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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.

ADA: Disability-Related Inquiries and Medical Examinations; Terms and Conditions of Employment

November 7, 2000

Dear :

This is in response to your letter dated September 19, 2000, to Peggy Mastroianni regarding the Americans With Disabilities Act of 1990 (ADA or the Act). In connection with a book that you are writing about career issues for persons with mood disorders, you asked whether an employer can require an employee to take medication as a condition of employment.

As you know, the ADA prohibits an employer from discriminating against a "qualified individual with a disability" on the basis of disability. A "disability" is a physical or mental impairment that substantially limits a major life activity, a record of such impairment, or being regarded as having such an impairment. A "qualified individual with a disability" is a person with a disability who can perform the essential functions of the position held or desired with or without a reasonable accommodation. An employer must provide reasonable accommodation to the known physical or mental limitations of an otherwise qualified individual with a disability unless doing so would cause an undue hardship.

The Commission has never explicitly addressed the precise question you have asked. It has, however, emphasized that the decision to take medication should be made by the employee with a disability, and not by the employer. An employer instead should focus on whether an employee is having performance or conduct problems and deal with those problems accordingly.

For example, in its 1997 Enforcement Guidance on the Americans with Disabilities Act and Psychiatric Disabilities ("Psychiatric Guidance"), the Commission considered the question of how an employer should deal with an employee who is engaging in misconduct because of a failure to take medication. The Commission stated that the employer should focus on the employee's conduct and explain the consequences of continued misconduct. That explanation should be in terms of disciplinary procedures applied uniformly at the workplace. It is the employee's, not the employer's, responsibility to decide whether to take medication and to consider the consequences of not taking it. Psychiatric Guidance EEOC Notice No. 915.002, at 32, question no. 32 (March 25, 1997)(enclosed).

Further, the Commission has said that medication monitoring by the employer is not required as a reasonable accommodation. Employers do not have an obligation to monitor medication because doing so does not remove a barrier that is unique to the workplace. When people do not take medication as prescribed, it affects them on and off the job. Id. at 27-8, question no. 28; EEOC Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act ("Reasonable Accommodation Guidance"), EEOC Notice No. 915.003, at 49, question no. 36 (March 1, 1999)(enclosed). Moreover, an employer is not relieved of the obligation to provide a reasonable accommodation simply because an employee does not take medication as prescribed. Reasonable Accommodation Guidance, at 49-50, question no. 37 (March 1, 1999). We emphasized that there are many reasons, including side effects and even cost, why an employee might choose not to take medication. Id. Of course, if an employee refuses to take medication and as a result is not qualified for a job with or without a reasonable accommodation or poses a direct threat, then the employer can take appropriate action. Id.

I hope that this information has been helpful to you. Please note, however, that this letter is an informal discussion of the issues raised by you and is not an official opinion of the EEOC. In addition, our failure to address other matters that may have been presented should not be construed as agreement with statements or analysis related to those matters.


Christopher J. Kuczynski
Assistant Legal Counsel
ADA Policy Division


This page was last modified on April 27, 2007.