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Elysa Lanz, an economist in California with multiple sclerosis and chronic pain, had just finished speaking at a forum about discrimination faced by people with disabilities when a man approached her. He had heard her remarks and he wanted to know if Lanz would come to work for him doing economic analysis. Lanz was intrigued but she also was upfront that she became fatigued easily and would need some small adjustments to make a return to office work possible. That wouldn¡¯t be a problem, he said. Soon Lanz was working six hours a day, free to take rest breaks on the couch in the ladies¡¯ room, wrapping her legs with blankets when she got cold, and heading home in the early afternoon. ¡°They told me I did more in six hours than most people did in eight. It was a win-win because I was very grateful that someone would accommodate me,¡± Lanz says. ¡°Work is very important. It was a way for me to feel I was valued, a contributing member of society, someone with a value and a purpose.¡±

Many people with disabilities would like to return to work, but not many are as fortunate as Lanz. With its mandate that employers must provide ¡°reasonable accommodations¡± for their employees with disabilities, the Americans with Disabilities Act appeared to open new vistas for people with disabilities who wanted to be part of the workforce. But more than a quarter century later, the 2017 Disability Statistics Annual Report found only 35.9% of working age people with disabilities were employed, compared with 76.6% of working age people without disabilities. ¡°We thought it was going to be the big fix,¡± says Pam Capraro, former Manager of Vocational Rehabilitation Services at the Shirley Ryan ³Ô¹ÏÌìÌÃ91. ¡°But things haven¡¯t really changed except that people with disabilities have become empowered. I don¡¯t know why things haven¡¯t moved faster. We have the most educated, well-trained group of people with disabilities ever.¡±

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To get at the question of why progress has been so slow, researchers Priyanka Anand and Purvi Sevak analyzed 2015 data from 2,282 people with disabilities in Ohio, Mississippi and New Jersey. All of the individuals had work histories and had applied for vocational rehabilitation services between August and December of 2014. Their average age was 43. The researchers found that those who were unemployed had run into an average of four employment barriers during their job search, including inaccessible workplaces and a lack of reliable transportation. The outlook for those with physical disabilities was particularly poor.

When the researchers looked at people who had received accommodations such as flexible scheduling, help with transportation or a personal care attendant/assistant, they found employment rates that were eight percentage points higher than those who had not. Anand and Sevak noted that despite the ADA, some people chose not to request accommodations or were not aware that accommodations were available. In a 2017 article in the IZA Journal of Labor Policy, they concluded that more effort to educate employers and workers about the value of accommodations was needed.

The study¡¯s conclusion is no surprise to Center for Rehabilitation Outcomes Research (CROR) Director Allen Heinemann, Ph.D. Earlier CROR research with stroke patients found that job accommodations were crucial in getting people back to work. But overall, there is a dearth of research into what type of accommodations people receive and which of them are most helpful. The research that does exist is tightly focused on specific conditions such as low back pain or lymphedema, arm swelling related to the surgical removal of lymph nodes as part of breast cancer surgery. ¡°We thought we could make a contribution by examining the question of accommodations from both the employer and employee perspective,¡± Heinemann said. To broaden the research, Heinemann is leading a new study funded by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) that involves surveying employers and employees about job accommodations to see what is working and where the biggest barriers to employment lie.

As the ADA approaches its 30th anniversary, some vocational rehabilitation experts say that it is both easier and harder for people with disabilities to go back to work. On the plus side, many work arrangements that help people ease back into the workforce have gone mainstream, such as work-from-home days and flexible hours. Technology such as hands-free phones and voice recognition software are making it easier for people with conditions such as Parkinson¡¯s or partial paralysis to function. And universal design in office equipment has created modular furniture that is more easily rearranged to accommodate wheelchairs or other assistive devices. Standing desks, once an expensive request by people with chronic back problems, have become a widely sought-after perk among nondisabled office workers. As demand for standing desks has increased, prices have fallen.

In fact, most workplace accommodations cost less than $250, says Robert Trierweiler, a Vocational Rehabilitation Counselor at Shirley Ryan ³Ô¹ÏÌìÌÃ91, who will be working with Heinemann on the study along with Capraro. ¡°People move through the healthcare system a lot quicker than they used to so many of them still have jobs,¡± notes Trierweiler. ¡°In the old days if someone spent nine months in the hospital, their job was long gone.¡±

Yet some aspects of the contemporary workplace are making it harder for people with disabilities to function. The shift to open office environments can make it more difficult for someone with ¡°brain fog¡± from a stroke or a traumatic brain injury to concentrate. The rapid pace of organizational and technological change means that some employees¡¯ skills are becoming outdated faster and bosses change more often.

With the rise in start-up companies, some employers may never have had a worker with a disability ask for an accommodation and they may fear the cost will be high or that they will be taking on a potentially large liability if someone is injured. Yet the opposite is more likely true¡ªthat employers will incur little cost from accommodations and they will benefit from reduced costs for disability and unemployment insurance when workers return. ¡°Part of our job is to work with companies that have never had an employee with a disability. They may truly want to support their employee, but they often aren¡¯t sure what to do,¡± says Trierweiler.

On balance, Heinemann believes important progress has been made, mostly because of the ADA¡¯s requirement that new buildings and public transportation upgrades be accessible. Although the ADA only applies to companies with 50 employees or more, many smaller companies have made accommodations as well, especially in cases where company leaders have had personal experience with a family member or friend with a disability. ¡°They¡¯ve appreciated how motivated people are to keep working and how little it can cost. They see benefits to the organization in terms of morale and productivity,¡± Heinemann says. ¡°But we still have so far to go. When you look at the societal cost for people who want to work, there¡¯s a lot of human potential that¡¯s not realized.¡±