A qualified employee with a disability is entitled to reasonable accommodations at work, so long as the accommodations would not pose an undue hardship to the employer. Since this post was first published, Congress also enacted the Pregnant Workers Fairness Act (PWFA), which took effect on June 27, 2023, and extended similar accommodation rights to employees with limitations related to pregnancy, childbirth, or related medical conditions.
Employers are permitted to require reasonable medical documentation in support of your accommodation request, but unfortunately, the lawyers of KCNF often see attempts at medical documentation that fall short of what the law demands. Here are guidelines for preparing a strong letter from your healthcare provider — whether you are seeking accommodations under the ADA/Rehabilitation Act or the PWFA.
Medical Documentation Under the ADA and Rehabilitation Act
1. Include the name, severity, and expected duration of the impairment/disability.
Name the condition explicitly, stating its severity when relevant. In some circumstances, it may be helpful to explain common symptoms of the condition, especially where the condition is uncommon or not widely understood. The letter should also state whether the condition is temporary or permanent and if it is temporary, provide an end date or expected duration for the condition.
2. Articulate the major life activities that are substantially limited by the impairment.
Explain which major life activities — referencing those articulated by the ADA regulations, such as caring for oneself, seeing, hearing, sleeping, walking, standing, concentrating, and thinking — the impairment substantially limits. These should be broad categories. For example, depression may limit someone’s ability to concentrate, interact with others, and sleep. Cancer, on the other hand, may limit normal cell growth and immune system functioning. See 29 C.F.R. § 1630.2(i)(1) (containing examples of major life activities). Your health care provider should specifically state (if true) that you are “substantially limited” in those major life activities, as the law requires that an impairment do so to qualify as a disability.
3. Explain how the impairment impacts the completion of job duties.
Describe how the impairment impacts your ability to do your job, thereby establishing that an accommodation is necessary. This may require providing your health professional with your job duties, or at least a list of your typical duties. In many instances, this can be explained briefly in just one sentence.
4. Clarify that, with a reasonable accommodation, you can perform your job duties.
Make clear that either with or without an accommodation, you can successfully perform your job. This is critical because under the relevant laws, an employee is only entitled to accommodations if they can perform their job successfully. If you have performed successfully even without accommodation, this will be easier. On this issue, the explanation should only be as long as necessary to make the point.
5. Recommend particular workplace accommodations.
Be specific. A letter that states an accommodation is needed but does not specify the accommodation(s) will not be helpful. While you are not entitled to the precise accommodation your health provider recommends, the employer’s starting point for granting an accommodation is the medical recommendation. Moreover, the recommendation is a strong reference point for assessing whether any alternative accommodations your employer may recommend are sufficient to meet your needs.
When is documentation required?
Employers may only request documentation when the disability and/or need for accommodation is not known or obvious. Employers also may not ask for documentation unrelated to the accommodation request — including an employee’s complete medical records.
Who can provide documentation to support an accommodation request?
The ADA does not require that documentation come from a licensed MD. Documentation can be provided by an “appropriate professional,” which may include doctors (including psychiatrists), psychologists, nurses, physical therapists, occupational therapists, speech therapists, vocational rehabilitation specialists, and licensed mental health professionals, among others.
Overlapping protections under the ADA and the PWFA
In some situations, a pregnancy-related condition may qualify for accommodation under both the ADA and the PWFA, and employees may be entitled to invoke either statute. If you are uncertain which law applies to your situation — or whether both do — it is worth consulting with an employment attorney.
Following the above guidelines will yield strong medical documentation in support of your reasonable accommodation request. Is your employer still refusing to accommodate your disability or pregnancy-related limitation? The lawyers of KCNF can help. Contact us for a consultation today.