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Joint Replacements: Are They Covered?

Learn more about joint replacements and whether they might be covered by the ADA

From the desk of Beth Loy, Ph.D., Principal Consultant/Technical Specialist

Joint replacement surgery may be a solution for someone who has dealt with osteoarthritis or rheumatoid arthritis for a long time, has an injury where replacement is the best option, or has other conditions where non-surgical management has not been successful. Although nearly every joint in the body can be replaced, most replacement surgeries involve the hip or knee (Kraay, 2013). Candidates for joint replacement surgery often have severe joint pain, stiffness, limping, muscle weakness, limitation of motion, and swelling before and after surgery (Cleveland Clinic Foundation, 2009).

The ADA does not indicate whether temporary impairments are covered or excluded. However, it has been indicated that the duration of an impairment is not a key factor in determining whether someone meets the definition of disability under the ADA. In other words, the question is, “Is the person substantially limited in a major life activity?” Most individuals who have joint replacements will likely be substantially limited, at least temporarily, in walking, lifting, standing, and performing manual tasks. These are major life activities specifically mentioned in the ADA, the ADA Amendments Act, and their corresponding regulations. So, to be on the safe side, employers might not want to rule out the possibility that short-term impairments resulting in joint replacements might now be covered by the ADA.

Keep in mind that even if impairments resulting in a hip or knee replacement end up being covered, most employers already accommodate people with such impairments so the actual accommodations will not be that burdensome. And, once the joint replacement area heals, the employee will likely no longer need accommodations so in most cases we are talking about minor, short term accommodations such as a parking space, stand/lean stool, leg rest, mobility aid, chair, ramp, leave time, and flexible scheduling.

The bottom line is that the impact of the duration of an impairment on the definition of disability is an unsettled issue. Different legal experts have different opinions, and we hope to have clarification in the future. For now, if employers want to err on the side of caution, they should not rule out coverage based on how long an impairment lasts, and this means that accommodations should be considered for individuals who have joint replacement surgery.


knee replacement