Article

Schizophrenia at Work: Your ADA Rights to Accommodation, Fair Treatment, and Privacy

How the ADA covers schizophrenia at work, including symptoms that come and go, medication side effects, accommodations, conduct rules, stereotypes, privacy, and deadlines.

8 min read

Schizophrenia Should Easily Qualify as a Disability

Title I of the Americans with Disabilities Act applies to private employers with 15 or more employees for 20 or more weeks in the current or preceding calendar year and to state and local government employers; federal workers are covered through the Rehabilitation Act, and many state laws reach smaller employers. The National Institute of Mental Health describes schizophrenia as a serious mental illness that affects how a person thinks, feels, and behaves. Under 29 CFR 1630.2(j)(3)(iii), it should easily be concluded that schizophrenia substantially limits brain function, and the EEOC's guidance for workers with mental health conditions lists schizophrenia among the conditions that should easily qualify. The ADA protects you from being fired, refused a job or promotion, or forced onto leave simply because you have the condition.

Stable on Medication or Between Episodes Still Counts

MedlinePlus explains that symptoms of schizophrenia can include psychotic symptoms such as hallucinations and delusions, negative symptoms that can make a person seem withdrawn, and cognitive symptoms such as trouble making decisions and paying attention, and that medicine can help control many of the symptoms. Under 42 U.S.C. Section 12102(4)(D) and (E), an impairment that is episodic or in remission counts if it would be substantially limiting when active, and the helpful effects of mitigating measures such as medication are not considered. The EEOC says that if your symptoms come and go, what matters is how limiting they would be when the symptoms are present. Doing well at work on treatment does not take away your ADA protection.

Accommodations to Ask For

Under 42 U.S.C. Section 12111(9), reasonable accommodation may include job restructuring, part-time or modified work schedules, and reassignment to a vacant position. The EEOC lists examples for mental health conditions such as altered break and work schedules, including scheduling work around therapy appointments, quiet office space or devices that create a quiet work environment, changes in supervisory methods such as written instructions from a supervisor who usually does not provide them, specific shift assignments, and permission to work from home. In one EEOC example, an employee whose psychiatric medication made him restless and easily distracted asked for a quieter workspace and more structured assignments with more deadlines; the employer confirmed the side effect with medical documentation and provided both. You may ask in plain language, you do not need a specific accommodation in mind, and if more than one would work the employer may choose which one to provide.

Your Employer Cannot Dictate Your Treatment

The EEOC's guidance on performance and conduct standards says an employer may not require an employee to receive or change treatment for a disability to comply with a conduct standard, because decisions about medication and treatment often involve many considerations beyond the employer's expertise. In the same guidance, the HR director appropriately rejected a supervisor's suggestion that a special medication could control an employee's restlessness and turned to accommodation instead. The ADA requires reasonable accommodation regardless of what effect medication or treatment has on your ability to do the job. The EEOC also says, however, that if an employee does not take medication or receive treatment and as a result cannot perform the essential functions of the job or meet a conduct standard even with accommodation, the employer may treat the employee as unqualified or take disciplinary action.

Conduct Rules and Symptoms That Make Coworkers Uncomfortable

The EEOC says employers may enforce conduct rules that are job-related and consistent with business necessity, and rules against violence, threats of violence, stealing, and destruction of property will always meet that standard. Coworker discomfort alone is different. In an EEOC example, a long-time employee who performed well, in a job without customer contact or close work with coworkers, was often seen murmuring to himself because of a psychiatric disability, without raising his voice, making threats, or using inappropriate language; it did not affect his work, and medical documentation supported his explanation. When coworkers complained and the manager moved him to an isolated night shift with less chance for advancement, the EEOC said disciplining him was not job-related and consistent with business necessity and the transfer would violate the ADA. The EEOC also says employees should not assume an employer knows an accommodation is needed to address a conduct issue merely because it knows about the disability, so ask early and in writing.

Myths, Direct Threat, and Harassment

The EEOC says an employer cannot rely on myths or stereotypes about a mental health condition when deciding whether you can perform a job or whether you pose a safety risk. Under 29 CFR 1630.2(r), a direct threat means a significant risk of substantial harm that cannot be eliminated or reduced by reasonable accommodation, and the decision must be based on an individualized assessment of your present ability to safely do the job, using reasonable medical judgment and the most current medical knowledge or best available objective evidence. A diagnosis by itself is not that evidence. Harassment based on a disability is not allowed under the ADA; tell your employer and follow its reporting procedures if there are any, and write down dates, what was said or done, and who saw it.

What You Have to Disclose and What Stays Private

The EEOC says an employer may ask medical questions only when you request an accommodation, after a job offer but before work begins if everyone entering the job category is asked, for voluntary affirmative action tracking, or on the job when there is objective evidence that you may be unable to do the job or may pose a safety risk because of your condition. When you ask for an accommodation, the employer may ask you to describe your condition generally and how it affects your work, and may request a letter from your health care provider. If you do not want the employer to know your specific diagnosis, the EEOC says documentation that describes your condition more generally may be enough. Any medical information you share must be kept confidential, even from coworkers.

Leave, Retaliation, and Deadlines

If you cannot perform all the essential functions of your job to normal standards and have no paid leave available, the EEOC says unpaid leave may be a reasonable accommodation when it will help you get to a point where you can perform them. You may also qualify for leave under the Family and Medical Leave Act; under 29 CFR 825.110, an eligible employee has worked for the employer for at least 12 months, has at least 1,250 hours of service in the 12 months before leave starts, and works at a location where the employer has at least 50 employees within 75 miles. Under 42 U.S.C. Section 12203, an employer may not retaliate against you for opposing disability discrimination or taking part in an ADA charge or investigation, and may not coerce, intimidate, threaten, or interfere with you for exercising ADA rights. A charge with the EEOC generally must be filed within 180 calendar days of the discriminatory act, extended to 300 days where a state or local agency enforces a law prohibiting the same kind of discrimination; federal employees generally must contact an agency EEO counselor within 45 days. Keep copies of accommodation requests and replies, provider notes, performance reviews, and warnings.

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