Unmet Need for Workplace Accommodation

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Unmet Need for Workplace Accommodation

Kathleen J. Mullen, RAND and IZA

with Nicole Maestas, Harvard University and NBER August 2015

Funding from Social Security Administration/NBER Disability Research Center (NB15-07) gratefully acknowledged

C ^{ENTER for}

D ^ISABILITY

R ^ESEARCH

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Understanding Accommodation is Important for Disability Policy

• Recent proposals target employer incentives to retain workers who become disabled

• Limited evidence base

– Is there unmet need for workplace accommodation?

– Does accommodation prolong employment?

• We collected new data showing the

– Size of the population sensitive to accommodation – Degree of unmet need for workplace accommodation – Employment outcomes

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Accommodation Required under Americans with Disabilities Act (ADA)

• Mandates that employers provide “reasonable accommodation” of disabled workers except in cases of “undue hardship”

• Employers do not have to provide the specific accommodation requested by the employee

• Reach of ADA was initially limited by strict interpretation of disability by the courts

• 2008 Amendments attempted to correct this

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New Survey Data

• RAND American Life Panel (ALP)

• First survey fielded in May 2014

– N=2,479 nat’lly representative sample ages 18-70 – Questions about workplace accommodation

– Randomized order of questions

• Follow-up survey fielded end of June 2015 to N=1,417 respondents who worked last May

– Response rate after two weeks: 74%

– Health and work transitions

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Health and Retirement Study (HRS) Question Sequence and Skip Patterns

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Question Sequence

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Question Sequence

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Question Order Matters

Estimated Proportion of Population with Work-Limiting or Accommodation- Sensitive Health Problems

WLHQ asked…

First Last Diff. p-val.

% Report work-limiting health problem 16.3% 18.0% 1.7% 0.241

No. observations 1,233 1,246

Note: WLHQ="work limiting health question"

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Question Order Matters

Estimated Proportion of Population with Work-Limiting or Accommodation- Sensitive Health Problems

WLHQ asked…

First Last Diff. p-val.

% Report work-limiting health problem 16.3% 18.0% 1.7% 0.241 + Accommodated at workplace 20.6% 27.4% 6.8% <0.001

No. observations 1,233 1,246

Note: WLHQ="work limiting health question"

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Question Order Matters

Estimated Proportion of Population with Work-Limiting or Accommodation- Sensitive Health Problems

WLHQ asked…

First Last Diff. p-val.

% Report work-limiting health problem 16.3% 18.0% 1.7% 0.241 + Accommodated at workplace 20.6% 27.4% 6.8% <0.001 + Accommodation would help 25.4% 34.7% 9.3% <0.001

No. observations 1,233 1,246

Note: WLHQ="work limiting health question"

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Especially for The Employed*

Estimated Proportion of Population with Work-Limiting or Accommodation-Sensitive Health Problems

WLHQ asked…

First Last Diff. p-val.

A. Overall

% Report work-limiting health problem 16.3% 18.0% 1.7% 0.241 + Accommodated at workplace 20.6% 27.4% 6.8% <0.001 + Accommodation would help 25.4% 34.7% 9.3% <0.001

No. observations 1,233 1,246

* Note: reported work status not affected by question order. ¹¹

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Especially for The Employed*

WLHQ asked…

A. Overall

B. Working for Someone Else (63.4%)

No. observations 688 729

* Note: reported work status not affected by question order. ¹²

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Especially for The Employed*

WLHQ asked…

A. Overall

C. Self-Employed (7.3%)

% Report work-limiting health problem 14.8% 15.2% 0.5% 0.935 + Accommodated at workplace 19.2% 18.5% -0.7% 0.908

* Note: reported work status not affected by question order. ¹³

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Especially for The Employed*

WLHQ asked…

A. Overall

C. Self-Employed (7.3%)

% Report work-limiting health problem 14.8% 15.2% 0.5% 0.935 + Accommodated at workplace 19.2% 18.5% -0.7% 0.908

D. Not Working (29.3%)

% Report work-limiting health problem 39.2% 40.6% 1.4% 0.622 + Accommodation would help 43.2% 43.9% 0.7% 0.823

* Note: reported work status not affected by question order. ¹⁴

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Prevalence of Work Disability

Health Limits Work

19%

Health Does Not Limit Work

81%

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Accommodation Among Those Whose Health Limits Work

Health Does Not Limit Work

81%

Accommodated 10%

Accommodation Would Help

32%

Accommodation Not -Sensitive

58%

Health Limits Work

19%

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Accommodation Among Those Whose Health Does Not Limit Work

Health Limits Work 19%

Accommodated 11%

Accommodation Would Help

9%

Accommodation Not -Sensitive

80%

Health Does Not Limit Work

81%

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35% Have Work-Limiting or

Accomm.-Sensitive Health Problem

Health Limits Work & Not Accommodation

-Sensitive 11%

Accommodation Would Help

6%

Accommodated 2%

Accommodated Accommodation 9%

Would Help 7%

Health Does Not Limit Work &

Not

Accommodation -Sensitive

65%

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24% Accommodation-Sensitive; Of those, 46% Percent Accommodated

Health Limits Work & Not Accommodation

-Sensitive 11%

Accommodation Would Help Accommodated 6%

2%

Accommodated Accommodation 9%

Would Help 7%

Health Does Not Limit Work &

Not

Accommodation -Sensitive

65%

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Implications for Measuring Work Disability and Unmet Need

• Only 10% of those who say health limits work are accommodated, but…

• Most people who are accommodated say their health does not limit their work (83%)

• Adding the accommodation-sensitive

increases prevalence of work disability to 35%

– 24% of population “accommodation sensitive”

– Of these, 46% accommodated -> 54% unmet need

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Implications for Measuring Work Disability and Unmet Need

• Surveys like the HRS which condition

questions about accommodation on whether one reports a work-limiting health problem are biased in two ways:

– Misses those whose health problem is “fully”

accommodated (no longer limits work)

– Asking about work-limiting health problem first reduces reports of employer accommodation (primes respondents to think too severe?)

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Next Steps

• Match data from May 2014 to June 2015 follow up survey

• Measure health and work transitions one year later among those working in 2014

• Added measures of more general changes in working conditions, health (SF-12) and

“cognitive flexibility”

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Unmet Need for Workplace Accommodation