ADA Brings Hidden Conditions Into The Spotlight: Allergies, Celiac/Autoimmune Illnesses Recognized

Allergies: for some, they are a regular annoyance of itching, scratchy throat, and sneezing. For others, it is a daily battle for life.

In a recent case between the United States Department of Justice (DOJ) and Lesley University in Massachusetts, students with celiac disease alleged that they were required to pay for a meal plan in which could not eat the food provided. Rather than removing the mandate to buy the on-campus dining plan, the school settled the case, agreeing to provide gluten-free food options, allowed students to pre-order food, addressed cross-contamination concerns, and plan to train their staff about food allergies.

Why is this case important to everyone else? In a monumental decision, the DOJ expanded the Americans with Disabilities Act (ADA) to include individuals with autoimmune conditions such as celiac disease and all severe allergies. The ADA “prohibits public accommodations (such as healthcare providers, hotels and establishments serving food) from discriminating against disabled individuals by impeding their access to full and equal enjoyment of the goods, services or programs offered by the establishment, and requires them to make reasonable accommodations to provide full and equal access”.

For the text of the official ruling, click here.

The advantages and disadvantages

For those with life threatening allergies, the ruling is a major recognition of a condition which when controlled, may otherwise be hidden. Serious allergies can affect an individual anywhere from a few minutes to hours later causing symptoms such as swelling, abdominal pain, nausea or restricting of airways. Ingesting the wrong food can also cause intestinal, immune and neurological damage in the case of celiac disease (and some maintain, in other bowel conditions). Would such damage significantly limit ones daily activity? The answer is YES!

On the other side of the coin, any establishment that serves food may have new concerns about making their services equally available. In addition to the increased costs of foods such as gluten free flour, fears about cross contamination of common allergens and the potential complication of customized meals for every individual with a severe allergy may make owners want to hang up their aprons and close shop, especially for smaller establishments.

While the definition of what constituted a “reasonable accommodation” was settled at Lesley University, there is no crystal clear answer as to where the line between reasonable accommodation and unreasonable requests for adjustment is elsewhere. In general, it was agreed at the Convention on the Rights of Persons with Disabilities that a reasonable accommodation means necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden. However, the ADA uses the term “readily achievable” instead of “reasonable accommodation” for privately owned public places. Simply put, it too is a change that is “easily accomplishable and able to be carried out without much difficulty or expense” which allows individuals with disabilities to participate in or benefit from the goods, services or facilities. These definitions certainly act as a useful guideline, but do allow for a bit of interpretation. How do we decide what is “easy” or “expensive”? One case at a time, learning as we go, I imagine.

As an individual who deals with multiple allergies & sensitivities, who has worked with others with severe allergies, and someone who also loves to contribute to ICS’ evening social programs, I am sympathetic to both sides. People who suffer from severe allergies want to live life as freely as anyone else. Even with the new ADA ruling in place though, I believe the best way to minimize your risk is to take charge of your care and plan ahead!

What can you do?

  1. Bring your medicines & medical ID. Whether you use an EpiPen, prescription, an over- the-counter or alternative medicine, you should always be prepared for the unexpected when you are outside (but you knew that, right?). Make sure those close to you know where your medicine & medical IDs are in case of an emergency.
  2. Make others aware – in advance. People can’t even attempt to help you if they don’t know. It is important that those around you are aware of your severe allergies. For example, in a private space such as a home, if you become extremely ill & have trouble breathing in the presence of certain fragrances, ask those around you to go fragrance free (my motto: the smell of “clean” is the smell of nothing! I used to run around my friends’ houses yanking out all the air fresheners while wearing my filter mask). Gently inform and remind them. Your life and wellbeing are worth it. However, it’s unreasonable to expect that a public space will suddenly be able to accommodate major needs (ex. walking into an Italian restaurant and demand rice pasta). It’s better to call ahead, find out what your options are and see if there is an accommodation that can be easily made.
  3. Carry your own food if you have a food allergy; read labels. Yes, it’s a royal pain to be carting around a hot/cold bag with a meal or snacks, but it’s far more convenient than the effects of eating a food you’re allergic to. Despite the best efforts of friends, family or places which serve food, mistakes and cross contamination does happen. Do not be ashamed to ask what is in the food, read ingredient labels, or politely refuse a food if you are uncertain it is free of a suspected allergen. Some restaurants even have gluten free or vegan (free of animal products including dairy) menus available, so do speak up!
  4. Bring a mask. If your immune system is lowered, or you suffer from airborne allergies, consider a carbon filter mask, such as the I Can Breathe! brand.

At ICS:

  • Make sure your care manager and PCA/Home attendant is aware of your allergies.
  • Some programs may have food available, but as ICS does not prepare the food, (often it is provided pot luck style by program participants and/or buffet style from local establishments) we cannot guarantee allergen-free options or eliminate the possibility of cross contamination. Since it is pot luck, we encourage you to bring food to the table as well and ask questions!
  • If you come to programs, ICS’ offices are equipped with refrigerators to store your food for the day. Be sure to ask where is the correct place to store your food. Don’t forget to remove your leftovers before you leave – we want to keep the refrigerators clean & fresh!
  • There are microwaves available for reheating food; in the Brooklyn office, you may also request special permission to use the stovetop for cooking on a particular day. Please notify the office in advance to check availability.
  • If you have any questions on accommodations at ICS, contact Loreen Loonie at loonie@icsny.org.

While most people are aware of disabilities that require the use of wheelchairs, crutches, and canes, many are not aware or don’t take seriously the challenges of those whose fight is internal- invisible or hidden disabilities. I believe the ADA’s judgment raises awareness on the serious nature of allergies and autoimmune conditions. What’s your take on the ruling?

 

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