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Accommodation and Compliance Series:
Employees with Back Impairments

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Introduction

JAN's Accommodation and Compliance Series is designed to help employers determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). Each publication in the series addresses a specific medical condition and provides information about the condition, ADA information, accommodation ideas, and resources for additional information.

The Accommodation and Compliance Series is a starting point in the accommodation process and may not address every situation. Accommodations should be made on a case by case basis, considering each employee's individual limitations and accommodation needs. Employers are encouraged to contact JAN to discuss specific situations in more detail.

For information on assistive technology and other accommodation ideas, visit JAN's Searchable Online Accommodation Resource (SOAR) at http://AskJAN.org/soar.

Information about Back Impairments

How prevalent are back impairments?

According to the Bureau of Labor Statistics, back injuries account for nearly half of all musculoskeletal disorders in the workplace (BLS, 2013).

What are the symptoms of back impairments?

The major symptom of most back impairments is back pain, which can be localized or widespread radiating from a central point in the back.

What causes back impairments?

If ligaments and muscles are weak then discs in the lower back can become weakened. With excessive lifting, or a sudden fall, a disc can rupture. With years of back abuse, or with aging, the discs may simply wear out and a person may live with chronic pain for several years. However, back pain caused by a muscle strain or a ligament sprain will normally heal within a short time and may never cause further problems. Poor physical condition, poor posture, lack of exercise, and excessive body weight contribute to the number and severity of sprains and strains. Degeneration of the spine, due to aging, is also a major contributor to lower back pain.

How are back impairments treated?

Most back impairments are treated with non-invasive treatment techniques.  Treatment options include drug therapy, chiropractic adjustments, acupuncture, physical therapy, and rest.  In a few cases surgery may need to be performed.

Back Impairments and the Americans with Disabilities Act

Are back impairments disabilities under the ADA?

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet (EEOC Regulations . . ., 2011). Therefore, some people with back impairments will have a disability under the ADA and some will not.

A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment (EEOC Regulations . . . , 2011). For more information about how to determine whether a person has a disability under the ADA, visit http://AskJAN.org/corner/vol05iss04.htm.

Accommodating Employees with Back Impairments

(Note: People with back impairments may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with back impairments will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.)

Questions to Consider:

  1. What limitations is the employee with a back impairment experiencing?
  2. How do these limitations affect the employee and the employee's job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee with a back impairment been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee with a back impairment to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training regarding back impairments?

Accommodation Ideas:

Activities of Daily Living:
 
  • Allow use of a personal attendant at work
  • Allow use of a service animal at work
  • Make sure the facility is accessible
  • Move workstation closer to the restroom
  • Provide accessible restroom
  • Allow longer breaks
Fatigue/Weakness:
 
  • Reduce or eliminate physical exertion and workplace stress
  • Schedule periodic rest breaks away from the workstation
  • Allow a flexible work schedule and flexible use of leave time
  • Allow work from home
  • Implement ergonomic workstation design
  • Provide a scooter or other mobility aid if walking cannot be reduced
Gross Motor Impairment:
 
  • General
    • Modify the work-site to make it accessible
    • Provide parking close to the work-site
    • Provide an accessible entrance
    • Install automatic door openers
    • Provide an accessible restroom and break room
    • Provide an accessible route of travel to other work areas used by the employee
    • Modify the workstation to make it accessible            
    • Make sure materials and equipment are within reach range
    • Move workstation close to other work areas and break rooms            
  • Industrial
    • Provide overhead structure for lifting devices
    • Modify the work area to make it adjustable
    • Place frequently used tools and supplies at or near waist height
    • Provide low task chairs for work that cannot be brought to waist height
    • Provide stand/lean stools and anti-fatigue mats for standing work
    • Make wheelchairs, scooters, industrial tricycles, or golf carts available if walking long distances is required
    • Provide compact lifting devices to push and pull supplies and tools from storage
  • Office Settings
    • Provide a height adjustable desk and ergonomic chair
    • Move workstation close to common use office equipment
    • Provide low task chair and rolling safety ladder to access high and low file drawers and supplies
    • Provide a cart to move files, mail, and supplies
    • Provide a lazy Susan carousel or desktop organizers to access frequently used materials
  • Service Settings
    • Provide anti-fatigue mats and stand/lean stools for functions requiring long periods of standing
    • Provide a height adjustable desk and ergonomic chair
    • Move workstation close to commonly used office equipment
    • Provide compact lifting devices to push and pull stock and supplies from shelves
    • Provide carts to move supplies and stock
  • Medical Settings
    • Provide a spring-bottomed linen cart
    • Make patient lifting and transfer devices available
    • Make wheelchairs, scooters, industrial tricycles, or golf carts available if walking long distances is required
    • Train employees on proper lifting techniques and on proper use of patient lifting and transfer devices
    • Provide powered beds for transporting patients
    • Provide adjustable exam tables
    • Provide a height adjustable desk and ergonomic task chairs

Situations and Solutions:

A systems administrator with a back impairment is required to move, lift, and carry computers throughout the office.  The person was accommodated with a compact, adjustable height lifting device with straps to secure the load. 

A maintenance worker with a bending and lifting restriction due to a back injury is required to lift manhole covers.  The worker was accommodated with a truck mounted jib crane and manhole cover lifter.

A clerical worker with scoliosis has sitting and standing restrictions.  Because the worker is required to work at a desk a majority of the time, the worker was accommodated with an ergonomic workstation evaluation, ergonomic chair, and a sit/stand computer workstation.

A mechanic with a bending restriction due to a low back impairment has problems accessing the engine compartment and low task areas of vehicles.  The mechanic was accommodated with a tire lift, a mechanic's low task chair, and a specialty creeper designed to support the body while accessing engine compartments.

A file clerk with a back impairment has functional limitations limiting her ability to bend and access files in low file drawers.  An electric automated filing system was purchased to allow accessing of file drawers at a standing height.

A chemical process plant worker is limited in his ability to turn large wheel valves due to a back injury.  The worker was accommodated with a specialty tool designed to increase torque on wheel valve handles.

An appliance delivery driver with a lifting restriction due to a low back injury was accommodated with a stair climbing hand truck.  This battery-powered piece of equipment also doubles as a lift gate to help lower appliances on and off the truck.

A grocery check-out person with a standing restriction due to a back injury was accommodated with a sit/lean stool and anti-fatigue mats. 

A mailroom worker with a push/pull restriction was required to deliver the mail on a cart that weighed more than the individual's push/pull restriction.  An accommodation of a motorized cart allowed the person to stay on the job.

A truck driver with a back impairment was limited in the time he could drive.  Accommodations of a suspension seat and a vehicle cushion designed to reduce vibrations allowed the driver to comfortably sit for longer periods of time. 

A health care worker with a lifting restriction was accommodated with patient transfer devices and individualized training on proper use and selection of the equipment.

Products:

There are numerous products that can be used to accommodate people with back impairments. JAN's Searchable Online Accommodation Resource at http://AskJAN.org/soar is designed to let users explore various accommodation options. Many product vendor lists are accessible through this system; however, JAN provides these lists and many more that are not available on the Web site upon request. Contact JAN directly if you have specific accommodation situations, are looking for products, need vendor information, or are seeking a referral.

Resources

References

Bureau of Labor Statistics. (2013). Occupational injuries and illnesses by selected characteristics for state and local government news release. Retrieved from http://www.bls.gov

EEOC Regulations To Implement the Equal Employment Provisions of the Americans With Disabilities Act, as Amended, 29 C.F.R. § 1630 (2011).


Updated 11/25/14

 

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