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Implementing the Americans with Disabilities Act
What is a Brain Injury? held employment prior to their injury.
WORKING The brain is a complex organ, the focal
Following a period of rehabilitation to
increase capacities often effected by the
point of our capacities to: think; receive, injury, that employee may desire to return
EFFECTIVELY understand language and respond;
remember; feel and express emotions;
to his/her prior position, be reassigned, or
develop his/her career path in other ways.
and more. The brain is protected by the For those individuals who sustain a brain
WITH bones of the skull and by an intricate
system of membranes, fluids and blood
injury prior to establishing a work history,
the ADA still holds the same rights of
vessels. But, like anything else, the brain access to their communities and
EMPLOYEES can be damaged. employment.
Brain injury often results from a trauma to If a person who has sustained a brain
WHO HAVE the head and/or brain. Traumatic brain
injury can result from a bump to the head
injury applies for a job with your company,
reviewing his/her past education and
such as in a motor vehicle crash. Other experience will let you know if he/she is
SUSTAINED A conditions that can result in a brain injury
include: heart attacks, aneurysms,
minimally qualified. Having previously
identified essential job functions will also
chemical and drug reactions, lung assist you in determining whether or not
BRAIN problems, infections, lack of oxygen to
the brain, and a variety of other causes. In
the individual is qualified, with or without
a reasonable accommodation. If an
most cases, an injury sustained as a result employee sustains a brain injury after
INJURY of one of these mechanisms will result in
an increased need for support in the
having been at work, the same strategies
will assist you in determining this person's
following areas: physical capacities (the current qualifications for re-employment.
way we move and manipulate things); In cases of re-employment, involvement
behavioral and emotional capacities (the of the employer in the rehabilitation
way we act, tolerate, and feel); and process is critical. You will be able to play
cognitive capacities (the way we think a large role, given the employee permits
and process information). your involvement, in assisting the
rehabilitation team in knowing exactly
A brain injury is different from many what that employee was like prior to his/
other disabilities because the onset of the her injury, what his/her job entailed, and
injury can be traumatic and occur what essential job functions he/she will
suddenly. Everyday people, like you and be required to perform upon returning.
your family, are susceptible to brain injury
at any time. This brain damage can result Accommodating an Applicant or
in permanent, irreversible damage which Employee Who Has Sustained a
can effect tasks and things you have
typically done in the past with great ease.
Brain Injury
There is no cure for brain injury and
prevention is the best option for Employee Selection Process:
minimizing its occurrence.
As in all applicant cases, your main
priority, regardless of disability, should
Implications of the ADA for be to determine whether an applicant has
Individuals Who Have Sustained the necessary skills, experience, education,
a Brain Injury or other background to successfully
perform the essential functions of the job.
The Americans with Disabilities Act Your first step is going to be to determine
guarantees the rights of individuals with what are the components in applying for,
disabilities. The Employment Provisions obtaining, maintaining a job, and being
Program on Employment and Disability (Title I) hold interesting implications for promoted within your company. Once
New York State School of Industrial individuals who have sustained a traumatic you have clearly identified the different
and Labor Relations injury such as a brain injury. In most human resources activities an applicant
CORNELL UNIVERSITY cases, recipients of a brain injury have or employee must go through, you will be
January, 1994 CORNELL UNIVERSITY
Working Effectively with Employees Who Have Sustained a Brain Injury
able to determine possible • Ask if s/he has an aide or assistant examples of simple accommodations we
accommodations along the way which who might make the interview process make to be more productive and ease our
may make the process more accessible for more comfortable and aid him/her in workload. The ADA asks employers to
a wider variety of applicants/employees. presenting his/her skills and reasonably accommodate the limitations
qualifications for the job; imposed by a disability. Reasonable
However, the reasonable accommodation • Follow-up spoken communications accommodation is defined as modification
obligation applies to an individual as the (phone calls, dialogues, etc...) with or adaptation of a job, employment
need arises. The ADA does not require written communication to assist a practice, or work environment that makes
you, as an employer, to make general person who may have memory it possible for a qualified person with a
adjustments and modifications for a wide support needs (i.e. directions, disability to be employed. The law states
variety of employment situations. appointment times, etc...); that employers must make
• Make sure your interviewing site is accommodations from the first point of
When you advertise an open position, accessible to aid the individual who contact with a person with a disability
make sure the qualifications required may have physical support needs including: the application screening
and application directions are stated resulting from his/her injury. process; on the job; in training; on the
clearly and concisely. This will assist an worksite; and when considering
individual who may have cognitive support When you are conducting an interview be promotions and layoffs. If job duties
needs in processing the information, yourself. Disability does not mean change, new accommodations may need
allowing him/her to make a clear decision inability. Treat the applicant who has to be made. The ADA requires an
as to whether or not s/he may minimally sustained a brain injury as you would any employer to accommodate unless doing
qualify for the job. other applicant. To increase your comfort so would cause an undue hardship.
level and accommodate the potential
The first rule of thumb when attempting support needs of the applicant who has If an employer finds that the cost of an
to determine ways to increase the sustained a brain injury be mindful of: accommodation would impose an undue
accessibility of human resources policies • Speaking clearly and concisely; hardship and no funding is available from
and practices within your company and • Repeating a statement that an another source, an applicant or employee
accommodate an individual who has applicant has told you is unclear or with a disability should be offered the
sustained a brain injury, is to recognize unintelligible; option of paying for the portion of the cost
that not all brain injuries result in the • Decreasing distractors in the room that constitutes an undue hardship, or of
same support needs. (i.e. phone calls, interruptions, etc...); providing the accommodation.
• Doing a walk-through or a tour to
For example...one individual may have make sure it is accessible, prior to Selecting an Accommodation:
no difficulty reading an application form, interview;
while another may have a vision problem • Decreasing the number of The employee candidate who requests an
resulting from his/her brain injury which introductions made or reassure the accommodation has lived and perhaps
affects his/her ability to read. applicant that s/he will meet quite a worked while having the disability. He/
few people and it may take some time she may already have identified what
Ask the individual how s/he would prefer to get to know them all; accommodations work best for him/her.
to meet the requirements of a given • When explaining tasks or jobs, Given that support needs are
process. For example, if a right-handed breaking down each into steps which individualized based on the severity of
applicant has limited use of his/her right may be easier to remember or a brain injury, so must the
arm as a result of the brain injury some sequence. accommodation. The process of
strategies may include: (Remember, not all applicants will need identifying and selecting an
• Allow the person to take the these accommodations; don’t forget to accommodation should be a dialogue
application home and have assistance ask the applicant what may assist him/ between the employee and the employer.
filling it out; her). The accommodation may be able to be
• Mail the application to the candidate provided using easily identified supports
who requests it; Enhancing Productivity on the Job: (low tech) or may require the use of more
• Offer the services of someone in the intensified and expensive supports (high
office to assist in completing it. Why do we use a chair to reach dishes on tech).
a high shelf? Why do we use automatic
Some effective human resources strategies pencil sharpeners? Why do we use Identifying an accommodation for an
to use when interviewing with an applicant ergonomically designed office chairs? individual who has sustained a brain injury
who has sustained a brain injury include: could potentially include a variety of
• Give clear concise directions; Simply put, these adaptations make a task support strategies including: memory log
easier and may save time. These are
CORNELL UNIVERSITY January, 1994
Working Effectively with Employees Who Have Sustained a Brain Injury
books; wheelchair-accessible facilities; job Resources Employers talk with Human Factors
sharing or modified shortened work Consultants about an individual with a
schedules; job checklists and cues; tools There are a number of resources that can disability (not limited to brain injury).
to assist the person in tracking while assist employers and people who have The consultant will search JAN’s database
reading such as a ruler or piece of paper sustained a brain injury. It is important to for information related to the functional
with a window cut in it; smaller job steps remember to begin all discussion of requirements of the job, the functional
to improve sequencing; raised desks or accommodation with the employee. If limitations of the employee,
tables to allow for a wheelchair; Teletype additional information is needed, consult environmental factors, etc. The search
(TTY) or Text Telephone (TT) if the the following organizations: will provide information about similar
person has difficulty with speech or situations, names and addresses of
hearing; ramps; handrails; computer ADA Regional Disability and Business appropriate resources.
keyboard guards; to name only a few Technical Assistance Center Hotline -
accommodations. (800) 949-4232 (voice/TTY). National Head Injury Foundation, Inc.,
202/296-6443, 1776 Massachusetts
Tips for On-The-Job Training: The Equal Employment Opportunity Avenue, NW, Suite 100, Washington,
Commission, 1801 L Street, N.W., DC 20036-1904.
All employees, regardless of disability, Washington, DC 20507, 800-669-4000
need the same introduction and orientation (Voice) to reach EEOC field offices; for Provides informational services and
to a job and initial training. Determining publications call (800) 800-3302 or (800)- resources on traumatic brain injury. Offers
the learning style of any new employee is 669-EEOC (voice/TTY). employment-related publications on
a good human resources practice which vocational rehabilitation, job seeking
maximizes inservicing and training Ability Magazine / Jobs Information skills, job placement, return-to-work and
provided. Ask the employee whether s/he Business Service, 800/453-JOBS, 11682 employment issues, and adaptive work
learns best from strictly verbal instruction, Langley, Irvine, California 92714 behaviors for victims of brain injury. Local
or a combination involving hands-on, associations can be accessed for local
written, and verbal instruction. Provides an electronic “classified” system information.
which allows employers to recruit qualified
Any new employee has his/her own unique individuals with disabilities and people State Vocational Rehabilitation Office
way of setting up a work station or with disabilities to locate employment
organizing job tasks and supplies. opportunities. Through magazine, State agency which provides vocational
Allowing the employee with a brain injury provides information on locating qualified rehabilitation services to individuals with
this flexibility can promote increased readers, interpreters, personal assistants disabilities. Services can include:
performance as long as job quality and and assistive devices, and overcoming counseling, advocacy, job training, job
quantity is not negatively affected. architectural, communications, and placements, and a variety of additional
transportation barriers, performing job support services including continuing,
In some cases, individuals with more analysis, job modification, and job adult and post-secondary education. For
severe disabilities may be represented by restructuring. the Office of Vocational Rehabilitation
a rehabilitation agency or employment Services in your State, consult a phone
program which provides specialized Association for Persons in Supported directory.
support and technical assistance to Employment (APSE), 800/282-3655,
employers surrounding the employment 5001 West Broad Street, Suite 34,
of people with disabilities. Although Richmond, Virginia 23230
these services can benefit the employer,
they should not take the place of internal International association which can
training, orientation, inservicing, and provide resources and information on how
promotional strategies and techniques to utilize subsidized “supported
utilized by your company. The key to employment” programs. Association also
successful on-the-job training is provides referral to state chapters which
integrating, investing, and involving the can then provide referral to local supported This publication was developed by
new employee to the greatest degree employment programs in your locality. Thomas P. Golden, M.S., Coordinator
possible without stigmatizing the person for Community Rehabilitation Programs
who may have sustained a brain injury or Job Accommodation Network (JAN), and Supported Employment Personnel
any other disability. 800/526-7234, West Virginia University, Training at the Program on Employment
PO Box 6080, Morgantown, West and Disability at Cornell University,
Virginia 26506-6080 Ithaca, New York, (607) 255-7727.
January, 1994 CORNELL UNIVERSITY
For further information contact:
ILR PROGRAM ON EMPLOYMENT AND DISABILITY
ILR Extension Building, Room 102
CORNELL UNIVERSITY
Ithaca, New York 14853-3901
Voice: (607) 255-7727 TTY: (607) 255-2891
This material was produced by the Program on Employment and Disability , School of Industrial and Labor Relations - Extension Division,
Cornell University, and funded by a grant from the National Institute on Disability and Rehabilitation Research (grant #H133D10155). It
has been reviewed for accuracy by the U.S. Equal Employment Opportunity Commission. However, opinions about the Americans with
Disabilities Act (ADA) expressed in this material are those of the author, and do not necessarily reflect the viewpoint of theEqual Employment
Opportunity Commission or the publisher. The Commission's interpretations of the ADA are reflected in its ADA regulations (29 CFR Part
1630), its Technical Assistance Manual for Title I of the Act and in various enforcement guidance.
Cornell University is authorized by the National Institute on Disability and Rehabilitation Research (NIDRR) to provide information,
materials, and technical assistance to individuals and entities that are covered by the Americans with Disabilities Act (ADA). However, you
should be aware that NIDRR is not responsible for enforcement of the ADA. The information, material, and/or technical assistance is
intended solely as informal guidance, and are neither a determination of your legal rights or responsibilities under the Act, nor binding on
any agency with enforcement responsibility under the ADA.
In addition to serving as a National Materials Development Project on the Employment Provisions of the Americans with Disabilities Act
of 1990, the Program on Employment and Disability also serves as the training division of the Northeast Disability and Business Technical
Assistance Center. This publication is one of a series edited by Susanne M. Bruyère, Ph.D., C.R.C., Director of the ILR Program on
Employment and Disability at Cornell University.
OTHER TITLES IN THIS IMPLEMENTING THE ADA SERIES ARE:
y Working Effectively with People who are Deaf or Hard of Hearing
y Working Effectively with People who are Blind or Visually Impaired
y Working Effectively with Persons who have Cognitive Disabilities
y Workplace Accommodations for Persons with Musculoskeletal Disorders
y Working Effectively with Employees who have Sustained a Brain Injury
y Employing and Accommodating Workers with Psychiatric Disabilities
y Employing and Accommodating Individuals with Histories of Alcohol and Drug Abuse
y Employment Considerations for People who have Diabetes
y Accommodating the Allergic Employee in the Workplace
y Causes of Poor Indoor Air Quality and What You Can Do About It
y Working Effectively with People with Learning Disabilities
y Working Effectively with Individuals who are HIV-Positive
These and other informational brochures can be accessed on the World Wide Web at:
www.ilr.cornell.edu/ped/ada
For further information about publications such as these, contact the ILR Program on Employment and Disability,
Cornell University, 102 ILR Extension, Ithaca, New York 14853-3901; or at 607/255-2906 (Voice), 607/255-2891
(TTY), or 607/255-2763 (Fax).
CORNELL UNIVERSITY
