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Reasonable Accommodation for HIV

Reasonable accommodations for HIV might include periodic mental and communicable disease evaluations. The potential of dementia might disqualify employees from driving a truck, but it would not affect their ability to load the truck. The difference is that the employer can monitor the loading of the truck and correct problems without risk to others. Close monitoring of employees' performance and neurological status is an appropriate accommodation for HIV-infected employees. This may not be possible for employees engaged in activities that are so hazardous that sudden impairment would subject others to substantial harm.

The most problematic cases are HIV-infected persons who are knowledge workers in health and safety occupations--air traffic controllers, physicians, and others who must exercise critical judgment. If such a person is identified as an HIV carrier, the employer must monitor him or her closely to detect any diminution of mental capacity. For a physician, this may require practicing with a preceptor who will perform frequent chart reviews and supervision of procedures. Once there is any evidence of mental impairment, the physician may be allowed to continue practice only under the direct supervision of another qualified physician. For difficult-to-supervise jobs such as air traffic controllers, the first evidence of mental impairment would disqualify the individual from continued employment.

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