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UNITED STATES DEPARTMENT OF LABOR

Challenges persist under Americans with Disabilities Act Amendments Act: How can oncology providers help? (Feuerstein et al., 2017)

Review Guidelines

Causal Evidence Guidelines

Absence of conflict of interest.

Citation

Feuerstein, M., Gehrke, A. K., McMahon, B. T., & McMahon, M. C. (2017). Challenges persist under Americans with Disabilities Act Amendments Act: How can oncology providers help? Journal of Oncology Practice, 13(6), e543-e551. http://dx.doi.org/10.1200/JOP.2016.016758

Highlights

  • The study's objective was to examine the impact of the implementation of the American with Disabilities Amendments Act on discrimination allegations and their merit among people with cancer.  

  • The study used a nonexperimental design to compare discrimination allegations and their merit, pre and post Amendments Act. Using a subset of the Equal Employment Opportunity Commission Integrated Mission System data, the authors conducted statistical models to compare the number of allegations filed by claimants before and after the implementation of the Amendments Act. 

  • The study found that allegations of workplace discrimination involving terms of employment and relations were significantly more likely to be filed post ADA Amendments Act.  

  • This study receives a moderate evidence rating. This means we are somewhat confident that the estimated effects are attributable to the intervention, but other factors might also have contributed. 

Intervention Examined

American with Disabilities Act (ADA)

Features of the Intervention

The American with Disabilities Act (ADA) was passed in 1990 to protect individuals that have various impairments (e.g., behavioral, sensory, neurologic, or medical conditions, including cancer) that substantially limit a major life activity from discrimination in the workplace. The law was designed to protect individuals and provide legal coverage against discriminatory actions related to hiring practices, terms of employment, relations, provisions of reasonable accommodations, and termination of employment. Under Title I of the ADA an employee can file an allegation of discrimination if a personnel action was related to the existence or consequence of a disability.  

The ADA Amendments Act was passed in 2008 and became operational on January 1, 2009. The Act provides more comprehensive coverage for individuals with disabilities by expanding the definition of impairment and more accurately reflecting the natural history of many chronic illnesses. In addition, the coverage is more inclusive as it requires that employees maintain their status as an American with a disability even when their impairment improves (e.g., remission, managed through medications). Therefore, the ADA Amendments Act improved coverage for individuals with cancer who were undergoing active treatment. The ADA Amendments Act applies to working adults in the US with a chronic illness and served to improve coverage for individuals with cancer undergoing active treatment and expanded coverage for those who may have been denied in the past. 

Features of the Study

The study used a nonexperimental design to examine the impact of the ADA Amendments Act on discrimination allegations and their merit, before (2001 to 2008) and after (2008 to 2011) implementation. The study used a subset of the Equal Employment Opportunity Commission (EEOC) Integrated Mission System data, which is maintained by the National EEOC ADA Research Project. The authors restricted the data to maintain consistency with the typical working age range in the U.S. and included only claimants ages 18 to 64. The analyses also only included claimants with full sets of data on all retained variables. The variables included in the analysis were age, race, sex, employer industry, employer region, employer size, allegation type, and merit of the allegation as determined by the EEOC or federal courts. The final sample included 1,500 individuals with a history of cancer that had filed allegations. At the time of filing, the claimants ranged in age from 20 to 64 years old with an average age of 49. They were primarily female (65 percent) and worked at both small (31 percent) and large (44 percent) companies. The sample was spread across the U.S. geographic regions, with the largest subset from the Midwest (23 percent) and Southeast (26 percent). The treatment group included 1,209 individuals with cancer who filed an allegation between 2009 and 2011 (post-Amendments Act). The comparison group included 1,291 individuals with cancer who filed an allegation between 2001 and 2008 (pre-Amendments Act). The authors conducted a series of statistical models to compare the number of allegations filed by claimants and their merit before and after the implementation of the ADA Amendments Act.  

Findings

Employment 

  • The study found that claimants with cancer and cancer survivors were significantly more likely to file allegations related to terms and conditions of employment (e.g., promotion, forcing retirement, denying wage increases, ignoring seniority) after the implementation of the ADA Amendments Act. 

  • The study also found that claimants were significantly more likely to file allegations related to strained relations at work (e.g., harassment, intimidation, breach of confidentiality) after the implementation of the ADA Amendments Act. All other allegations did not change.  

  • The study found that the allegations involving terms of employment were also significantly more likely to be judged as having merit, supporting the validity of the claims. 

Causal Evidence Rating

The quality of causal evidence presented in this report is moderate because it was based on a well-implemented nonexperimental design. This means we are somewhat confident that the estimated effects are attributable to the implementation of the ADA Amendments Act, but other factors might also have contributed.  

Reviewed by CLEAR

February 2023

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