Disability & Working in Non-Profits

Joeita Gupta:
I'm Joeita Gupta, and this is The Pulse. The workplace disability accommodation process can get really challenging for some people with disabilities. Not always, and not for everyone, but often. Employees with disabilities struggle with questions such as, "What accommodations can I ask for? When is the right time to ask? And even, who should I be asking?" On top of that, many are forced to provide medical documentation to validate their lived experience and verify their disability. It can be really invasive to provide intimate details about one's disability, perceived limitations, and what accommodations are needed to modify the role or even the workplace environment.
So perhaps, there is another way to make workplaces more inclusive of workers with disabilities to better utilize their skills and strengths. Today, we discuss disability and workplace accommodations. It's time to put your finger on the pulse.
Hello and welcome to The Pulse on AMI-audio. I'm Joeita Gupta joining you from the AMI Studios in Toronto. My hair is in a pretty messy bun, which I'm really glad you can't actually get to see, but my hair is pulled back in a bun and I'm wearing a shirt with three-quarter sleeves and a V-neck and a couple of buttons down the front. There are about three buttons there. And the shirt is in a burnt orange or mustard depending on the light in which you see it. So it's a really nice fit for the spring-summer. I love this particular shirt and I might wear it again on the program.
But enough about my wardrobe. That's not what we're here for today. I have a really incredible guest who's done years of work in the field of disability and employment. Alexis Buettgen is a postdoctoral fellow in the Department of Economics at McMaster University and has done some work with me in the past. Alexis, hello and welcome to The Pulse. I believe this is your first time on the show.

Alexis Buettgen:
It is. Thank you so much for having me. It's a pleasure.

Joeita Gupta:
As I mentioned, you've done a lot of work in the field of disability, workplace accommodations and employment. What piqued your interest?

Alexis Buettgen:
Well, I've had a long concern about the problem of profound poverty experienced by people with disabilities in Canada and around the world. I myself grew up in a low-income family and experienced some of the challenges of dealing with social assistance systems and welfare and so on. And then even though I don't identify as a person with a disability, I started working in social services with people labelled with intellectual disabilities and found so many people were unemployed, couldn't find work, living on a meagre disability income every month.
And I started to wonder, why is this that so many people are living in this way? It doesn't seem right that just because you have a disability, you're almost always necessarily poor. And then when I started doing some more international work, it became even more obvious, the connection there. And so I started wondering about employment as a potential solution to work as something that gets promoted a lot by government narratives and policies and so on. A lot of investment goes into trying to get people with disabilities jobs, but I was a bit critical of it because I thought, what kinds of jobs are people getting? Are the actions actually going to provide them with a better quality of life and more income?
So I've been exploring that for a while. So really, I guess I would describe it as a critical exploration of work and employment at the potential solution to poverty, but not thinking that it's the only thing for sure.

Joeita Gupta:
Now, your article was published in the Canadian Journal of Disability Studies, and it's called From the Standpoint of Employees with Disabilities: An Analysis of Workplace Accommodation Processes in the Non-Profit Sector. What got you thinking about the non-profit sector specifically?

Alexis Buettgen:
Well, as I just said, I started my career working in social services. And that was 20-something years ago. And did that work because I wanted to promote social justice, and I thought that's the place to do it. But I started to see that there were a lot of barriers and challenges in terms of how the social service and human service system was able to actually meet the needs of the people that they were supporting. And I've since gone on to do quite a bit of community-based research, working with non-profits to do program evaluation and thinking about and supporting them to look at whether or not their services and programs are actually doing what they are intending to do.
So thinking about employment, I thought the non-profit sector also is a big player in terms of promoting the employment of people with disabilities, are they doing that themselves? And since they work with the social justice agenda, that could potentially be a really great place to promote inclusive employment. And having had experience in the sector and wanted to explore it a little bit more deeply.

Joeita Gupta:
I'll grant you that this might be a bit of an oversimplification, and please call me on it if it is, but are people with disabilities more likely to be employed in the non-profit sector versus a for-profit sector?

Alexis Buettgen:
So there are limited statistics to show where people are getting jobs, but my research indicates that the non-profit sector can indeed be a potential site for inclusive employment and to potentially be more open to employing people with disabilities because they work from a vantage point of thinking about the skills and abilities of people who are historically marginalized and oppressed from various places in society. So it also is, in Canada and in Ontario in particular, it's a huge employer overall. It's a huge sector. There's lots of opportunity for work and lots of opportunity to provide decent work. So statistics are, I would say, that would need to be explored a little bit more. That's not entirely clear, but there's opportunity there.

Joeita Gupta:
Absolutely. And anyway, this is just anecdotally, everybody I know within the disability community that is working, I would say predominantly they're working in the non-profit. But mind you, that could just be my friend circle, so don't quote me on that. Tell me a little bit about the study and what your objectives were with this study that has since become the paper published in the Canadian Journal of Disability Studies.

Alexis Buettgen:
Yeah. So this study was actually my dissertation that I did for my Ph.D. in critical disability studies at York University. And it was a study to do a little bit of a... I've just been talking about exploring the potential for inclusive employment in the non-profit sector. And so the study was really about looking for opportunities and looking for solutions. Studying issues of poverty nationally and internationally, it can really wear you down. And so I was very interested in thinking, okay, so what's working well? And let's look at... I wanted to look at organizations that received awards or recognition or had a long history of doing inclusive employment, and capturing those processes, documenting them, understanding how they work, and then sharing that knowledge outward, which is what led to this paper.
So I looked at three organizations in the non-profit service-providing sector. So those are organizations providing services to different groups of people. Two of the organizations... Like I said, three organizations. Two were organizations run by and for people with disabilities. And another was a larger organization that had a broader mandate and was not run by people with disabilities that had a significant chunk of their workforce included people with disabilities. So really it was a study to look at also the ways in which policies and laws influence and impact the possibilities for inclusive employment in the non-profit sector.

Joeita Gupta:
The Ontario Human Rights Code, and indeed other Human Rights Codes across the country, talk about an employer's duty to accommodate an employee with a disability up to the point of undue hardship. So how did the three employers that you talked to within the non-profit sector manage their duty to accommodate? Did they have the same approach or did they have divergent approaches?

Alexis Buettgen:
They were similar in the way that they all used the Ontario Human Rights Code as their, what I call a governing text, drawing from the methodology of institutional analysis that I used for this study. So they all drew from the code in terms of providing reasonable accommodation, as you were saying, up to the point of undue hardship. The two organizations, run by and for people with disabilities are what we call OPD, organizations of persons with disabilities, they provided workplace accommodations in terms of meeting with employees directly that made an accommodation request, and they did not ask for medical documentation in that process.
They met with employees, they talked with them about their needs, they talked about what the needs of the job were, and they negotiated back and forth and came to a decision together in terms of how people were going to be accommodated in their job. So they did that. That process overall was the same as the third organization, organization C I call it in my paper is that the organization C also received an accommodation request from an employee. They've met with the employee, they talked with them about their needs, they talked about the needs of the job, and then they implemented an accommodation plan.
But the third organization, they also employed a disability management specialist who worked with the human resource representative, who then before providing any accommodation to an employee, would require the employee to go to their doctor and get a note to describe their functional limitation and what they were or were not able to do in their job and provide medical documentation. And that was really the basis for the way in which the accommodation was designed. They included the input of the employee, but they looked to the medical documentation and required that as a key piece of the accommodation plan.

Joeita Gupta:
Isn't that interesting? So in the first two organizations, the OPDs, the organizations of persons with disabilities, it sounds like they didn't really lean on the medical advice as much as they did on the lived experience of people with disabilities. Whereas in the third organization, which I should note is quite a bit larger than the other two, they bring in an outside expert, and they also ask for this functional limitation assessment and they want a doctor's note. Do you have any ideas as to why they took such different approaches?

Alexis Buettgen:
As I said, all three organizations, they use the Ontario Human Rights Code for guidance in the process, and they all followed that policy and that law correctly. However, there's different ways in which the Ontario Human Rights Code can be interpreted. It has a principle around inclusive design, for example, and this was the principle that was highlighted for the OPDs where they looked at how they can design their workplace and even individual jobs to meet the needs and interests of the people they employ as well as the needs and interest of the organization.
So they engaged in some constant iterative approach of designing the workplace and designing the jobs in order to really capture the strength and the skills and the abilities of the people that worked there, and then advance the organization in that way. But the other part of the code, which organization C leaned on more was the possibility to require medical evidence to move forward with the accommodation process, and that this can be used to help supplement the accommodation request to provide more information in order to provide an accommodation.
And so you can do this legally to provide accommodation for someone by getting information from their doctor about what somebody can and can't do, and then using that information to figure out what the possibilities are for accommodations. So that was really one of the key differences there. The OPDs knew that they could use medical documentation in their workplace accommodation process, but they explicitly didn't use it because they, as an organization that was really steeped in disability issues, believed that it was important to work directly with employees with disabilities and understand their lived experience, their capabilities, as well as their limitation in order to help them be as productive and effective in the workplace as possible and be creative in the way in which they did that.
So they actively resisted this use of medical documentation because it really abstracts the individual from their lived experience and places the authority and the power really more so in the hands of medical professionals to decide and describe what someone can and can't do. And not all doctors or medical professionals do that purposely, but when you lean on that kind of documentation, then there's a shift in power there. And it also can create some distrust between employers and employees when you lean more towards medical evidence for this. So that was something that the OPDs really resisted in the way that they did their accommodation processes.

Joeita Gupta:
Do you think that that way of accommodating employees with disabilities, leaning on lived experience, having conversations, creating an inclusive environment, that is just more feasible for a smaller organization? If you look at organization C, they did have 500 staff. And when you factor in the scale and the size of the organization, it's possible that your direct supervisor isn't actually going to be the person who signs off on your accommodations. So how do we take what works for organizations A and B and apply it to a bigger organization like organization C?

Alexis Buettgen:
So one of the things that I do mention in this paper, what my colleague and I, Emile Tompa is the co-author, is that there's, I think, a need for more research in terms of how to resist medical documentation in larger organizations. And the thing that we found was that the use of medical documentation meant that the accommodation process took more time, it took more resources, it disrupted an employee's ability to get an accommodation quickly and get back to work and do what they needed to do or to take the time that they needed in order to get back to work at some point.
So in terms of a large organization, I think it actually could be more efficient to eliminate the need for medical documentation and just talk directly with your employees about what their needs are, what their interests are, what the needs of the organization are, and have this much more collaborative, inclusive process, which builds trust, which can build loyalty, it can build engagement in an organization and actually help reduce turnover in that regard. So there's a lot of benefits to doing that in a larger organization.
And really the crux of all this and the thing that bothers me the most is to think about why there's a need for medical documentation, what's the rationale for asking for it? And previous literature talks about this, that it can actually be steeped in this idea that people might be faking disability, that they might not actually experience an impairment that would affect their job, that somehow, people aren't being believed for their own lived experience. What they say about what they need and what they want in their job to do their job may not actually be true. And so, therefore, you need to look to some sort of outside expert for that.
And so I think that in any organization, big or small, and regardless of the sector, before asking for medical documentation to think about why, what's the need for the medical documentation, what's the rationale for it?

Joeita Gupta:
Right. And if you think about other identity markers that require accommodations, let's just take religious accommodations. You don't have to prove your religion if you need a day off or if you need some kind of religious accommodations. Why are people with disabilities expected to prove their disability? Why isn't it enough to say, "I need X, Y, or Z?"

Alexis Buettgen:
Yeah. Well, exactly. That's a good question. And I mean, that point that you're making about when people ask for religious accommodations, the Ontario Human Rights Code also, in it's related policy, does also say that accommodations can be provided without the requirement of any other documentation or any other external specialist or professional or credible figure in order to say that somebody is indeed owed or deserves a religious accommodation. So it is possible to do things differently in that way.
But for people with disabilities, the literature point all the way back to the 1800s and the English poor laws that existed in terms of thinking about who was worthy and who was unworthy of support for social assistance. And so people with disabilities have often been thrown into this group of those who are potentially unworthy of dignity, mutual respect, respect for human difference and so on. And so I think it really has a lot to do with the fact that there's some challenges around thinking about distributive criteria and who deserves what when it comes to any sort of social assistance broadly understood in terms of mutual support, support in the workplace, support via government policy or programs and so on.
So it really, I think, goes back to that, and this overarching myth of disability fraud, again, that people are faking it in order to get some sort of free handout. And that's simply not the case.

Joeita Gupta:
Yeah. No, it's not. And the other thing around this with non-profits particularly, is that non-profits often get a lot of their funding, perhaps from the government, they might get fundings from private foundations. And with every funder, there are oodles of strings attached, as you can imagine.

Alexis Buettgen:
Yeah.

Joeita Gupta:
So how do non-profits negotiate those conversations? Because oftentimes, the requirement to get medical documentation may not be because the executive director or the management in the non-profit wants it, but they feel that they need to do things a particular way in order to remain accountable and transparent to their funders. How do they negotiate that particular issue?

Alexis Buettgen:
Well, the folks that I talked to, the senior managers at the organizations that did not require medical documentation describe this in terms of concept that we describe in the paper, of everyday resistance. So resisting the norm that force non-profit to engage in oppressive practices, such as forcing somebody to go to a doctor to get a note to prove they are disabled. So they did this in a very intelligent way, I think, in terms of knowing and understanding the system and what was possible and what was not possible, thinking about both formal and informal accommodation processes in that way.
They were also, because they worked from an inclusive design principle, they were able to easily, and they had already created workplace structures that were more accessible and inclusive in the first place, so it didn't cost them a lot of money to provide accommodation. But even though it did cost money, they still invested in that because it actually made them more productive and more effective, which would then they'd be able to go back to their funder and demonstrate their outcomes and impacts because their workers were working well, they were engaged, they were happy, they were accommodated, they were supported, and that helped them meet the deliverables to be accountable to their funder.
However, it was talked about in organization C, the one that did use medical documentation, is one reason why they used medical documentation was because of concerns about their funder. And so in that case, there may be situations in which these desires to want to resist medical documentation might bump up into other systems and other policies and other accountability measures. And in which case, I would encourage employers and the non-profit sector to really think critically about that and think outside the box in terms of what's possible.
And read this paper and look at the ways in which other organizations have done it without providing or requiring medical documentation. And also thinking about the ways that they accommodate other people, like y'all parents who need to pick up their children at a certain time or provide childcare responsibilities or other caregiving responsibilities, and how is that managed. So I think COVID also presents a lot of opportunities for us to think about work in a much more flexible and adaptable way.

Joeita Gupta:
I've only got about a minute to ask you a big question, so I hope you'll indulge me on this. Non-profits are primarily mission-driven. And so if we were to really change the way we do accommodations for people with disabilities and incorporate the inclusive design principles that you talked about, do away with the medical model and rely on lived experience, how can this impact the mission, vision, values and mandate of a non-profit organization? Does it have ripple effects beyond the employees in question to actually change how these non-profits do their work and how they help the community?

Alexis Buettgen:
My research says absolutely yes, that placing value on employee experience with disability, employing a significant number of people with disabilities in the workplace helps the organization to place explicit value on lived experience of oppression, of marginalization, that highlights adaptability, resourcefulness, subjugated knowledges of people with disabilities. And this gets passed on to clients or people who use non-profit services because workers with disabilities can use their lived experience to support others. It also helps us think differently about this idea of dependence and start thinking about how we can work independently and support one another in the workplace, in the community, in society, and really thinking about the particularity of various lived embodiment and human diversity. So it has a lot of benefits that way.

Joeita Gupta:
Subjugated knowledges. I'm glad you said it, so I don't have to. Hey, Alexis, thank you very much for being on the program today. It was so great talking to you about your paper, and you do such great work.

Alexis Buettgen:
Thanks. Thank you. Thank you.

Joeita Gupta:
Alexis Buettgen is a post-doctoral fellow in the Department of Economics at McMaster University. Folks, I know workplace accommodation is a burning topic and we could keep talking about it, but I got to run. It was great being with you today. If you want to provide some feedback, whether it's on the color of my shirt or on the excellent study we talked about today, you can find us on Twitter at @amiaudio. Use the hashtag #pulseami. You can write us an email, feedback@ami.ca. Thank you to those of you who do send emails. I try and get back to you individually, even if I don't have a chance to read the emails out on air.
But keep those emails coming. And of course, not that any of you have, but do consider giving us a call and leaving a voicemail. We will play those on air. You can give us a call at (1866) 509-4545. That's (1866) 509-4545. Don't forget to leave your permission to play the voicemail on the program. Well, as I said, that's it for us today. Ted Cooper has been our videographer. Ryan Delehanty is the coordinator for podcast at AMI-audio. Marc Aflalo is our technical producer. Andy Frank is the manager for AMI-audio. And I've been your host Joeita Gupta. Thanks for listening.