[HumanSer] Work Accommodation Concerns

Mon Jun 2 08:22:43 UTC 2025

Hi Sarah,
So sorry you’re having these difficulties. I worked for a business organization which implemented an inaccessible database system and did nothing to provide accommodation other than to tell me that I could not do half of my job and deprive me of the opportunity to have access to the materials, I needed to professionally complete tasks. I don’t want to say much publicly here, as I went to court to fight this after making numerous attempts to request that they make their programs accessible. Happy to talk with you off-line if you like. Unfortunately, this is not something where legal presidents are clear. I believe you know how to get in touch with me. Please feel free to call.
So sorry you are having these difficulties.
Amy.
Sent from my iPhone

> On Jun 1, 2025, at 11:11 PM, Sarah Meyer via HumanSer <humanser at nfbnet.org> wrote:
> 
> Hello,
> 
> I have been employed at a community mental health agency for 2 years now =
> as
> a therapist and it has been the most challenging experience of my life =
> in
> terms of not having effective reasonable accommodations to do my job. I =
> will
> try to keep this as brief as possible because it has become such a =
> complex
> situation but apologize in advance for the length. I will share some of =
> the
> major issues and my questions below. This is honestly a very vulnerable
> message for me so I just ask for grace and some gentleness in responses.
> 
> =20
> 
> Problems:
> 
> *    Despite having discussions prior to my hire and ongoing advocacy
> efforts, as well as reassurances from the agency for months that they =
> were
> prioritizing accessibility to the EMR because they recognized that our
> work-arounds would not be sustainable/effective, I have never had access =
> to
> use any aspect of our EMR (NextGen) with JAWS or any other screen =
> reading
> options. I believe some of the issues are that NextGen is housed on a =
> Remote
> Desktop, but most notably that the agency has never used the latest =
> version
> of the EMR which NextGen has indicated would be most likely to be
> compatible/accessible with JAWS because that is where their developers =
> have
> invested their efforts to meeting accessibility guidelines/requirements.
> *    The agency has indicated JAWS scripting is too expensive. They never
> engaged with me or VR when trying to reach out to explore if VR could =
> help
> with some of the cost.
> *    I had to fight to get them to consider work-arounds for months
> because they insisted they were "so close" to providing accessibility =
> for me
> to independently access NextGen. Eventually I got them to be willing to =
> try
> using Word templates for me to do documentation, which I then sent to my
> supervisor and other leadership to upload into the database. The =
> templates
> have had a lot of accessibility barriers themselves, and it has been
> challenging, to say the least, to acquire information from client charts =
> in
> accessible formats. Additionally, I can't access the calendar, =
> scheduling
> features, notifications of client arrivals, communication
> intra-professionally with members of other teams involved in clients' =
> care,
> etc. Other staff indicated repeatedly that they knew our work-arounds =
> were
> short-term and not truly sustainable (for me, for them, for quality =
> client
> care).
> *    I've proposed other options including Aira, Seeing AI on work cell,
> installation of my own provided Kurzweil 1000 and Duxbury Braille
> Translation software onto work laptop to try to make various materials =
> more
> accessible, and several other accommodations proposed. I also use a =
> Focus 40
> Braille Display which has had a lot of problems not pairing via =
> Bluetooth. I
> have requested permission to transfer documents via SD card between =
> Focus
> display and laptop but have never received a solid response though they =
> have
> previously been very hesitant to allow use of flash drives or anything =
> that
> could potentially cause concerns about privacy, which I understand from
> their perspective. Wired connection with laptop works better, though =
> still
> has issues, and JAWS has had other issues as well.
> *    The toll of chronic inaccessibility and having to work so much extra
> to compensate for these barriers, which also apply to trainings and =
> other
> aspects of the job beyond the EMR accessibility barriers, have =
> repeatedly
> exacerbated symptoms of multiple other chronic health disabilities. I
> eventually had to go on an extended medical leave last year. I =
> continually
> have tried advocating and have frequently received no response, =
> inaccurate
> follow-up, dismissiveness, and have faced an often hostile and =
> intimidating
> work environment when I have tried to speak up and advocate.
> *    When I returned from my leave last Fall, I truly hoped there would
> be improvements; however, the agency has actually doubled down and =
> indicated
> that the supposedly temporary work-arounds, which failed miserably =
> before,
> are now the ongoing "accommodation system." They have come up with some =
> new
> methods for notifying me of client arrivals, and there has been some
> improvement in support staff notifying me of scheduled client =
> appointments
> and cancellations, but this has been inconsistent. The client =
> documentation
> I've requested to prepare for sessions and help with pre-filling my
> templates has at times been missing crucial information, not provided, =
> and
> is filled with accessibility problems in their efforts to convert
> inaccessible PDFs into Word files. The templates I am using for =
> completing
> documentation are still in process of being revised for accessibility =
> and
> the burden has been placed on me to provide written narratives of the =
> issues
> so they can "fix them". Until recently, leadership would not meet with =
> me,
> and this has been inconsistent.
> *    I've requested having a visual assistant and have yet to receive a
> response.
> *    The agency has been through significant transitions with "merging"
> under a larger umbrella parent company which has also caused a lot of
> confusion and worsened miscommunications. I also have had issues with
> getting clear, accurate, timely, accessible information and =
> determinations
> of my leave time accommodation requests to manage my other health =
> concerns,
> especially during the transition to new leave management entities. I was
> allowed to work remotely in the past when seeing clients, and during the
> training refresher/catching up upon my return to work, but I was =
> recently
> informed that I am only allowed to conduct client sessions from the =
> office
> and only when team leader coverage, support staff, and crisis staff are =
> on
> site. (Never mind that many other staff are working hybrid due to =
> limited
> office space, work modified schedules including seeing clients past 5PM,
> etc.).
> *    I have been told I've been provided all the necessary accommodations
> to fulfill the essential functions of my job, despite my and my medical
> providers' statements that this is not accurate. I have received =
> corrective
> action notices/statements and discussions which place all the
> blame/responsibility on me for problems with note timeliness, session =
> length
> (running over on time), running late to sessions, etc., without
> acknowledgement of how the accessibility barriers play a significant =
> role.
> *    I am burned out but I care so much about my clients and believe I
> have unique assets and skills to support them and the mission of the =
> agency,
> plus I am not fully licensed and need the supervision (I am close to =
> being
> able to apply for full LMHC licensure which would open more options).
> 
> =20
> 
> Questions:
> 
> *    I know several folks here have shared about work-arounds to
> compensate for inaccessibility; I am wondering where you draw the line,
> especially in community mental health where the service delivery and
> documentation expectations/demands are so high and able-bodied staff =
> even
> say they struggle to keep up with all of the expectations? I have never =
> been
> able to reach a full case load and service delivery because of the
> accessibility barriers and how much I've struggled to keep up as a =
> result.
> It's hard to not internalize and beat myself up for not being able to =
> put in
> all of the extra time and energy to compensate, especially because of =
> the
> toll this has taken on my own physical and mental health.
> *    If you have worked in a community mental health or otherwise
> fast-paced, high demand setting, and had either very limited or no =
> access to
> the EMR, how did you keep up with service delivery and note timeliness
> standards? How much work-life balance has been realistic? I understand =
> this
> can vary for each person. What accommodations have been non-negotiables =
> for
> you?
> 
> =20
> 
> There's unfortunately more but I have already shared quite a lot here.
> Please feel free to ask questions if you need additional clarification. =
> I
> readily admit I do have areas I am constantly needing to improve in,
> especially when it comes to time management and being more concise (I do
> have ADHD which I am still learning to navigate and again I know there =
> is
> overlap with the impact of my other chronic health disabilities; I was =
> so
> much better at pushing past my limits in school and college/grad school =
> but
> chronic override of self-care is never sustainable).
> 
> Thanks in advance for taking the time to read and share any feedback.
> 
> =20
> 
> Sincerely,
> 
> Sarah
> 
> =20
> 
> Sarah K. Meyer, MA, LMHCA (she/her)
> 
> (317) 402-6632
> 
> <mailto:Sarah.meyer55 at gmail.com> Sarah.meyer55 at gmail.com
> 
> =20
> 
> "Although the world is full of suffering, it is full also of the =
> overcoming
> of it. My optimism, then, does not rest on the absence of evil, but on a
> glad belief in the preponderance of good and a willing effort always to
> cooperate with the good, that it may prevail." =AF Helen Keller
> 
> =20
> 
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