This article is more than 5 years old. Information may no longer be current.
Optometrists can help patients with disabilities live fuller lives
Click Here to Manage Email Alerts
 Alfred A. Rosenbloom |
The Americans with Disabilities Act of 1990 celebrates its 20th anniversary this year. It is the most comprehensive federal civil rights law specifically for people with disabilities.
Individuals are provided civil rights protection on the basis of race, sex, national origin and religion. By breaking down barriers, the Americans with Disabilities Act (ADA, Public Law 101–336) enables society to benefit from the skills and talents of individuals with disabilities, as well as benefit from their increased purchasing power, which leads to fuller, more productive lives for all Americans.
The ADA guarantees equal opportunity for individuals with disabilities in employment, public accommodations, state and local government services and telecommunications. As service providers and employers, optometrists should be aware of the ADA’s provisions and requirements.
Employment accommodations
The ADA prohibits discrimination in all employment practices, including job application procedures, hiring, firing, advancement, compensation, training, conditions and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits and all other employment-related activities.
Employment provisions apply to private employers, state and local governments, employment agencies and labor unions.
A qualified individual with a disability is a person who meets legitimate skill, experience, education or other requirements of an employment position that he or she holds or seeks and who can perform the “essential functions” of the position with or without reasonable accommodation.
|
Resources |
Source: Rosenbloom AA |
An employer may not ask or require a job applicant to take a medical examination before making a job offer. The employer can make no pre-employment inquiry about a disability or the nature or severity of a disability. An employer may, however, ask questions about the ability to perform specific job functions and may, with certain limitations, ask an individual with a disability to describe or demonstrate how he or she would perform these functions.
The law does not require the hiring or promotion of a person with a disability who is unable to perform the essential duties of the job, even with appropriate accommodations.
For an individual with a visual disability, accommodations may include use of a magnifier or other optical devices on the job, use of electronic devices such as Closed Circuit Television Viewers, use of screen magnification and screen reading software for computers, and posting of notices in large print or Braille.
The ADA also allows for employers to receive tax credit for devices they provide to accommodate employees with vision loss.
An employer can hold employees with disabilities to the same standards of production/performance as other similarly situated employees without disabilities for performing essential job functions, with or without accommodations. If the disability affects the person’s ability to perform marginal functions, the employer must provide some type of reasonable accommodation such as job restructuring.
Public transportation
Public transportation provides for people unable to use the regular public transportation system due to their disability. The paratransit program also permits service animals on public transportation vehicles, including on curbs, subway platforms and other raised platforms identifiable by raised dots to a person with a vision loss. Sound indicators are also required at major crosswalks for those with vision loss.
Public accommodations
“Public accommodations” refers to the provision of goods and services to people with vision loss. The act requires that businesses allow individuals with service animals to bring their animal into the place of business (restaurant, hotel, theater, grocery store).
A public entity must ensure that individuals with disabilities are not excluded from services, programs and activities because existing buildings are inaccessible. A state or local government’s programs, when viewed in their entirety, must be readily accessible to and usable by individuals with disabilities.
Public entities do not necessarily have to make each of their existing facilities accessible. They may provide program accessibility by a number of methods including alteration of existing facilities, acquisition or construction of additional facilities, relocation of a service or program to an accessible facility or provision of services at alternate accessible sites.
The ADA expressly provides that a public accommodation may exclude an individual if that individual poses a direct threat to the health or safety of others that cannot be mitigated by appropriate modifications in the public accommodation’s policies or procedures, or by the provision of auxiliary aids.
Telecommunications
“Telecommunications” refers mostly to telephone communications for those with vision loss who are unable to read a telephone book. Operator assistance, such as 411, is provided free of charge. It also establishes the telephone relay system, allowing those with hearing and speech impairments with a TTY phone to contact those without a TTY phone via an operator at no charge.
Optometrists’ role
Because visual impairment is such a significant problem with an increasing number of older people, optometrists must recognize and appreciate the value and importance of our primary care role in geriatric and low vision patient care.
People with disabilities are reported to comprise the largest, fastest-growing minority in the United States. According to the Congressional Research Service, one out of every six Americans has some type of disabling condition, totaling more than 43 million people nationwide.
|
Optometric interviewing recommendations |
Source: Rosenbloom AA |
Optometrists should be informed about and counsel patients regarding local services for people who are disabled. Perhaps one of our greatest services is our ability to encourage people who are visually impaired or disabled to become independent in every way possible and to learn as quickly as is practical the new skills needed to be once again a contributing member of society. The extent to which this is possible depends significantly on our ability to help foster the patient’s aspirations, self confidence and potential to realize attainable goals.
Improving communication
While proper language can portray people with disabilities and their conditions accurately, language can also reinforce stereotypes and misconceptions about people who are disabled. Today, social service agencies and disability publications advocate terminology that places the person before the disability and eliminates negative connotations and patronizing language.
A disability is a condition caused by accident, trauma, genetics or disease that may limit a person’s mobility, hearing, vision, speech or mental function. Some people may have one or more disabilities.
A handicap is a physical or attitudinal constraint that is imposed upon a person, regardless of whether or not that person has a disability.
People with disabilities prefer to be called just that, people with disabilities. Terms that can be considered patronizing and stereotypical include: brave, courageous, inspirational, physically challenged and disabled.
When appropriate, note that a person has a motor, sensory or mental disability and define that disability according to recommended usage. Never use the terminology: crippled, unfortunate, pitiful, suffers from, afflicted by, invalid, retarded, emotionally disturbed or victim.
- Alfred A. Rosenbloom, OD, MA, DOS, FAAO, is the founder and chair emeritus of the Low Vision Service for the Chicago Lighthouse for People Who Are Blind or Visually Impaired. For a 25-year period he served as dean then president of the Illinois College of Optometry. Dr. Rosenbloom is a member of the Primary Care Optometry News Editorial Board and he was inducted into the National Optometry Hall of Fame earlier this year. He can be reached at the Chicago Lighthouse, 1850 West Roosevelt Rd., Chicago, IL 60608-1298; (312) 997-3688; fax: (312) 997-3663.