THE WORK BOOK TCA For Disabled Individuals

User Manual: Work Book TCA for Disabled Individuals

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THE WORK BOOK
TEMPORARY CASH ASSISTANCE
FOR
DISABLED CUSTOMERS©

TABLE OF CONTENTS
Section
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228

Revised September 2014

Topic
Special Accommodations
Work Requirements
Disabled TCA Customers
Case Managers
About the 312
Customers Must Apply for all Benefits
SSI Interim Reimbursement
Completing the Authorization for Interim Assistance
Reimbursement (DHR/FIA 340) form
340 form Distribution
Local Finance Departments
Caretaker Relatives other than Parents
Disabled Customers less than 12 months
Disabled 16-17 year old –not a Parent (child on the TCA)
TCA Adults Caring for a Disabled Family Member
Two Able-bodied Parents Providing Care for a Disabled Individual
Denial of SSI/SSDI
Conciliation
CARES PROCEDURES for TCA CASES with Disabled Individuals
SSI Approval
SSDI Approval
SSI or SSDI Denial and All Appeals have been Exhausted
Parent/Child Cases
Sanction for Non-cooperation with SSI Process
Non-parent-Con-cooperation
Action on Food Supplement Program Benefits
Action on MA
Case Manager Tips
Ten Most Common Disabilities Claims under ADA

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201

SECTION 200

American’s with Disabilities Act and Section 504 of the Rehabilitation Act

A. The Americans with Disabilities Act (ADA) provides a broad definition of disability
as well as providing protection from discrimination for disabled individuals . ADA
also protects the family and friends of a disabled individual from discrimination.
For example, an individual whose spouse has HIV/Aids cannot be denied a job
because the spouse has Aids.
The broad definitions include:
1. Impairments that substantially limit major life activities. This definition
applies to what most people think of when they think about a disabled
individual, such as: seeing, hearing, speaking, walking, breathing, performing
manual tasks, learning, caring for oneself, and working.


Individuals with epilepsy, paralysis, HIV infection, AIDS, a substantial
hearing or visual impairment, mental retardation and other specific
learning disabilities are covered.



Environmental, cultural or economic disadvantages such as lack of
education or a prison record also are not impairments. For example, a
person who cannot read because he has dyslexia is an individual with a
disability and would be covered under the ADA. An individual who cannot
read because he dropped out of school is not considered to be an
individual with an impairment, because lack of education is not an
impairment.

2. The second definition includes people who have a record of disability
such as but not limited to those who are recovered from cancer or a
mental illness or other such illness or disease. This also covers people in
remission from a disease or those who have flare ups of diseases but
otherwise can usually function well on a day to day basis.


This coverage includes people with illnesses such as cancer, Multiple
Sclerosis or diabetes who may be recovered, in remission or currently
undergoing treatment.

3. The third definition protects individuals who are regarded as having
a substantially limiting impairment even though they may not have
impairment.


An individual may have suffered a severe facial disfigurement in an
accident or in combat. Employers may not deny employment to an
individual qualified to perform a job because the employer fears the

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"negative reactions" of customers or co-workers who see the
disfigurement.
B. ADA and Section 504 of the Rehabilitation Act outline three key requirements
that protect the rights of DHR customers with disabilities. They are:
1. Ensure equal access to all DHR programs. The local department must
offer appropriate services that allow people with disabilities to receive:
a. Individualized treatment –
i. Evaluate each customer on a case-by-case basis.
 Look at each customer’s situation.
 Don’t lump customers together and send them all to the same work
activity.
 What does the customer want to do?
 What can the customer do now?
 What can the customer do When we help him or her get what they
need to do what they want to do?
a. Assess potential based on facts and objective evidence instead of
generalizations and stereotypes.
 Complete an assessment as soon as possible to determine the
customer’s skills, knowledge, abilities, support systems and then
road blocks.
 Don’t make road blocks or barriers the first thing that is assessed.
Usually there is a detour or a new road around a road block, our job
is to help customers find it.
b. Do not assume people with disabilities can only participate in the most
rudimentary work activities. See examples below.


There are people with Downs Syndrome who work as banks tellers, as
actors, waiters and waitresses and in other areas that 20 years ago
people never thought they would be able to.
 Renowned physicist, Steven Hawking has been in a wheel chair for
most of his life suffering from an incurable motor neuron illness called
amyotrophic lateral sclerosis.
 Nick Vujicic is a world known motivational speaker who was born with
no arms or legs.
c. Effective and meaningful opportunity –
 Guarantee that customers with disabilities receive the same
opportunity to fully benefit from every program aspect as customers
without disabilities.
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d. Provide “meaningful access” to all programs by offering reasonable
accessibility, accommodations, auxiliary aids, communications and
services.
2. Modify practices and procedures. Adjust, to the extent possible, the application
process and procedures, training and education programs, work activities and other
factors to ensure equal opportunities.
a. Modifications do not have to be expensive and do not have to result in program
alterations and administrative burdens.
b. A telephone interview instead of a face to face interview. (We encourage
telephone interviews for everyone.)
1.
2.
3.
4.
5.
6.

Home visits
On site interpreters for speakers of other languages, including sign language.
Screen magnifiers for electronic devices and for paper applications
Large print paper forms
Flashing lights in the office to identify an emergency situation
A reader or note taker for someone who has a learning disability or someone
who cannot read or write
7. Much like a hospital triage, LDSS offices can monitor their reception rooms
and move people who self-identify with an illness or disability through faster.
8. Post signs in the office that an application can be completed and left at the
office, an application can be completed in SAIL and a phone interview can be
completed.
3. Provide non-discriminatory program administration.
a. Ensure that vendors and service providers are experienced and skilled in working
with individuals who have disabilities.
b. Assess the treatment that customers receive from contractors and vendors.
c. Protect customers from experiencing disability-based discrimination resulting
from unlawful actions by contractors and vendors.
d. Ensure contractors and vendors are providing reasonable accommodation such
as:
i. Hearing amplification devices, speech, or visual impairment aids
ii. Readers, note-takers,
iii. Materials in alternative formats
iv. TTY/TTD telephone access.
v. Interpreters and interpretation services for non-English speakers and for
hearing and speech impaired customers.
C. Special/Reasonable Accommodations
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1. Customer Contact
a. When there is customer contact with the local department regardless of
who initiated the contact, the local department must ask the customer if the
customer requires special accommodation because of a disability.
b. When the local department contacts the customer about a required
interview, participation in a work activity or for other reasons, the local
department must advise the customer that special accommodations will be
made to assist the customer.
c. Customers who are not able to come to the LDSS or a vendor appointment
because of a disability must be offered a phone interview, home visit or
other accommodation.
202

Work requirements (See additional information in the Work Participation
section of THE WORK BOOK.)

For Universal Engagement, all customers must be in a federally defined work
activity (FDWA) or a state defined activity (SDA) unless an individual is:
A. The single custodial parent of a child under age 1. They are exempt for a
maximum of 12 months in the parent’s lifetime.
Note: The child under one exemption does not apply to two parent households.
B. A needy caretaker relative with no children of his or her own in the assistance
unit;
C. Disabled (individual with a disability of at least 12 months duration or whose
medical condition will result in the individual’s death, who is actively pursuing an
SSI application); or
D. Subject to sanction
203

Disabled TCA Customers

A. Disabled TCA customers fall into specific groups:
1. Adults or children determined, based on the medical form (500), to have a
disability that will last 12 months or more or, if less than 12 months, will result
in the individual’s death;
2. Adults or children determined to have less than a 12-month disability;
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3. Minor custodial parents determined, based on the medical form, to have a
disability that will last 12 months or more;
4. Minor custodial parents determined to have less than a 12-month disability.
B. Adults may have a physical, learning or developmental disability, or the
disability may involve the individual’s mental health. However, the disability
must be considered severe enough to limit:
1. Access to employment;
2. Employment; or
3. Learning and development, which limit access to employment.
C. Children may also have a physical, learning, developmental or mental health disability
that limits the child’s daily routine activities and requires such care from the adult that it
prevents the adult’s employment.
1. Verify with a statement from the child’s doctor that the parent is needed in
the home to care for the child.
2. The parent must complete a DHR/FIA 434 C form stating why the parent
must be in the home with the child and what the child’s daily activities are.
204

Case Manager Responsibilities

A. Screen all TCA adults and children at application and recertification to determine
if an adult or child in the assistance unit has an illness or disability and if the
impairment will limit access to employment, daily routine activities, or educational
opportunities.
B. If impairment is claimed the LDSS case manager and the customer complete the
TCA Supplemental Medical Evaluation Form – Child Only (DHR/FIA 434-C) for
children.
C. The case manager must request that the customer have a Medical Evaluation
form DHR/IMA 500 completed by a licensed health care provider for any
disabled person included in the assistance unit (AU).
 The 500 must state the diagnosis and the expected length of the
disability.
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D. When an applicant does not have health insurance or medical assistance to pay
for a medical examination to have the form completed, the case manager should
provide the customer with a DHR/FIA 312.
E. Customers who have medical assistance:
1. Should use their medical assistance to pay for the medical examination and
any lab work or tests needed.
2. Should not be given a 312 to pay for medical examination and tests.
Note: Doctors may not bill Medical Assistance and also receive payment through
the 312.
F. The case manager determines the length of the disability and whether the adult
is mandatory for participation in a FDWA, based on the medical evaluation (500),
the medical supplement (402W) and the case manager’s own knowledge of the
disabled person.
205

About the DHR/FIA 312

A. Authorizing the Exam
1. To authorize the medical exam and/or lab/test fees the case manager
completes the following on the DHR/FIA312 form:
a.
b.
c.
d.
e.

The name of the local department
Case information
Case manager signature
Check the box for Medical Examination
Check the box for Lab fees if not included in exam

2. The allowable fee amounts for an examination and lab work or tests are
preprinted on the DHR/FIA 312 form. Do not write any fee amount in the
“Cost Must Not Exceed” section at this time.
Note: The supervisor does not sign the DHR/FIA 312 form until after the local
department receives the 500 form completed by a qualified, licensed, certified
health care provider and any lab work or tests that are required are attached
or the doctor states the date the lab work or test results will be available.
B. Payment Authorization

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1. When the case manager receives the completed DHR/FIA 500 form and lab
work or tests results back from the doctor or lab, he or she authorizes
payment to the health care provider in the amount of:
a. DHR/FIA 500 indicating a medical examination was completed, but with
no lab work report or test results attached and no date indicated on the
DHR/FIA 500 indicating when the lab work or test results will be
available, and
b. $40 for lab work or test results report when they are received with the
completed DHR/FIA 500 or when the completed DHR/FIA 500 indicates
the date the lab or test results will be available.
2. The case manager, based on the above allowable fees, will complete the
“Cost not to Exceed” section on the DHR/FIA 312 form, and then forward the
form to his or her supervisor for signature.
3. The supervisor’s signature on the DHR/FIA 312 form authorizes the local
department finance office to pay for the examination and/or lab work /test
results. The supervisor forwards the signed form to the local department
finance office for payment.
Note: The DHR/FIA 312 form must have the medical provider’s federal ID
number listed for payment. If the form does not list the federal ID number,
contact the medical provider to obtain the number.
To be in compliance with the Health Insurance Portability and Accountability Act of
1996 (HIPAA), the local department can not forward any medical documentation of an
applicant or recipient to the Finance Office.
206

Customers Must Apply for all Benefits

A. It is a condition of technical eligibility that TCA customers must file for all
benefits they may be entitled to receive. These include, but are not limited to
unemployment insurance, child support, SSI and Social Security Disability
Insurance (SSDI).
B. A customer who has a severe illness or disability that is expected to last 12
months or more or expected to result in the customer’s death must file for SSI
benefits at Social Security.
1. At application, upon receipt of all required verifications including proof of the
customer’s SSI application or claim status:
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a. Code the CARES screens;


Ensure that disability codes and IAR date are entered on the DEM2
screen; and



Enter Application Status codes for SSA (SI) and DEAP (DE) on the
UINC screen.

b. When the customer meets technical and financial requirements, certify
the case for 12 months.
2. If the customer has submitted a 500 form stating he or she has a 12 month
disability and provides proof they tried to apply and SSA could not give them
an appointment within the 30-day application processing time :
a. Approve the TCA case for 12 months.
b. Have the customer complete and sign the 340. Enter the disability dates
and the IAR date on the DEM2 screen.
c. Complete a mandatory 745 alert to follow up within 3 months to ensure
that the customer has filed a claim with Social Security.
C. If the customer does not apply for all potential benefits, deny the pending
application or close the active case, after appropriate adverse action.
207 SSA Interim Reimbursement
A. On June 11, 2001, the Department of Human Resources (DHR) and the Social
Security Administration signed an Agreement for Reimbursement to the State for
Interim Assistance Payments, Pursuant to Section 1631(g) of the Social Security
Act. Under this Agreement, the Social Security Administration reimburses
Maryland through the federal Interim Assistance Reimbursement (IAR) program
for assistance that the State pays to individuals during:
1. The months that their applications for Supplementary Security Income (SSI)
are pending (Initial Payment), or
2. The months that SSI benefits were suspended or terminated where
individuals are subsequently found to be eligible for SSI benefits during the
suspension or termination period (Initial Post eligibility Payment).
B. At the point when the customer has applied for both cash assistance and SSI,
the cash assistance funds become reimbursable. The customer's signature on
the 340 form allows the state to retain the full reimbursable amount (an amount
equal to the amount of assistance the customer received from the time the
customer applied for both cash assistance and SSI) from the SSI lump sum or
through direct payment from the customer
C. When the Form 340 is in effect at the Social Security Administration (SSA), the
retroactive lump sum SSI benefits are sent to the local department’s finance
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office.
D. Maryland is able to collect a reimbursement for the long term disabled TCA
population because they are paid out of State General funds. Federal TANF
dollars are not used.
208 Completing the Authorization for Reimbursement of Interim Assistance
(DHR/FIA 340) form
A. The applicant and case manager complete the lower portion of the DHR/FIA 340
form according to the following guidelines


For local jurisdiction other than Montgomery County , check the upper box
and enter the name of the Local Jurisdiction



If the local office is a district office, enter the County and District Office name
(e.g.: Anne Arundel – Annapolis or Prince George’s – Camp Springs).



In Montgomery County, check the lower box alongside the heading
MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN
SERVICES.

B. Check either the INITIAL PAYMENT ONLY or the POST ELIGIBILITY
PAYMENT ONLY block. (See information in Section I B below on how to
complete this section) Check only one box.
C. Enter the identifying information:


Customer ID Number – Enter the CARES customer ID;



AU (Assistance Unit) Number – Enter the CARES AU number;



Category – Write out “TDAP, TCA” or “PAA”;



The customer’s Social Security Number;



District/Territory – Enter the CARES code for your Local Department Office;



Federal Code - Enter the Federal code for the State of Maryland which is
always 21 (See attachment of Code Listings)



County DSS Federal Code – Enter the 3-digit code for the jurisdiction of the
Local Department of Social Services (See attachment of Code Listings);



Applicant’s Name – Enter the disabled applicant’s last, first, and middle
names;



Enter the Applicant’s Street Address;



Enter the Applicant’s City or Town of residence;



Enter the Applicants Zip Code;

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

Enter the Applicant’s Telephone number;



Instruct the Applicant to sign on the Signature of Recipient line and enter
the current date on the Date line.



The Case Manager signs and dates on the Signature of State
Representative line and enters his/her telephone number.



GR (Grant Reimbursement) Code –Enter the 5-digit code. This code is the
combination of the Federal Code and County DSS Federal Code (See
attachment of Federal Code listings).

D. Only one box for INITIAL PAYMENT ONLY or the POST ELIGIBILITY
PAYMENT ONLY should be checked. Checking both boxes may void the 340.
Review each customer’s situation to determine which box is appropriate to
check.
1. Initial Payment Only- the customer is filing a new SSI application and does
not have an existing SSI application pending or in any stage of appeal, as
verified in SVES, SOLQ, by SSA or customer’s attorney’s letter.
a. If the customer is found eligible, SSA will send the State the first
retroactive SSI payment or an amount equal to the amount of
reimbursable public assistance the State paid.


SSA may calculate what the amount of assistance was and send the
State only the amount of reimbursement owed to the State, or



SSA may send the whole SSI amount to the State to calculate what is
owed, and the State sends the balance to the customer within 10 days
of the State having received it.

b. The State may:


Deduct from the first SSI payment an amount equal to the amount of
public assistance the State paid to or on behalf of the customer



Have SSA send the State an amount equal to the amount of public
assistance the State paid to or on behalf of the customer.

2. Initial Post Eligibility Payment Only: The customer previously received SSI
benefits but the benefits were suspended or terminated by SSA as verified by
SVES, SOLQ or a letter from Social Security.
a. If the customer is found eligible for SSI to be resumed, SSA will send the
State the first retroactive post-eligibility payment of SSI benefits
b. The State may:


Deduct from the first retroactive SSI payment an amount equal to the
amount of public assistance the State paid to or on behalf of the
customer

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

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Have SSA send the State an amount equal to the amount of public
assistance the State paid to or on behalf of the customer

NOTE: Retroactive SSI can be from one month to several years of benefits
depending on the time SSA takes to make a determination and issue benefits to
the customer. Some specific illnesses qualify the customer for presumptive
eligibility from SSI which means they will receive SSI within a few months.
E. The DHR/FIA 340 form remains in effect until one of the following:
1. The Social Security Administration makes the first payment of retroactive
SSI benefits on the customer’s claim or
2. The Social Security Administration makes the first post eligibility payment
of retroactive SSI benefits following the suspension or termination of the
customer’s benefits; or
3. The Social Security Administration makes a final determination on the claim
and no timely request for review is filed; or
4. The State and the customer agree to terminate the authorization
209

340 Form Distribution

The case manager completes and has the customer sign and date the DHR/FIA 340
form during the interview, when the customer’s DHR/FIA 500 equals or exceeds 12
months or when the 500 form shows the disability is expected to result in the
customer’s death and:


Gives the Goldenrod copy to the customer



Scans the signed 340 form into the Onbase document imaging system



Makes sure it is clear and readable



Shreds the original paper 340

Note: As soon as the customer signs the 340 form enter the date in CARES on the
customer’s DEM2 screen. The same information that is on the 340 is obtained from
CARES and electronically sent to SSA. Do not send a paper 340 to SSA.
210

Local Finance Department Responsibilities

A. The local Finance Department:


Receives an e-mail from SSA telling them the interim assistance is
available for reimbursement-the customer’s SSI has been approved.



The Finance department acknowledges the e-mail



Completes the on-line forms for accepting the reimbursement.

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Ensures there is a signed DHR/FIA 340 in the document imaging
database or the case file if the file has not been scanned yet.

B. Receives the SSI lump sum payment
C. Calculates the amount of the reimbursement owed to the State
D. Sends the customer the balance of the SSI payment that is owed to the customer
within 10 days of the receipt of the payment
E. Keeps a record of any SSI reimbursement that could not be retained because the
340 was not available
The LDSS Finance offices have further instructions from SSA on processing the
electronic processing of SSI reimbursements in the Finance Manual.
211

Caretaker Relatives other than Parents

A. There are two categories of needy disabled caretaker relatives other than
parents:
1. Those who have children of their own included in the TCA grant, and
2. Those who do not.
B. Disabled Needy caretaker relatives who do not have their own children
included in the TCA benefit
1. The children on the TCA, living with a needy caretaker relative other than
their parent, are paid a “Room and Board Allowance” out of State funds.
2. The benefit amount is one person higher than the TCA benefit for the
number of children on the TCA grant.
3. Case managers include the needy caretaker in the assistance unit as usual;
the allowance will be initiated centrally.
4. The needy non-parent caretaker relative is not subject to work requirements.
C. The disabled needy caretaker with his or her own children on the TCA
benefit is included in the TCA benefit.
1. The benefit is a regular TCA benefit, not a room and board payment.
2. Follow the procedures for the customer with a disability less than 12 months
or more than 12 months depending on the caretaker’s medical disability.
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3. If the caretaker fails to cooperate with applying for all potential benefits or
other eligibility requirements, only the caretaker and the caretaker’s own
children are sanctioned.
212

Disabled Customers < 12 months

A. Customers disabled less than 12 months
1. Customers with less than a 12-month disability receive federal TCA (TANF
disabled).
2. They are placed in the State defined activity Wellness Rehabilitation (OTM)
for work participation and have good cause for not participating in a federally
defined work activity.
3. At redetermination, they must provide a new medical report verifying the
continuation of the disability before the end of the current certification period.
(If no new medical is received, the customer must meet work requirements.)
4. If the cumulative disability becomes 12 months or more, the customer must
file for all potential benefits (SSI, SSDI etc.) and sign the 340 (Interim
Reimbursement form). The customer is exempt from work requirements.
B. Training or work for disabled customers
1. Americans with Disabilities Act of 1990 (ADA) requires us to “provide a
reasonable accommodation for an individual’s desire for work.”
a. It is discriminatory to deny an individual with a disability the right to
participate in or benefit from any service or aid provided to others.
b. Benefits and services provided to disabled individuals must be equal to
the services and benefits provided to others.
c. Services and benefits may be different only when the differences ensure
that they are as effective as those provided to others.
d. Accommodation must be made to individuals with disabilities without cost
to the individual.

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Accommodations include, but are not limited to:
Qualified interpreters, assistive listening headsets, videotext displays, taped text,
readers, materials in Braille, large text print materials and telecommunication devices for
the deaf (TDDs).

2. Disabled TCA individuals (those disabled for 12 months or more) are not
required to participate in a work or training program as part of their TCA
eligibility. However, local departments of social services must have a
screening and referral process in place for any disabled individual who
wishes to be referred for work or training.


Local departments must make reasonable accommodation for any
customer wishing to participate in a work or training activity.

3. Disabled customers and those who provide care for a disabled person should
be encouraged to plan for their future.


Some people will never be able to work because of physical, emotional or
mental disabilities. Others with appropriate training and skills
development may become self-sufficient.

4. Where appropriate, case managers should encourage customers with
disabilities or those caring for people with disabilities to become involved in
available training activities.
a. Disabled customers may also be referred to the Maryland State
Department of Education, Division of Rehabilitation Services (DORS).
b. DORS will complete an assessment of the disabled person’s abilities and
skills and work to place the individual in an appropriate training or work
program.
5. Disabled customers receiving SSI (parents or caretaker relatives) should be
encouraged to contact the Social Security Administration (SSA) about the
Ticket to Work program.
213

Disabled 16-17 year old –not a Parent (child on the TCA)

A. The disabled 16-17 year old, not in school, must provide a medical report
verifying a disability.
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B. If the medical report is not provided, the 16-17 year old cannot:
1. Claim good cause for not attending school, or
2. Be disregarded from the WPR, and must meet work requirements.
214

TCA Adults Caring for a Disabled Family Member

A. When a TCA adult is needed in the home to care for a disabled family member.
1. The adult caregiver is exempt from federal work participation requirements.
2. The care provided becomes the caregiver’s work activity for universal
engagement.
3. The caregiver must provide a statement from the disabled person’s physician
indicating:
a. The caregiver is needed to care for the disabled individual.
b. The diagnosis and length of the disability for the disabled individual
except for those receiving SSI or SSDI.
c. If the disabled individual is a child, the parent must complete the DHR/FIA
434C.
B. The local department must evaluate each assistance unit’s needs individually
because if the disabled person is out of the home during the day (for school or
therapy or rehabilitation for example) it may be appropriate to refer the caregiver
to a different federally defined work activity.
215

Two Able-bodied Parents Providing Care for a Disabled Individual

A. Families with two able-bodied parents and a disabled individual are subject to
the 60-month time limits.
B. The parent providing care for the disabled individual is exempt from work
participation.
C. The parent providing the care must have a medical statement verifying the
disability and supporting the need for the parent to provide care for the disabled
person.
D. To meet work requirements
1. One parent must provide care while the other parent participates in a FDWA.
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2. The parents may not share the work requirement and the care for the
disabled person.
3. The disabled individual must live in the home.
216

Denial of SSI/SSDI

When a customer has been denied SSI/SSDI and has exhausted all appeals or has not
filed an appeal to the Social Security Administration (SSA), the customer is considered
work eligible and is subject to participation in a FDWA and the 60-month time limits.
217

Conciliation

A. Customers can prevent sanctions by resolving non-compliance issues during the
conciliation period.
Please refer to the Conciliation and Sanction section for information on conciliation and
sanction procedures.
B. Unless the child is disabled, there is no good cause for a child (age16-17) not
being enrolled and attending school 80% of the time. If the minor has not
provided a current medical indicating continued disability impose an individual
sanction.


218

When an individual sanction is imposed for non-compliance with education
requirements, not only is the grant reduced but also the non-compliant
individual is mandatory for work participation.

CARES PROCEDURES for DISABLED TCA CASES

A. On the customer’s DEM2 screen enter
1. In the Approval Source field enter HO, HP, MP, PA, or VZ
2. In the IAR DATE field, enter the month and year (MM YY) date the 340 was
signed
3. Enter the MM YY of the disability in the Begin Date and End Date fields
4. The End Date field can be changed to reflect any consecutive extension of
the medical disability. The date should reflect a 12-month disability.
5. Breaks in the disability period require a new Begin and End Date.
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B. On the customer’s UINC screen enter:
1. APPL TYPE field enter SI for SSI STAT field enter P for pending
2. DATE field enter the date the customer applied for SSI
C. The codes above identify the case as TCA State funded for program reporting
requirements.
D. On the STAT screen, the children who are not the caretaker’s children on a
caretaker relative other than a parent TCA case, in their relationship to the head
of household and must be coded as:
N/N
GC
SI
SS
FC
AU
HS
219

niece or nephew,
grandchild/great grandchild,
sibling (brother or sister),
sibling stepbrother or sister),
first cousin,
aunt or uncle,
half sibling (half brother or sister).

SSI Approval

A. On the customer’s DEM2 screen enter SS and MM YY for the month and year
the SSI was approved in the Approval Source field.
B. On the customer’s UINC screen enter:
1.
2.
3.
4.
5.

SI in the Source field
The SSI amount in the AMT 1 field
Type of verification in the V field
AC in the Frequency field
Change the P to an A at the bottom of the UINC screen to show SSI app
is no longer pending.
6. MM DD YY the SSI was approved in the Date field
C. CARES will automatically code the adult customer as NM and child customer as
SI on the STAT screen the Financial Responsibility field and 203 (receiving
SSI) in the Reason field.
220

SSDI Approval

A. If the customer’s SSDI application is approved:

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1. On the customer’s DEM2 screen enter RS and MM YY (the month and year
SSDI was approved) In the Approval Source field enter
2. On the customer’s UINC screen enter:
a.
b.
c.
d.
e.
f.
g.

LS in the Source field
The amount of the SSDI in AMT1 field
Type of verification received in V field
AC in the Frequency field
SA in the APPL Type field
A in the STAT field
Change the P to an A at the bottom of the UINC screen to show
SSDI app is no longer pending.
h. MM DD YY the SSDI was approved in the Date field
B. CARES will reduce or close the TCA case if the income exceeds the income limit
with a 301-reason code.
C. If the lump sum exceeds the income a penalty type L will appear along with a
penalty end date.
At this time CARES does not count the lump sum penalty correctly. The case
manager must manually calculate the length of the lump sum penalty off line.
1.

The case manager must enter the correct lump sum amount remaining on
the MISC screen in the Lump Sum Remain field.

2.

On the CAFI screen use the PF 13 key to add free-form text to the notice
explaining the penalty to the customer.

D. If the customer reapplies for benefits at the end of the penalty on the UINC
screen enter:
1.
2.
3.
4.

SA in the Source field
The SSDI amount in the AMT1 field
Type of verification in the V field
AC in the Frequency field

E. For on-going months, enter only the SSDI amount and remove the remaining
lump sum amount.
F. If the SSDI and other income exceeds the TCA grant amount, CARES will close
the TCA with a 301 code.
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SECTION 200

SSI or SSDI Denial and all Appeals have been Exhausted

A. On the DEM2 enter MM YY the SSI or SSDI was denied in the End Date field
B. On the UINC screen enter
1. SI or SA in the APPL Type field (may be already entered)
2. D in the STAT field
3. MM DD YY the SSI or SSDI was denied in the DATE field
C. The TCA counter on the DEM2 screen will begin to count in the month following
the month the SSI or SSDI is denied.
222

Parent/Child Cases

A. Deny the TCA application, when a parent in the Disabled TCA case:
1. Refuses to sign the Interim Payment Reimbursement Authorization form for
themselves or for a disabled child
2. Does not cooperate with the local department's vocational rehabilitation
requirements or
3. Fails to apply for SSI or follow through on the SSI appeal process
B. Follow these steps in CARES
1. In Option O on the AMEN screen enter the 566 (Non-Cooperation with the
Eligibility Process) code in the AU Status RSN field of the TCA STAT
screen.
2. Commit the interview to the database.
3. Process each application month insuring that the 566 code shows in the AU
Status RSN field of the TCA STAT screen.
4. Finalize the pending TCA AU.
5. On the CAFI screen, press PF-13 and add additional lines of text as follows
to the system generated notice:
“Your application for TCA has been denied because you did not cooperate with
the necessary TCA Program requirements.”
223

Recipients-Sanction for Non-Cooperation with SSI process

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When a TCA recipient does not comply with the TCA requirements for cooperation
with the SSI process take the following actions on CARES after allowing the one
conciliation period:
A. Access the TCA AU via option R on the AMEN screen.
B. On the TCA STAT screen enter the 566 code in the AU Status RSN field.
C. Fast Path to the DONE screen.
D. Confirm eligibility on the ELIG screen.
E. Confirm eligibility on the CAFI screen.
F. On the CAFI screen, press PF-13 and add the following additional lines of text to
the system generated notice:
“Your TCA case is being closed because you did not cooperate with TCA
program requirements for cooperation with the SSI process.”
224

Non-parent caretaker relative recipient with the caretaker’s own children in
the assistance unit non-cooperation with the SSI process

A. When the head of household (non-parent caretaker relative) is non-cooperative
with TCA program SSI application and appeal requirements and has other
related children in the TCA assistance unit, eligibility continues for the other
related children. The caretaker and the caretakers own children are no longer
eligible.
B. The CARES procedure for this situation is as follows:
1.
2.
3.
4.
5.
6.

Access the TCA AU via option R from the AMEN screen.
On the TCA STAT screen change financial responsibility to NM for the
parent and the parent’s children.
Fast path to the DONE screen.
Confirm eligibility on the ELIG screen.
Confirm eligibility on the CAFI screen.
On the CAFI screen, press PF-13 and add the following additional lines of
text to the system generated notice:
“We cannot pay TCA for you and your children because you did not comply
with TCA program requirements for SSI cooperation”

225

Action on Associated Food Supplement Program Benefits

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A. When a TCA sanction occurs due to non-cooperation with TCA requirements for
SSI cooperation, the associated food supplement (FS) benefits are processed in
the following manner:
1.

Access the FS AU via the R option on the AMEN screen.

2.

Fast path to the UINC screen for the case head.

3.

On the UINC screen enter the TCA benefit amount using code OF (other
Unearned Income, FS Countable). If the TCA grant has been reduced use
the difference between the prior grant and the sanctioned grant as income
type OF.

4.

Follow normal CARES processing.

B. To issue the correct Food Supplement benefit to a household with a sanctioned
individual, the following procedure must be used:
1. On the CARES UINC screen for the head of household, enter the TCA
benefit amount as “phantom” income using code “OF” (Other unearned
income, FS countable only).
2. This will maintain the FS allotment at the level prior to the sanction.
226

Medical Assistance- Sanctioned TCA recipient

A. If there is an individual sanction for non-compliance with work requirements, the
customer remains eligible for MA (category F01) with the same end date.
B. The eligibility for Medical Assistance must be determined for a family whose
TCA application is denied because of non-compliance with an eligibility
requirement.
NOTE: ALWAYS NARRATE THE CASE ACTION
227

TCA Disabled Individuals Case Maintenance Tips

A. Complete and review SVES, SOLQ, or SDX for each person on the list. Review
the:
1. SSI application date
2. Decision date
3. Appeal date
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4. Appeal decision date.
B. The customer must verify SSI status. It is not acceptable to just accept the
customer’s word that they are cooperating with the SSI process. Unless
accurate information is available on SDX or SVES, at least once per year the
customer needs to provide verification from SSA or their representative
indicating SSI status.
C. Make sure to review the SSA codes on the SVES or SDX screens customers
may appear to be in pending status with SSI or SSDI when in fact the code
indicates the customer is not eligible. Following are the most frequent codes
seen.
1. APPEALS DECISION and Decision Code: A 2-position alphabetic field
showing the decision rendered on an appeal. Immediately to the right of the
APPEALS DECISION Code is the APPEALS DECISION CODE DATE.
Code
AD

Value
Dismissed/Abandoned

Code
UA

FA
FC

Favorable/Appeal Approved
Fully/Partially Favorable (converted
records only)
Fully Favorable

UF
UN

Favorable/SSA not appealed (court cases
only)
Closed: Other
Partially Favorable
Dismissed: Claimant Deceased
Dismissed/Abandoned
Favorable/Appeal Approved

WD

Fully/Partially Favorable (converted
records only)
Fully Favorable

UF

Favorable/SSA not appealed (court cases
only)
Closed: Other

WC

FF
FN
OT
PF
T1
AD
FA
FC
FF
FN
OT

WC

1D
2D
3D
4D
UA

UN

WD

Value
Unfavorable/appealed by recipient (court
case only)
Unfavorable
Unfavorable/not appealed by recipient
(court case only)
Dismissed/Withdrawn (converted records
only)
Dismissed: Withdrawn
Dismissed: Cannot be appealed
Dismissed: Filed by improper requestor
Dismissed: Filed late without good cause
Dismissed: Withdrawn
Unfavorable/appealed by recipient (court
case only)
Unfavorable
Unfavorable/not appealed by recipient
(court case only)
Dismissed/Withdrawn (converted records
only)
Dismissed: Withdrawn

2. Non-Pay Status. Indicates that claimant/recipient is not eligible for
SSI/State Supplement payments or that a previously eligible recipient is not
currently eligible.

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Code
N01

SECTION 200

Value
Recipient's countable income exceeds
Title XVI payment and State's payment
standard
Recipient is an inmate of public
institution

Code
N33

Value
Engaging in SGA despite impairment. No
visual impairment.

N34

N03

Recipient is outside U.S.

N35

N04

N36

N06

Recipient's non excludable resources
exceed Title XVI limitations
Recipient gross income from self
employment exceeds Title XVI limitations
Recipient failed to file for other benefits

N07

Cessation of recipient's disability

N39

N08

Cessation of recipient's blindness

N40

N09

N41

N13

Recipient refused vocational
rehabilitation without good cause
Recipient refused treatment for drug
addiction
Recipient refused treatment for
alcoholism
Recipient voluntarily withdrew from a
program
Not a U.S. citizen or eligible alien

N14

Aged claim denied for age

N46

N15

Blind claim denied. Applicant not blind

N47

N16

N48

N17

Disability claim denied. Applicant not
disabled
Applicant failed to pursue claim

N18

Failure to cooperate

N50

N19

Recipient voluntarily terminated
participation in the SSI program

N51

N20

Recipient failed to furnish a required
report
Inmate of a penal institution
Not a U.S. Resident
Convicted of felony of fraudulently
misrepresenting residence in two or

N52

Impairment is no longer severe at the time
of decision and did not last 12 months. No
visual impairment
Impairment is severe at the time of decision
but not expected to last 12 months. No
visual impairment.
Insufficient or no medical data furnished.
No visual impairment
Failure or refusal to submit to consultative
examination. No visual impairment
Applicant does not want to continue
development of claim. No visual
impairment
Applicant willfully fails to follow prescribed
treatment. No visual impairment.
Impairment(s) does not meet or equal listing
(disabled child under age 18 only). No
visual impairment.
Slight impairment. Medical condition alone.
Visual impairment or blindness
Capacity for SGA. Customary past work.
Visual impairment.
Capacity for SGA. Other work. Visual
impairment.
Engaging in SGA despite impairment.
Visual impairment.
Visual impairment no longer severe at the
time of decision and did not last 12 months.
Visual impairment is severe at the time of
decision but not expected to last 12 months.
Insufficient or no medical evidence
furnished of visual impairment
Failure or refusal to submit to consultative
examination regarding visual impairment
Applicant does not want to continue
development of a visual impairment claim
Applicant willfully fails to follow prescribed
treatment for visual impairment
Visual impairment(s) does not meet or
equal listing (disabled child under age 18
only).
Deleted from State rolls before 1/73
payment
Deleted from State rolls after 1/73 payment
Unable to locate applicant
Impairment due to DAA (nonvisual
impairment)

N02

N05

N10
N11
N12

N22
N23
N24

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N37
N38

N42
N43
N44
N45

N49

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N54
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N25

N27
N30
N31
N32

more States
Claimant is fleeing to avoid prosecution
for, or custody or confinement after
conviction for, a crime which is a felony
under the laws of the place from which
he/she flees, or is violating a condition of
parole imposed under Federal or State
law.
Disability terminated due to Substantial
Gainful Activity (SGA)
Slight Impairment. Medical consideration
alone. No visual impairment
Capacity for SGA. Customary past work.
No visual impairment.
Capacity for SGA. Other work. No
visual impairment.

SECTION 200

N56

Visual impairment due to DAA

3. Administrative Suspend
Code
S01

Value
Report of death by Treasury.

Code
S09

Value
Temporary institutionalization

S04

S10

S05

System is awaiting disability
determination (system generated)
SGA decision pending

S06

Address unknown

S21

S07

Returned check for other than address,
payee change, or death of payee or
representative payee
Representative payee development
pending

S90

Recipient has a bank account and refuses
to receive benefits via direct deposit
Potential rollback case or disability made
prior to 7/73 (inactive)
Recipient is presumptively disabled or blind
and has received three months’ payments
PR1 change in process because SSR was
established under incorrect SSN (rare)

S08

S20

S91

PR1 change in process because SSR was
established under incorrect SSN (rare)

The information on SVES or SDX may not be totally accurate, but it is a good indicator
of what is going on at SSA.

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Ten Most Common Disabilities Claims under ADA
LegalBrief Law Journal Issue 2, Article 3
Cite as: Norman H. Kirshman & Roger L. Grandgenett II, ADA: The 10 Most Common
Disabilities and How to Accommodate, 2 LegalBrief L.J. 3, par. # (1997)


ADA: The 10 Most Common Disabilities and How to Accommodate
By Norman H. Kirshman & Roger L. Grandgenett II
I. Introduction
{1} The Americans with Disabilities Act ("ADA") is the most significant employment
legislation in a decade. This paper discusses what constitutes a disability under the
ADA and what reasonable accommodation and undue hardship mean. This paper
will also analyze the ten most common disability claims and how employers
accommodate these disabilities.
{2} Title I of the ADA is intended to ensure that individuals with disabilities not be
excluded from job opportunities unless they are actually unable to do the job. In a
nutshell, no covered entity shall discriminate against a qualified individual with a
disability because of the individual's disability with regard to all aspects of
employment (job application procedures, hiring and firing, advancement, training,
compensation, benefits, etc.). 42 U.S.C.A. § 12112(a). A covered employer must
make a reasonable accommodation to the known physical or mental limitation of a
qualified individual with a disability unless the employer can show that the
reasonable accommodation would cause an undue hardship on the operation of its
business. 42 U.S.C.A. § 12112(b)(5)(A). The ADA provides some examples of
reasonable accommodation and undue hardship, and these issues will be
analyzed later.
II. ADA DEFINITION OF DISABILITY:
{3} Title I of the ADA protects qualified individuals with disabilities from
employment discrimination. Under other employment legislation, such as Title VII
or the Age Discrimination in Employment Act, whether an individual is in a
protected class is a relatively simple matter. Race, color, sex, national origin and
age are, in most cases, easily determined. However, whether an individual is in a
protected class under the ADA is more complicated. Disabilities in the Workplace,
§1053 (Andrew W. Boden et al. eds., 1996)
{4} The ADA has a three-prong definition of disability, where satisfaction of any of
the three prongs constitutes a disability. The ADA's definition of disability is based
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on the definition of "handicap" found in the Rehabilitation Act. A judgment under
either is precedent for the other. Henry H. Perritt, Jr., Americans With Disabilities
Handbook, § 3.3 (2d ed. 1991).
{5} The first definition of disability defines an individual with a disability as an
individual who has a physical or mental impairment that substantially limits one or
more major life activities, has a record of such an impairment, or is regarded as
having such an impairment." 42 U.S.C.A. § 12102(2).
A. A Physical or Mental Impairment that Substantially Limits One or More
Major Life Activities
{6} In cases where there is an issue of whether an individual has a disability, the
first definition of disability is most often litigated. This definition has three subparts
that must be shown by plaintiff.
i. Physical or Mental Impairment
{7} A physical impairment is defined by the ADA to include: "[a]ny physiological
disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or
more of the following body systems: neurological, musculoskeletal, special sense
organs, respiratory (including speech organs), cardiovascular, reproductive,
digestive, genito urinary, hemic and lymphatic, skin, and endocrine." 29 CFR §
1630.2(h)(1).
{8} A mental impairment is defined by the ADA to include: "[a]ny mental or
psychological disorder, such as mental retardation, organic brain syndrome,
emotional or mental illness, and specific learning disabilities." 29 CFR §
1630.2(h)(2).
{9} The ADA and EEOC regulations do not list all of the "specific conditions that
constitute impairments both because of the difficulty of ensuring
comprehensiveness and because new disorders might develop in the
future." Henry H. Perritt, Jr., Americans with Disabilities Act Handbook § 3.2 (2d
ed. 1991). However, examples of covered physical and mental impairments
were included in the legislative history of the ADA: orthopedic, visual,
speech and hearing impairments, cerebral palsy, epilepsy, muscular
dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental
retardation, emotional illness, specific learning disabilities, drug addiction
and alcoholism and HIV infection. Id. (citing House Labor Report at 51; House
Judiciary Report at 28). Serious impairments such as cancer and multiple
sclerosis, however, have been held not to be disabilities.
{10} An impairment under the ADA must be a physiological or mental disorder.
Tough calls like stress and depression are "conditions that may or may not be
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considered impairments, depending on whether these conditions result from a
documented physiological or mental disorder" or whether they result from job or
personal life pressures. Equal Employment Opportunity Commission, Technical
Assistance Manual for the Americans With Disabilities Act, at II-3.
ii. Substantially Limits
{11} The second subpart of the definition is that the impairment must substantially
limit one or more major life activities. 42 U.S.C.A. § 12102(2)(A). The EEOC
regulations use the term "substantially limits" to characterize "the extent to which a
physical or mental impairment interferes with an individual's ability to perform one
or more of the major life activities." Henry H. Perritt Jr., Americans With Disabilities
Act Handbook, § 3.2 (2d ed. 1991). The regulations define "substantially limits"
as:
{12} "i) Unable to perform a major life activity that the average person in the
general population can perform; or
{13} ii) Significantly restricted as to the condition, manner or duration under which
an individual can perform a particular major life activity as compared to the
condition, manner or duration under which the average person in the general
population can perform that same major life activity." 29 CFR § 1630.2(j)(1)(i) &
(ii).
{14} The impairment is to be made in comparison to normal people. An example
would be a person who can walk ten miles continuously, but experiences pain on
the eleventh mile. Because this discomfort is typical of the population, it is not a
limitation and, thus, not an impairment. Id.
{15} The EEOC regulations also include three factors influencing a determination
of substantial limitation: nature and severity of the impairment, how long the
impairment is expected to last, and whether the impairment is characterized as
permanent or long-term. 29 CFR § 1630.2(j)(2)(i)-(iii).
{16} These factors must be considered because "it is not the name of an
impairment or a condition that determines whether a person is protected by
the ADA, but rather the effect of an impairment or condition on the life of a
particular person." Equal Employment Opportunity Commission, Technical
Assistance Manual for the Americans with Disabilities Act, at II-4. AIDS, deafness
and blindness are by their nature substantially limiting, but "many other
impairments may be disabling for some individuals but not for others,
depending on the impact on their activities." Id.An example would be where an
individual has mild cerebral palsy. Although cerebral palsy may limit the major life
activities of one individual, an individual with mild cerebral palsy only slightly
interfering with the ability to speak and has no significant limitation on other major

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life activities is not an individual with a disability under the ADA. Id. at II-5.
iii. Major Life Activity
{17} The third subpart is that one or more major life activities must be substantially
limited. 42 U.S.C.A. § 12102(2)(A). Major life activities are activities that an
"average person can perform with little or no difficulty." Equal Employment
Opportunity Commission, Technical Assistance Manual for the Americans With
Disabilities Act at II-3. Examples include walking, speaking, breathing, performing
manual tasks, seeing, hearing, learning, caring for oneself, sitting, lifting, reading,
standing and working. Id.
{18} The major life activity of working needs to be especially analyzed, as there
are many cases where disability is challenged on this matter.
{19} "It is not necessary to consider if a person is substantially limited in the major
life activity of `working' if the person is substantially limited in any other major life
activity." Id. at II-6. Thus, if an individual is blind, there is no need to consider
whether the individual is substantially limited in working. Id.
{20} An individual will not be considered to be substantially limited in working if he
or she is only substantially limited in performing a particular job for one employer,
or unable to perform a specialized job in a particular field. Id. The individual need
not be totally unable to work. An individual, therefore, who cannot qualify as a
captain of an airline flight because of a minor vision impairment, but who could
qualify as a co-pilot, would not be considered substantially limited in working just
because he could not perform a particular job as captain. Id. A baseball pitcher
who can no longer pitch because of a bad elbow is not substantially limited in
working just "because he is no longer able to perform the specialized job of
pitching in baseball." Id. "The person must be significantly restricted in the ability to
perform either a class of jobs or a broad range of jobs in various classes,
compared to an average person with similar training, skills and abilities." Id. at 116.
B. Record of Substantially Limiting Condition
{21} The second type of disability is intended to "include people who have
recovered from physical or mental impairments, or who have been misclassified as
having such impairments." Henry H. Perritt, Jr., Americans with Disabilities Act
Handbook, § 3.2 (2d ed. 1991). Individuals with a record of mental or
emotional illness, cancer, heart disease or other debilitating illness or have
been misclassified or misdiagnosed as having these illnesses, are protected
under the ADA, whether or not the individual is currently substantially
limited in a major life activity. 29 CFR § 1630.2(k); 42 U.S.C.A. §

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12102(2)(B).
C. Regarded as Having Such an Impairment
{22} The third type of disability includes individuals with impairments that do not
substantially limit major life activities, but who are perceived as having substantial
limiting impairments or an individual with an impairment that substantially limits
major life activities only as a result of attitudes of others toward the impairment. 42
U.S.C.A. § 12102(2)(C).This category of disability was needed, as the Supreme
Court has stated, because "society's myths and fears about disability and disease
are as handicapping as are the physical limitations that flow from actual
impairments." School Board v. Arline, 480 U.S. 273 (1987).
{23} The EEOC regulations indicate three circumstances where an individual may
be protected under this definition of disability: where an individual may have an
impairment which is not substantially limiting but is treated by the employer as
having such an impairment, where an individual has an impairment that is
substantially limiting because of attitudes of others toward the impairment, and
where an individual has no impairment but is regarded by an employer as having a
substantially limiting impairment. 29 CFR § 1630.2(l)(1)-(3).
{24} The ADA provides three definitions of disability. Although the ADA provides
these definitions, the question of whether an individual is considered disabled
under ADA is best suited to a case-by-case determination, no matter what the
impairment is. Henry H. Perritt, Jr., Americans with Disabilities Handbook, § 3.2
(2d ed. 1991). Whether one is disabled cannot be known though lists of
impairments because some impairments may be a disability for one person and
not for another. The facts and circumstances of each case must be analyzed
to determine whether an individual has a disability.
III. WHAT DOES NOT CONSTITUTE A DISABILITY
{25} The ADA explicitly excludes certain conditions from being disabilities:
homosexuality, bisexuality, transvestism, transsexualism, pedophilia, exhibitionism,
voyeurism, gender identity disorders not resulting from physical impairments, other
sexual behavior disorders, compulsive gambling, kleptomania, pyromania and
psychoactive substance use disorders resulting from current illegal use of
drugs. 42 U.S.C.A. § 12211.
{26} Furthermore, "[t]emporary, non-chronic impairments that do not last for a long
time and that have little or no long-term impact usually are not disabilities." Equal
Employment Opportunity Commission, Technical Assistance Manual for the
Americans with Disabilities Act at II-5. Broken limbs, sprained joints, concussions,
appendicitis, influenza, common colds, spasms and "except in rare and unusual
circumstances," obesity, are generally not considered disabilities. Henry H. Perritt,
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Jr., Americans with Disabilities Handbook, § 3.2 (2d ed. 1991). However, if an
individual had a temporary impairment that did not heal properly and resulted in a
permanent impairment that substantially restricted the use of a limb, the individual
would be considered to have a disability. EEOC, Technical Assistance Manual for
the Americans with Disabilities Act at II-5.
{27} Simple physical characteristics such as eye color and hair color are not
impairments. Id. at II-2. Moreover, personality traits, "such as poor judgment, quick
temper, or irresponsible behavior" are not impairments. Id. at II-2. "Environmental,
cultural, or economic disadvantages, such as lack of education or a prison record
also are not impairments." Id.
{28} Courts have found the following not to be disabilities: pregnancy as it is a
physical condition not the result of a physiological disorder (Tsetseranos v. Tech
Prototype Inc., 4 AD Cases 1635 (D.N.H. 1995); being lefthanded (De La Torres v.
Bolger, 781 F.2d 1134 (5th Cir. 1986); chemical hypersensitivity syndrome
(McCauley v. Georgia, 4 AD Cases 1470 (N.D. Ga. 1994); average height or
strength that renders a person incapable of performing particular jobs (Jasany v.
U.S. Postal Service, 755 F.2d 1244 (6th Cir. 1985); very muscular physique which
prevented an individual from complying with employer's valid weight requirement
(Tudyman v. United Airlines, 608 F.Supp. 739 (C.D. Cal. 1984). illiteracy (Morisky
v. Broward County, 80 F.3d 445 (11th Cir. 1996); violent temper (Fenton v. The
Pritchard Co., 926 F.Supp. 1437 (D.Kan. 1996); smoking (Matter of Fortunoff v.
New York State Division of Human Rights, 642 NYS.2d 710 (A.D. 2 Dept. 1996).
IV. REASONABLE ACCOMMODATION AND UNDUE HARDSHIP
{29} The ADA prohibits employment discrimination against qualified individuals
with disabilities. A qualified individual is "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. 29 CFR § 1630.2(m) (emphasis addes).
{30} An employer must make reasonable accommodations to the known physical
or mental limitation of a qualified individual with a disability unless it can show that
the accommodation would cause an undue hardship on the operation of its
business. 42 U.S.C.A. § 12112(b)(5)(A). A reasonable accommodation is "any
change in a job or work environment, or an application process that enables a
qualified person with a disability to enjoy equal employment opportunities." BNA,
Americans With Disabilities Act Manual, § 20:0007. The ADA specifically lists
what may constitute reasonable accommodation:

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{31} "(A) making existing facilities used by employees readily accessible to and
usable by individuals with disabilities; and
{32} (B) job restructuring, part-time or modified work schedules, reassignment to a
vacant position, acquisition or modification of equipment or devices, appropriate
adjustment or modifications of examinations, training materials or policies, the
provision of qualified readers or interpreters, and other similar accommodations for
individuals with disabilities." 42 U.S.C.A. § 12111(9).
{33} The ADA does not provide an exhaustive list of reasonable accommodations;
the list is only general guidance.Henry H. Perritt, Americans with Disabilities
Handbook, § 4.14 (2d ed. 1991). Other examples of reasonable accommodation
include "permitting the use of accrued paid leave or providing additional unpaid
leave for necessary treatment of the impairment, making employer-provided
transportation accessible, providing personal assistants, and providing reserved
parking spaces." BNA, Americans with Disabilities Handbook Manual, at §
20:0008. Note that employers do not need to promote a disabled employee as part
of accommodation or to reallocate the essential functions of a position. Id.
{34} The employer is not required to provide a reasonable accommodation that
would constitute an undue hardship on the employer. Undue hardship is defined by
the ADA as action requiring significant difficulty or expense. 29 CFR §
1630.2(p)(1). In determining what constitutes an undue hardship, an employer
must consider:

{35} "i. the nature and cost of the accommodation needed.
{36} ii. the overall financial resources of the facility or facilities involved in the
provision of the reasonable accommodation; the number of persons employed at
such facility; the effect on expenses and resources, or the impact otherwise of
such accommodation upon the operation of the facility;
{37} iii. the overall financial resources of the covered entity; the overall size of the
business of a covered entity with respect to the number of its employees; the
number, type and location of the facilities; and
{38} iv. the type of operation or operations of the covered entity, including the
composition, structure, and facilities of the workforce of such entity; the geographic
separateness, administrative, or fiscal relationship of the facility or facilities in
question to the covered entity." 42 U.S.C. § 12111(10).
{39} An employer has the burden of establishing undue hardship. Henry H. Perritt,
Jr., Americans with Disabilities Act Handbook, § 4.22 (2d ed. 1991). An
accommodation may be an undue hardship on one employer and not another
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employer. Undue hardship, therefore, is to be determined on a case-by-case basis.
V. TEN MOST COMMON DISABILITIES:
{40} The ten most common disability claims under the ADA will be discussed,
along with any relevant case law discussing reasonable accommodation or undue
hardship and any other pertinent information or guidance.
A. BACK\SPINAL INJURY:
{41} The most common disability claim is a back or spinal injury. These account
for 19.1% of ADA charges. Who's Filing Charges With EEOC-And Why, Disability
Compliance Bulletin (A Service of the National Disability Law Reporter),
September 28, 1995 at 3.
{42} The accommodation most likely to be required for employees with back and
spinal injuries is lifting limitations. InLeslie v. St. Vincent New Hope, Inc., 5 AD
Cases 1773 (S.D. Ind. 1996), the court held that the employer did not reasonably
accommodate a disabled resident attendant with an injured back when attendant
did not receive light duty. The plaintiff testified that she knew of another resident
attendant who hurt her back and received a transfer to another unit and that
plaintiff was not considered for a vacant position in another unit when she asked
supervisor for light duty.Id.
{43} Besides lifting limitations, there are other accommodations that may be
required for back injuries. In Anzalone v. Allstate Insurance Company, No. 93-2248
(E.La. 1995), the court held that a former insurance claims adjuster who injured his
back was entitled to a trial on his ADA claim that, as a reasonable accommodation,
his employer should have allowed him to work at home. The court found that most
of the adjuster's duties required him to be outside the office and evidence existed
that other employees had been allowed to work at home. Id. And in Stewart v.
County of Brown, 5 AD Cases 1018 (7th Cir. 1996), the court held the county
reasonably accommodated a deputy sheriff with neck and back pain after he was
assigned to a courthouse security position. The county built a platform to raise his
chair, installed mini-blinds on windows and placed film on doors of security room to
minimize glare, purchased an ergonomically correct chair, lowered monitors and
reduced his work schedule. Id.
B. PSYCHIATRIC\MENTAL IMPAIRMENTS:
{44} The second most common disability claim under the ADA is psychiatric
and/or mental disability. Psychiatric and mental impairments account for 11.7% of
the ADA claims and include such impairments as depression, psychological
problems, anxiety, post-traumatic stress syndrome and bipolar disorder\manic
depression. Who's Filing Charges With EEOC-And Why, Disability Compliance

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Bulletin (A Service of the National Disability Law Reporter), September 28, 1995 at
{45} In Marschand v. Norfolk & Western Railway Co., 4 AD Cases 1099 (N.Ind.
1995), the court analyzed the reasonable accommodation required for posttraumatic stress syndrome. The court found that the railroad's efforts to find
alternative employment for a locomotive engineer who developed post-traumatic
stress syndrome after an accident were more than reasonable
accommodation. Id. The employer offered him clerical positions on the condition
that he pass a typing test, offered to pay for a typing class, waived the typing
requirement and the engineer accepted one of the three clerical positions
offered. Id. at 1111.
{46} In Morton v. GTE North, Inc., 5 AD Cases 524 (N.D.Tex. 1996), the court held
that the employer reasonably accommodated the plaintiff who suffered from severe
depression. The employer directed the plaintiff to the staffing department so
plaintiff could determine how to apply for a transfer, plaintiff and supervisor
evaluated positions available at the time of request and did not find any position
that plaintiff would accept or she could perform successfully, and plaintiff was
unable to find a job she could perform. Id. at 531-532. Because there was no
suitable vacant position available to her, employer did not have to grant plaintiff a
transfer. Id. at 532. See also Voytek v. University of California, 5 AD Cases 1255
(N.D.Cal. 1994) (University reasonably accommodated director of department who
had a depressive disorder by offering him a different position either at comparable
salary as previous position or reduced responsibilities and salary).
{47} If an employee has a psychiatric or mental impairment that is a disability, the
EEOC suggests the following reasonable accommodations: [s]chedule
modifications, such as eliminating rotating shifts; extra time off at lunch or at some
other time for therapy sessions; job modifications, such as reassignment of
marginal tasks to other workers; or reassignment to vacant positions." Psychiatric
Disabilities, Total Disability's Effect Focus of Conference, Fair Employment
Practices: Summary of Latest Developments, June 17, 1996 at 69.
{48} Furthermore, reasonable accommodations may include environmental
modifications for "employees who cannot tolerate noise or distractions, such as
putting up partitions or providing offices with doors." Id.
C. NEUROLOGICAL IMPAIRMENTS:
{49} Neurological impairments account for 11.7% of ADA claims. Who's Filing
Charges With EEOC-And Why, Disability Compliance Bulletin (A Service of the
National Disability Law Reporter), September 28, 1995 at 3. Epilepsy, severe
migraine headaches and nervous system disorders are examples of neurological

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impairments.
{50} In Pattison v. Meijer Inc., 4 AD Cases 997 (W.D.Mich. 1995), the court found
that the employer provided reasonable accommodation to an employee with a
head injury and seizure disorder when it offered two modified work schedules and
two reassignments. The employee's disability precluded him from driving at night,
and a flexible schedule would have allowed the employee to use alternative
transportation. Id.
{51} However, employers do not have to provide certain accommodations for
neurological impairments. In Barfield v. Bell South Telecommunications, Inc., 4 AD
Cases 1159 (S.D. Miss. 1995), the court held that it would be unreasonable to
allow an employee with migraine headaches to work only on her "good" days
because regular attendance at work is an essential job function. And in Jacques v.
Clean-Up Group, 5 AD Cases 1594 (1st Cir. 1996), the court held that an employer
was not required to accommodate an epileptic cleaning person, who could not
drive, by allowing the individual to start after 10 a.m. and to split a shift with
another employee. The Jacques court stated these accommodations were
unreasonable, as they would eliminate the position's essential function of arriving
at 8 a.m. Id. at 1599. The court also held that it would be an undue burden to
require the employer to provide transportation for the employee and economically
detrimental to hire another individual to drive the employee. Id. at 1600.
D. EXTREMITIES:
{52} Extremity impairments account for 8.1% of ADA charges. Who's Filing
Charges With EEOC-And Why, Disability Compliance Bulletin (A Service of the
National Disability Law Reporter), September 28, 1995 at 3. Hand and leg
impairments and carpal tunnel syndrome ("CTS") are included under this category
of impairments (CTS, however, is often successfully challenged as not being a
disability under the ADA).
{53} In Hudson v. MCI Telecommunications, 5 AD Cases 1099 (10th Cir. 1996), a
customer service representative with CTS requested unpaid leave of indefinite
duration. CTS prevented the individual from typing and performing keyboard
work. Id. at 1100. The court held that unpaid leave of indefinite duration is not a
reasonable accommodation under the ADA. Id. Reasonable accommodations,
according to the court, are accommodations which "presently, or in the near
future," enable employee to perform essential job functions. Id. at 1101.
{54} If the only accommodation for an individual with CTS is removal of all or a
significant portion of keyboard work and keyboard work is an essential job function,
this accommodation is unreasonable. Feliberty v. Kemper Corporation, 4 AD
Cases 875 (N.Ill. 1995). In Feliberty, the position of medical director required
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extensive work on a computer. The court held the ADA only requires
"accommodations which would allow a disabled employee to perform the essential
functions of his job." Id. at 878. Because the position required six to eight hours of
keyboard work a day, the court held keyboard work was an essential job function
and plaintiff, therefore, was unqualified for position. Id.
E. HEART IMPAIRMENTS:
{54} 4.4% of all ADA charges are heart impairment claims. Who's Filing Charges
With EEOC-And Why, Disability Compliance Bulletin (A Service of the National
Disability Law Reporter), September 28, 1995 at 3. When an individual has a heart
defect, the accommodation required will probably be restrictions on lifting or
strenuous activity.
{55} In Keiss v. D&H Distributing, 5 AD Cases 897 (D.Md. 1996), the court held
that an employer had no duty to accommodate a kitchen installer whose heart
impairment precluded him from heavy lifting. Id. The court found that frequent
lifting of more than twenty pounds was an essential function of the kitchen installer
position, and the ADA does not require an employer to restructure the essential
functions of a position by pushing off heavy work to co-employees. Id. The
employer had no vacant positions for the employee and was not required to create
a position for the individual. Id. at 898.
F. SUBSTANCE ABUSE:
{56} Substance abuse accounts for 3.5% of all ADA claims. Who's Filing Charges
With EEOC-And Why, Disability Compliance Bulletin (A Service of the National
Disability Law Reporter), September 28, 1995 at 3. Substance abuse refers to both
alcohol and drug abuse for ADA purposes.
{57} The ADA specifically excludes an individual who is currently engaging
in the illegal use of drugs as being a qualified individual with a disability. 42
U.S.C.A. § 12114(a). An employer cannot "exclude as a qualified individual with a
disability an individual who:
{58} "(1) has successfully completed a supervised drug rehabilitation program
and is no longer engaging in the illegal use of drugs, or has otherwise been
rehabilitated successfully and is no longer engaging in such use;
{59} (2) is participating in a supervised rehabilitation program and is no longer
engaging in such use; or
{60} (3) is erroneously regarded as engaging in such use, but is not engaging in
such use." 42 U.S.C.A. § 12114(b).
{61} The ADA does not require the employer to accommodate illegal drug use.
Employers are allowed to prohibit the use of drugs and alcohol in the workplace
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and require employees not to be under the influence, permit adverse treatment of
unsatisfactory performance related to drug and alcohol abuse, and require
compliance with the Drug Free Workplace Act and governmental testing
requirements. 42 U.S.C.A. § 12114(c). Additionally, the ADA expresses neutrality
on whether it encourages or prohibits drug and alcohol testing. 42 U.S.C.A. §
12114(d).
{62} Most of the reasonable accommodation in substance abuse disability cases
involve providing a leave of absence. In Corbett v. National Products Co., 4 AD
Cases 987 (E.D.Pa. 1995), the court held that the employer could have reasonably
accommodated an alcoholic employee who had entered a 28-day in-patient
treatment program by providing him with a leave of absence, where there was no
evidence that his attempt at alcohol rehabilitation would be futile. And in Schmidt v.
Safeway Inc., 864 F.Supp. 991 (D.C. Oregon 1994), the court held that providing a
leave of absence to obtain medical treatment for alcoholism is a reasonable
accommodation if it is likely that following treatment, the recovering alcoholic would
be able to safely perform his or her duties. The Schmidt court noted, however, that
the employer is not required to pay for rehabilitation. Id.
{63} In McDaniel v. Mississippi Baptist Medical Center, 4 AD Cases 241 (S.D.
Miss. 1995), the court held that the employer did not violate the ADA when it fired
an employee for relapsing into illegal drug use. Although the ADA protects
individuals who are participating in supervised rehabilitation and no longer
engaging in drugs or alcohol, the court held that the plaintiff did not fall within the
exception. Id. According to the court, the plaintiff, free of drugs for a few weeks,
was not drug-free for the necessary length of time to be considered "no longer
engaging" in drugs or alcohol. Id.
G. DIABETES
{64} Diabetes claims account for 3.5% of all ADA claims. Who's Filing Charges
With EEOC-And Why, Disability Compliance Bulletin (A Service of the National
Disability Law Reporter), September 28, 1995 at 3.
{65} Diabetes is an impairment specifically listed in the legislative history of the
ADA as constituting a physical impairment. Henry H. Perritt, Jr., Americans With
Disabilities Handbook § 3.2 (2d ed. 1991) (citing House Labor Report at 51;
House Judiciary Report at 28). But courts in some instances have found diabetes
not to be a disability under the ADA. See Deckert v. City of Ulysses, 4 AD Cases
1569 (Kan. 1995) (a discharged diabetic police officer was not disabled within the
meaning of the ADA because no evidence of substantial limitation of work existed;
an EEOC guideline stating insulin-dependent diabetes is a per se disability is
invalid); Gilday v. McCosta County, 5 ADA 728 (W.D. Mich. 1996) (a plaintiff with
diabetes was not disabled under the ADA because there was no substantial
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limitation in the major life activity of work or any other major life activity; his
condition does not prevent him from caring for himself, performing manual tasks,
learning or performing any other major life activity).
{66} Two recent cases have analyzed reasonable accommodation and diabetes.
In Siefken v. Village of Arlington Heights, 4 AD Cases 1441 (7th Cir. 1995), the
court held that a proposal by a diabetic ex-police officer that he be given another
chance after a severe hypoglycemic episode to change his monitoring techniques
is not a request for reasonable accommodation. The court held the ADA requires
employers to consider changes in its work rules, facilities, terms and conditions of
employment, but does not require employers to give employees second
chances. Id.at 1442.
{67} Furthermore, in Myers v. Hose, 4 AD Cases 391 (4th Cir. 1995), the court
held that the employer was not required to hold a job indefinitely until a diabetic exemployee's health problems were corrected. According to the court, it would
significantly burden the employer to grant an indefinite period of leave to give the
employee time to control his diabetes. The court stated the employer must
promptly fill positions to met business demands and cannot be forced to keep a
position open for indefinitely. Id.
H. HEARING IMPAIRMENTS:
{68} Hearing impairments constitute 3% of ADA claims and include complete
deafness and significant hearing loss. Who's Filing Charges With EEOC-And Why,
Disability Compliance Bulletin (A Service of the National Disability Law Reporter),
September 28, 1995 at 3.
{69} In Bryant v. Better Business Bureau of Greater Maryland, 5 AD Cases 625
(D. Md. 1996), the court held that the employer should not have denied a hearing
impaired coordinator the accommodations of a text telephone system (TTY) device
to assist the coordinator with telephone calls. The court held that undue hardship
was not shown by employer, despite claims by employer that the TTY would have
slowed plaintiff down in her work, been awkward and created time delays for calls
to be completed. Id.
{70} In Schmidt v. Methodist Hospital of Indiana, Inc. 5 AD Cases 1340 (7th Cir.
1996), a failure by the employer hospital to transfer a hearing-impaired nurse, who
had problems setting up a dialysis machine because of her impairment, from
hemodialysis to orthopedics did not violate the ADA. The court found the hospital
offered the nurse additionally training in hemodialysis unit but he refused, and
hospital offered nurse the opportunity to resign from his position and reapply for a
position in orthopedics, which he declined. Id. at 1342. The court held the failure to

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accept these reasonable accommodations rendered him unqualified. Id.
I. VISION IMPAIRMENTS:
{71} Vision impairments account for 2.8% of ADA claims. Who's Filing Charges
With EEOC-And Why, Disability Compliance Bulletin (A Service of the National
Disability Law Reporter), September 28, 1995 at 3. Vision impairments include
total blindness and serious vision problems and accommodations may range from
providing reading assistants to purchasing certain equipment.
{72} In Fink v. New York City Dept. of Personnel, 4 AD Cases 641 (2d Cir. 1995),
the court found a city personnel agency that conducted civil service examination
made reasonable accommodations to visually disabled candidates. The agency
provided the visually disabled with a tape recorder, a tape recording of the
examination, and a reading assistant to assist with the tape recorder and to read
questions and answers. Id. at 643. The agency also provided a private room to
visually disabled candidates and allowed additional time to take the
examination. Id. In Courtney v. American National Can Co., 4 AD Cases 1583
(Iowa 1995), an employer reasonably accommodated a warehouse forklift driver's
vision disability when it assigned him to a machine operator position, where his
vision impairment did not affect the operation of the machine.
{73} But as is the case with other disabilities, an employer is not required to create
a position for a visually impaired employee or reassign individual to another
position. In Riblett v. Boeing Co., 4 AD Cases 1679 (D.Kan. 1995), the court held
that the ADA did not require an employer to transfer a draftsman, who had no
concept of flat pattern development due to vision defects, to a different position.
According to the court, reassignment to another position is not required by the ADA
and plaintiff did not show employer had vacant positions for which plaintiff was
qualified. Id.at 1684.
J. BLOOD DISORDER:
{74} 2.6% of ADA claims involve blood disorders, including hepatitis. Who's Filing
Charges With EEOC-And Why, Disability Compliance Bulletin (A Service of the
National Disability Law Reporter), September 28, 1995 at 3.
{75} It is important to note that an employer may refuse to assign or continue to
assign an individual to a position involving the handling of food if the individual has
hepatitis a or any other covered pathogen and if employer cannot eliminate the risk
of transmission through reasonable accommodation. 42 U.S.C.A. § 12113(d)(2).
{76} In a Rehabilitation Act case, the court held that the U.S. Marshals Service did
not have to reassign an employee with hepatitis. Fedro v. Reno, No. 93-1489 (7th
Cir. 1994). In Fedro, the court found that all full-time positions available risked the
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transmission of hepatitis during a "scuffle or confrontation" and the employer was
not required to combine two available part-time positions into one full-time position.

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