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Accommodation: Can You Ask Employees to Undergo An Independent Medical Examination?

By November 1, 2017November 28th, 2019Employment Law

Accommodation is a process mandated by the Ontario Human Rights Code where an employee requires some sort of modification to their schedule or duties due to disability or some other reason protected by the Human Rights Code (i.e. family obligations, addiction, religious needs, etc.).

Employers are required to accommodate employees who genuinely require accommodation to the point of undue hardship.  For more on what may be considered “undue hardship” read To What Extent Do Dentists Have to Accommodate Employees.

In certain circumstances, and as part of the accommodation process, employers may ask employees to provide a doctor’s note outlining the prognosis and any accommodation requirements which the employee needs to return to work. For more information on your obligations when an employee is sick, read Staff On Sick Leave: What Are Your Obligations As An Employer. But what happens if that note is contradictory (i.e. says the employee does not need accommodation but you notice that the employee cannot perform their job due to the disability) or if the note is from a doctor who is unqualified (i.e. the employee brings a note from their chiropractor regarding the employee’s cancer treatment – a medical issue they are unqualified to diagnose or treat)? Well in circumstances such as these, employers may be justified in asking for a second opinion or independent medical examination (“IME”).

Recent Case Law

Recently, the Ontario Divisional Court upheld a decision by the Human Rights Tribunal which ruled that an employer may, in certain instances, require an employee to undergo an independent medical examination (“IME”) during the accommodation process without the need for specific contractual provisions (Bottiglia v. Ottawa Catholic School Board, 2017 ONSC 2517).  Mr. Bottiglia had worked for the Ottawa Catholic School Board (“OCSB”) for over 40 years.  He started off as a teacher and progressed to superintendent.  Mr. Bottiglia became ill in 2010 and was unable to work for approximately two years. He communicated in February 2012 that he was unable to return to work and that his recovery would take a prolonged period of time. In June 2012, the OCSB received a letter from Mr. Bottiglia’s doctor stating that he was unable to attend work and that a return to the OCSB might place him at a serious risk of a relapse. Then in August 2012, the OCSB was told that Mr. Bottiglia was capable of returning to work on a limited basis sometime in the next two months. The OCSB required Mr. Bottiglia to submit to an IME with a doctor of their choosing. Mr. Bottiglia refused to do so and filed a complaint of discrimination with the Human Rights Tribunal.

The Tribunal assessed Mr. Bottiglia’s case and found it reasonable, given the significant and unexpected changes in Mr. Battiglia’s stated ability to return to work, that the OCSB would want further information about his medical condition and ability to return to work. The OCSB also found it suspect that Mr. Bottiglia’s return to work coincided with the end of his paid leave, which the Tribunal also took into consideration. Ultimately, the Tribunal found that there was no discrimination and that Mr. Bottiglia should have submitted to the IME requested by the OCSB.

The Divisional Court, when reviewing the Tribunal’s decision stated that:

In my view, the Tribunal’s decision on this issue was a reasonable one.  In certain circumstances, the procedural aspect of an employee’s duty to accommodate will permit, or even require, the employer to ask for a second medical opinion.  Without attempting to define all of those circumstances, they will include the circumstances that the Tribunal reasonably found existed here, where the employer had a reasonable and bona fide reason to question the adequacy and reliability of the information provided by its employee’s medical expert. [emphasis added]

As the OHRC says in its Policy, an employer is not entitled to request an IME in an effort to second-guess an employee’s medical expert.  An employer is only entitled to request that an employee undergo an IME where the employer cannot reasonably expect to obtain the information it needs from the employee’s expert as part of the employer’s duty to accommodate.

It is important to note that in August 2017 the Court of Appeal for Ontario refused Mr. Bottiglia’s application for leave to appeal, thereby confirming that the Divisional Court decision remains good law in Ontario and employers may, in some cases, be justified in requiring employees to undergo IME.

The Human Rights Commission

The Human Rights Commission has advice of their own (which is cited by the Court in the Bottiglia case):

While the employer is entitled to get all the information needed to make the accommodation, it must also accept accommodation requests in good faith and respect the dignity of employees. A request for a second opinion, an opinion from a specialist or an independent medical examination (IME) must be necessary to provide accommodation. Such a request should not be made to refute whether the employee has the disability in the first place or to avoid providing the accommodation.

Example: An employee provides a doctor’s note that asks for accommodation but does not state any particular diagnosis. The employee shows no observable symptoms of illness in the workplace, and the employer suspects that the employee is making up a disability to get more flexibility in her work arrangements. The employer wants to prove this by having the employee take an independent medical examination. Such an approach would not be consistent with the Code.

It is not normally advisable for an employer to second-guess the validity of an employee’s doctor’s advice, only on a suspicion that it is not objective because it is based on the employee’s own perceptions. Avoid challenging a medical note or requiring a second opinion unless there is evidence that the doctor’s recommendations are based on something other than his or her best opinion as to what is needed to make sure the patient recovers.

The legitimacy of a request for more medical information will depend on the information already received. A request for more medical information will be appropriate if there is a reasonable and objective basis for seeing the initial information as inadequate or inaccurate. Examples might be if there appears to be a problem with the degree of expertise or type of expertise of the doctor who provided the initial medical opinion, or if there is some reasonable basis to believe that the employee is not fit to do the job despite the existence of a medical report to the contrary. Document reasons for requesting more medical evidence.

Example: After a serious car accident, an employee is cleared by her doctor to return to work. On more than one occasion, she becomes dizzy at the end of her 12-hour night shift operating a machine and narrowly misses hurting herself. The employer asks for more information from her doctor about possible accommodations. Once again, the doctor’s note indicates that the employee is fit to work and that no accommodation steps are needed. The employer then asks the employee to attend an assessment by a doctor of her choosing, with expertise in workplace accommodations.

If a second opinion or independent medical exam (IME) is warranted, a good approach is to select a doctor who is acceptable to both the employee and the employer, and the union (if there is one) rather than insisting that an employee meet with a doctor that the employer has chosen. Give the employee enough information to understand the purpose of such an examination, who will conduct it and what assessments will be used.

The Takeaways

As an employer, you are required to accommodate employees who are genuinely in need of such accommodation.  However, accommodation is a two-way street – as discussed in Your Staff Must Co-Operate in Obtaining Accommodation. Employees cannot simply dictate the type and amount of accommodation they need.  As an employer you can request information from a medical professional to help guide the accommodation process.  In certain, albeit limited circumstances, you may have occasion to ask the employee to submit to a second opinion or an IME.

If you need advice about your obligations as an employer under the Ontario Human Rights Code, or need help with the accommodation process, please contact us.  We are your legal dental team.

 

DMC