Lessons About Reasonable Accommodations for Disabilities

If you were suddenly confined to a wheelchair or forced to use crutches, what kind of world would you confront?

Occupational safety and health is a noble profession. Most of us chose our career based on a fundamental desire to help others. All too often, however, our focus on statistics and a top-level view of accident causation and prevention can lead us to become numb to the real human costs of accidents and injuries.

Recently, I was on a mat in physical therapy (PT) while my physical therapist was bending my knee. While trying to maintain a shred of control and not to scream or flail too extravagantly, my gaze fell on a young lady who was also undergoing PT that day. She could not move her hands above waist level, and she had trouble moving her feet. Her PT was to try to learn to walk again. I commented to her that she should be happy and certain in her determination in that, a year before, I also could neither lift my hands nor walk. Now I can do both. She responded angrily, "I don't intend to take a year to accomplish those tasks!"

What will happen to her during that year? What happened to me in that year? During that year, she will have pain and take drugs. She will spend an immense amount of time in PT and at home. She will have uncompensated medical and lost wage costs. She will be a source of strain to her spouse and family, because they never know what crisis or pain will greet them when they see her. That issue is never adequately measured when workers' compensation data is analyzed.

There is another issue: how your bosses and co-workers deal with your disability. Those without serious disabilities, which of course applies to almost all of your bosses and co-workers, seldom stop to consider what it would be like to be handicapped. Imagine that, in one instant, you are suddenly confined to a wheelchair or on crutches and unable to "walk" distances. What kind of world would you confront?

For me -- and for David Lee, ASSE Region II vice president, who has spent part of the last year in a wheelchair after an accident, and for some of my injured friends in PT sessions -- lessons were quick to follow. Says David, "Simply opening a door and trying to get through it is a challenge." Why? Door springs are too strong for someone with injured arms. He continues: "Frustration can happen very quickly in public rest-rooms when you are in a wheelchair. Even when stalls are properly sized for wheelchairs, individuals who show no outward appearances of being disabled already occupy them. Often sink faucets, which are too hard to turn, and soap dispensers are not readily accessible from the wheelchair. The paper towels are always located on the other side of the room, totally out of reach from the sink." The floor is slippery with water, which is a real hazard if you are on crutches.

Many other challenges suddenly appear. "One quickly learns that city sidewalks are not flat. From a wheelchair, it becomes evident that sidewalks are sloped slightly toward the street," David says. "Pushing a wheelchair against that slope quickly tires the downhill arm. Sidewalks can present several other challenges -- ridges created by tree roots, broken and missing pieces, cobble stones, lack of wheelchair access at curb sides, just to name a few. When sitting in a wheelchair, you quickly learn to identify obstacles that you never even considered before."

Pieces of my electric wheelchair were prone to falling off as I motored over those obstacles. Interestingly enough, the handicapped parking spaces at the University of Michigan were on what for me was an impossibly steeply sloping portion of a parking lot. Fortunately, one of my colleagues in the dean's office understood my plight and had the parking places moved.

All of my handicapped friends report to me that there is a certain amount of resentment from their co-workers about the issue of parking. "What do you mean you can't be somewhere for a meeting? There are plenty of handicapped parking spaces [down the block one-fourth of a mile away]!" Our able-bodied co-workers don't understand the meaning of one-fourth of a mile when your arms and legs don't work.

Reasonable Accommodation

Another widely reported issue is the re-design of workstations to provide a reasonable accommodation for your injury. It appears to be common that there are subtle forms of resistance by organizations to spending money for this purpose. Organizational resistance to such accommodation can make the handicapped worker very uncomfortable.

I even had a colleague in our profession tell me, "Why, you don't even deserve a reasonable accommodation! Your company should not have to pay for the injury that you did to yourself on your motorcycle!" (I hope this OHS professional will never be in an accident when he is not at work.) Fortunately for the disabled, the law does not agree with my colleague. Reasonable accommodation must be available to all.

Since his recovery, David says: "Today, when I enter a building, I look at it differently than I used to. I have numerous questions about disabled access that I want answers to. I used to think that if the ramps, labels and signs were present, the needs were being met. Until my own injury, I never really stopped to evaluate the accommodations themselves. What few of us ever stop to consider is that an accident doesn't just happen to the injured individual. It happens to their entire family."

For me, this means that my wife is now, for the first time in a year and a half, getting her life back. This is a very serious issue. How often did she enter the room to see the look of pain on my face, or answer the phone and say that she could not accept a contract to perform the work to which she is accustomed? Now, multiply the experience of my wife and David by the number of disabling accidents or injuries in the workplace today. Mere accident statistics and workers' compensation costs cannot even begin to measure this issue.

Bill, one of my PT friends from the nursing home I was in during rehabilitation, fell off a roof while supervising a construction job. His wife, Elaine, has seen him through two comas, one amputation and two years in the nursing home. Now that Bill is recovering, they must face the dual issues of resurrecting Elaine, who used to be a grade school teacher, and finding some useful employment for himself. Bill does not have the luxury that Dave and I have. As a construction worker, he needs his body to do his job. Dave and I can work as long as we can think and talk, perhaps longer.

One way we can educate our bosses and co-workers about the consequences of workplace injuries and illnesses is to teach them that they are "temporarily able-bodied workers." Just as society must look at disability as temporary, and return to work as a useful and achievable goal, so must society look at the concept of being "temporarily able-bodied." That may help our bosses and co-workers achieve a level of empathy that they might not otherwise have.

Dave speaks for both of us, and for Bill and for our friends in physical therapy when he says: "As a result of my own experience, I have a renewed understanding of the importance of the safety and industrial hygiene professions. We must help prevent others from having to experience what I recently went through. We owe them that much." That is the most important lesson for OHS professionals about reasonable accommodations for disabilities.

Contributing Editor Steven P. Levine, Ph.D., CIH2, is president-elect of the American Industrial Hygiene Association. He is a professor of environmental health sciences and co-director of the University of Michigan WHO Collaborating Center for Occupational Health, and adjunct professor at the Institute for International Health of Michigan State University.

The opinions expressed in this column are the author's and not necessarily those of the AIHA or the AIHA boeard of directors.

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