From the desks of Tracie DeFreitas, M.S., Program Leader, Director of Training, Services, and Outreach and Lisa Mathess, M.A., SHRM-CP, Principal Consultant, ADA Specialist
When an employee with a disability requests an accommodation under the Americans with Disabilities Act (ADA) and the employee’s disability and need for the accommodation are not obvious, the employer can require reasonable medical documentation (EEOC Guidance, Q6) to show that the employee has a disability and needs the requested accommodation. Health care and other appropriate professionals can play a key role in the success of workplace accommodations by providing the necessary documentation. One of the more common questions JAN receives related to medical documentation is, “Must the documentation to support an employee’s accommodation request be provided by a medical doctor (MD)?” The simple answer under the ADA is no, the ADA does not specify that medical information be provided by a licensed MD.
However, according to the Equal Employment Opportunity Commission (EEOC), employers can require that medical documentation come from an appropriate professional (EEOC Guidance, Q6) who has expertise in the medical condition and direct knowledge of the individual’s impairment and functional limitations. EEOC notes that appropriate professionals include, but are not limited to, doctors (including psychiatrists), psychologists, nurses, physical therapists, occupational therapists, speech therapists, vocational rehabilitation specialists, and licensed mental health professionals. This is not an exhaustive list under the ADA, appropriate professionals may also include certified physician assistants, nurse practitioners, social workers, and other professionals.
What about non-traditional health care providers such as chiropractors, acupuncturists, reflexologists, massage therapists, and others who offer alternative health care and wellness solutions? Because the appropriate professional in any situation will depend on the medical condition and limitations it imposes, a non-traditional health care provider who is knowledgeable about and has expertise in an individual’s medical condition and limitations can be an appropriate professional to provide documentation for ADA purposes. For example, if an employee has a back impairment and a chiropractor is recommending periodic breaks for stretches and rest, the chiropractor may be the appropriate professional to provide documentation. Chiropractors are trained to manage back impairments and their symptoms.
In contrast, if a chiropractor is providing medical documentation for someone with a mental health condition, something a chiropractor is typically not trained to diagnosis or treat, the employer may have legitimate questions about the documentation. In this case, an employer may want to find out if the chiropractor is qualified to diagnose and treat mental health conditions.
Health care and other appropriate professionals should keep a few tips in-mind when preparing documentation to support a request for accommodation. For example, employers tend to place more value on medical documentation that is on professional letterhead and may find it helpful when the documentation includes ADA specific language (e.g., that the individual has an impairment that substantially limits one or more major life activities, what major life activity the impairment substantially limits, what limitations are causing the patient’s work-related problems, etc.). It can also be helpful to include accommodation ideas if the health care provider has any. More tips can be found in JAN’s Practical Guidance for Medical Professionals: Providing Sufficient Medical Documentation in Support of a Patient's Accommodation Request.
JAN offers many resources on the topic of medical inquiries, documentation, and the ADA. A list of these resources can be found at the bottom of JAN’s A to Z by Topic: Medical Exams and Inquiries page. For more information, please contact JAN.
Disclaimer: The Job Accommodation Network provides information to assist with engaging in the interactive process and successfully resolving accommodation situations. This information is informal guidance only; it is not legal advice.