with disabilities. Two reports from the National Academies Institute of Medicine (IOM, 1991, 1997) played a major role in the refinement of the conceptual model. This emerging model distinguished between impairment, a loss of function at the organ system level; functional limitation, the inability to perform a specific task, such as lifting a 20-pound package; and disability, a limitation in performing socially expected roles. Impairment and functional limitation are characteristics of an individual; disability de-notes a mismatch between an individual’s functional capacity and the individual’s environment. In the workplace, this translates into a mismatch between an individual’s functional capacity and the essential requirements of his or her job. For example, a worker who could not lift a 20-pound package might be totally disabled as a construction laborer, but that same person might be able to carry out all of the job requirements of a secretary. This concept of disability as a mismatch between the worker’s functional capacity and the demands of their job leads easily to the concept of workplace accommodations—modifications of the job or workplace that allow the worker to carry out the essential functions of his or her job in spite of functional limitations.

Parallel to this change in the conceptual model of disability, there has emerged a new public policy approach as well (Miller, 2000). As discussed earlier in this report, the Americans with Disabilities Act of 1990 marked the ascendance of a new approach to persons with disabilities, a civil rights approach that aimed to help them overcome the barriers to full participation in American society. Specifically, Title 1 of the ADA was aimed at integrating workers with disabilities more fully into the workforce. It prohibited discrimination against qualified employees (or job applicants) with disabilities. A qualified person with a disability is an individual who, with or without reasonable accommodation, can perform the essential functions of the job. Reasonable accommodation may include, but is not limited to:

  1. making existing facilities readily accessible to persons with disabilities;

  2. restructuring jobs, modifying work schedules, and reassigning employees to vacant positions;

  3. modifying equipment, examinations, training materials, or policies; and

  4. providing qualified readers and interpreters.

As noted above, older workers are more likely to have a wide variety of impairments and may require accommodations to remain in or reenter the workplace. Although a dozen years have passed since ADA became law, we still know relatively little about key aspects of these workplace accommodations.



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