
- Linda Carter Batiste, J.D., Principal Consultant
Job Application/Interview Stage Dos and Don’ts JAN has been around for about 30 years so as you might imagine, we’ve heard just about everything there is to hear about job accommodations and the ADA. Over the years, one thing we’ve heard repeatedly is that employers are sometimes confused about how the ADA applies at the job application/interview stage of employment. So, we thought we’d address some of the issues that tend to cause this confusion.
We always like to start with the general ADA rules and then discuss any exceptions, so here are the general dos and don’ts that apply at the job application/interview stage:
- Don’t focus on an applicant’s disability.
- Don’t ask unnecessary medical questions or require unnecessary medical examinations or documentation.
- Don’t base hiring decisions on myths, fears, or stereotypes about people with disabilities.
- Do focus on an applicant’s qualifications.
- Do get the information needed to determine whether an applicant is qualified.
- Do base hiring decisions on skills, qualifications, and experience.
1. What happens if an applicant has an obvious disability?
What you do in this case depends on the applicant’s limitations and the job he’s applying for. Before asking any questions about the applicant’s disability, the interviewer must have a reasonable belief, based on objective evidence that the disability will potentially interfere with job performance.
In many cases, an applicant’s obvious disability will not be relevant to whether he can perform the job. For example, an applicant for a clerical position uses a wheelchair, but has full use of his arms and hands. The job involves data entry and some phone work. There does not appear to be a valid reason for the interviewer to ask questions about the applicant’s use of a wheelchair.
In other cases, an applicant’s obvious disability is relevant. Take the same applicant in a wheelchair, but this time he’s applying for a warehouse stock clerk job, which involves retrieving items off of tall shelves in the warehouse to fill customer orders. In this case, there are valid questions about how the applicant is going to do the job so the interviewer can ask the applicant to explain or demonstrate how he will retrieve items from tall shelves.
2. What happens if an applicant brings up medical information?
The good news is that the answer to the previous question above applies here as well. What if you’re not sure whether the applicant’s disclosure is relevant to his ability to participate in the job interview or his qualifications for the job? One thing you can always do if someone discloses during the job interview is to ask “is there anything you need in order to participate in the interview or to perform the job tasks”? This question acknowledges the applicant’s disclosure, but stops short of asking any specific questions about the applicant’s medical condition. It also gives the applicant the chance to ask for an accommodation if one is needed or to clarify why he is disclosing.
3. What happens if an applicant asks for an accommodation for the job interview?
When an applicant asks for an accommodation for the job interview, the employer can require medical documentation. This is an exception to the general rule that employers cannot ask medical questions or require medical documentation prior to a job offer. What is allowed when someone asks for an accommodation? You’re basically allowed to get the information you need to verify that the applicant has a disability and needs the accommodation and whatever information is necessary to process the request and come up with successful accommodations.
Do you have to get all this information? Not necessarily. You may want to just provide the accommodation and skip the medical documentation, especially when there is a time crunch.
4. What happens if disability is a qualification standard?
For example, what if you want to hire someone with a history of drug addiction for a position as a peer counselor for people with drug addiction who are currently undergoing treatment? In this case, having a disability is a qualification standard. Does that mean you can ask applicants whether they have a disability? The answer is “maybe.” While it might be better to follow the rules for affirmative action hiring (invite voluntary disclosure, but don’t ask specific disability-related questions until post offer), according to informal guidance from the Equal Employment Opportunity Commission, this situation might provide an exception to the general rule that employers cannot ask applicants whether they have a disability prior to a job offer. For more information, see: http://www.eeoc.gov/eeoc/foia/letters/2007/ada_disability_1.html
The general rule is no medical inquiries or exams at the application/interview stage. One exception to this rule is when an applicant asks for an accommodation for the application/interview process. Then you’re allowed to ask medical questions or require documentation to show that the applicant has a disability and needs the accommodations WHEN it’s not obvious.
Another exception is when you have a reasonable belief based on objective evidence that the applicant is going to have trouble performing the job because of a known or obvious disability. Here you’re allowed to ask medical questions, but you cannot send the applicant for a medical exam or require medical documentation. Medical exams and documentation related to job performance must wait until post offer under this exception.
And a potential final exception is when having a disability is a qualification for the job, but it might be better to wait until post job offer to confirm that an applicant has the requisite disability if the applicant did not voluntarily disclose.
For more information, see:
- Pre-Offer, Disability-Related Questions: Dos and Don'ts
- Preemployment Disability-Related Questions and Medical Examinations
- Affirmative Action and Disability: What Can Employers Ask?
- Beth Loy, Ph.D., Principal Consultant
Years ago, employers never would have imagined being asked to consider implementing a policy to ban fragrances from the workplace. However, with the multitude of chemicals the public is exposed to every day, it’s not surprising that we have arrived here. Think of it like the discovery of the impact of exposure to second-hand smoke in the late 80s, early 90s. The health effects of fragrance chemicals are quite similar and public awareness of the issue is growing with increased information sharing. How does this affect the workplace? It’s been estimated that indoor environmental air quality-related health issues, which can develop from exposure to chemicals and other irritants in the workplace, cost business in the range of $20-$70 billion annually due to lost productivity, decreased performance, and absences from illness (Women for a Healthy Environment). Recognizing fragrances and other commonly used products as contributing factors to poor air quality and making positive changes to improve workplace air quality can benefit all employees, as well as an employer’s bottom line.
Exposure to fragranced products can make it difficult to impossible for some employees to function effectively at work. JAN Consultants often discuss fragrance-related accommodation solutions and best practices with employers and employees who report fragrance sensitivity. Fragrance sensitivity is either an irritation or an allergic reaction to some chemical or combination of chemicals in a product. Although perfumes and colognes are generally what come to mind, fragrance is commonly added to a variety of daily use items like toiletries, cosmetics, air fresheners, scented candles, laundry soaps and softeners, and cleaning products. People with fragrance sensitivity often experience symptoms such as breathing difficulties (wheezing, a tight feeling in the chest, or worsening of asthma symptoms); headaches; nausea; hives and other skin irritations; and limitations in memory and concentration.
Situations involving fragrance sensitivity can be a little complicated because accommodation solutions can sometimes affect others in the work environment. Certainly there are various accommodation solutions to consider, but one accommodation that is becoming more common in the workplace is the implementation of a fragrance policy or notice requesting that all employees refrain from wearing or using scented products in the workplace. While a 100% fragrance-free environment may not be considered reasonable under the ADA (due to the impracticality of enforcing such a policy), employers are not precluded from implementing fragrance policies, or sending out memos to make people aware of the concept of being courteous to fellow co-workers. Essentially, an employer can still take measures to reduce or eliminate exposure to known irritants – without having to establish a 100% fragrance-free environment. It becomes a matter of increasing fragrance-use awareness and informing the workforce about the impact of fragrance chemicals on health – their own and others’.
Developing, implementing, and enforcing a fragrance policy should be handled in much the same way as any other employment policy. It is suggested the term fragrance-free policy not be used, given that it is virtually impossible to create a 100% fragrance-free environment. A 100% fragrance-free environment may not be feasible, but steps can be taken to limit overall exposure to fragrances at work. Employers who have concerns about implementing a policy specifically about products worn into the work environment could begin by implementing a policy related to what is used IN the work environment. For example, banning the use of plug-ins, scented candles and aerosol sprays in the workplace but requesting that employees refrain from wearing scents INTO the workplace. It will be more feasible to enforce actual policies related to products used in the workplace. However, this might simply be the first step toward implementing an enforceable policy that bans wearing fragrances into the workplace and creates a healthier environment for everyone.
Employers who do wish to implement a fragrance policy, either as a workplace accommodation or a proactive step toward better indoor air, do not have to go to great lengths to research and develop policy language. Many employers in the United States, as well as internationally, have developed such policies and procedures and have made the information available to the public. This means you do not have to reinvent the wheel, you just have to determine what is reasonable for your organization to implement. Simply searching Google using the term “fragrance policy” will produce a number of credible examples. A good example of a generic fragrance policy template that JAN has identified is offered by the American Lung Association (ALA) – although the policy does use the term fragrance-free and we would suggest dropping “free” from the policy. See the following:
Workplace Fragrance Policy Examples (American Lung Association)
- [EMPLOYER] expects that all offices and spaces used by the staff and their visitors remain free of scented products.
- Personal care products such as cologne, perfume, aftershave lotions, scented lotions, fragranced hair products and/or similar products are not to be worn in the facilities owned and operated by [EMPLOYER] including company owned vehicles.
- Use of air fresheners and candles are prohibited from the facilities owned and operated by [EMPLOYER] including company owned vehicles.
- Use of cleaning products other than those purchased by the [EMPLOYER or BUILDING MANAGEMENT] are prohibited for cleaning personal workspaces.
Procedural information from ALA, shown below, offers ways to implement, inform people about, and enforce a policy:
- Employees will be informed of the [EMPLOYER] Fragrance-free Policy through signs posted throughout properties owned and operated by [EMPLOYER] including company-owned vehicles.
- Visitors will be informed of the [EMPLOYER] Fragrance-free Policy by their hosts, the meeting invite, email correspondences and signs posted throughout the properties owned and operated by [EMPLOYER].
- Sample email signature for guests: “This is a fragrance-free workplace. Thank you for not wearing any of the following during your visit: cologne, aftershave lotion, perfume, perfumed hand lotion, fragranced hair products, and/or similar products. Our chemically-sensitive co-workers and clients thank you.”
- Any violations of this policy will be handled through the standard disciplinary procedure.
For more information, go to http://action.lung.org/site/DocServer/fragrance-free-workplace.pdf.
The Society for Human Resource Management (SHRM) offers a useful generic fragrance policy template as well (for members only link):
- Recognizing that employees and visitors to our offices may have sensitivity and/or allergic reactions to various fragrant products, [Company Name] is a fragrance-free workplace. Personal fragrant products (fragrances, colognes, lotions, powders and other similar products) that are perceptible to others should not be worn by employees. Other fragrant products (scented candles, potpourri and other similar items) are also not permitted in the workplace. Any employee with a concern about scents or odors should contact his or her manager or the Human Resource Department.
As with any accommodation situation, it is up to the employer to determine what is reasonable with regard to the type of accommodation(s) to implement. There may be many solutions to consider. For more information, JAN recently offered a free Webcast entitled Accommodating Employees with Fragrance and Chemical Sensitivities that is now available as an archive. Anyone can access this Webcast to learn more about accommodation ideas, the ADA, and fragrance policy issues. Additional information can also be found by visiting the A-Z of Disabilities section at AskJAN.org, or by contacting a JAN Consultant.
- Tracie DeFreitas, M.S., Lead Consultant, ADA Specialist
Gastrointestinal (GI) disorders include conditions such as Crohn’s disease, gastroparesis, ulcerative colitis, irritable bowel syndrome, spastic colon, and diverticulitis. People with GI disorders may experience various symptoms including constipation, nausea, abdominal pain, or diarrhea. Feeling miserable and stressed out also are common complaints and can exacerbate the symptoms associated with GI disorders.
We all know that stress can be hard on the stomach (emotional “butterflies” are manifested in the stomach) and there is a strong connection between stress and bowel issues. As mentioned above, often there are underlying conditions that result in GI problems, but when there are no known medical causes, these problems are referred to as “functional GI symptoms.” Studies have shown a strong relationship between anxiety, depression, and functional GI symptoms. It follows that stress management and exercise may be helpful to alleviate functional GI symptoms as well as GI disorders in general.
Unfortunately, many people do not discuss their symptoms even with their doctor and often feel embarrassed to discuss their situation with their employer, which can certainly add to their stress. And when there is a work related performance issue linked to a GI disorder, individuals with GI disorders may need to disclose or risk losing their jobs. There may be accommodations that would help overcome the performance issues, but employers are not required to provide accommodations unless they know they are needed. Individuals who are embarrassed or uncomfortable talking about their GI disorders may feel more comfortable making a written accommodation request. For ideas about what to include in a written accommodation request, see: JAN's How to Request an Accommodation.
For employers who have a reasonable belief that an employee’s performance issue is related to a GI disorder and that the employee might benefit from a reasonable accommodation, it might be beneficial to initiate a conversation with the employee. Employers are allowed to address the specific work related problems, may ask why the problem exists without alluding to a possible disability, and if an underlying medical condition is cited by the employee, the employer may ask how they can help to make an improvement, i.e., reasonable accommodation.
The following are real life examples of accommodation situations involving employees with GI disorders:
- A retail sales clerk was frequently tardy to work because he spent the early morning in his bathroom at home due to a GI disorder. The employer allowed a later arrival time at work as a reasonable accommodation.
- A customer service representative was absent from her desk to the point that it was negatively impacting her performance numbers because of frequent and urgent need to use the restroom. The employer moved her workstation closer to the nearest office restroom, thereby reducing her absence from taking phone calls at her desk and increasing her productivity.
- A supervisor at a detention center asked for a less stressful job as possible accommodation because the workplace stress often triggered symptoms of his GI disorder. The employer complied and even suggested the supervisor take some exercise breaks to calm his nerves.
- Eddie Whidden, M.A., Senior Consultant, Motor Team
In honor of National Donate Life month, JAN wanted to take time to talk about accommodations for individuals who have undergone organ transplants. Many people who have had organ transplants have already experienced chronic health conditions for many years. After receiving an organ transplant they do get a new lease on life, but significant challenges can remain. After an organ transplant, transplant recipients have to take immunosuppressant drugs to keep their bodies from rejecting the new organs. These drugs can cause serious side effects, and sometimes they can increase the risk of developing other impairments. As a result, employers might want to be aware that accommodations may be needed both before and after the transplant. To provide employers with accommodation information, JAN recently published an article on accommodations for employees who have undergone organ transplants in the JAN Blog.
In addition, here are several accommodation examples involving employees who have undergone organ transplants:
- An administrative employee at a busy hospital who had a heart transplant was told by his doctor he needed to avoid areas where he would be exposed to pathogens because he was taking immunosuppressant medications. The employee’s job did not require him to have direct contact with the public and in fact it was determined that the essential functions of the employee’s job could be done from home. The employer allowed the employee to work at home as an accommodation.
- A call center employee who works in a cubicle that is also used by other employees was concerned about being exposed to germs. The employee had undergone a liver transplant and was taking immunosuppressant medication. The employer allowed the employee to have her own private cubicle and purchased a keyboard, mouse, and telephone headset that could be sterilized.
- An employee at a law firm had to sign many documents as a part of her job. The employee was taking immunosuppressant medications, which caused a side effect of severe tremors in her hands making it difficult for her to sign documents. The employer provided a weighted pen temporarily and ordered a signature stamp as a long term solution.
- Burr Corley, MSW, Consultant, Motor Team
As we transition from winter into spring, we are reminded of other transitions as well. One of the biggest and most exciting transitions to take place in the next several months is graduation! Some students may be graduating from high school and going on for post-secondary training, but others may be entering the job market at this time. Still others may be completing their college or post-secondary training and will be looking for employment.
Graduation can be a joyous time when the dreams for our futures become more of a reality. Whether we sailed through our program of study, or succeeded by just the skin of our teeth, we realize that now we are ready to embark on the next step of our journey, the one that involves employment. Looking for employment can bring on a mixture of thoughts and emotions including anticipation, excitement, anxiety, or dread. It is perfectly normal to be a bit uneasy, because we don’t know what might happen as we move forward. But for someone with Autism Spectrum Disorders (ASD), the thought of employment can be downright distressing or unnerving. Let’s look at why this may be so.
Social skills deficits are common among individuals with ASD and can be a cause of great anxiety. Many individuals with ASD have difficulty successfully managing job interviews due to interactions with strangers and people in authority. Interviewing for a job can be a stressful experience for anyone looking for employment, but if job applicants have social difficulties associated with ASD, the experience could be paralyzing. Anxiety of this kind may cause applicants to be unable to think on the spot, and ultimately be unable to respond in ways that effectively communicate their knowledge and experience. However, when given very specific examples of how to better present themselves and interact with others in an interviewing situation, individuals with ASD may become more competent in altering their social interactions in employment settings.
Accommodations for the interviewing process can be helpful in assisting job applicants with ASD remain calm and more positively represent themselves and their abilities. For more information on those specific accommodations and tips to help applicants with ASD in interview situations, read our new Consultants’ Corner: Interviewing Tips for Applicants with ASD.
Once individuals with ASD are thoroughly prepared for a job interview, they will be able to perform to the best of their ability. Then all they need to do is relax, smile, and most importantly, be themselves! Congratulations to the graduates, and best wishes in the interviewing process.
For accommodation ideas on the job, see our Accommodation and Compliance Series: Employees with ASD.
The Ask JAN Blog provides an opportunity for you to share with others your workplace accommodation solutions. JAN receives over 40,000 contacts per year – conversations with all of you that help us better understand what’s working effectively in your workplaces. We have a great deal to learn from one another. We encourage you to share your experiences and interact with the JAN staff. Your accommodation success stories can benefit many others around the Nation. Enjoy the new postings and additional Spanish selections:
- April is Donate Life Month: Accommodations for Employees Who Have Received Organ Transplants
- Telework Week 2014 Begins with a March Snowstorm
- February is American Heart Month
- Go Red! February 7th is National Wear Red Day
- Don’t Break the Bank in 2014 — Low Cost Accommodations Do Exist!
- JAN Publishes Consultants' Corners.
- Find technical assistance on Does the ADA Apply to Foreign Employment? >> Read JAN's Consultants' Corner, Volume 10, Issue 02.
- Find information on Interviewing Tips for Applicants with Autism Spectrum Disorders (ASD). >> Read JAN's Consultants' Corner, Volume 10, Issue 01.
- JAN Releases Webcast Archive Series.
- Making Online Applications Accessible for Federal Contractors. The new Section 503 regulations stop short of requiring federal contractors to make their online application systems accessible, but the regulations do codify the OFCCP’s position that federal contractors must make reasonable accommodations for any applicants with disabilities who cannot access online systems and further state that making online application systems accessible is a recommended best practice. In light of this, many federal contractors are implementing changes to make their online application systems accessible. In this session, JAN Consultants shared practical tips and tools to help these contractors succeed in their efforts. >> View the Online App Webcast Archive.
- Best Practices: Federal Government. Viewers will learn more about the President's Executive Order 13548, "Increasing Federal Employment of People with Disabilities;" the Schedule A Hiring Authority for People with Disabilities; the competitive federal hiring process and USAJOBS; and best and promising public and private sector practices for hiring and retaining people with disabilities. >> View the Best Practices Webcast.
- Section 503 Basics and Practical Tips. In this session, Bobby Silverstein, J.D., Director of the Center for the Study and Advancement of Disability Policy, discussed the new Section 503 regulations and provided practical tips for compliance. Bobby was joined by a federal contractor. >> View the First of JAN's Federal Contractor Webcast Series.
- JAN Releases New and Updated Documents. Learn more about The Interactive Process and Service Providers. >> Download this document and more from JAN's Comprehensive List.
- Spanish Library. JAN updates its Spanish library. Look for new publications coming to JAN's library of documents and other postings. >> Download a JAN document in Spanish.
- Assistant Secretary Martinez Pens Blog on Meeting the Demands of an Expanding Health Care Workforce. In her April 15 posting on the Department of Labor's official blog site, Kathy Martinez, Assistant Secretary of Labor for Disability Employment Policy, focused on the increasing demand for health care workers, particularly nurses. She highlighted a recent policy roundtable hosted by the Office of Disability Employment Policy that examined strategies for employing people with disabilities in these professions. "People with disabilities not only represent an untapped talent pool that can help respond to looming labor shortages in nursing and other health care occupations, but they also offer significant value and insight that can improve care for patients and their families," noted Martinez. >> Read the blog.
- Celebrating Women with Disabilities: An Interview with Kathy Martinez. Kathy Martinez, Assistant Secretary of Labor for Disability Employment Policy, was interviewed for the EARN|Exchange Business and Disability blog in honor of Women's History Month. She spoke about role models, changing attitudes, and employment for women with disabilities, among other topics. When asked what advice she would give to young women with disabilities about pursuing their dreams, Martinez responded "Pursue them. Think big. Play hard. Mentor other women. It's really about continuing the dialogue and continuing to bring other women into our community." >> Read the blog.
- What's New with Disability.gov? Disability.gov, the federal government website for information on disability programs and services nationwide, now offers nine "Guides to Information" to help users quickly find a variety of resources on a single topic. The subjects covered include employment, federal government grants, self-employment, housing, transportation and other topics. >> Read the Disability.gov blog.
- U.S. Access Board Enhances Animations on the ADA and ABA Standards. The U.S. Access Board recently released a series of animations as part of its new online guides on the Americans with Disabilities Act (ADA) Accessibility Standards and the Architectural Barriers Act (ABA) Accessibility Standards. >> Visit the Guide to the ADA Standards and the Guide to the ABA Standards.
- CAP Appoints New Director. The Defense Human Resources Activity (DHRA) announced that Stephen M. King joined the Computer/Electronic Accommodations Program (CAP) as Director in March 2014. >> Find out more.
- The Department of Veterans Affairs Launches Website. The Employment Center website, the single federal source for Veterans looking for new career opportunities in the private and public sectors, as well as service members transitioning to the civilian workforce, military spouses and dependents looking for employment opportunities, G.I. Bill® beneficiaries transitioning from training to the job market and employers looking to connect with high quality applicants. This new site integrates multiple tools and resources for both job seekers and employers, including the Veterans Job Bank. >> Learn more.
- Direct Optical to Pay $53,000 to Settle Disability Discrimination Suit. Direct Optical, Inc., an optical store in Farmington Hills, Mich., will pay $53,000 and furnish other relief to settle a disability discrimination and retaliation lawsuit filed by the U.S. Equal Employment Opportunity Commission (EEOC), the agency announced today. >> Read more.
Events of particular interest: Get the most up-to-date and comprehensive training on employing people with disabilities. To view the complete JAN travel schedule go to JAN-on-the-Road.
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This document was developed by the Job Accommodation Network, funded by a cooperative agreement from the U.S. Department of Labor, Office of Disability Employment Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Labor. Nor does mention of tradenames, commercial products, or organizations imply endorsement by the U.S. Department of Labor.