The occupational medicine physician, in consultation with appropriate experts and the employee, must determine the appropriate accommodation. The employer must then decide if the person is otherwise qualified. Can the employee do the job with the accommodation, and is the accommodation reasonable? These decisions are legally contentious because they reflect economic and policy questions about the workplace. For example, is it reasonable to employ a sign-language interpreter for a manual laborer when the cost of the interpreter may double the cost of employing the laborer? While the employer may consult with the occupational medicine physician about the accommodation, the physician should avoid making the determination of reasonability. Making such decisions will impair neutrality that the ADA seeks to preserve for the examining physician.
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