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ENews: Volume 9, Issue 4, Fourth Quarter, 2011

The JAN E-News is a quarterly online newsletter of the Job Accommodation Network. 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.


  1. Think Pink!!!
  2. Medical Documentation: Think about What is Needed and Stop There!
  3. Leave as a Reasonable Accommodation
  4. Working with Alzheimer's Disease: When We Forget Accommodations Can Remind Us
  5. October 22nd is International Stuttering Awareness Day
  6. Employees with Fragrance Sensitivity: Publication Update and Accommodation Situations
  7. Apps Keep the Laptops Away and Accommodations with You All Day
  8. Common Measures of Central Tendency: Mean, Median, Mode and JAN's Cost of Accommodation, 2011 Update
  9. JAN Releases New Resources
  10. E-vents
  11. JAN Exhibit and Training Schedule
  12. Subscribe to JAN Newsletter

1 - Think Pink!!!

October is Breast Cancer Awareness Month. Everywhere you look you see pink reminders of that – from every item of clothing possible to jewelry and even some of our favorite foods! College and high school sports teams are taking part in the support of breast cancer as well. The number of supporters grows every year.

JAN Goes Pink Logo

With many members of the JAN family touched by cancer, consider JAN a supporter as well. Consultants at JAN are available to provide information and support to employers of cancer patients, breast cancer included, and the individuals themselves who are in need of accommodations while they are in treatment and working, or needing time off for recuperating. We can be helpful even later on after treatment is completed, when the effects of the treatments are still lingering. The JAN Website is available 24/7 at AskJAN.org. Click on the A-Z of Disabilities menu item at the top of the home page. Click on the By Disability link that will take you to the A-Z listing where you will find Cancer listed. Click there to view all of our publications related to cancer. Accommodation and Compliance Series: Employees with Cancer and a Consultants' Corner entitled Using Ergonomics to Accommodate Limitations from Breast Cancer are just two examples. See that link for the complete listing. JAN Consultants are available from 9:00 am to 6:00 pm eastern for questions via telephone, TTY, e-mail, and live chats and social networks. Think pink and get started by clicking on JAN's Go Pink logo!!!

- The JAN Staff

2 - Medical Documentation: Think about What is Needed and Stop There!

In our experience at JAN, there seems to be a lot of confusion about medical documentation under the ADA. Employers aren't sure what they can ask for, when they can ask for it, or whether the ADA Amendments Act changed the rules for medical documentation. Employees aren't sure what medical information they have to provide or how much to disclose. And medical professionals aren't sure what documentation will be the most helpful in getting their patients the workplace accommodations they need. Most of these questions come up when an employee requests an accommodation.

The good news is that the medical inquiry rules that apply when an employee requests an accommodation are not as complicated as they may seem. The general rule is that when the disability or need for accommodation is not obvious, an employer may require an employee to provide documentation that is sufficient to substantiate that s/he has an ADA disability and needs the reasonable accommodation requested, but cannot ask for unrelated documentation. So when thinking about what medical information to request or to provide, think about what is needed and stop there!

Let's start with the documentation needed to substantiate that the employee has a disability. The definition of disability for accommodation purposes is "a physical or mental impairment that substantially limits a major life activity or a record of such an impairment." So to determine whether an employee has a disability, the employer can ask whether the employee has (or had) an impairment. And if yes, can ask whether the impairment affects (or affected) a major life activity. And if yes, can ask whether the impairment substantially limits (or limited) the major life activity.

This is where the ADA Amendments Act changed some things. Although the definition of disability did not change, the threshold for showing substantial limitation is much lower than it used to be. Therefore, the documentation needed to show that an employee has a disability should be much less extensive.

What about the documentation needed to substantiate the need for an accommodation? The ADA Amendments Act did not change the reasonable accommodation provisions of the ADA so the rules for medical documentation likewise did not change. An employer is allowed to verify that the accommodation is needed, to ask questions about the employee's limitations that are causing the problem, and to get other relevant information about the request to help determine effective accommodations.

For more information, see JAN's recently updated publications related to medical documentation, including:

- Linda Carter Batiste, J.D., Pincipal Consultant

3 - Leave as a Reasonable Accommodation

One of the more vexing issues faced by both employers and employees involves leave time related to a medical condition, particularly when the period of leave exceeds an employer's permitted leave allowance or otherwise violates an established attendance policy. While such situations may be challenging and confusing, they must be confronted directly because one thing is clear relative to the ADA: the use of leave does constitute a reasonable accommodation when necessitated by the employee's disability.

The U.S. Equal Employment Opportunity Commission's (EEOC) Reasonable Accommodation Guidance provides examples of some of the reasons an employee with a disability may require leave:

Below is a discussion of some of the more frequent and confusing leave-related issues presented to JAN from employers and employees.

How Much Leave is Reasonable

Under the ADA, there is no specific amount of time established relative to the use of leave as a reasonable accommodation. As with any accommodation situation, considering a period of leave for an employee with a disability should be a case by case analysis. If an employee needs a leave of absence that exceeds his or her accrued paid leave, the employer should permit the employee to exhaust the paid leave and then allow the use of unpaid leave absent undue hardship.

Although there is no limit established on the amount of leave used as a reasonable accommodation under the ADA, the EEOC has said that employers do not have to grant indefinite leave as a reasonable accommodation (see the EEOC Guidance on Applying Performance and Conduct Standards, Question 21). However, the employee does not have to provide a specific, fixed date of return. A request for leave is acceptable with an approximate date of return (e.g., around the end of August) or a range of dates for a return to work (e.g., sometime between August 24 and September 23).

ADA and the Family and Medical Leave Act (FMLA)

An employee's rights under the ADA and the FMLA are separate and distinct. The EEOC has said that when an employee is entitled to leave under both laws, the employer should allow leave under the law providing the employee with the greatest rights (see the EEOC's Fact Sheet on the FMLA, ADA, and Title VII). Additionally, employers should note that the ADA may require them to grant leave beyond the 12 weeks allowed under the FMLA as a reasonable accommodation. In this instance, an employer can consider the FMLA leave taken in their analysis of whether the requested leave time poses an undue hardship.

Erratic or Unreliable Attendance

Employers are required by the ADA to modify attendance policies as a reasonable accommodation absent undue hardship. This does not mean that employers must completely exempt an employee from time and attendance requirements and unquestionably accept irregular and unreliable attendance. Frequent occurrences of tardiness or absenteeism, particularly those over an extended period and without adequate notice, could certainly impose an undue hardship in many situations. See the Commission's Guidance on Applying Performance and Conduct Standards for a more detailed discussion with examples of specific scenarios.

Alternative Accommodations

Although employers are encouraged to give primary consideration to an employee's choice of accommodation when more than one reasonable accommodation is possible, they can ultimately choose the accommodation to be implemented, assuming it is equally effective. Accordingly, under the ADA an employer can offer a reasonable accommodation that requires an employee to remain on the job, as long as it is effective and does not interfere with the employee's medical needs.

Holding the Employee's Position

Under the ADA, an employer must consider returning the employee to his or her same position absent undue hardship. If undue hardship applies, the employer must consider reassignment to a vacant, equivalent position for which the employee is qualified.

Undue Hardship

As with any other reasonable accommodations, whether an employer should allow the use of leave as an accommodation will sometimes come down to an undue hardship analysis. In the case of leave, undue hardship will generally relate to a possible disruption in the operations of the entity. For instance, the absence of an employee who performs highly specialized duties may give rise to legitimate undue hardship issues, as might leave that occurs in a frequent and unpredictable manner. Generalized assessments are not adequate, as undue hardship must be determined based on individual and specific circumstances. Additionally, the EEOC has said that an undue hardship claim cannot be based on the idea that a reasonable accommodation might negatively impact the morale of other employees or that other employees may have to cover for the employee who is on leave.

What to Remember

Ultimately, much of the confusion involving leave as an accommodation occurs when there are not clear and open lines of communication. Lack of communication is usually the biggest obstacle to executing an effective accommodation solution. All parties need to be aware of any relevant updates or concerns, and everyone should make an effort to keep the information flowing. Contact JAN if you need ideas on how to encourage ongoing communication during the accommodation process.

- Bill McCollam, MPA, Consultant

4 - Working with Alzheimer's Disease: When We Forget Accommodations Can Remind Us

I was 15 years old, and I'd just arrived on the campus of the University of Tennessee. I had made it into the National High School Band, as it was called many years ago. Being from a small town in rural West Virginia, I was stunned. We walked onto the biggest basketball court I'd ever seen, and the members of Lady Vols were slam dunking basketballs. The bright PMS021 from the Pantone Matching System was mesmerizing me. Then, Pat Summitt came over and had a few words to say to us. I had no idea who she was. Coach Summitt offered to let us sit in on a practice. She exhibited everything you could possibly learn in leadership training. She was determined, intelligent, funny, concise, supportive, and motivating.

We pick up a decade later...my grandmother was everything you could imagine in a grandmother. She was determined, intelligent, funny, concise, supportive, and motivating. As time went on, she started exhibiting behaviors that made her seem like a different person. She was confused, frustrated, and forgetful. She would lose track of time and forget that people and pets had long passed. Of course, she wasn't famous, but those around her made accommodations for her so she could remain productive.

We pick up in August, 2011... Now Coach Summitt is faced with the same challenge as my grandmother and five million other Americans. Their biggest challenge is irreversible. Coach Summitt made the full disclosure that she had been diagnosed with early-onset Alzheimer's disease. She said, "I felt something was different." Those around her will make accommodations so she can remain productive.

According to the Alzheimer's Association, Alzheimer's disease is a progressive brain disorder that damages and eventually destroys brain cells, leading to loss of memory, thinking, and other brain functions. It is the most common form of dementia. According to the Mayo Clinic, the term early-onset or younger-onset refers to Alzheimer's that occurs in persons under the age of 65. Early-onset Alzheimer's has been known to develop between ages 30 and 40, but it is more common for someone in his or her 50s to have the disease.

The majority of people with Alzheimer's are 65 and older (Alzheimer's Association, 2011), and with an aging population continuing to work after age 65, JAN has been receiving numerous questions from individuals with all types of dementia, but primarily Alzheimer's disease. Many of JAN's calls involve individuals still in their forties and early fifties, who are working and have been diagnosed with Alzheimer's disease. The questions revolve around guidance on what rights individuals may have under the ADA and what accommodations may work in their present jobs with their current limitations.

Because of the increased demand for accommodation ideas for individuals with Alzheimer's disease, a new JAN publication on accommodation ideas for employees with Alzheimer's will soon be released. Based on JAN data, accommodations for individuals with Alzheimer's disease often involve solutions for memory, organization, and time management limitations, but may include solutions for mobility and sensory limitations. Solutions range from technology to integrated employment. For example:

JAN wants to hear from you if you have helpful hints that worked for you during the accommodation process or valuable Alzheimer's disease resources you have used. Also, if you or someone you know has been diagnosed with Alzheimer's disease and is still working and you need assistance with a workplace situation related to Alzheimer's disease, please contact JAN to connect to a consultant. You can call, e-mail, or try a live chat.

- Melanie Whetzel, M.A., Senior Consultant, and Beth Loy, Ph.D., Principal Consultant

5 - October 22nd is International Stuttering Awareness Day

International Stuttering Awareness Day Ribbon

In honor of International Stuttering Awareness Day, JAN would like to share information about stuttering and accommodation tips. Most of us probably recognize stuttered speech when we hear it, but may not know much about people who stutter. People who stutter come from all walks of life and excel in an endless variety of career fields from acting to zoology. You can find a list of Famous People Who Stutter on the Stuttering Foundation Website at http://www.stutteringhelp.org/Default.aspx?tabid=128

According to the American Speech Language and Hearing Association (2008), about 1% of people stutter. Stuttering, a fluency disorder, impacts a person's speech by interrupting the flow of speech causing words or parts of words to be unintentionally repeated. Speech sounds may be prolonged or seem stretched out. Pauses or hesitations may also be present. Some people stutter only when saying certain words or may rarely stutter except in certain situations such as when speaking on the phone.

There is no single cause of stuttering, but current thinking indicates that it tends to run in families and may have neurological causes. Stuttering is not caused by an emotional or nervous disorder.

Some individuals who stutter benefit from stuttering therapy on either an intensive or extended basis or find the use of fluency aids to be helpful. Others may choose to participate in self-help or support groups. Regardless of what tools a person chooses to use to manage stuttering symptoms, individuals who stutter can be highly qualified and capable workers if provided the chance to get their foot in the door.

With that in mind, here are some accommodation tips to help job candidates with stuttering shine from JAN's newly updated fact sheet on Job Accommodations for People who Stutter.

Application and Interview-Information for the Employer:

Application and Interview-Information for the Individual:

You can read more about accommodation ideas and resources for individuals who stutter on the JAN Website.

Resources: American Speech Language and Hearing Association (ASHA). (2001). Incidence and Prevalence of Speech, Voice, and Language Disorders in Adults in the United States: 2008 Edition Retrieved on 10/13/11, from http://www.asha.org/Research/reports/speech_voice_language/

- Teresa Goddard, MS, Senior Consultant

6 - Employees with Fragrance Sensitivity: Publication Update and Accommodation Situations

As fragrance sensitivity continues to become more recognized as a workplace accommodation challenge, employers and employees may be unsure of what options can be explored and where to locate products, such as air purifiers and masks. JAN recently updated its publication about fragrance sensitivity to include accommodation options, information on fragrance free policies, and sample policy language used by employers.

When addressing accommodation requests related to fragrance sensitivity, there are a couple of common options for an employer to consider. Removing the offending fragrances is one accommodation that can be effectively implemented. For example, if the fragrance is emitted from a cleaning product an employer can have janitorial staff substitute fragrance free products. A fragrance free policy can also be developed, such as this one from an anonymous employer: "This is a fragrance free office. Please help us to accommodate our co-workers and clients who are chemically sensitive to fragrances and other scented products. Thank you for not wearing perfume, aftershave, scented hand lotion, fragranced hair products, and / or similar products."

Other accommodations can include removing the employee from the area where the fragrances are located or exploring ways to reduce the employee's exposure to fragrances. This can be done by allowing the employee to work in an enclosed area with an air purifier and by modifying ways that the employee communicates with others so that the need to meet face-to-face with coworkers or supervisors is reduced. This can also mean allowing the employee to wear a mask or respirator, although this is not something that an employer can force an employee to do. Although JAN does not sell products or devices, we do make information available about manufacturers and distributors. Listed below are links to product information and vendors for review.

The following are examples of recent JAN calls that illustrate accommodations that were put into place for employees with fragrance sensitivities.

An employee in a healthcare facility was experiencing reactions to fragranced products. The employer purchased an air purifier, asked certain employees who wore heavy scents to refrain from doing so, and placed posters around the office to educate people about fragrance sensitivity. The employer also moved the employee to a larger room where she was not so confined.

A protective services employee was experiencing reactions to fragrances in the work environment. The employer purchased an air purifier, custodians were instructed to use non-scented janitorial products, certain areas of the facility were designated as strictly non-scented/fragrance-free zones, employees were educated on wearing non-scented fragrances on the job, and the employee was allowed to work one day from home.

Employees of a state agency were having adverse reactions when exposed to fragrances in the workplace. The employer purchased masks and developed a policy restricting other employees from wearing strong fragrances.

To review the updated Accommodation and Compliance Series: Employees with Fragrance Sensitivity visit: http://AskJAN.org/media/fragrance.html

- Elisabeth Simpson, MS, Consultant

7 - Apps Keep the Laptops Away and Accommodations with You All Day

According to Federal Computer Week (July 1, 2011), the Veterans Affairs Department expects to enable employees to use iPhones, iPads, Androids, and other popular mobile devices with the departmental network. This move towards a mobile device policy for such a large federal government agency is a telling sign that more employers are ready to improve efficiency by allowing employees to become extremely mobile at work. The demand for mobile devices and their apps, application software, has reduced the demand for traditional size laptops, which can be cumbersome to move around. Today almost everyone has a mobile device. They can update a user on current weather and sports statistics and link a person to every social network available. These devices enable a user to connect to the internet faster than most computers and provide many channels of communication to co-workers, friends, and loved ones. These mobile devices do not stop there; with the thousands of apps available at the app store a user can now turn even a smart phone into a viable tool as an accommodation either in the workplace or for personal use. JAN provides information on all types of apps, including those that may be implemented as an alternative to rather expensive assistive technologies. A sample of these include:

The above apps are just a few of the hundreds available that could be used by individuals with disabilities or the people close to them. These apps can be used in the work setting or in one's personal life. Although most of the above apps are primarily used for Apple products, there are very similar apps that can be used on Android and Blackberry products -- just one more nifty use for those beloved smart phones and other mobile devices.

Remember that apps can be an excellent solution when concerns turn to the cost of an accommodation. While employers fear making an accommodation investment that is not guaranteed to solve the issue, employees may be reluctant to request an accommodation that will pose a financial burden to employers. Add the ever-changing and updating technology spin to the accommodation issue, and the result is often more strain on an already complex and stressful situation. JAN can help find an app that might be helpful in resolving that situation.

For additional information on the accessibility of apps developed for mobile devices, visit AppleVis. Here you can find user groups, recommendations, articles, and usability/accessibility ratings.

- Lisa Dorinzi, M.A., Consultant, and Beth Loy, Ph.D., Principal Consultant

8 - Common Measures of Central Tendency: Mean, Median, Mode and JAN's Cost of Accommodation, 2011 Update

Recently, JAN's Accommodation and Compliance Series Publication - Workplace Accommodations: Low Cost, High Impact, which provides new research findings addressing the costs and benefits of job accommodations for people with disabilities, was updated. These data indicated that the "typical" one-time cost of accommodation reported by employers was $500 (JAN, 2011). Because too few employers provided cost data on accommodations that are recurring, the results focused on those with one-time costs. What does this mean?

Let's start by deciphering the term "typical" cost. All data sets have constructs that best represent the distribution of the data. When we have several elements of a data set, we want to find one measure of central tendency, if possible, that best represents these data. This gives us a clearer picture of what is happening and allows us to make inferences about the data. For some data sets either the mode, mean, or median may be the best choice. For others, all two or three may be reported to provide readers with additional information.

The mode, the most frequently occurring number in a data set, is often used with non-numerical data. Because of this, JAN rarely reports the mode as a measure of the one-time cost of accommodation reported by employers. If using the mode as the typical cost indicator in the most recent update, the typical one-time cost of accommodation, when including those that cost nothing, was $0. When using the mode as the typical cost indicator and excluding those that cost nothing, the typical cost of accommodation was $100. Using the mode as a representative measure of central tendency for these data is probably not a good representation of what employers report as the cost of accommodation.

The mean usually refers to the arithmetic mean, which is the average of a data set. Because the mean is primarily used for symmetrical distributions with no outliers, JAN rarely reports the mean cost of accommodation reported by employers. For example, say one employer reported to JAN that it modified a building to add an elevator and reported this cost of accommodation as $100,000. Reporting an average as the cost of accommodation, when most accommodations cost far less, would not represent the typical cost of accommodation. Because most accommodations are low cost, any high dollar outliers would pull the average cost of accommodation away from the typical cost of accommodation. If using the mean as the typical cost indicator in the most recent update, the typical one-time cost of accommodation, when including those that cost nothing, was $1,036. When using the mean as the typical cost indicator and excluding those that cost nothing, the typical cost of accommodation was $2,564. Although useful in some situations, using the mean as a representative measure of central tendency for these data is probably not the best representation of what employers report as the cost of accommodation.

The median, the middle number in a data set, is used when outliers exist in a data set. Because of outliers reported by a few employers, JAN reports the median one-time cost of accommodation as the typical cost of accommodation. If using the median as the typical cost indicator in the most recent update, the typical one-time cost of accommodation, when including those that cost nothing, was $0. JAN, however, excluded the 56% that cost nothing and reported the median of those accommodations that had a reported cost. This cost of accommodation was $500. Because of a few reported outliers, the median is a good representation of what employers report as the cost of accommodation.

Given that these three measures of central tendency have different meanings, researchers may certainly have reasons to choose one over the other when reporting JAN's data on the cost of accommodation. Most data remain consistent; however, the typical one-time cost of accommodation, when there is a cost, dropped from $600 to $500.

Job Accommodation Network. (2011). Accommodation and compliance series - Workplace accommodations: Low cost, high impact. Retrieved October 1, 2011, from http://AskJAN.org/media/lowcosthighimpact.html

- Beth Loy, Ph.D., Principal Consultant

9 - JAN Releases New Resources

10 - E-vents

11 - JAN Exhibit and Training Schedule

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 here: http://AskJAN.org/training/On-the-Road.htm

12 - Subscribe to JAN Newsletter

To subscribe to or unsubscribe from JAN Updates:

To subscribe, e-mail us at subscribe@AskJAN.org. When subscribing, be sure to include the e-mail address at which you want to receive the newsletter.

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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.


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