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Amputation means the loss or absence of all or part of a limb. Causes of amputations include peripheral vascular disease (often associated with diabetes), trauma, tumors, and infections. In the United States, limb loss resulting from vascular conditions, referred to as dysvascular amputation, accounts for the majority of lower extremity amputations. Although the rates of limb differences due to congenital anomalies have remained consistent for several decades, dysvascular amputations have increased significantly.
Upper extremity amputations are most often a result of an accident or trauma, with recent warfare increasing the rate of occurrence in the United States. In general, upper extremity amputations occur more often in younger age groups. In the wake of an amputation, a new amputee could have a myriad of post-operative medical concerns such as pain management, infection, and controlling the swelling and shaping of the residual limb. Additionally, there will likely be a period of significant rehabilitation, with a wide range of therapeutic goals that will vary for each individual. Amputees may experience a wide range of emotions in response to the loss of a limb, including anxiety, sadness, depression, anger, and grief.
Amputation and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Amputation
People with amputations may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with amputations will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
- Limiting lifting, reaching, pushing, and pulling by job restructuring
- Using Proper Lifting Techniques
- Reallocating lifting duties, if marginal
- Providing assistance moving objects, to reduce weight
- Organizing items in a way that reduces the need to move or lift items
- Reducing weight to be lifted by separating items into smaller groups
- Reassigning an employee to a modified duty position or modifying duties by removing the lifting duties
- Periodic rest breaks to get up and move around
- Modified break schedule so that you can stretch your legs when needed
- Using break reminder software to remember to get-up and move around
- Alternating between sitting and standing while working by using a sit/stand workstation
- Ergonomic/adjustable office chair
- Work at home, where employee can lie down, sit, stand, move freely
Situations and Solutions:
An applicant, who had both of his legs amputated, uses a wheelchair to help him ambulate.
The office building that he will be reporting to work in does not have an elevator and if he gets the position his workstation will be located on the third floor. As an accommodation, the employer agrees to allow the individual to work in an office on the first floor should he be selected for the position.
A child care worker with cancer had difficulty walking through a campus environment.
The employee requested the ability to stay in one building. The employer contacted JAN for options. JAN suggested a mobility aid that the individual used solely for job functions.
An employee who works as a police officer has recently had one of his legs amputated.
The employer is unable to locate an accommodation that would allow the employee to safely perform the essential function of this position. However, an administrative position within the unit will become vacant soon so the employer arranges to allow the employee to be reassigned into this position as an accommodation.
A veteran with double, above-elbow amputations, works for a federal agency and must take a laptop and paperwork to and from work each day
Her employer provided a personal assistant to carry the laptop and paperwork to and from the employee’s car.
An employee who works as a truck driver has recently had her dominant arm amputated.
She has expressed concern in her ability to return to work because she is unable to shift the gears in the vehicle. As an accommodation, the employer arranged for the employee to drive an automatic transmission truck.
An employee who works as a teacher has recently had her dominant arm amputated.
She states that she is having trouble writing important information on the dry erase board due to lack of practice in writing with the non-dominant arm. The employer allows her to use a projector and type the information on a keyboard as an accommodation until a smart board can be purchased.
An applicant, who has had both of her arms amputated, is applying to work in an accounting position.
The applicant mentioned that in a previous position, her employer allowed her to use speech recognition software and a head tracking camera mouse to access her workstation computer. The employer reviewed these options and decided to provide them should the applicant be selected for the position.
An employee recently returned to work after having one hand amputated.
The employee had difficulty using a staple remover. The employer agreed to switch from using staples to paper clips as the employee finds those much easier to work with.