From "Workplace: Disclosure and Accommodations" issue of Visions Journal, 2018, 13 (4), p. 24
Amy* was in trouble and she knew it. As a single mom with two children requiring special care and a demanding and stressful full-time job in a health care facility, she faced financial and emotional strain. She had been coping in her own way: with cocaine. But she had finally reached the point where she was scared for her own safety.
One day at work, Amy had an emotional breakdown. She started to act out towards her colleagues. She swore and was confrontational. As a result, she was called in to the human resources department to discuss her manager’s concerns about her behaviour. It was there that Amy made her best possible decision. She disclosed to her employer that she had an addiction to cocaine.
Instead of disciplining Amy for her erratic behaviour in the workplace, Amy’s employer was required by law to accommodate Amy’s addiction. Under the BC Human Rights Code, an employer cannot discriminate against an employee because of a mental disability.1 Legally, the definition of mental disability includes addiction to drugs or alcohol. This shifts the employer paradigm from discipline-oriented to treatment-oriented.
Luckily, Amy’s employer and Amy’s union, the Health Sciences Association of British Columbia (HSABC), are joint sponsors of the Enhanced Disability Management Program (EDMP), which assists employees who have disabilities to successfully return to work. Disability management programs are common in BC, as employers strive to comply with the law. Smaller employers, who may not have the resources to run their own programs, often contract the services of an outside organization to help manage disability accommodations in the workplace.
In addition to being a sponsor of the EDMP, HSABC includes a full-service disability management department, which consists of experienced labour relations officers, rehabilitation experts and lawyers. These professionals assist union members with a range of issues, including returning to work, accommodations, Workers’ Compensation Board (WCB) claims and long-term disability claims.
Amy was paired with a disability advisor from her employer and a labour relations officer from HSABC. The union and Amy’s employer met with Amy to discuss her addiction and set in motion a plan of action, and to determine how to get her back to work as soon as it was safe to do so. Amy was an active and consenting party in the process. Generally, accommodations are not effective if the individual with the disability does not support and participate in the plan of action.
Like most HSABC members, Amy is a paramedical professional. Paramedical professionals are employed in some of the most safety-sensitive positions in health care facilities. When a member has an addiction, HSABC labour relations officers work with employer representatives and the employee to ensure that the employee receives adequate treatment and monitoring and can eventually return to work safely and successfully.
In Amy’s case, this meant taking some time away from work and undergoing an assessment to determine what steps to take.
The first step was to ensure that Amy received appropriate treatment. HSABC and the employer agreed to send Amy to an addictions specialist for treatment recommendations, which included attending a residential treatment program, followed by two years of monitoring by an addiction monitoring company to ensure she was complying with abstinence.
Amy’s case required a unique approach because of the complex practical challenges she faced during the treatment and accommodation process. As the primary caregiver of two children who required special care, Amy carried a significant financial burden and had specific childcare needs. The recommended residential treatment program was several weeks’ duration. But Amy’s children had no other caregiver and Amy was the only income-earner in the family. Attending a residential program meant Amy would have to find and pay for additional care during a period without income.
HSABC requested clarification from the addictions specialist about whether an intensive outpatient program could be used instead. The addictions specialist endorsed this option. Amy was able to get the programming necessary for her treatment and return to work sooner, while maintaining her role as primary caregiver for her children. An earlier return to work meant less financial strain.
Amy’s privacy and her safety as a patient (and the safety of those around her) required a fine balancing act. Within a unionized context, there is always a push and pull between the need for employee privacy and the requirement for safety. Sometimes these two needs are in opposition; balancing them requires appropriate care and thoughtful deliberation.
On one hand, Amy was acting in good faith when she disclosed her addiction to her employer, and she was entitled to privacy. On the other hand, her employer needed to ensure Amy’s safety and the safety of the work environment and to prevent the risk of patient and employee harm. In order to do that, Amy’s employer had to disclose some of the details of Amy’s personal circumstances to specific individuals who would be involved in the treatment and accommodation plan.
To fulfill Amy’s particular treatment requirements, and to maintain work environment safety, Amy submitted to random blood sampling as part of the monitoring program, in order to ensure her system was free of cocaine. This in turn required that Amy leave her worksite on short notice. As in the case of most paramedical positions, Amy’s job offered no back-up options—there was no “substitute Amy.” If Amy was not seeing her patients, then her colleagues would have to fill in for her. This type of situation raises questions about fairness in workload and work performance. An easy solution would be to tell Amy’s colleagues that she was being treated for an addiction. This would explain the need for frequent short absences and any extended time away from work. But that would also be unfair to Amy, who has a right to privacy.
HSABC and Amy’s employer agreed that Amy’s direct supervisor would be advised that Amy had been ill but had been cleared to return to work. The supervisor was also told that, for the foreseeable future, Amy would need to attend medical appointments on a routine basis and on short notice. Finally, if there were any issues with Amy’s employment or workplace behaviour in the future, the supervisor was to contact the HSABC disability advisor.
In the EDMP, all medical information about employees is kept private. Amy’s medical information is not in her human resources file and not shared with supervisors or managers. Instead, her medical information is contained in a separate health file, which can only be accessed by HSABC disability advisors. And before the information is shared with anyone else, Amy must first give her authorization to have it shared.
Over the next two years, Amy continued to abstain from cocaine use and her medical privacy was maintained. Amy met regularly with her labour relations officer and her disability advisor. She successfully completed her outpatient programming and obtained counselling, sponsored through the EDMP, to help her manage the ongoing stress that had initially led her to use cocaine. After two years without relapse, Amy received from the monitoring company a certificate of successful completion of her monitoring agreement.
The temporary accommodations that had been put in place during Amy’s recovery are no longer necessary, and she has remained healthy at work without relapse—though should she relapse, the supports are in place to manage that possibility. But most importantly, Amy now has the tools to successfully cope with life stressors and maintain her sobriety.
*Amy is a pseudonym. Some facts have been changed to protect the identity and privacy of the individual. Amy’s experiences are common to many employees in various circumstances, communities or neighbourhoods
About the author
Adam is a lawyer for the Health Sciences Association of British Columbia (HSABC), a union that represents more than 18,000 health science professionals at over 250 hospitals and agencies in acute care, longterm care and community health. He helps HSABC members in various employment and labour matters, particularly disability management
BC Coroners Service. (2017). Illicit drug overdose deaths in BC January.