Using the Work Experience Survey and the Job Accommodation Network to Identify Reasonable Accommodations in the Workplace: Case Studies of African American Women With Multiple Sclerosis

PurposeFour African American women with multiple sclerosis (MS) participated in an evaluation of barriers to their continued employment.MethodsA trained interviewer completed the Work Experience Survey (WES) in teleconsultation sessions with each participant to identify their: (a) barriers to worksite access, (b) difficulties performing essential functions of their positions, (c) concerns regarding continued mastery of their careers, and (d) extent of job satisfaction.ResultsResulting largely from the physiological, sensory, and cognitive sequelae of their disease, participants reported a wide range of difficulties in performing essential functions of their jobs (15–45) that have the potential to significantly affect their productivity. Career mastery problems reflected issues associated with MS such as “believing that others think I do a good job” and “having the resources (e.g., knowledge, tools, supplies, and equipment) needed to do the job.” Other career mastery concerns reflected idiosyncratic aspects of a specific job setting such as “being able to speak with my supervisor about promotion.” Considering these barriers and relationships with employers, the majority of participants reported low levels of job satisfaction.ConclusionThe interviewer concluded the WES interview by recommending a job accommodation plan, which included suggestions from Job Accommodation Network (JAN) consultants. The interviewer also offered guidelines for the employee to follow in requesting job modifications and assistive technology.

Barriers and facilitators to requesting accommodation among individuals with psychiatric disabilities: A qualitative approach

BACKGROUND: Employees with psychiatric disabilities experience a great amount of workplace challenges such as lacking workplace supports and job accommodations. There is a lack of research surrounding job accommodations for persons with psychiatric disabilities within the United States. Thus, research is warranted to understand how to meet the needs of this population via accommodations. OBJECTIVE: This study examined barriers and facilitators to requesting accommodations among employees with psychiatric disabilities through a qualitative approach. METHODS: This study recruited 120 participants from multiple agencies serving individuals with psychiatric disabilities in the United States. Themes regarding barriers and facilitators were identified using the conventional content analysis approach. RESULTS: The most commonly identified themes were employees’ fear and anxiety negatively impacting accommodation seeking behaviors, employer discrimination and non-inclusive workplace culture, and employers lack knowledge of disabilities and ADA. Participants also identified positive experiences in requesting accommodations. CONCLUSION: Rehabilitation professionals and employers may utilize current findings, facilitate a positive and inclusive workplace environment and assist employees with disabilities to take full advantage of workplace resources and job accommodation to exert their potentials.

Identifying the job accommodation needs of american workers with mid-career neurological disabilities: A multiple case study investigation

METHODS: Four employed people with neurological disabilities who took part in a larger job retention project funded by the United States Department of Labor completed structured interviews to determine their needs for employment accommodations during COVID-19. A trained interviewer administered the Work Experience Survey (WES) in teleconsultation sessions with each participant to identify: (a) barriers to worksite access, (b) difficulties performing essential job functions, (c) concerns regarding continued job mastery, and (d) extent of job satisfaction. RESULTS: Owing primarily to the sequelae of their disabling conditions and less so to social distancing requirements and telecommuting technology, participants reported a wide range of accessibility barriers and difficulties in performing essential functions of their jobs that they believed had the potential to significantly affect their ongoing productivity. Considering the stress and uncertainty that have accompanied the COVID-19 pandemic, it is surprising that the majority of participants reported high levels of job mastery and job satisfaction. CONCLUSION: The interviewer concluded the WES interview by recommending a job accommodation plan, which included suggestions from Job Accommodation Network (JAN) consultants.

Occupational Participation of Persons with Schizophrenia: Exploring Issues of Job-Termination in Supported-Employment

Occupational participation in a supported-employment is a rehabilitation strategy to improve both vocational and non-vocational domains of people with psychiatric disabilities, enabling them to access and/or re-enter employment. This study aims to identify the factors associated with unsatisfactory job-termination among the participants of supported-employment to inform future intervention. A cross-sectional survey was conducted on a group (with a diagnosis of schizophrenia) who participated in a supported-employment program in a large psychiatry institution in Malaysia. Within the first week of job termination, interviews were conducted with three subgroups independently - the participants, the employers and the hospital employment specialists, using the Job-Termination Interview. Factors linked to job-termination and job-accommodation were analysed using univariate and multivariate logistic regression.Key reasons for job termination were- poor job performance (n = 32; 47.1%), interpersonal issue (n = 31; 45.6%), medical illnesses (n = 30, 44.1%), incompatibilities between work-schedule and environment (n = 30; 44.1%), and job-dissatisfaction (n = 29, 42.6%). Key factor for sustaining job/ job-accommodation was “higher pay” (n = 4; 33.3%). Overall, an unsatisfactory trend of job terminations was observed where many (n = 53; 77.9%) quit their job without a ready job at hand. Unsatisfactory job-terminations were associated with three factors -(i). Enrolment in the Individual Placement-Support (IPS) (Adj. OR = 10.70, 95% CI 1.32-86.98, p = 0.012), (ii). Unstable medical issues (Adj. OR = 22.51, 95% CI 1.74-291.08, p = 0.003), (iii). Interpersonal issues (OR = 18.26, 95% CI: 2.24-149.15, p < 0.001).Most participants terminated their jobs in an unsatisfactory manner (77.9%). A high 63.2 percent quit their job without another ready-job at hand, while 14.7 percent were fired. Unsatisfactory job-endings were correlated to, poor job-performance, interpersonal problems and medical illnesses. Occupational re-entry intervention program must be tailored to the individual levels and needs, and be fully integrated within the clinical system to ensure job-person-environment fit, in order to improve job-experience and to lower unfavourable job terminations.

Association between Employment Status and Hospitalization of Patients with Sickle Cell Disease: A Retrospective, Observational Pilot Study

Introduction: Sickle cell disease (SCD) has a negative impact on job functioning and majority of SCD patients cannot retain their jobs. Recurrent acute vaso-occlusive crises (VOC) and organ dysfunction related to SCD can limit employment options and interfere with job retention. Potential associates of unemployment and poor job performance in adults with SCD include health-related (pain frequency and intensity, health-care utilization) and psychosocial (support system, coping mechanism). Unemployment can lead to major psychosocial stress that may translate into physiologic stress resulting in increased emergency department (ED) visits and hospitalizations. Poor psychosocial state may predispose patients to increased chronic pain, and use of alcohol or illicit drugs. The aim of this study is to identify the association between the status of employment of SCD and SCD pain-related hospitalizations. Patients and Methods: This was a retrospective, observational pilot study of SCD patients at our comprehensive SCD clinic. Surveys were administered during routine clinic visits. Surveys contain multiple questions relating to patients' employment history and healthcare utilization. We excluded patients on chronic transfusion therapy and those with disabling conditions unrelated to SCD. We reviewed extensive data in our electronic medical records relating to subjects of interest. Among the patients who have at least 12 months of continuous employment status (employed or unemployed), we assessed SCD pain-related hospitalization rates in the previous 12 months period. Descriptive analysis was performed with frequency distributions. Univariate logistic regression was conducted to investigate the association between employment status and hospitalization rate. Results: A cohort of 74 SCD patients completed surveys about employment and hospitalization history. Of the patients, 51 patients showed continuous employment history greater than 12 months. Thirty-nine out of fifty-one (76.47%) were unemployed. Majority of patients (90.20%) were hospitalized at least once and sixteen patients (31.37%) were hospitalized more than 5 times during the previous 12 months. The univariate logistic regression analysis showed SCD patients with employed status were significantly less likely to be admitted to the hospital compared with unemployed SCD patients (Odds Ratio 0.255, 95% CI: 0.073-0.895). Conclusions: In this cohort, unemployed SCD patients have a significantly higher rate of hospitalization for pain crisis when compared with employed SCD patients. Development of interventions and programs that can improve job accommodation for SCD patients will likely decrease hospitalization and reduce related healthcare costs. In addition, the negative economic impact of SCD on the society will be less. Moreover, improved job accommodation will likely lead to better psychosocial and overall well-being for the patients. Providers who care for SCD patients should encourage patients to engage in job activities as tolerated which may positively influence their overall health. Disclosures No relevant conflicts of interest to declare.

Exploring the Costs of Providing Assistive Technology as a Reasonable Accommodation

The provision of assistive technology (AT) as an accommodation is often associated with a cost. Employer concerns about the cost of providing AT can be a barrier for individuals with disabilities (IWD) who are seeking employment. Rehabilitation counselors & students should be prepared to address employer concerns regarding the cost of an accommodation in order to facilitate successful job placement and/or retention of IWD. This study evaluated the average cost of providing AT in the workplace compared to the average cost of providing other types of accommodations, as reported to the Job Accommodation Network (JAN) by employers. Results of this study show that there is no significant difference in the cost of providing AT in comparison to the cost of providing other types of accommodations (N=72). Rehabilitation professionals can use this information when exploring strategies for negotiating for the use of assistive technology by consumers as an accommodation.

Examining Impacts of Mindfulness in Requesting Job Accommodations for Individuals With Disabilities

This study aimed to examine the relationship between mindfulness and the request for job accommodations among individuals with disabilities. One hundred fifty individuals with disabilities who needed a job accommodation completed a survey assessing the cognitive, affective, and mindfulness factors involved with requesting job accommodations. Pearson correlations were calculated between scales and subscales measuring mindfulness, positive affect, self-efficacy, outcome expectations, and intentions to request accommodations. The results showed significant correlations between mindfulness and all other scales. In addition, multiple regression and logistic regression analyses were conducted to examine the impacts of cognitive, affective, and mindfulness factors on an individual’s intention and decision to request or withhold a request for an accommodation. Mindfulness was not found significant in predicting the intention to request accommodations; however, positive affect, self-efficacy, and outcome expectations accounted for 35% of the variance in intention to request. The interaction between mindfulness and intention to request, along with self-efficacy, was found significant in predicting request behavior. Mindfulness and the interaction between mindfulness and intention to request contributed an additional 8% of the variance in requesting behavior. The results of this study indicate the need for more research into the relationship of mindfulness and the decision to request accommodations.