According to the 2017 Canadian Survey on Disability, 1 in 5 Canadians between 25-64 years of age have at least one disability. That means there are about 4 million adults experiencing limitations, many of which are not immediately apparent to others. Accommodating workers with these nonvisible disabilities is not just a legal requirement, but it also makes good business sense. Most accommodations are not costly, and lead to positive return on investment with a productive, committed and engaged employee.

Understanding nonvisible disabilities

Nonvisible disabilities refers to a wide range of limitations, from chronic pain to cognitive to neurological to mental, that are not immediately apparent to others. This can include learning disabilities such as dyslexia, mental health conditions like post-traumatic stress disorder, and physical disorders like fibromyalgia and diabetes. What they have in common is that the disability is severe enough to limit people to some extent in their daily activities, and that includes the ability to work.

Take Talia, for example. As an administrator at the hospital, she works on a team that is responsible for organizing and overseeing the health services and daily activities. She effectively manages her staff and budgets, communicating between departments and working long and odd hours to ensure that the facility delivers the best care possible. She does all of this despite having to take some sick time every month and experiencing ongoing pain at work. But she wonders how much longer she can do this. The back pain, cramps, and overwhelming discomfort from her endometriosis (a debilitating disorder involving abnormal growth of endometrial tissue) have her frustrated. “I feel so terrible on the inside, but it doesn’t show on the outside.” She worries that her co-workers perceive her as being lazy or moody, when, in fact, she is quietly suffering in pain.

When these disabilities are not obvious, the worker may be reluctant to reach out because they fear being discriminated against or stigmatized. The hashtag #InvisiblyDisabledLooksLike rose in popularity on social media to dispel the notion that disabilities are only physical, with thousands of people sharing photos and thoughts related to how their nonvisible disabilities have affected them. Despite growing awareness from these social campaigns and other efforts, workers can still feel misunderstood by others in that their pain and challenges are somehow not genuine because their symptoms are not readily visible.

What the law says

At the federal level discrimination is prohibited on the basis of any of the 13 grounds identified in section 2 of the Canadian Human Rights Act, including genetic characteristics and disability. For activities that are not federally regulated, the provinces and territories have their own anti-discrimination laws that apply.

Employers have a duty to accommodate on a case-by-case basis the employees who fall into these groups up to the point of undue hardship, taking into account health, safety and cost. If an employer does not know about a disability, then the duty to accommodate does not apply.

Aside from legal requirements, it makes good business sense for employers to reduce absenteeism, turnovers, presenteeism, and long-term disability rates and costs by supporting workers with nonvisible disabilities.

How to accommodate

When planning for accommodation or a return to work due to nonvisible disabilities, the guiding principles are very similar as those for a physical injury. The focus of the plan should be on the functional abilities of the worker, not the symptoms of the injury or illness, or the causes. If you have a return to work program, ensure that it will accommodate workers returning from nonvisible-related absences.

When planning a return to work or modifications to work:

• consider recommendations from treating professionals;
• begin with tasks that the employee agrees would be easiest for them to accomplish;
• gradually increase the employee’s working hours over a period of time;
• allow flexible scheduling to attend medical appointments; and
• consider employee energy levels at various times of the day and schedule work accordingly.

As everyone is unique, there are many possible accommodations. Some involve flexible scheduling that allows time off for medical appointments, helps the worker prioritize work and activities, and fits their energy and concentration levels. The workspace may need to be changed in regards to noise, space, light and other ergonomic factors that may impact the workers’ concentration and well-being. Does the worker have access to a private, quiet space if needed?

An employer may need to include additional job training for a worker with a learning disability. Provide a worker with social anxiety with advance notice of meetings, events and projects to help them prepare. Allow exemptions to workplace policies and rules if they make a positive difference for the worker – for instance, a worker may be permitted to take naps at work if their chronic fatigue syndrome symptoms would otherwise adversely affect their job performance.

Some additional keys to successful accommodation include:

• Ensure that policies and procedures are accommodation-friendly
• When possible, base accommodations on fostering healthy social interaction rather than providing physical tools or aids
• Educate managers and workers on diversity and inclusion
• Consider wider organizational changes that prioritize a healthy workplace culture
• As with other components of your workplace health and safety program, regularly review and evaluate your program to look for areas of improvement

A comprehensive accommodation plan should involve the worker, manager, human resources, any treating healthcare professionals and a union/professional association representative. Each party has a shared responsibility. Remember that employers only need to be aware of the functional limitations and not the actual diagnosis.

With input from her manager, human resources, and her doctor, Talia is now on a modified work schedule that allows her flexibility to cope with her symptoms and attend medical appointments as needed. She feels supported, motivated and valued for her strengths and not marginalized by her disability.

This article was submitted by The Canadian Centre for Occupational Health and Safety(CCOHS) which promotes the total well-being — physical, psychosocial and mental health — of workers in Canada by providing information, training, education and management systems and solutions that support health and safety programs and the prevention of injury and illness.