On July 26, 1992, Title 1 of the Americans with Disabilities Act (ADA) will become effective for companies with 25 or more employees. Two years hence, it will apply to companies with 15 or more employees. Much of this act is patterned after a substantial portion of the Rehabilitations Act of 1973, which applies mainly to government contractors.
Since this piece of legislation has gotten so much attention around the final days before it goes into effect, I thought it might be timely to describe that portion of this act pertinent to the chiropractic physician who is currently doing or may do physicals after this legislation is in place.
The ADA prohibits an employer from discriminating against a qualified individual with a disability in all employment practices, including the hiring procedure itself. We should define a qualified individual with a disability as it is under the EEOC Regulations: "an individual with a disability who satisfies the requisite skill, experience, education, and other job-related requirements of the employment position such individual holds or desires, and who, with or without reasonable accommodation, can perform the essential functions of such position." Let us define disability as it is used in this definition: "Disability means with respect to the individual, a physical or mental impairment that substantially limits one or more of the major life activities of such individual, has record of such impairment, or is regarded as having such an impairment." Let us define physical or mental impairment as it is used in this definition: "Physical or mental impairment means any physiological disorder or condition, cosmetic disfigurement, anatomical loss affecting one or more body systems, any mental or psychological disorder, such as mental retardation and specific learning disabilities." Let us define major life activities as it is used in this definition: "Major life activities means functions such as caring for oneself, performing manual tasks, walking, seeing, hearing, breathing, and working. If these activities are substantially limited it means that under the EEOC regulation it is understood to be significantly restricted in the ability to perform either a class of jobs or a broad range of jobs in various classes as compared to the average person having comparable training, skills, and abilities."
Finally, it should be kept in mind that the final term "disability" is in regard to a third-party perception of that individual. Therefore, the individual has a physical or mental impairment that substantially limits major life activities only as a result of the attitudes of others toward such impairment.
Basically, the individual must be able to perform the essential functions of the job. There are and have been multitudes of seminars for the employer, directed at writing the proper job descriptions to comply with these guidelines. That portion really doesn't concern the physician and what he is doing for the screening, except that he must be cautious to screen for the essential job functions. Let us define essential job functions:
The bottom line is this: In terms of "pre-employment physicals," the screening procedure can only be performed that is the end result of a number of procedures that have been put in order concerning a proper job analysis of the tasks in question. The screening is a simple procedure. The tough part is the job analysis as it pertains to the physical demands inherent to the work force and the relationship to the other workers. Any portion of the physicals should now be performed after the job offer by the company, that is unless you feel that your job analysis is solid and can withstand the test of doing part of it before the job offer. I will be doing the latter, and I will keep you posted as to the outcome of this procedure. Doing it right will win points with the company; doing it wrong will surely lose a client. Finally, the government cannot afford to maintain the ranks of the unemployed on its already overburdened payrolls. It seeks to remove this liability and put the unemployed as well as the unemployable on the payrolls of those who can afford it, at least for now. Businesses will be expected to shoulder this burden and continue to compete in markets that are, at best, unstable in these tough economic times.
Regardless of ADA legislation, physicals provide baseline data and are even more important than they were before, because of the information that will give some indication as to the status of that individual relative to any forthcoming injury.
The next article will deal with pre-employment physicals in recognition of ADA, July 1992.
Theodore Oslay, D.C.
DeKalb, Illinois
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
