Impact of Accommodations and Disability on Work

The effects of occupational injuries after returns to work: Work absences and losses of on-the-job productivity

Butler, R. J., Baldwin, M. L., & Johnson, W. G. (2006). "The effects of occupational injuries after returns to work: Work absences and losses of on-the-job productivity." Journal of Risk and Insurance, 73(2): 309-34.

We extend the research on post-injury employment by estimating productivity losses for workers with permanent partial disabilities (PPDs) in the first three years after injury. Our method distinguishes between productivity losses attributed to spells of work absence versus reduced earnings during spells of employment. The method is applied to data for 800 Ontario workers with PPDs. The results document large productivity losses persisting at least three years after injury, with different loss patterns for workers returning to stable versus unstable employment. Human capital investments or job accommodations can reduce productivity losses, but the significant determinants of losses differ for the stable versus unstable employment groups.

How accommodations affect the duration of post-injury employment spells

Campolieti, M. (2005). "How accommodations affect the duration of post-injury employment spells." Journal of Labor Research, 26(3): 485-99.

I examine the effects of accommodations on the duration of employment spells using a sample of workers reentering the work force after an occupational injury. Unlike previous research, I analyze the post-injury employment history, i.e., more than one employment spell. The results indicate that accommodations have a smaller effect on employment duration than previous studies for workers who have not left their jobs. In addition, only certain types of accommodations, flexible work schedules and modified workplaces, are associated with significant increases in employment duration. The implications of these estimates for disability policy are also briefly discussed.

The extent and effect of employer compliance with the accommodations mandates of the Americans with Disabilities Act

Charles, K. K. (2004). "The extent and effect of employer compliance with the accommodations mandates of the Americans with Disabilities Act." Journal of Disability Policy Studies, 15(2): 86-96.

Using data from several waves of the National Institute on Aging's Health and Retirement Study, the author of this article evaluates whether employers have complied with the requirements of the Americans with Disabilities Act (ADA) that they (a) accommodate workers who become disabled while in their employ and (b) not pass on the costs of that treatment in the form of lower wages. The author also examines the impact of accommodations on improved job attachment. Study results suggest that workers were accommodated slightly more after the passage of the ADA than before, though in certain specific ways only. Workers appear to have paid for their accommodations in the form of lower wages. Finally, the author shows that accommodation has been very effective at increasing job attachment for individuals with disabilities, but this effectiveness has lessened with time since the ADA's passage. (PsycINFO Database Record (c) 2006 APA, all rights reserved)

Will the costs of accommodating workers with disabilities remain low?

Chirikos, T. N. (1999). "Will the costs of accommodating workers with disabilities remain low?" Behavioral Sciences & the Law, 17(1): 93-106.

Whether the costs of job accommodation remain low as more persons with disabilities enter the work force is a crucial issue in evaluating the progress of the employment provisions of the Americans with Disabilities Act (ADA). Much depends on the extent to which health and economic factors thought to raise or lower the costs of accommodation to employers actually predict accommodation outcomes. An empirical model of employer accommodation is specified and tested with data on a representative sample of Americans in their fifties. Among others, the results show that both the likelihood and extent of job accommodation are significantly influenced by cost-increasing and cost-decreasing factors, in each case in the direction predicted by the model. Inferences about the future trajectory of the costs of job accommodation and the employment effects of the ADA are discussed.

Accommodating workers with spinal cord injury

Dowler, D., Batiste, L., & Whidden, E. (1998). “Accommodating workers with spinal cord injury." Journal of Vocational Rehabilitation, 10(2): 115-122.

Describes the types of jobs, functional limitations, job functions, career status and accommodation suggestions for over 1,000 cases from the Job Accommodation Network (JAN) caseload involving workers with spinal cord injury. The JAN, a service of the President's Committee on Employment of People with Disabilities, was designed to provide a toll-free consulting service for information about accommodations in the workplace. The mission of JAN is to assist employers, service providers and people with disabilities by giving accommodation information related to the hiring, retraining, retention, or advancement of persons with disabilities. The career progression recorded for each caller reflects how the accommodation was used to place or retain the caller in employment. Overall, JAN data show that workers with spinal cord injury can be gainfully employed and maintain this employment over time. Results indicate that nearly three-quarters of the callers needed an accommodation in order to maintain their current job or to improve their productivity in their current job. Only 1% of the callers were being considered for promotion. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Reasonable accommodations for workers with serious mental illness: Type, frequency, and associated outcomes

Fabian, E. S., Waterworth, A., & Ripke, B. (1993). "Reasonable accommodations for workers with serious mental illness: Type, frequency, and associated outcomes." Psychosocial Rehabilitation Journal, 17(2): 163-172.

This paper reports on a study of reasonable accommodation for workers with serious mental illness undertaken at a community supported employment program in Bethesda, Maryland. The participants in the study consisted of 30 individuals who held a total of 47 jobs during the time frame of the study. Two hundred thirty-one accommodations at the worksite were identified for these individuals, for an average of 5.1 accommodations per job. The most frequently identified accommodation was Orientation and Training of Supervisors to provide necessary assistance (38.1%), followed by Modifications of the Non-physical Work Environment (16.4%); and Modifications of Work Hours and Schedules (15.69). Employment tenure was significantly associated with number of job accommodations.

Workplace-based return-to-work interventions: A systematic review of the quantitative literature

Franche, R. L., Cullen, K., Clarke, J., Irvin, E., Sinclair, S., & Frank, J. (2005). "Workplace-based return-to-work interventions: A systematic review of the quantitative literature." Journal of Occupational Rehabilitation, 15(4): 607-631.

Introduction: A systematic review was conducted to review the effectiveness of workplace-based return-to-work (RTW) interventions. Method: Seven databases were searched, in English and French, between January 1990 and December 2003 for peer-reviewed studies of RTW interventions provided at the workplace to workers with work disability associated with musculoskeletal or other pain-related conditions. Methodological quality appraisal and data extraction were conducted by pairs of reviewers. Results: Of a total of 4124 papers identified by the search, 10 studies were of sufficient quality to be included in the review. There was strong evidence that work disability duration is significantly reduced by work accommodation offers and contact between healthcare provider and workplace; and moderate evidence that it is reduced by interventions which include early contact with worker by workplace, ergonomic work site visits, and presence of a RTW coordinator. For these five intervention components, there was moderate evidence that they reduce costs associated with work disability duration. Evidence for sustainability of these effects was insufficient or limited. Evidence regarding the impact of supernumerary replacements was insufficient. Evidence levels regarding the impact of the intervention components on quality-of-life was insufficient or mixed. Conclusions: Our systematic review provides the evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs, however the evidence regarding their impact on quality-of-life outcomes was much weaker. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Do injured workers pay for reasonable accommodation?

Gunderson, M., & Hyatt, D. (1996). "Do injured workers pay for reasonable accommodation?" Industrial & Labor Relations Review, 50(1): 92-104.

The authors present evidence on the extent to which injured workers in Ontario in 1979-88 "paid," through lower wages, for "reasonable accommodation" requirements designed to facilitate their return to work after their injury. The data source, the Ontario Workers' Compensation Board's Survey of Workers with Permanent Impairments, provides detailed information on two categories of accommodation. Work-place modifications, such as customized equipment and shortened work schedules; and reductions in physical demands, such as exemption from bending and heavy lifting. Employers who rehired their own injured workers appear to have absorbed virtually all the cost of the accommodations they made, but employers who hired workers who were injured at other firms shifted a substantial portion of the cost of workplace modifications (though not the cost of reductions in physical demands) onto the injured workers, in the form of lower pay.

Cost and effectiveness of accommodations in the workplace: Preliminary results of a nationwide study

Hendricks, D. J., Batiste, L., Hirsh, A. (2005). "Cost and effectiveness of accommodations in the workplace: Preliminary results of a nationwide study." Disability Studies Quarterly, 25(4), Available from: Disabilities Studies Quarterlyopens a new window

Real-life issues in job accommodation: Employers' and employees' perspectives

Hendricks, D. J., Dowler, D. L., & Judy, B. T. (1994)."Real-life issues in job accommodation: Employers' and employees' perspectives." Journal of Vocational Rehabilitation, 43(3): 174-182.

Over 2000 recent cases from the files of the Job Accommodation Network were examined to expose the relationships among the issues discussed, the type of job involved, and the career progression of individuals with disabilities for calls by employees with disabilities and calls by their employers. Six types of issues (understanding the ADA, impact of the accommodation, conflict between employer and employee, cost, government agency problems, and other) were identified. Both employers and employees cited understanding the ADA as their most critical concern. As implementation of the ADA proceeds, it is expected that issues of concern will shift from definitions of ADA terminology to more practical implementation strategies.

Back pain and work disability: The need for a new paradigm

Johnson, W. G., Baldwin, M. L., & Butler, R. J. (1998). "Back pain and work disability: The need for a new paradigm." Industrial Relations, 37 (1): 9-34.

Using a unique data set of workers' compensation claims from Ontario, this study analyzes the determinants of first returns to work and subsequent patterns of employment for a sample of workers with back pain and a comparison group of workers with other injuries. The results suggest that the costly and pervasive problem of work-related back claims could be reduced by abandoning the traditional work injury model in favor of a separate paradigm for back pain that reflects its unique characteristics. A change in economic incentives would increase the probability of return to work for back cases, and an expansion of employer-provided job accommodations would increase the probability of stable employment after the first return.

Intellectual disability, challenging behavior and cost in care accommodation: What are the links?

Knapp, M., Comas-Herrera, A., Astin, J., Beecham, J., & Pendaries, C. (2005). "Intellectual disability, challenging behavior and cost in care accommodation: What are the links?" Health & Social Care in the Community, 13(4): 297-306.

The paper examines the links between degree of intellectual disability, challenging behaviour, service utilisation and cost for a group of people with intellectual disabilities living in care accommodation in England. A cross-sectional survey was conducted of people with intellectual disabilities, identified via provider organisations, with supplementary collection of costs data. Multivariate analyses of cost variations were carried out for 930 adults with intellectual disabilities. There were strong, nonlinear, interdependent links between degree of intellectual disability, behaviour, service use and costs. Higher costs were associated with more severe intellectual disabilities and more challenging behaviour. Sector and scale of residence also influenced cost in quite complex ways. Access to and use of services by people with intellectual disabilities were not always appropriately linked to perceived or actual needs. Policy makers and local commissioning agencies need to explore the sources of cost variation between individuals, sectors and types of accommodation in order to achieve national policy objectives on quality, choice, independence and inclusion. ABSTRACT FROM AUTHOR Copyright of Health & Social Care in the Community is the property of Blackwell Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

Work problems and accommodations reported by persons who are post polio or have a spinal cord injury

McNeal, D. R., Somerville, N. J., & Wilson, D. J. (1999). "Work problems and accommodations reported by persons who are post polio or have a spinal cord injury." Assistive Technology, 11(2): 137-157.

This study documented (1) whether employees with a disability who are aging have experienced new work problems as a consequence of functional declines, and (2) whether their work problems are being accommodated adequately. 96 individuals with a disability (50 postpolio and 46 who had a spinal cord injury, SCI) were interviewed by phone. 49 of the 50 postpolio persons reported they had experienced functional declines in recent years, and 41 of the 50 rated the severity of their disability as greater than when they first began working. As a result of the functional declines, 90.9% of their work problems were rated as new and would not have been significant problems for them when they first began working. The situation was very different for the group with SCIs. Only a few members of that group had experienced functional declines that were causing new problems at work. A total of 480 work problems were reported by participants. Three out of every 8 problems did not have an accommodation satisfactory to the employee, primarily because no accommodation had been identified. Employers were generally supportive of the employee's need for accommodation; they paid for 59.1% of the accommodations that had a cost and refused to provide an accommodation for only 18 of the 480 problems. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Reducing workplace barriers to enhance job satisfaction: An important post-employment service for employees with chronic illnesses

Roessler, R. T., & Rumrill, P. D., Jr. (1998). "Reducing workplace barriers to enhance job satisfaction: An important post-employment service for employees with chronic illnesses." Journal of Vocational Rehabilitation, 10(3): 219-229.

Examined the factors associated with job satisfaction among 41 employed people (aged 23-66 yrs) with chronic illnesses. The interview protocol included biographical questions, comprehensive checklists on barriers to workplace access and performance of essential functions, and job mastery and job satisfaction questions based on the Career Mastery Inventory (J. Crites, 1990). Results indicate that job satisfaction is a function of the number of job mastery and accessibility/performance of essential function barriers occurring in the workplace. Hence, reduction of workplace barriers is an important post-employment service goal for employees with chronic illnesses. High priority post-employment services include (a) objective assessment of barriers to productivity in the workplace and (b) job accommodation and career counseling interventions to reduce or remove the barriers. (PsycINFO Database Record (c) 2006 APA, all rights reserved)

Multiple sclerosis and workplace discrimination: The national EEOC ADA research project

Rumrill, P. D., Roessler, R. T., McMahon, B. T., & Fitzgerald, S. M. (2005). "Multiple sclerosis and workplace discrimination: The national EEOC ADA research project." Journal of Vocational Rehabilitation, 23(3): 179-187.

Information from the Integrated Mission System of the United States Equal Employment Opportunity Commission (EEOC) was used to investigate the employment discrimination experience of Americans with multiple sclerosis (MS) in comparison to Americans with other physical, sensory, and neurological impairments. Specifically, the researchers examined demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom allegations were filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcome or resolution of these allegations. Findings indicate that persons with MS were younger than the comparison group and comparatively overrepresented by Caucasians and women. People with MS were proportionally more likely than the comparison group to allege discrimination related to reasonable accommodations, terms or conditions of employment, constructive discharge, and demotion. People with MS were proportionally more likely than the comparison group to file allegations against employers in the service and financial/insurance/real estate industries, employers with 500 or more workers, and employers in the North United States Census region. People with MS were proportionally more likely than the comparison group to receive merit resolutions as a result of the EEOC's Americans with Disabilities Act Title I investigatory process. Implications for policy and advocacy are addressed. (PsycINFO Database Record (c) 2006 APA, all rights reserved)

Workplace barriers and job satisfaction among employed people with multiple sclerosis: An empirical rationale for early intervention

Rumrill, P., Roessler, R., Vierstra, C., Hennessey, M., & Staples, L. (2004). "Workplace barriers and job satisfaction among employed people with multiple sclerosis: An empirical rationale for early intervention." Journal of Vocational Rehabilitation, 20(3): 177-183.

This article presents findings pertinent to the relationship between on-the-job barriers and job satisfaction among employed people with multiple sclerosis (MS). Fifty-nine adults with MS (N = 59), who self-initiated a telephone call to an employment hotline for assistance in managing their MS on the job, participated in structured job accommodation interviews (Work Experience Survey - WES). Respondents reported few worksite accessibility problems, a moderate number of performance difficulties, few job mastery problems, and relatively high levels of job satisfaction. Restricted range in the job mastery variable precluded its contribution to the hypothesized regression equation predicting job satisfaction, but the total number of worksite accessibility and essential function barriers correlated significantly and negatively with job satisfaction (r = -0.33, r^2 = 0.11, p < 0.015). A rationale for early intervention to reduce workplace barriers is presented, grounded in these findings and career development theory. (PsycINFO Database Record (c) 2006 APA, all rights reserved)

Evidence-based practice in workplace accommodations

Sanford, J. A., & Milchus, K. (2006). "Evidence-based practice in workplace accommodations." Work: Journal of Prevention, Assessment & Rehabilitation, 27(4): 329-332.

The article comments on evidence-based practice (EBP) in workplace accommodations for employees with disabilities. According to the author, the field is not yet mature and dominated by practice. EBP is an approach to health services that supports the integration of best research evidence with professional expertise and client values for decision making. The benefits of EBP are enumerated and discussed.

Workplace accommodations: Evidence based outcomes

Schartz, H. A., Hendricks, D. J., & Blanck, P. (2006). "Workplace accommodations: Evidence based outcomes." Work: Journal of Prevention, Assessment & Rehabilitation, 27(4): 345-354.

One central component to meaningful employment for people with disabilities is the ADA's workplace accommodation provision that allows qualified individuals to perform essential job functions. Little empirical evidence is available to evaluate the costs, benefits, and effectiveness of accommodations. Previous research has focused on direct costs. This article advocates an inclusive accommodation cost/benefit analysis to include direct and indirect costs and benefits and to differentiate disability-related accommodation costs from typical employee costs. The inclusive cost/benefit analysis is applied to preliminary data from interviews with employers who contacted the Job Accommodation Network (JAN). Results suggest that accommodations are low cost, beneficial and effective.

A model of factors affecting the treatment of disabled individuals in organizations

Stone, D. L., & Colella, A. (1996). "A model of factors affecting the treatment of disabled individuals in organizations." The Academy of Management Review, 21(2): 352-401.

A model of factors thought to affect the treatment of disabled individuals in organizations is presented. Specifically, the model suggests that person characteristics (e.g., attributes of the disabled person, attributes of the observer), environmental factors (i.e., legislation), and organizational characteristics (e.g., norms, values, policies, the nature of jobs, reward systems) combine to affect the way disabled individuals are treated in organizations. Furthermore, the model indicates that the relationships just noted are mediated by observers' cognitions (i.e., categorization, stereotyping, expectancies) and affective states. Finally, the model predicts that the disabled person's responses feed back to modify observers' expectancies and organizational characteristics. Implications for conducting research on disability issues and facilitating the inclusion of disabled individuals in organizational settings are discussed.