Essential Job Functions Research Articles

The Organizational Factors that Impact Employment: Agreed-Upon Barrier and Facilitators

<h3>Research Objectives</h3> To describe and compare the perspectives of employees with disabilities (EWD) and employers on the organizational factors that affect employment. <h3>Design</h3> Cross-sectional surveys of EWD and employers. <h3>Setting</h3> EWD and employers in the Midwestern United States. <h3>Participants</h3> Convenience sample of 270 EWD and 53 employers involved in hiring and managing EWD. <h3>Interventions</h3> None. <h3>Main Outcome Measures</h3> Organizational factors that affect employment from the perspective of EWD and employers. Respondents categorized factors as related to social interactions, the work environment, or job demands. <h3>Results</h3> A similar proportion of employers (33%) and EWD (32%) agreed that negative attitudes of others in the workplace were barriers to job retention. In contrast, EWD reported support from their supervisor (80%) and acceptance of disability from co-workers (77%) were key facilitators of employment retention. Employers recognized the need for disability awareness and acceptance: 82% reported the benefit of training for job accommodations and 66% reported disability awareness training as a useful facilitator. Overall, safety of the work environment was not a major concern; fewer EWD reported concerns about safety in the workplace (23%) compared to employers (37%). While 41% of EWD reported challenges related to job demands and workload, 34% of employers worried that EWD could not perform essential job functions and 37% fear disciplining an EWD for poor job performance. <h3>Conclusions</h3> Achieving disability inclusion in the workplace is a goal of people with disabilities and employers alike. Employment for people with disabilities is complex and influenced by various personal and contextual factors. Our findings demonstrate that employers and EWD have similar perceptions of the barriers and facilitators to employment. Employers may benefit from participating in disability training and developing employee/business resource groups to encourage diversity, equity and inclusion goals broadly, and disability awareness and support specifically in the workplace. <h3>Author(s) Disclosures</h3> The authors report no conflicts of interest.

Overview and commentary of the California Workplace Technology Accountability Act

ABSTRACT Technological innovation and the resulting automation are increasingly being applied in the workplace, which is a high-risk context where decisions can majorly impact a worker’s life. Consequently, a number of ethical concerns with automated employment decision systems have been raised, with California proposing the Workplace Technology Accountability Act to limit the use of electronic monitoring systems and automated decision systems to specific times of day, activities and locations that must be proven as essential job functions. Workers would also be given the right to know, review and correct data held about them by their employer. In this article, we summarise and discuss the key points of the legislation before providing a commentary, where we identify four key themes: (i) how boundaries can contribute to a healthy work-life balance and protect the privacy of workers; (ii) how the requirement for impact assessments reflects the wider movement towards algorithmic assurance; (iii) the necessary and potentially problematic requirement to share notices and impact assessment reports with the Labor Agency; and (iv) how the Act might conflict with existing laws. Our intended readership is those interested in the regulation of automated employment decision tools, algorithmic assurance, and the potential impact of the proposed legislation.

Current Topics in Health Care Law

Current Topics in Health Care Law

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

BACKGROUND: The COVID-19 pandemic has wrought an unprecedented toll on vocational rehabilitation efforts to assist workers with disabilities in maintaining their careers. OBJECTIVE: To demonstrate the use of a psychometrically sound assessment instrument and resource-driven planning procedure to help workers with disabilities resume or retain their employment. 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.

Denial of disability versus inability to meet essential job functions

The return to work process following a prolonged medical leave includes an assessment of both work capacity and ability to meet essential job functions. We present the case of an administrative assistant with a congenital vocal cord injury who was denied total permanent disability. The initial fitness for duty examination after her prolonged absence resulted in a determination of fitness, but with limitations. After performing a risk assessment and review of the essential job functions of her occupation, she was dismissed based on inability to meet the essential demands of the job. Assessments of work capacity/disability must be multidisciplinary, integrating the diagnosis, treatment, course of the illness, and conducted from both a preventive and work perspective.

Highlights from occupational safety and health continuing education needs assessment.

There is a lack of trained Occupational Safety and Health (OSH) professionals able to meet the current and future demand for such expertize in the United States. Many OSH professionals are required to perform duties, which are outside of their primary area of expertize; thus, expansion of continuing education (CE) may be necessary to properly train individuals for new OSH responsibilities. The National Institute for Occupational Safety and Health-funded Education and Research Centers collectively developed and distributed an internet-based survey to gauge the CE needs and interests of the OSH workforce. A total of 2064 responses were received. The most common primary professions represented were safety (28%), occupational health nursing (18%), and industrial hygiene (12%). The majority of respondents (61%) reported that they perform work activities outside of those associated with their primary OSH profession. The CE offerings with the highest interest among respondents were related to safety. Other courses with high levels of interest included topics such as legal issues in OSH (88%), compliance (88%), risk management (85%), OSH management (83%), risk communication (83%), and communication in accident prevention (81%). Health and safety leadership (82%), health and safety culture (78%) and total worker health (74%) were also significant interests. It is important to be responsive to the evolving needs of the OS&H community. Developing relevant courses will help ensure that OS&H professionals have access to the training they need to perform essential job functions and keep employees healthy and safe.

Workplace barriers encountered byemployed persons with systemic sclerosis.

Systemic sclerosis (SSc) is an auto-immune connective tissue disease characterized by fibrosis of skin, blood vessels, and internal organs that results in significant disability. To identify the work barriers faced by people with systemic sclerosis (SSc) in maintaining employment. Thirty-six people with SSc who were working more than 8 hours per week completed the Work Experience Survey, which contains lists of potential work barriers, including the ability to travel to and from work; get around at work; perform essential job functions, including physical, cognitive, and task-related activities; work with others; and manage work conditions. Thirty-three participants completed and returned the questionnaires, most of whom were female, and working full time and in professional careers. Principal disease symptoms included fatigue, Raynaud's phenomenon, esophageal involvement, and leg or hand/wrist pain. All participants reported some barriers with a mean of 18 barriers per participant. At least three quarters of participants cited outside temperature (82%), cold temperatures inside the workplace (76%), and household work (76%), as barriers. The next most common barriers were using both hands (64%), arranging and taking part in social activities (64%), being able to provide self-care (61%) and working 8 hours (58%). Participants reported a wide range of barriers, from cold temperatures, to physical job, fatigue related, and non-workplace demands, in maintaining the worker role. The barriers reflect the disease symptoms they reported. Identifying workplace barriers facilitates the creation of job accommodations or adaptations that will allow people with SSc to continue working.

A Survey Study of Benefits and Limitations of using CellaVision™ DM96 for Peripheral Blood Differentials

In most clinical laboratories, hematologists rely on the microscopic analysis of stained blood films to accurately classify cells, aiding in the diagnosis and monitoring of a variety of disorders and conditions. Use of the microscope, although considered the gold standard in performing white blood cell differentials, presents a variety of limitations Digital image technology can facilitate a variety of essential job functions in clinical hematology such as: consulting with colleagues, improving training, referencing an abnormal cell, and utilizing archived images for quality assurance and competency assessment. A questionnaire was developed to survey medical laboratory professionals about their perceptions regarding the benefits and limitations for using digital images in clinical hematology. The questionnaire was sent in March 2012 to an entire list of 81 current CellaVision DM96 (CellaVision AB, Sweden) consumers. A response rate of 46% was obtained. Background information on participants, 5-point Likert scale averages, percentage agreement (strongly agree and agree), and disagreement (strongly disagree and disagree) were calculated and analyzed. The benefits of using the CellaVision DM96 rated the strongest by respondents included: decreased eyestrain, consistency among patient results and advantages in training personnel. Respondents reported notable limitations as being: restrictions with accurately estimating platelets and red cell morphology. Digital image software is currently being utilized in preclinical and clinical hematology and offers potential benefits. With upgrades in slide scanning features and improved capabilities to view platelet and red cell morphology, a transition to digital image technology from the conventional method for performing peripheral blood cell differentials is possible.

Drug Information Activity and Nonprescription Requests Over the Malaysian Counter.

Providing drug information has become one of the essential job functions of a community pharmacist. To ensure the availability of up-to-date information, pharmacists should have access to reliable drug information. The current study was an effort to explore the use of drug information resources at a community pharmacy in Penang Island, Malaysia. This study also explores nonprescription requests, with a special emphasis on pharmacists' agreement to dispense medicines without a prescription. A cross-sectional study was performed among the community pharmacists practicing in 3 populous areas of Penang Island. Face-to-face interviews were conducted using a 24-item questionnaire. The response rate was 67.3%. Online drug information, compared with other resources, was preferred by a majority of pharmacists (n = 19, 51.4%). Of the pharmacists, 28 (75.7%) mentioned that patients often make a nonprescription drug request for anti-inflammatory agents, painkillers, and medicines for cough and flu. In about 59.5% of the cases, pharmacists dispensed the requested medicine without question. Most of the pharmacists stated they have dispensed painkillers, creams and ointments, antifungals, body tonics, and inhalers without prescription.

A model to guide the rehabilitation of high-functioning employees after mild brain injury

Impairment in executive functioning can occur after mild stroke, mild Traumatic Brain Injury, and neurodegenerative disease, and this can have deleterious effects on employment outcomes, occupational functioning, and general quality of life. What is not as well identified is the symbiotic relationship between executive functioning and other important psychosocial constructs inherent in successful employees ("Employee Performance Enablers"), and how various aspects of the employment environment can enable or inhibit the success of the employee with executive functioning deficits in meeting their essential job functions ("Workplace Ecology"). From an extensive review of the literature and the author's practice experience, a clinical model was developed to elucidate these two critical variables, as well as to provide guidance for organizing, planning, and implementing interventions that will address both employee enablers and workplace ecology to affect positive return to work outcomes for individuals with mild brain injury.

Americans With Disabilities Act-Related Considerations When an Alcoholic Nurse Is Your Employee

When contemplating the legal and ethical issues surrounding employment of an alcoholic nurse, nursing administrators are challenged with recognizing and upholding the Americans With Disabilities Act (ADA)-related civil rights of their employees while ensuring the quality of care provided by the practitioners in their facility. The "direct-threat" exception to disability accommodations relieves employers from making accommodations for a disability if those accommodations would necessitate lowering patient care quality standards. According to the ADA's direct-threat exception, a healthcare facility may legally terminate a nurse with the disability of alcoholism if that practitioner poses a threat to the safety of its patients. This article provides an informative overview of alcoholism as a disability in the context of nursing. A nurse administrator could use the information provided to objectively and competently make a determination of direct threat. The focus is on the importance of making an objective and unbiased assessment when determining if an alcoholic nurse meets the direct-threat" criteria that eliminates the requirement for making reasonable accommodations for a disabled employee. General ADA guidelines are provided, but the assessment must be individualized based on the patient care setting, the requirements of the position, and the nurse's present ability to safely perform the essential job functions.

Roles and functions of benefits counseling specialists: A multi-trait analysis

The purpose of this study is to examine the roles and functions of benefits counseling specialists. One-hundred and forty-eight benefits counseling specialists rated the Benefits Specialists Practice Inventory – Revised using a 5-point importance rating scale. Data were analyzed using multi-trait analysis. The multi-trait analysis tentatively supported the three-factor structure of the Benefits Specialists Practice Inventory – Revised, indicating that benefits screening (M= 4.43, SD= 0.47), benefits advisement (M= 4.49, SD= 0.56), and benefits management (M= 4.07, SD= 0.88) are most central to the job performance of benefits counseling specialists. In addition, benefits counseling specialists in the current study rated themselves as relatively well prepared to perform these benefits counseling job functions, with benefits advisement rated the highest (M= 4.23, SD= 0.76), followed by benefits screening (M= 4.15, SD= 0.70), and then by benefits management (M= 3.75, SD= 0.96). However, multi-trait analysis also suggested that there might be more than three essential job functions for benefits counseling specialists and more comprehensive research in the future is warranted.

Evidence base for pre-employment medical screening.

This paper examines the evidence base for the use of pre-employment/pre-placement medical examinations. The use of pre-employment examinations is often driven more by cultural practices than evidence. There is a lack of evidence on their effectiveness in preventing health-related occupational risks. Hypertension screening is highlighted as a common pre-employment practice for which there is no standardized criteria to use to determine fitness for work. There are inherent problems in screening for psychiatric disorders and substance abuse as well as potential for racial bias and other unintended negative effects. This paper questions the economic case for this practice and also expresses concerns about paternalism related to identified risk factors. Health assessments should only be included when appropriate to the task environment and the general use of pre-employment exams and drug screening should be eliminated. Generally, a health assessment by questionnaire should suffice. Occupational health providers should advise against the application of physical or mental standards that are not relevant to fulfilment of the essential job functions. Consensus development regarding best practice, as well as consideration for acquiring outcome data related to pre-employment practice, is recommended.

Workplace accommodations: Occupational therapists as mediators in the interactive process

Employers are required under the Americans with Disabilities Act to provide qualified individuals with disabilities workplace accommodations if needed to enable their performance of essential job functions, maintain successful employment, and effectively contribute to the workforce and society. The Equal Employment Opportunity Commission and many federal courts recommend an "interactive process" between the employee and employer, to facilitate effective accommodations. Research demonstrates, however, that often the parties to the process are uncertain of their roles and responsibilities. Similarly, court decisions have not uniformly clarified the specific requirements of the interactive process or alternate best practices to achieve an effective outcome. This article asserts that an occupational therapist with special training in ergonomics may make a significant contribution to identifying and implementing effective workplace accommodations, by mediating the interactive process between employer and employee. This unique role is illuminated by examination of the occupational therapist's professional expertise implementing a successful accommodation (case study) contrasted with an unsuccessful accommodation process that required litigation to resolve. Furthermore, we discuss the role of legal mediation principles in the occupational therapist's practice, suggesting ways to improve accommodation outcomes and avoid litigation. Recommendations for future research and practice are presented.

Occupational Psychophysics to Establish Vision Requirements

To develop and implement a comprehensive procedure for determining vision requirements for different vocational and occupational tasks. Evaluations performed for more than 10 state agencies and businesses were conducted over a period of approximately 9 years. The procedure included a literature review, an assessment of potential visual functions to address, a formal job analysis, interviews with incumbent workers, obtaining advice and recommendations from subject matter experts (experienced incumbents and administrators), development of job-related simulation studies, linkage of simulation results to the job analysis, a review of appeals and critical incidents, a thorough assessment of work environments and conditions, and final recommendations. Examples of occupational simulations for quantitative job-related task performance for best-corrected visual acuity, uncorrected visual acuity, color vision, peripheral vision, the use of one vs. two eyes, naïve vs. experienced incumbents, and impoverished visual conditions are presented. Changes in task performance and confidence ratings were obtained for various levels of degraded vision. This procedure, referred to as "occupational psychophysics," provides a quantitative systematic method of defining the vision requirements for various essential job functions. In conjunction with the frequency of performance, requirements at entry to the job, safety, reasonable accommodation, alteration of the work environment, and administrative issues, this approach provides a quantitative, rational basis for establishing job-related vision requirements.

Important Elements of the Americans with Disabilities Act for Persons with Diabetes

Having diabetes can have profound implications for individuals in the workplace. Due to the increasing number of people who are diagnosed with this disease and the often complex treatment it requires, this issue continues to pose challenges for not only employees with this illness, but also for their employers. The 1990 Americans with Disabilities Act (ADA) was influential in promoting accommodations for and nondiscrimination against people with diabetes in the workplace. This article discusses 3 of the elements that can make it difficult for persons with diabetes to file a successful claim under the ADA. These important elements include employee disability status, the ability to perform essential job functions, and direct threat concerns.

Validity of Pushup as predictor of success in Law Enforcement

Selection of prospective law enforcement officers can be facilitated with the use of simple, field-expedient fitness tests. Identification of qualified candidates has been demonstrated to significantly reduce costs for work-related injuries. PURPOSE: Develop a simple, field expedient, pre-hire muscular fitness tool to predict success in effecting an arrest and other essential job functions in the form of a Criterion Task Test (CTT). METHODS: A Job Task Analysis (JTA) was conducted via survey, on-site observations and interviews of incumbent federal officers (n=1025) with the objective of creating a surrogate (CTT) for the essential function of foot pursuit and effecting arrest. Respondents were asked to provide best estimates of distances, heights and weights associated with critical and arduous tasks. SUBJECTS: Applicants (N=266, including 45 females) who presented for employment from October of 2005 through August of 2006 served as unrestricted subjects for this study. Because they had received no prior physical screening these subjects represent a sample of applicants that was not range restricted on physical ability. A test for maximum pushups in 2-minutes was administered twice, separated by one day as a reliability test to determine test-retest reliability (intraclass coefficient= 0.967, p<0.001,n = 235). RESULTS: Incumbent and supervisory personnel, (n=100) acting as Subject Matter Experts (SMEs) independently reviewed and rated (acceptable or unacceptable) five representative paces of an actor performing the CTT. The cutpoint for graduation success was established through a consensus model (2/3rds agreement). A two-way contingency table for sensitivity and specificity was developed to demonstrate the predictive power of the 2-minute push-up test. There was no evidence of sex bias for any of the fitness predictors. The ability to perform pushups was highly correlated with success on the CTT (pushups predict 44% of variance in CTT, p <0 .001). Recommendations: The ability to perform a minimum of 10 push-ups correctly predicted a pass rate of 89% (sensitivity); conversely, failure identified 100% (specificity) of those who failed the CTT.

What Resources are Available for Creating Documents Describing Essential Job Functions?

The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members and do not necessarily represent the views of AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the panel. This month's panel members include Norman DePaul Brown and Robin Tourigian.

Vision Requirements for Driver???s License Examiners

The purpose of this study was to determine the vision requirements for licensing and registration examiners (LREs) of motor vehicle drivers in the state of California. A comprehensive investigation was conducted that included a literature review, consideration of the Americans with Disabilities Act, analysis of materials with a subject matter expert panel, an overview of visual function tests, a formal job analysis, job audits and site visits to licensing offices, analysis of accidents and critical incidents, performance of simulation studies, and a review and evaluation of all materials collected during the study. Based on this analysis, three visual functions (best-corrected visual acuity, peripheral visual field extent, and color vision) were determined to be important for performing the essential job functions of an LRE. It was recommended that LREs demonstrate a best-corrected visual acuity of at least 20/20 in each eye, a peripheral visual field of at least 100 degrees diameter of horizontal and vertical extent in each eye (with no evidence of scotomas or pathologic areas of nonseeing within the visual field), and color vision capabilities that permit a passing score on the Farnsworth Panel D-15 color vision test. The findings of this investigation provide a strong basis for specifying and justifying vision requirements for performing essential job functions for an LRE in the state of California.