Mentally Ill Workers Rarely Prevail in ADA Discrimination Claims, Survey Finds

In the 13 substance abuse claims, employees had no victories in 2001, and the same result turned up in the three cases involving comorbid mental illness and substance abuse.

The researchers pointed out that the “largest category of case decisions are those in which employers prevailed summarily, without the merits of the employees’ claims ever being considered.”

They blame this situation in large part on the ADA’s complex procedural and technical requirements, which, they noted, create “difficult obstacles for plaintiffs to overcome.” These obstacles include “satisfying the requirement that the plaintiff meet the ADA’s restrictive definition of disability—a physical or mental impairment that substantially limits a major life activity, a record of such an impairment, or being regarded as having such an impairment—and still be qualified to perform essential job functions with or without reasonable accommodation.”

In addition, the functional assessment of the worker’s disability must evaluate whether it is corrected or correctable through medications or other measures, such as prosthetic devices or therapies, that mitigate the severity of the impairment’s functional consequences.

Psychiatrist Marcia Scott, M.D., cochair of the APA Committee on Psychiatry in the Workplace and a disability expert, stressed in an interview with Psychiatric News, however, that in the minds of the law’s framers, “the purpose of the ADA was to get those who had pervasive problems into the workforce and keep them there. The purpose was not to adjudicate the problems of worker-employer relationships or those caused by temporary illness, which are clearly covered by disability benefits” rather than the ADA.

She pointed out as well that to be eligible for protection under the ADA, the person’s limitations must extend to functions beyond just work.

Scott suggested that having an illness, such as depression, bipolar disorder, panic disorder, or even PTSD, that is characterized by occasional recurrences and remissions “is not the same as being pervasively disabled, even at baseline. These people don’t need the ADA. They need benefits when they are too sick to work and physician help returning to work,” she asserted. The law was not meant to cover temporary medical conditions or exacerbations of illnesses, even if those flare-ups could be considered a disability. And an employee must be able to do the essential function of his or her job to be eligible for ADA provisions, not necessarily every function, Scott added.

The U.S. Supreme Court clarified the scope of the ADA this year when it ruled in a case against Toyota Motor Manufacturing that to qualify for ADA protections, a worker’s disability must be “permanent or long term.”

“No one believed the ADA would do much for the severely mentally disabled, even though they hoped it would,” said Scott. “The accommodations advocated for the severely mentally disabled are often unrealistic for an employer and tend to stigmatize the employee—things such as high walls, extreme quiet, not working with others. The accommodations that best serve workers with a chronic, disabling mental condition are access to additional treatments, supportive treatments, a limited but well-structured job, and sometimes direct supervision.”

Despite the marked lack of success in getting legal redress for ADA-based claims, Jennifer Mathis, an attorney and ADA expert with the Judge David Bazelon Center for Mental Health Law, said she hopes people with mental illness or substance abuse disabilities do not become so discouraged by these data that they fail to file complaints when they feel they are victims of disability discrimination.

Mathis explained to Psychiatric News why it is so difficult for employers and mentally disabled workers to agree on remedies that would avoid ADA-related legal claims—and why such workers have a hard time convincing courts that an employer has violated the ADA.

For example, “many of the accommodations needed by individuals with mental illnesses, while they are not expensive, are not as simple for employers to understand and to do as are accommodations” for other conditions, she said. “Accommodating someone with a mental illness may require some flexibility and entail trying different things to see what works, such as flexible scheduling, leave time, working at home, or eliminating marginal job duties.”

She added, “Plaintiffs with mental illnesses often lose cases because it appears [to the court or EEOC] that the employer made some effort to accommodate them, even though the accommodations tried were really not effective.”

The process of achieving a solution that satisfies the employer and the worker is often so difficult, and stigma so deeply rooted, that the result turns out to be “bad blood between employer and employee,” Mathis explained, “leading agencies and courts to conclude that an employee was let go not based on prejudice, but simply based on a personality conflict.”

Scott cautioned, however, that “a reasonable accommodation isn’t a job with no stress. The ADA is not relapse prevention. If workers can’t do the essential functions of their job, they need another job,” and psychiatrists can play an important role in helping patients realize this. ▪