Baby It’s Cold…Inside

Posted by Kim Cordingly on December 21, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By Tracie DeFreitas, Lead Consultant — ADA Specialist

Lately, I’ve had that holiday tune, Baby It’s Cold Outside, melodically playing in my mind (imagine the Lady Gaga and Tony Bennet rendition). The song makes me smile and, ironically, warms my soul. Of course, it’s the holiday season and that means the song is playing everywhere we go. But, this isn’t the only reason I’ve had this catchy tune on my mind; JAN customers have me thinking of it as well. Now that winter has arrived, we’ve been hearing from employers who have questions about accommodating employees who are sensitive to cold temperatures. Interestingly though, the questions have been about the impact of exposure to cold indoor temperatures.

Thermostat wars are a common ongoing battle in the office. You’ve experienced it, right? Co-workers stealthily sneaking around the corner, adjusting the heat up or down to their comfort level when no one else is watching. It’s probably fair to say that there is no particular temperature that is comfortable for everyone. The Occupational Safety and Health Administration (OSHA) does not regulate indoor workplace temperature but does recommend that temperatures be maintained in the range of 68-76° F. This range may be comfortable for many workers, but not all. Although this indoor temperature range is suggested, some workplaces maintain indoor temperatures (in cool and warm months) that fall well below 68° (I’ve heard as low as 61°), making it a frigid environment, particularly for those who are medically sensitive to cold temperatures.

Sensitivity to cold temperatures is a limitation associated with a number of impairments, including anemia, asthma, diabetes, Raynaud’s disease, rheumatoid arthritis, scleroderma, and thyroid disorders. Some individuals with these types of impairments experience joint pain, stiffness, or numbness in their extremities (i.e., hands, fingers, toes) in response to cold temperatures, while others experience difficulty breathing. Exposure to cold temperatures at work can cause these symptoms to flare-up, making it difficult for an affected employee to perform job duties. This can lead to a request for accommodation under the Americans with Disabilities Act (ADA).

One solution for dealing with the effects of the cold indoors is a small space heater to be used at an employee’s workstation. JAN Consultants are frequently asked if an employer has any obligation to provide a space heater as an accommodation for an employee who requests one due to a medical impairment. This isn’t about providing a space heater simply to improve personal comfort, but rather, to enable an employee to manage the impact of the cold on their impairment, and in-turn, performance. Some employers provide space heaters to employees for non-disability related reasons, or allow employees to bring their own heaters to work. But, is there a duty to provide a space heater as an accommodation under the ADA? Or, is a space heater a personal need item?

In situations where the temperature is extreme, it could possibly be argued that if the employer is creating a workplace barrier by maintaining an indoor temperature that 1) falls below the minimum suggested standard, and 2) has an adverse effect on an employee’s medical impairment and ability to perform job duties, then the employer may have some responsibility to provide a reasonable accommodation to eliminate that barrier – this could include providing a space heater. If a healthcare provider can confirm the existence of an impairment and that the extreme temperature of the work environment causes limitations that affect performance, then there will be medical justification for the accommodation.

The Equal Employment Opportunity Commission (EEOC) has stated that, in some situations, items that might otherwise be considered personal may be required as reasonable accommodations where they are required to meet job-related rather than personal needs (EEOC, 2002). While a space heater may seem like a personal need item, when it is needed to help an employee perform job duties effectively, it may be a reasonable accommodation. It often makes sense to err on the side of caution, do a risk analysis, and use common sense when considering accommodations. At a cost of about $30.00 for a small space heater, it may be difficult to demonstrate that this low-cost solution is not reasonable. And, it’s certainly a lot less expensive to provide the accommodation than to deal with a disability discrimination complaint alleging failure to provide a reasonable accommodation.

In addition to a space heater, there are other accommodations that might be considered to manage the cold indoors. Some ideas can be found on JAN’s AskJAN.org website under A-Z, by limitation, temperature sensitivity, but consider the following:

  • Adjust work-site temperature
  • Redirect or cover air vents using air deflectors or vent covers
  • Do not situate workstation under air vents, near cold windows, or near opening exterior doors
  • Move workstation to warmer area of building
  • Use window insulation, rubber weather sealing, heavy curtains, or shades on windows to reduce draft
  • Provide an enclosed workspace with separate temperature control
  • Allow use of heated blanket, heating pad, hand warmers, etc.
  • Modify dress code to allow wearing of layers, gloves, outerwear, etc.
  • Provide speech recognition software to limit keyboarding
  • Allow flexible scheduling
  • Allow flexible use of leave
  • Allow work from home or an alternate (warmer) location

Accommodation needs and situations vary. If you have a specific situation or question you’d like to discuss with a JAN consultant, we’ll be happy to assist you. Contact us directly or visit AskJAN.org.

Reference:

Equal Employment Opportunity Commission. (2002). Enforcement guidance on Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act. Retrieved from http://www.eeoc.gov/policy/docs/accommodation.html

Seasonal Affective Disorder (SAD) — More than Gray Skies in Winter

Posted by Kim Cordingly on November 23, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sarah Small, Consultant – Cognitive/Neurological Team

As I was driving on the interstate this past week, I couldn’t help but notice that most of the trees had lost their leaves. The beautiful reds, yellows, and oranges have slowly become bare branches. This, along with the slowly declining temperatures means one thing…winter is coming. Winter has its own excitement with the holidays and many traditions; however, at times it tends to bring with it feelings of dread. Winter means snow, ice, and for those of us in daylight savings time, shorter days. It’s easy to feel not ready and sad as the warm days leave us. But for some people, these feelings can be more intense than others.

Seasonal Affective Disorder (SAD) is a form of depression that comes and goes with the change in seasons. SAD is most common in the winter months starting in the beginning of fall and peaking in December, January, and February (Mental Health America).

Common symptoms include:

  • Irritability and stress intolerance
  • Decreased energy
  • Oversleeping
  • Fatigue
  • Changes in weight
  • Difficulty concentrating
  • Changes in appetite
  • Decreased interest in daily activities, sex, and social interactions
  • Feelings of hopelessness or worthlessness

While the cause of SAD is unknown, it is believed that the reduced level of sunlight during the winter months disrupts the body’s internal clock (circadian rhythm), as well as the body’s levels of serotonin and melatonin (Mayo Clinic). This can impact sleep patterns as well as mood.

According to the Mayo Clinic, there are certain factors that increase an individual’s risk for SAD. These risk factors include:

  • Being female
  • Age – onset typically between the ages of 18 and 30
  • Family history of SAD
  • Having depression or bipolar disorder
  • Living far north or south of the equator- it is said to be rare in those who live within 30 degrees of the equator

Treatment for SAD can include prescription medications that fall within the same family of drugs that help treat depression. These types of drugs are typically non-sedative selective serotonin reuptake inhibitor (SSRI) drugs.

Another type of treatment is phototherapy. This type of therapy includes exposure to high intensity bright lights such as sun lamps or sun boxes. These forms of light are often portable and can easily be placed on a desk or table in a work area. They also can be used at home to simulate natural light and help reduce fatigue and feelings of depression.

Additional information regarding SAD as well as a variety of light products can be found at this Consultants’ Corner.

JAN also offers information on accommodating individuals with various types of depression in the workplace — Accommodation Ideas for Depression.

While the winter months can bog us down with gray skies and cold weather, make sure to find time these next few months for things you enjoy. Whether it’s spending time with family and friends, planning a ski trip, or curling up on the couch with a good book and some hot chocolate, don’t forget to take time for yourself. Spring will be here before we know it!

Resources:

Mayo Clinic – Seasonal Affective Disorder (SAD)

Mental Health America – Seasonal Affective Disorder (SAD)

 

 

Work After Breast Cancer

Posted by Kim Cordingly on October 16, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant – Motor Team

One of the most positive things about more people surviving breast cancer, and cancer diagnoses in general, is that life after a diagnosis goes on, including one’s work life. Many are able to continue working through treatment, while others choose to focus on treatment and then return to work. Often less recognized is that while a clinical diagnosis is made on a specific date, and various treatments are done on specific dates, the side effects may linger on for weeks, months, and sometimes years.

Cancer, as many oncologists say, is a lifelong, chronic condition. For some this may be a direct result of the disease process, while for others it may be the result of side effects from necessary, but often potent, treatment protocols.

Just like with any other chronic condition, people who have had breast cancer can be fantastic employees. Some return to work and continue on as they did prior to their diagnosis. Others may need accommodations to be the best employee they can be.

The following are some potential areas of accommodation that may assist someone who has had a diagnosis of breast cancer:

Need for ongoing medical treatment, follow-up appointments, and monitoring:

  1. Allow for a flexible schedule
  2. Allow employee to telework
  3. Allow for additional leave time

Need for an ergonomically adjusted workspace due to lifting restrictions, pain management, and so on:

  1. Provide workspace adjustments to desk height, monitor height, chair, arm support, and reach ranges for equipment and materials
  2. Provide ergonomically appropriate tools
  3. Allow for breaks from repetitive tasks
  4. Modify workspace layout to avoid tasks done over the head
  5. Allow time for physical movement to help circulation

Need for supports with cognitive processing:

  1. Allow for self-paced workload
  2. Adjust supervisory method to allow for prompting, adjusting instructional or management method, breaking large tasks into smaller tasks
  3. Allow for one task to be completed before the next is presented

Need to manage fatigue:

  1. Allow for periodic rest breaks
  2. Allow for a modified schedule
  3. Redesign workspace to bring all necessary materials within easy reach range
  4. Limit physical exertion required
  5. Move workspace closer to door, break room, or restroom
  6. Provide personal mobility device to maneuver around workspace without exerting more effort
  7. Allow telework from home and remote access to meetings

While wearing pink brings awareness to the needs of those who are living with or have survived breast cancer, providing accommodations concretely changes the lives of those who are affected, as well as strengthening the business as a whole.

For more information:

Accommodation Ideas for Cancer

EEOC Fact Sheet: Questions and Answers About Cancer in the Workplace and ADA

Healthcare Workers with Motor Impairments – Part 2

Posted by Kim Cordingly on August 18, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

In this final segment of the 2-part Blog on accommodations for healthcare workers with motor impairments, JAN Lead Consultant Elisabeth Simpson, MS., CRC, in collaboration with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, continues the discussion on some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the remaining four questions and offering resources and information on the topic.

Questions:

1) When a limited schedule is needed (e.g., 10 hour shift in place of a 12 hour shift), would allowing this for one nurse on a unit really be a hardship for the other nurses working?

The accommodation of a schedule modification, as well as modifications of a workplace policy regarding scheduling, are a couple of types of accommodations an employer would need to consider providing, absent undue hardship. The EEOC’s Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act (ADA) offers guidance on this area of accommodation that might be useful for an employer or individual to review.

According to Dr. Maheady, in some cases an employer may be able to limit an individual’s schedule without it posing a hardship. However, in most situations, nurses are working with limited staff and adding additional work can be problematic for various reasons. Safe staffing ratios are critical to patient care outcomes and allowing a nurse to leave early or come in late could impact safe staffing ratios.

Alternative options could be to consider accommodations that would enable an individual to work the hours required. This could include periodic breaks, modifying policies around eating and drinking, providing equipment, or restructuring a job to reallocate marginal functions. Reassignment may be necessary if accommodations would not be effective or would pose a hardship. This type of accommodation may also be necessary if an individual needs to limit hours to the extent at which they would be working part time rather than full time.

2) For medical professionals with upper extremity limitations, what are some alternative ways to place a catheter (male or female)? Is maintaining a sterile field ever a concern?

It depends on many factors (age of patient, patient’s condition, etc.). For males, in some instances, it is appropriate to have the patient assist while placing the catheter. Also, if teaching the patient to self-catheterize (or a family member), this is part of the teaching/learning process.

What would work best is to have a second person, possibly a nurses’ aid or family member, don gloves and assist. Then the individual can don gloves, clean the meatus, and insert the catheter. Dr. Maheady notes that, in her experience, many nurses ask for assistance, disabled or not.

3) How can a medical professional who uses a cane or mobility device address concerns around sterilizing the device?

In these situations, Dr. Maheady recommends that the Infection Control Department or designee should always be consulted. There may be specific infection control issues related to a facility or unit. Collaboration with all parties in determining effective solutions can help to speed up the process and ensure that policies and procedures around sterilization are kept in mind.

Concerns around cane or wheelchair use in sterile medical environments can be addressed by:

  • Having two wheelchairs available and keeping one chair in a sterile area. The individual could switch chairs in a dedicated area.
  • Using wheelchair tire covers.
  • Wheeling into the room with one pair of gloves and changing to a new pair of gloves before touching the patient.
  • Surgical gowns could also be used to cover exposed areas of the chair.
  • A long narrow plastic bag (like ones for wet umbrellas) could be used with a cane and taped around the cane to secure. Bags could be changed as needed.

It is important to note that in general patient care areas, nurses do not sterilize their shoes, sneakers or clogs. An employer would not want to unnecessarily impose more stringent rules or requirements for employees with disabilities as this could be a violation of the ADA.

4) When a patient lifting device is not available, what are some alternative options that a medical professional with a lifting restriction could consider?

This is another situation where job restructuring may be the most effective form of accommodation for individuals who have lifting restrictions and are working in healthcare positions that require them to lift. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as patient lifting techniques, individuals with a disabilities should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. For example, an individual could be permitted to ask for assistance when lifting a patient. Team lifting, or lift buddies, can also be a solution. However, there will still be risks associated with lifting patients and injuries can occur with any employee, not just those with restrictions. It is important to remember that team members have different strengths and body sizes and may contribute differently when lifting a patient.

Ultimately, if an individual is not able to lift patients even with accommodations, reassignment would need to be considered. Reassigning the individual to another unit (e.g., pediatrics, newborn nursery) where there is a vacant position could be explored.

JAN and Elisabeth would like to extend our appreciation to Dr. Maheady for her assistance in answering these common, but difficult questions related to healthcare workers with motor impairments. For assistance in determining accommodation options for individuals with motor impairments, JAN consultants are ready to assist!

Healthcare Workers with Motor Impairments

Posted by Kim Cordingly on July 1, 2015 under Accommodations, Employers, Organizations, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

According to the Bureau of Labor Statistics (2013), the health care and social assistance sector will account for almost a third of the projected job growth between 2012 and 2022. With 16,971,800 healthcare workers employed in the United States in 2012 (Bureau of Labor Statistics, 2013), accommodations for those with disabilities working, or planning to work in, the healthcare field is a timely topic to be discussing.

With the over ten thousand calls JAN has received related to accommodations in healthcare settings, JAN consultants can offer a wealth of experience with accommodation situations. For healthcare workers with motor impairments such as carpal tunnel, back conditions, leg impairments, or arthritis, certain job duties – tasks such as lifting, carrying, moving, transferring, standing, walking, manipulating extremities, and positioning individuals for activities of daily living or physical therapy – may be difficult to perform without accommodations.

There are a variety of accommodation options that can be implemented in order for an employee to perform the essential functions of the job. Proper lifting techniques, lowering adjustable exam tables and equipment (low-lipped showers), ergonomic layouts for equipment (cranks and handles on beds and carts) and supplies (storing items at waist height, lowering bed rails when attending to patient needs, etc.), and team lifting are beneficial work site and procedural changes.

Still, accommodation situations in healthcare settings can be tricky or complicated. When this is the case, JAN consultants might turn to other experts in the field for assistance so that those contacting us for guidance are provided with the most beneficial and accurate information. For this two part blog, I collaborated with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, to discuss some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the first three questions and offering resources and information on the topic.

Questions:

1) For medical professionals with either a hand or arm amputation OR restrictions that limit the use of one hand, what are some alternative methods for giving injections? What about placing IV’s?

According to the Equal Employment Opportunity Commission (EEOC), a reasonable accommodation must be provided to enable a qualified employee with a disability to perform the essential functions of a job currently held. In general, an accommodation is any change in the work environment or in the way things are customarily done that enables an individual with a disability to enjoy equal employment opportunities.

Job restructuring may be the most effective form of accommodation for individuals who have limited or no use of one hand and are working in healthcare positions that require them to perform injections, place IV’s, etc. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as placing an IV, an individual with a disability should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. Time to practice clinical skills or tasks may be needed as part of the accommodation.

A number of videos and articles are offered as an additional resource to support the work of those with motor impairments in healthcare settings:

Videos

Foreign object removal with prosthesis

Adult CPR with prosthesis

Nursing with the hand you are given

Disabled Nurse: Focus on abilities

Danielle’s story (nurse missing her lower arm)

A sequence of photos demonstrating the donning of sterile gloves with one hand can be found within the article: “Nursing with the Hand You Are Given

Articles and Book Chapters

In the book Leave No Nurse Behind: Nurses Working with Disabilities by Donna Maheady, Susan Fleming (nurse born missing her left hand) wrote a chapter about her journey.

In the book The Exceptional Nurse: Tales from the Trenches of Truly Resilient Nurses Working with Disabilities, edited by Donna Maheady, Connie Stallone Adleman wrote a chapter called “Loving Ourselves Exactly as We Are: Nursing after a Stroke.”

In the article “Missing a Limb but Not a Heart,” Carey Amsden, RN, discussed how she practiced performing certain job tasks with the use of one arm, such as starting an IV, and donning a sterile glove in nursing school and has been able to successfully work in the field of nursing.

2) For medical professionals who need to wear a brace or post-burn glove, how can concerns around sterility be addressed?

An employer may require as a qualification standard that an individual not pose a “direct threat” to the health or safety of the individual or others, if this standard is applied to all applicants for a particular job. Additionally, employers may comply with medical and safety requirements established under other Federal laws without violating the ADA.

However, an employer still has an obligation to consider whether there is a reasonable accommodation, consistent with the requirements of other Federal laws, which would not exclude individuals who can perform jobs safely. In situations where sterility is a concern, alternatives to standard practices should be explored with the individual.

One option could be for the employee to wear a sterile glove (perhaps a larger size), gown or drape over the brace or glove. In doing this, sterility would be addressed to the same standard that others would be held to.

It is also recommended that the Infection Control Department or designee be consulted. There may be specific infection control issues related to a particular facility or unit to consider.

3) Are there alternatives to taking a leave of absence during flu season for medical professionals who are not able to receive the flu vaccine?

Flu season, in some areas, can last a while and a leave of absence may not be feasible or could pose an undue hardship to the employer. Alternative options for accommodating those who are not able to receive the flu vaccine can include: allowing the employee to wearing a mask or protective gear, reassigning the employee to a position that does not require direct-patient contact, considering flu shot alternatives, modifying a policy if applicable and depending on state law, or allowing an extended leave and offering reassignment to a vacant position upon return. For more information, see the following article: “Vaccinating the Health-Care Workforce: State Law vs Institutional Requirements.”

Next month we will be exploring schedule modifications and specific work tasks, so stay tuned!

Resources:

Monthly Labor Review (2013). Bureau of Labor Statistics. Retrieved from http://www.bls.gov/opub/mlr/2013/article/industry-employment-and-output-projections-to-2022-1.htm

February Heart Health — Accommodating Employees with Pacemakers in the Workplace

Posted by Kim Cordingly on February 26, 2015 under Accommodations, Employers, Organizations, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant – Motor Team

For some, the month of February is about expressing love for family, friends, and even co-workers. For others, February is about thawing out from the cold and dark of winter and beginning to realize results from health commitments made in the New Year — to eating a healthier diet, exercising more regularly, and improving overall heart health.

However, for those who have experienced a heart attack, atrial fibrillation, or other heart conditions requiring a pacemaker to assist in maintaining a normal rhythm, February like any other month is a time to focus on the love of one’s work and new heart related concerns. This may seem particularly daunting to those who work around utility lines, strong electrical/medical equipment, or near the potential for a spark, like when welding. Electro-magnetic radiation emanating from these devices may cause electro-magnetic interference (EMI) that can interrupt the pacemaker’s functioning.

Fortunately, advances in occupational safety allow for job accommodations that may not have been possible years ago. The American Radio Relay League (ARRL) provides many suggestions for working around electrical appliances, cellular telephones, medical devices, and when working as arc welders if an individual has a pacemaker.

Due to increased exposure of those with pacemakers to EMI-producing elements in their day to day lives, pacemaker manufacturers have responded with more and better implant protection; however, this cannot protect against all incidents of exposure. For this reason many people using pacemakers also use an EMI detector to warn them of an EMI source above the threshold for their implanted device in the near vicinity. Most individuals will experience only minor and temporary interference with their implants when exposed and this will most often disappear as they move away from the source of the interference.

Employers can assist these individuals who are returning to work by:

  1. Ensuring electrical appliances and equipment are well-maintained to prevent leakage and sparking;
  2. Shielding gas-powered generators and gas-powered saws;
  3. Providing EMI protective gear for these workers;
  4. Providing electro-magnetic frequency (EMF) blocking/shielding devices and appropriate long-corded, headsets for cellular telephones;
  5. Allowing the use of an EMI detector and the ability for one to move away from an area if the alarm goes off.

On the JAN Website, you can find additional tips for accommodating people using pacemakers in the workplace.

Take a Deep Breath

Posted by JAN Tech on January 28, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Beth Loy, Ph.D. – Principal Consultant

For individuals with chronic obstructive pulmonary disease (COPD), it can be difficult to take a deep breath at times. This difficulty may be triggered by temperature changes, humidity levels, contaminants, pollution, chemical fumes, and the performance of a strenuous task. COPD is a progressive disease that gets worse over time, making it hard to breathe (National Heart, Lung, and Blood Institute, 2013). Millions of people have been diagnosed with varying levels of COPD. However, with advancement in oxygen portability, medications, and therapies, many individuals are continuing to work after a diagnosis.

High air quality is very important for those working with COPD. To improve air quality, workplace accommodations can include: air purifiers, fragrance-free common areas, and fresh air breaks. Fans can also help circulate air in confined areas. Telework and a modification of work schedule can also be helpful during times of inclement weather, such as excessively hot or cold temperatures.

Location of workstation can also be important to someone with COPD. Being close to food areas, restrooms, cleaning materials, and maintenance areas can cause odors that are hazardous to someone with COPD. Keeping a work area free of pollutants such as cleaning agents, pesticides, exhaust fumes, and tobacco smoke will improve air quality.

Use of oxygen at work is often a consideration when accommodating an employee with COPD. Besides compressed oxygen gas in a tank or cylinder, many portable and stationary concentrators are now available for use, making it easier for someone with COPD to use supplemental oxygen outside of the house. This could include work-related travel. Accommodations may need to be made to arrange for the transport of an employee’s oxygen when the employee is required to travel for work. This may include talking with hotels, airlines, and other facilities regarding what is needed for the employee to carry oxygen. Safety is always an important consideration with oxygen use, including accessing a safe electrical connection and keeping oxygen canisters and other devices away from an open flame. Often, an oxygen supply company will do an on-site visit regarding safe usage upon request.

For more information on how to have supplemental oxygen in the workplace, see: Oxygen Therapy Safety Tips: Preventing Fires and Other Accidents.

Other resources that might be helpful:

Because COPD can have such serious effects on an individual, it may also be linked to anxiety and depression. The lifestyle changes that accompany the disease cause physical as well as mental challenges. For more information on accommodations for individuals with anxiety and depression, see JAN’s Accommodation Information by Disability: A to Z. For additional information on accommodation ideas, contact JAN directly.

 

Elevating Lift Office Chairs

Posted by Kim Cordingly on January 8, 2015 under Accommodations, Products / Technology, Vendors | Comments are off for this article

By: Linda Batiste, Principal Consultant

For years, JAN consultants searched for an office chair that can elevate while a person is seated in the chair and that also has a braking system to prevent the chair from moving when a person is getting into or out of the chair. A chair with such features could be useful for employees with various motor impairments working in all sorts of jobs. For example:

A bank teller with multiple sclerosis uses a motorized scooter, but must work at a standing height. She needs to transfer into a chair and then raise up to the height of the teller workstation. The chair needs to stay in place while she is transferring, but then allow movement once she is seated.

A cashier with cerebral palsy and lower extremity limitations cannot stand for long periods, but has to work at a standing height. He cannot get up on a standing-height stool, plus he needs more support than offered by a stool; he needs an ergonomic chair that can raise him up to the proper height.

A little person works in an office setting with shared workspace. She needs a chair that will raise and lower her to average desk height while she is seated in the chair.

Happily, JAN consultants recently found a couple options for these types of accommodation situations:

The first is called the VELA Tango, which is a chair that has a both a locking mechanism to stabilize it as needed and a motorized lifting mechanism that operates with a person seated in the chair.  If you want to see the chair in action, visit https://www.youtube.com/watch?v=cSQsBflJIU4.

The other option is an elevating office chair from Clark Medical. This one is basically a lift with an ergonomic chair attached. The company will also custom mount other chairs to the lift if preferred.

And if you know of any other office chairs that can be raised and lowered with a person seated in them, please let us know!

Allergy Reminder for End of Year

Posted by Kim Cordingly on December 18, 2014 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant, Sensory Team

It’s that time again! With all the festivities at the end of the year, we may be tempted to bring in those leftovers or wear that new perfume, but what may seem like a nice gesture or harmless fun can turn deadly if someone in the workplace is allergic.

If your business has a fragrance-free policy in place, this is a good time to remind folks about it.
If your business does not currently have a policy, this may be a good time to institute one.

Sample policy language can be found at: Accommodation and Compliance Series: Employees with Fragrance Sensitivity.

The additional following general policies may be good starting places:

1. Ensure that all employer controlled spaces are fragrance-free:

  • Remove air fresheners from bathrooms
  • Use only fragrance-free soaps in bathrooms and kitchens
  • Provide hand lotion and hand sanitizer for employee use, ensuring only fragrance-free types are used
  • Ensure frequent and appropriate cleaning of workspaces with fragrance-free/chemical-free cleaners

2. Ensure that all employer controlled maintenance, repair, and remodeling are fragrance/chemical-free:

  • Use fragrance/chemical-free insecticide/pesticides
  • Use fragrance/chemical-free industrial cleaning agents
  • Use fragrance/chemical-free glues, sealants, waxes, and paints/stains

3. Ensure that all employer controlled spaces are free of known food allergens:

  • Do not permit foods with known allergens onsite
  • Provide all food on premises
  • Provide ample off-time for lunches to be done offsite
  • Provide designated, well-ventilated area for all food to be stored, prepared, and eaten

Additional information regarding accommodating people with fragrance/chemical sensitivities can be found on the JAN Website.
Additional information regarding accommodating people with food allergies can be found there as well.

Here’s wishing everyone a safe and happy rest of 2014 from the JAN family!

Focus on Effective Workplace Accommodations for Employees with Hearing Impairments

Posted by Kim Cordingly on October 7, 2014 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Teresa Goddard, Senior Consultant, Sensory Team

Recently, JAN’s Sensory Team has received a number of calls involving employees who are having difficulty purchasing or repairing hearing aids. Some employers choose to purchase hearing aids, but it is rare for them to have an obligation to do so as part of a workplace accommodation. Hearing aids are typically considered to be personal use items, meaning they are devices or equipment that are primarily for personal use and needed both on and off the job.  Other examples of personal use items include wheelchairs and prosthetic limbs.

In the context of the Americans with Disabilities Act (ADA), the guidance on providing personal use items is not as clear-cut as it may seem at first. There are some rare situations in which an employer may need to consider providing something that would otherwise be considered a personal use item. According to the Equal Employment Opportunity Commission (EEOC), equipment that is specifically designed or required to meet job-related rather than personal needs may be something that employers need to consider and provide, absent undue hardship, even if the item is something that would typically be seen as a personal use item. Likewise, employers may need to provide other reasonable accommodations to employees who are experiencing job-related limitations due to hearing loss, regardless of whether or not they obtain hearing aids on their own.

For more information about personal use items and the ADA, see the excerpt below:

From the ADA Technical Assistance Manual, Title I, Equal Employment Opportunity Commission (EEOC), III. THE REASONABLE ACCOMMODATION OBLIGATION, 3.4 Some Basic Principles of Reasonable Accommodation:

 “An employer is not required to provide an accommodation that is primarily for personal use. Reasonable accommodation applies to modifications that specifically assist an individual in performing the duties of a particular job. Equipment or devices that assist a person in daily activities on and off the job are considered personal items that an employer is not required to provide. However, in some cases, equipment that otherwise would be considered “personal” may be required as an accommodation if it is specifically designed or required to meet job-related rather than personal needs.”

“For example: An employer generally would not be required to provide personal items such as eyeglasses, a wheelchair, or an artificial limb. However, the employer might be required to provide a person who has a visual impairment with glasses that are specifically needed to use a computer monitor. Or, if deep pile carpeting in a work area makes it impossible for an individual to use a manual wheelchair, the employer may need to replace the carpet, place a usable surface over the carpet in areas used by the employee, or provide a motorized wheelchair.”

Whether or not an employee acquires hearing aids, accommodations may be needed to ensure effective communication in the workplace. One type of equipment that may be useful as part of an accommodation for an employee with a hearing impairment is an assistive listening device such as an FM system, induction loop system, or an infrared system. These types of devices assist with listening by enabling the user to hear the voice of a speaker who is wearing a microphone by making their voice louder than the background noise in a room. The speaker talks into a microphone or transmitter and the listener either uses the T-switch on their hearing aid or wears a receiver designed to work with the specific assistive listening device. These devices can usually be used with other sound sources as well, such as radios and training videos.

Some assistive listening devices are very simple, and basically consist of a microphone, an amplifier, and an earpiece or headphone jack. Others are more complex. When selecting an assistive listening device, it is helpful to know whether or not the individual uses hearing aids or cochlear implants and if the aids or implants have any special features such as telecoils or Bluetooth connectivity. This will make a difference in the type of listening device that might work best for the employee. Often the employee’s audiologist will be able to provide information about the type of hearing aid as well as individualized equipment recommendations.

More information regarding assistive listening devices is available in JAN’s Searchable On-line Accommodation Resource (SOAR) section of the Website.
For a person with a hearing impairment, one typical workplace task that may require an accommodation is telephone use. Telephone amplification is one type of accommodation that JAN consultants often discuss with employers who are seeking to accommodate employees with hearing loss. This is particularly the case if the employees do not currently use hearing aids or prefer to remove their hearing aids when using the phone. There are many types of telephone amplification devices and choosing the right one for a particular employment setting can be a challenge. A qualified audiologist may be able to provide valuable individualized advice. I often suggest working with the individual and their treating medical providers when appropriate to find a customized solution.

One option I often suggest exploring is whether an amplifier that the employee can adjust on their own would meet their needs. Most people with hearing impairments can hear some types of sounds or frequencies better than others. No telephone amplifier is as customizable or adjustable as a hearing aid, fitted by a qualified audiologist. However, one example of a telephone amplifier with easily adjustable volume across multiple frequencies is the Speech  Adjust-a-Tone from Hearsay. This device has six sliders which can be used to adjust the volume of sounds ranging from bass, mid, to treble. Some individuals with hearing aids can also benefit from this product since it can be used with a neck loop. It can also be used with certain types of headsets as well as with a bone-conducting transducer. Since there are multiple models of this product, it may be helpful to consult the manufacturer or a vendor to see which might work best in your setting. You can find more information on telephone amplification on the JAN Website.

If an employee needs assistance purchasing hearing aids, he/she may wish to apply for services through their state Office of Vocational Rehabilitation Services.

There are also organizations that provide hearing aid funding assistance, or refurbished hearing aids, based upon financial need. You can find information about hearing aid funding sources for individuals on the JAN Website.

It is also important to remember that even if an employee obtains hearing aids, the employer may need to consider equipment-related accommodations in order for the employee to use their hearing aids effectively at work. Additional information on accommodation ideas for employees who are deaf or hard of hearing is also available on the JAN Website.