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EEOC Informal Discussion Letter

The U.S. Equal Employment Opportunity Commission

EEOC Office of Legal Counsel staff members wrote the following informal discussion letter in response to an inquiry from a member of the public. This letter is intended to provide an informal discussion of the noted issue and does not constitute an official opinion of the Commission.

Title VII - Medical Documentation in English

April 8, 2005


This is in response to your letter dated March 8, 2005. You state that many of your employees seek health care in Mexico and present medical excuses and notes in Spanish. You ask whether it is legal to require that employees' medical excuses and medical "special needs" reports be written in English. We can address the legality of a specific policy only after a charge has been filed. However, we will provide you with general guidance.

The United States Equal Employment Opportunity Commission (EEOC) enforces Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. § 2000e et seq. (Title VII), which prohibits employment discrimination on the bases of race, sex, color, national origin, and religion. The Commission has not issued guidance on the specific issue of whether an employer can require that medical documents be written in English, although it has addressed the issue of employers who have instituted workplace policies requiring that employees communicate only in English. See EEOC Compliance Manual, Section 13, "National Origin," Whether a policy of requiring communication in English violates Title VII must be decided on a case-by-case basis.

As a preliminary matter, it would be unlawful to require medical documentation in English if the purpose of the requirement was to discriminate on the basis of national origin. It would also be unlawful to require only some national origin groups to provide the documentation in English.

Assuming that the English requirement applies equally to all employees, it would discriminate on the basis of national origin only if it adversely affected the conditions of employment for members of a particular national origin group. For example, if most of your Hispanic employees have limited English proficiency and most non-Hispanic employees speak English, the policy is likely to adversely affect Hispanic employees because it may be more difficult to obtain medical documents in English. People are likely to seek medical help from persons who speak their language, and their physicians, in turn, are less likely to be fluent in English, especially if their practice is in Mexico. If medical notes written in English are a condition of returning to work after being on leave or are necessary to request "special attention" for "medical or handicap needs," the ability of these employees to work and/or request accommodation will be adversely affected.

Nevertheless, even if the requirement disproportionately affects Hispanic employees, you can maintain it if you can show that it is job related and consistent with business necessity. Generally, a policy that has an adverse impact is justified by "business necessity" if it is needed for an employer to operate safely or efficiently. It seems likely that your need is not merely to have something written in English, but to be able to understand why an employee needs to be absent or needs an accommodation. If so, you should consider whether there are alternatives that would be equally effective in meeting your business needs but have less adverse impact, such as using a qualified translator. Indeed, requiring a physician with limited English proficiency to write in English may not serve your need to understand the employee's medical condition. Apart from the potential adverse impact on employees, your own goals are likely to be better served by finding a qualified translator than by requiring that the documentation be written in English.

You could ask employees to try to obtain medical reports in English but make clear to them that it is not a requirement. To the extent that some physicians can provide accurate documentation in English, this step would at least reduce the non-English medical documentation that you receive.

We hope that this information is helpful to you. Please note, however, that this letter does not constitute an opinion or interpretation of the Commission within the meaning of ' 713(b) of Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. § 2000e-12(b).


Dianna B. Johnston
Assistant Legal Counsel

cc: Michael Fetzer, Director
Dallas District Office

This page was last modified on April 27, 2007.