From the desk of Sarah Small, M.S., CRC, Consultant – Cognitive/Neurological Team
Imagine you live in New York City and work for a company that is being relocated to a different building. The move is coming up and, as the supervisor, one of your employees approaches you to ask for an accommodation after hearing the news that the department will be assigned to the 12th floor. The employee states that he has a phobia of heights and is concerned about his ability to work that high up in the building. Suddenly you are thinking, “Wait, I have a fear of heights. I would never ride a Ferris wheel, but I live on the top floor of my apartment complex. What is the difference?”
According to the Mayo Clinic, a specific phobia is “an intense, persistent fear of a specific object or situation that’s out of proportion to the actual risk.” The fear or anxiety triggers an immediate response that is stronger than the actual danger involved. Many types of phobias exist and it is not uncommon for someone to have multiple phobias or a phobia in addition to another type of anxiety disorder. You might be familiar with some of the terms such as claustrophobia, the fear of being confined to a space, or in the above example acrophobia, the fear of heights.
When it comes to the difference between a fear and a phobia, one key factor might be the term persistent. We all experience fear and may even encounter times of extreme fear during our lifetime. However, a phobia is a persistent fear that elicits the same reaction when the person encounters the trigger. If someone has a specific phobia they might do anything it takes to avoid encountering the object or situation even if that means isolating themselves or giving up something that they love. If someone has a specific phobia it can affect them in all aspects of life, including the workplace.
When it comes to workplace situations, there may be a need to consider reasonable accommodations to help someone who is having difficulty due to a phobia. We commonly receive questions here at JAN as to whether a person with a phobia is covered by the ADA. This is a tough question because there is no direct answer. In fact, when it comes to any disability or medical condition there is not a yes or no response. Under the ADA, there is no set list of disabilities or medical conditions. Instead, it is about determining whether a specific person meets the ADA’s definition of disability, which is “a physical or mental impairment that substantially limits one or more major life activities”.
If an employee were to approach an employer about a phobia, the employer would want to acknowledge the request and engage in the interactive process, not brush it off or assume that because everyone has something they are afraid of there is no need to consider it. The employer would, however, be able to ask for some medical documentation to help support the need for accommodation. The Equal Employment Opportunity Commission (EEOC) states that an employer may ask for limited medical documentation any time that a condition is not known or obvious. Because a phobia is not typically something that would be obvious, the employer would be able to ask for the documentation as a part of the interactive process unless the employee previously provided documentation.
This brings us to another tricky question regarding phobias. What if the person does not have documentation? With conditions like phobias, people who do not have a separate underlying condition may not have talked to their doctors about it. Instead, they may have developed their own coping mechanisms to avoid or deal with the phobia. It could be that the workplace situation is the first time they have faced a significant issue.
What does this mean for employers? If an employee approaches you about a phobia in the workplace, acknowledge that they are coming to you with the concern and further the conversation. If the employee has documentation, great. If they do not, then consider what you know and assess if you feel there is enough to move towards looking at accommodations. While an employer is entitled to medical documentation, it is also not a requirement. When it comes to phobias you might be able to consider if something can be done simply by talking with the employee about the situation. If you do feel that gathering some documentation is needed you might ask the employee if that might be possible or refer them to an employee assistance program (EAP) if it could be helpful.
What does this mean for employees? If you are having difficulty in the workplace due to a phobia it may be something that asking for an accommodation could help with. If you have documentation, you might be prepared to share it if needed. If you do not have documentation, you might try to explain as best as you can how the phobia is affecting you at work. Any information you can give about the limitations you are experiencing and how the accommodation will be beneficial can play a part in helping the employer understand. If the employer is insistent that documentation is a part of its interactive process then you might consider having the conversation with your doctor or see if there might be services available to you such as an EAP that might be able to help with the process.
At the end of the day, the important thing to remember is that all disabilities and medical conditions are individualized. What affects one person may affect someone else in a completely different way. It’s important to remember that the same goes for fear; while someone may be afraid of heights, it does not mean that everyone who is afraid of heights feels exactly the same. If someone tells you they have a phobia, don’t make assumptions; simply engage in the conversation.