Facing the realities of accommodations management

When it comes to accommodations management, many of us can feel like Alice in Wonderland — caught between the fantasy of a perfect process and the reality of the workplace. 

In a perfect world, accommodations management would be timely, fair and inclusive. Documentation would be exact and on point, employees and employers would collaborate seamlessly, and healthcare providers would always be responsive. And in the end, every case would result in the “right” decision where the business impact is clear, and all risk is avoided.

Sounds great, right? But if you’ve ever managed accommodations before, you know this is more myth than reality. Let’s look at what makes it difficult to achieve this ideal state and explore some practical solutions you can implement to make the process smoother.  

Less fantasy, more function: Streamline your decision-making

The biggest obstacle in the accommodations process is often the decision-maker. Many managers and HR professionals tend to exhibit some of the following avoidance behaviors when faced with a decision:

• Deferral: Postponing decisions without clear next steps or a timeline in hopes that things will resolve themselves. 
• Delegation despite authority: Passing the decision to someone else, even when they have the power and information to decide themselves. 
• Analysis paralysis: Delaying decisions by demanding excessive information, even if what they already have is good enough or likely the best that they are going to get.
• Process overreach as fraud prevention: Adding steps to the process out of concern that the employee is gaming the system. 

These behaviors are usually driven by fear of consequences or conflict, or in many cases, a desire for perfection. However, having the perfect process or documentation isn’t realistic. In fact, chasing perfection only causes unnecessary delays that open you up to legal risk — especially under the Pregnant Workers Fairness Act (PWFA), if the condition is obvious or permanent, or if interim accommodations aren’t provided.  

Moving decision-making from Wonderland to the real world starts with a shift in mindset. The goal of accommodations management isn’t to find reasons to say no; it’s to find practical ways to say yes. This means being realistic and reasonable in terms of what can be done to help employees succeed or return to work, and the kind of information that can support a decision.

Developing a clear decision-making framework can help ensure decisions are made consistently, reduce bias and streamline the process. Here are three models to consider:

• Social model: Focuses on removing barriers, influencing societal changes and promoting inclusion. Accommodations are not exceptional — they’re a right. 
• Biopsychosocial model: Focuses on how biological, psychological and social factors interact. The employee and employer collaborate on comprehensive, proactive and personalized accommodations. 
• Medical model: Focuses on “fixing” the employee through treatment and rehabilitation. Accommodations are reactive and treated as exceptions. 

While frameworks can be helpful, they’re only meant to be a guide. Which model to adopt is often a function of culture and risk tolerance, with a medical model being the most risky but potentially necessary, depending on the job and hardship considerations. Ultimately, decision-makers should be aware of the model their leadership or law department wants them to follow, and they should feel empowered to use discretion, even within prescribed parameters. No matter the model, there should be clear decision-making authority and an expectation that every action aligns with company values. Above all, decision-makers should presume employees are acting in good faith and focus on enabling solutions, not denying them.

Compliance without complexity: Focus on finding ways to say yes

Accommodation laws can present a key challenge for employers. Laws like the Americans with Disabilities Act (ADA) define “disability” so broadly that a condition will qualify if it limits everyday activities (like walking, learning or breathing) or if the employee’s body functions more than it typically does for most people, and eligibility rarely requires extensive documentation or analysis. 

Coverage under the PWFA is also broad. A qualifying limitation under the PWFA includes any physical or mental condition related to pregnancy, childbirth or related medical conditions — even if minor or temporary. Likewise, the standard for what counts as a “reasonable accommodation” is also low. If it seems reasonable in most cases, it probably is. This makes approving an accommodation relatively straightforward.

The real challenge comes when an employer considers denying a request. The bar is much higher here because they must prove that the accommodation would cause undue hardship, which is a significant, measurable impact on business operations, resources or colleagues. Undue hardship is difficult to demonstrate, and most requests won’t make a negative impact. Yet, some decision-makers may overcomplicate the process in an effort to justify denial, creating unnecessary delays and more compliance risk.

The best way forward is to focus on how to reasonably and practically say yes rather than getting caught up in finding ways to say no. Start by asking yourself whether the accommodation would truly create undue hardship. If it would, offer an alternative accommodation. If it wouldn’t — and the request is reasonable — there’s little reason to deny it. Streamlining decisions this way not only speeds up the process but also reduces your risk. 

Work smarter, not harder: Be resourceful with documentation

Gathering information can also be a challenge. Healthcare providers aren’t always willing or able to provide detailed clarifications. Some may even charge fees, require additional appointments or redirect requests to other providers to avoid it. Plus, following up can be time-consuming and rarely changes the outcome. In the end, searching for the perfect documentation just delays helping employees and creates more risk for employers. 

You can avoid this by streamlining the paperwork process and implementing interim accommodations while pursuing this paperwork, when possible. In some instances, you can make a decision without provider input or with information you already have. Consider leveraging existing medical documentation (like short-term disability paperwork) as a proxy. Then, get clarification from the employee: How does their condition affect their job performance, and what would an effective accommodation look like? 

This becomes particularly relevant with respect to the unique or individualized impact of the condition (i.e., flares). For example, a pregnant employee understands their personal experience with the frequency and duration of morning sickness, and feedback from the employee would be more useful in understanding the accommodation needs than provider information.

Make sure to use actionable, easy-to-use forms with checkboxes and short answer fields to gather these details, as providers prefer a more straightforward, less time-consuming documentation approach. If clarification is still needed from a provider, get a limited release to speak with them and document all efforts made to obtain that information.

The bottom line: Embrace practicality over perfection

While some of us would prefer to stay in Wonderland, the truth is that effective accommodations management comes from living in the real world. By embracing practicality over perfection and finding ways to reasonably say yes, you can keep the process moving forward, reduce your risk and most importantly, help your employees thrive.

At Sedgwick, our experts will partner with you to create an efficient accommodations approach that keeps you compliant, aligns with your culture and helps your employees get the support they need to stay productive at work. To learn more about our accommodations solutions, click here.