From the desk of Tracie DeFreitas, M.S., Program Leader, Director of Training and Outreach
Medical documentation may be requested when an individual makes it known to their employer that an accommodation is needed at work. Upon receiving a request for accommodation, it is a common practice for employers to request medical information as part of the interactive process. However, the Equal Employment Opportunity Commission (EEOC) has stated that documentation should only be necessary when the disability and/or need for accommodation is not known or obvious. Therefore, the medical documentation that may be requested for ADA purposes will depend upon the situation and how much information is already known about the impairment, functional limitations, and need for accommodation. An employer may not ask for documentation that is unrelated to the request for accommodation, this includes asking for an employee's complete medical records. Full records are likely to contain information unrelated to the reasonable accommodation request.
JAN Consultants respond to a variety of questions related to requesting medical documentation under the ADA. Here are some examples of common questions and responses:
Q: Is an employer required to request medical documentation as part of the interactive process under the ADA?
A: No. Employers may request sufficient documentation when the disability and/or need for accommodation is not known or obvious, but are not required to do so to provide an accommodation. The individual who requested the accommodation is often the best source of information about his or her medical impairment and limitations. Use logical judgment in deciding when to request the information. If the disability and need for accommodation are obvious, move-on to identify and implement accommodation solutions.
Q: When is medical documentation sufficient to determine if the employee has a disability and needs an accommodation?
A: Documentation is sufficient if it substantiates that the individual has a disability and needs the reasonable accommodation requested. Sufficient medical documentation should describe the nature, severity, and duration of the impairment, the activity or activities that the impairment limits, the extent to which the impairment limits the employee's ability to perform the activity or activities, and should also substantiate why the requested reasonable accommodation is needed.
For a sample request for medical information, see JAN's A to Z: Medical Exams and Inquiries. Employers should customize this form on a case-by-case basis depending on the information that is needed.
For EEOC's guidance on medical documentation in response to an accommodation request, see question 6 in Reasonable Accommodation and Undue Hardship under the ADA.
Q: What if the documentation provided is insufficient?
A: This is when the request for information may need to be clearer. Sometimes employers include a job description and simply ask the provider to comment on what the employee can or cannot do. This may not be effective. Instead, explain why the documentation was insufficient and ask specific job-related questions about how the impairment affects job performance and why the employee is requesting accommodation. Allow the individual the opportunity to return the additional information in a timely manner.
Q: Can employers require that documentation related to an accommodation request come from a medical doctor?
A: According to the EEOC, medical documentation may be requested from an appropriate health care or rehabilitation professional. The provider does not have to be a medical doctor (MD). Examples may include doctors (including psychiatrists), psychologists, nurses, physical therapists, occupational therapists, speech therapists, vocational rehabilitation specialists, and licensed mental health professionals, among others. For more information, read Who Can Provide Medical Documentation for ADA Purposes?
Q: If additional information is needed, how much time do employees have to provide it? What if they do not return the information that is needed?
A: Under the ADA, there is no set timeframe for providing medical documentation to support a request for accommodation. However, employers may have a reasonable accommodation policy that includes a timeframe for employees to respond. Allowing anywhere from ten to fifteen business days may be reasonable.
If an employee does not provide the information in a timely manner, it is up to the employer's discretion how to handle the situation, but we often suggest informing the employee in writing that the information was not received and that the employer is unable to proceed with the accommodation process until the information is received and reviewed.
Q: In response to an accommodation request, can an employer require an employee to sign a medical release to grant consent to obtain the employee's complete medical records?
A: According to the EEOC, in most situations under the ADA, an employer cannot request a person's complete medical records because the records are likely to also contain information unrelated to the disability and need for accommodation. Employers should not use a medical release form that constitutes a general release for all medical records. It is suggested that the employer allow the individual the opportunity to obtain the information directly from his or her healthcare provider. In this case, a separate release will not be necessary. If the employer must communicate directly with the provider for clarification, then either the employee may sign the consent provided by his or her healthcare provider, or the employer may ask the employee to sign a limited release that specifies the information to be requested.
Q: If an employee exhausts leave under the Family and Medical Leave Act (FMLA), may an employer request new medical documentation to support the need for a leave extension as an accommodation under the ADA?
A: An employee may be asked to provide additional medical information to support the continuing need for leave if the information provided for FMLA purposes does not constitute sufficient documentation under the ADA.
Q: If an employer makes adjustments for employees without disabilities, like flexible scheduling or telework, can medical documentation be required to afford employees with disabilities these same adjustments?
A: Employers should remember that if this type of flexibility is available to all employees as a matter of policy or practice, employees with disabilities should not have to jump through unnecessary hoops by providing medical documentation to receive the same benefit, even if needed because of a disability. If the employee with a disability qualifies for the benefit, he or she should be entitled to it, just like any other employee.
JAN offers tools that may be useful to employers in the process of requesting medical documentation. See JAN's Medical Inquiry in Response to an Accommodation Request and JAN's Practical Guidance for Medical Professionals: Providing Sufficient Medical Documentation in Support of a Patient's Accommodation Request.
For more information or questions related to medical documentation or inquiries and the ADA, please contact JAN to speak with a Consultant.