The Americans With Disabilities Act (ADA) and Irritable Bowel Syndrome (IBS)

July 26, 2012 marked the 22nd anniversary of the signing of the Americans with Disabilities Act of 1990 (ADA). This law was the result of years of advocacy and collaboration by numerous individuals, grassroots groups and organizations representing people with all types of disabilities, their family members, educators, health and human service professionals in the disability field, as well as prominent legislators and government officials from both major political parties, many of whom identified themselves or close family members as people with disabilities. At the time the ADA was originally signed, it was estimated, in the text of the law itself, that there were 43 million people with disabilities in the United States.  Figures released just this month from the most recent national census in 2010 now put the estimate at 56.7 million. (see page 4) The ADA was not the first national disability rights law in the U.S, nor has it been the last, but more than two decades later, it remains one of the more comprehensive ones.

Contrary to some popular misconceptions, the ADA does not include an exhaustive list of eligible disabilities.  A person with a disability is intentionally defined broadly as a person who has a “physical or mental impairment that substantially limits one or more major life activities” or who has “a record of such an impairment,”  in the past,  or who may experience potential discrimination because of being “regarded as having such an impairment,” whether the person actually has one or not.

In 2008, after 18 additional years of sustained advocacy throughout the U.S., the ADA Amendments Act was signed, in order to clarify the intent of the original law, as its protections had since been narrowed and eroded by court decisions. Among other points, these amendments made it clearer that the ADA also covers potentially disabling conditions that may come and go episodically, as well as conditions that impair major bodily functions, such as digestion and bowel function. The amendments also state that the extent of disability is to be determined by when it is active without regard to mitigating measures like medication or other types of assistance that might appear to improve or resolve the disability. All of these provisions in the amendments reinforce that conditions like IBS are potential disabilities under the law.

The law prohibits discrimination against “qualified individuals with disabilities” in five broad areas known as “titles.” Title I is for employment, covering all employers with 15 or more employees; state or local disability laws sometimes set lower numbers. Title II is for public services on the state or local government level, such as libraries or motor vehicle departments, police or other emergency services, courthouses and so on, including most public transportation.  Title III is for public accommodations or services owned by private entities such as stores, restaurants, hotels, banks, theaters and other recreational venues, hospitals, doctors, lawyers and so on. Title IV is for telecommunications access for those with hearing or speech impairments, and Title V is composed of miscellaneous minor provisions. The law requires that covered employers or other entities make “reasonable accommodations,” if necessary, for people with disabilities if doing so would not pose an “undue hardship” to the employer or entity. What is considered “reasonable” or “undue hardship” is also meant to be flexible enough to encompass a wide variety of individual situations. A large corporate employer or chain of retail stores would generally be expected to have more resources to provide accommodations or to remove barriers that make a physical premises or service inaccessible than a smaller employer or business.

The law presumes that the person with the disability is the one with the right to decide whether or not to disclose the disability and the responsibility to ask for any needed accommodations. Employers are only allowed to require medical exams after hiring if these are directly related to the “essential functions” of a position and are uniformly asked of all employees in a similar class of positions. Any disability information disclosed is considered confidential, to be shared only with those with a legitimate need to know, but obviously, individuals who choose not to self-identify as people with disabilities in the first place or to indicate any accommodations that may or may not be needed cannot claim legal protection under the ADA.

The following link is the full text of the Americans with Disabilities Act, as amended. Another article on work and school, disability benefits and the ADA is on the advocacy page of the IBS Impact main site, which also contains  links to articles on the subject by Dr. Barbara Bradley Bolen, the IBS Guide. Scroll down on the linked page to find it.

Please note that disability-related access to federal government entities, airlines, housing, communications and video, and the education of children with disabilities from preschool through high school are primarily covered by different U.S. laws, though there may be some overlap in a given situation. The ADA also does not affect eligibility for disability benefits. Please see the August 12, 2011 post for more information on U.S. veteran disability compensation for IBS and other functional GI disorders and the January 17, 2012 post for a brief discussion of U.S. Social Security and IBS.

For our readers outside the U.S., links to disability information in several English-speaking countries are available on the links page of the main IBS Impact site.  Some of these nations also have their own disability rights laws and IBS Impact encourages your input on your experiences, as well as resources and issues of concern specific to your countries.

Some members of IBS Impact, including its founder, have personal and/or professional experience with the broader cross-disability advocacy community and would be pleased to share further information and resources and to answer general questions on this blog,  although for those with actual current legal situations of concern, please consult an attorney experienced in disability law in your locality. IBS Impact was founded with the hope that the IBS community will one day emulate the cross-disability, bipartisan coalitions, stretching back to as early as the 1960s,  that made legislative and social advances like the Americans with Disabilities Act possible. May people with IBS become strong and visible advocacy voices for ourselves and our needs around the globe.

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