Abstract
BACKGROUND:
Much of the existing research on disability and disability-related workplace accommodations presume that disabilities are visible and commonly accepted. Yet, many disabilities are invisible and contested, or perceived as fake, low-severity/minor, and/or illegitimate.
OBJECTIVE:
The purpose of this research is to investigate the effect of identity management strategies that individuals with contested disabilities might use when requesting accommodations in a workplace setting.
METHODS:
We used two electronic experiments to investigate the effect of identity management strategies on perceived fairness of accommodations and attributions about individuals requesting accommodations. Studies 1 and 2 used online surveys to collect data from 117 and 184 working adults, respectively.
RESULTS:
Study 1 indicates that four invisible disabilities (chronic fatigue syndrome, attention deficit/hyperactivity disorder, generalized anxiety disorder, and chronic migraine) are viewed as significantly less legitimate than the visible disability paraplegia. In study 2, any form of disclosure of a contested disability (vs. no disclosure) resulted in higher perceived fairness and more positive attributions about the person requesting accommodations. There were minimal differences between the different identity management strategies tested.
CONCLUSIONS:
Workplaces should work to create spaces in which employees can disclose contested disabilities to managers and coworkers without fear of enhanced stigmatization.
Introduction
Since the passage of the Americans with Disabilities Act (ADA, 1990), employers in the U.S. must provide reasonable accommodations to employees with disabilities who request them. However, many employees may avoid asking for such accommodations in an attempt to avoid stigmatization or negative reactions from coworkers (Baldridge & Veiga, 2006; Stone & Colella, 1996). In the current research, we examine identity management strategies for individuals with invisible disabilities that are contested, or widely perceived to be de-legitimized. We investigate whether disclosure is beneficial compared to no disclosure, as well as whether specific types of disclosure provide greater benefits. In particular, we focus on coworkers’ perceptions of accommodation fairness (i.e., distributive justice) and attributions about accommodations as potential outcomes of disclosure.
Background
The term “contested” has been used to describe disabilities and other medical conditions that are controversial in their status as legitimate illnesses (Swoboda, 2006). Tarasuk & Eakin (1995) describe the difficulty people with contested illnesses face when seeking workplace accommodations. They found that employees with severe back pain following a workplace injury faced jeopardized job security, accusations of faking, and difficulty finding other jobs. These individuals’ experiences suggest that they do not receive needed and reasonable accommodations, even when they are protected by legislation. Based on this, we chose to use four disabilities for the current study that are widely contested: chronic fatigue syndrome (CFS), generalized anxiety disorder (GAD), attention deficit hyperactivity disorder (ADHD), and chronic migraine. All four may involve the reporting of symptoms that seem somewhat subjective. Although there are other disabilities which may be considered contested, we chose these four conditions because each has been discussed in previous work on legitimacy (Elraz, 2018; Kempner, 2014; Santuzzi et al., 2014; Swoboda, 2006). Simultaneously, these disabilities have primarily been examined using qualitative methods, and research has yet to experimentally test the effects of specific identity management strategies in terms of disclosing them.
Literature
Coworkers’ perceptions of accommodation fairness influence the experiences of employees with disabilities. Coworkers may depend on limited or false information about disabilities and accommodations when assessing fairness (Colella et al., 2004). Concerningly, many employees with disabilities withhold requests for workplace accommodations, even if they are eligible under the ADA or similar legislation (Baldridge, 2005; Baldridge & Swift, 2013; Norstedt, 2019). Employees with invisible or contested disabilities may be particularly likely to conceal their disabilities from a fear of appearing weak, lazy, or unwilling to work (Norstedt, 2019; Syme, 2018). Similarly, coworkers are often at least partially aware of disability-related accommodations (Colella et al., 2004; Norstedt, 2019; Syme, 2018), leading them to make (positive or negative) attributions about the employee receiving accommodation.
One factor that influences perceptions of accommodation fairness is the attributions coworkers and managers make about accommodation requests, which can lead them to view requests as either fair or unfair (Colella et al., 2004; Syme, 2018). For example, coworkers who perceive an accommodation as stemming from extraneous factors (e.g., favoritism) tend to have more negative attitudes toward employees receiving an accommodation than coworkers who believe that an accommodation is appropriate for the disability (Colella et al., 2004). People with invisible or contested disabilities may be more likely to receive negative attributions from peers (Deckoff-Jones & Duell, 2018), which can lead to poorer work-related and social outcomes. While coworkers’ perceptions of a workplace accommodation are influenced by a number of factors, the way in which the employee receiving the accommodation discloses or describes the disability can play a role (Colella et al., 2004). This is likely to be particularly true for contested disabilities, as there is a high degree of ambiguity regarding their legitimacy and/or severity (Deckoff-Jones & Duell, 2018; Norstedt, 2019; Swoboda, 2006). Therefore, research into factors that promote more positive attributions about workplace accommodations for employees with contested disabilities is necessary.
Purpose of study
We first aimed to verify that our chosen contested disabilities (chronic fatigue syndrome, generalized anxiety disorder, ADHD, and chronic migraine) were viewed as less legitimate compared to non-contested disabilities. As discussed previously, these disabilities may be viewed as less legitimate in part because they involve subjective reporting of symptoms. Additionally, all four disabilities are concealable, which may reduce perceived legitimacy (Swoboda, 2006). We compared these conditions to paraplegia and blindness, chosen based on prior research as prototypical exemplars of disability (Antonak & Livneh, 2000; Minton, 1994). In contrast to the contested disabilities described above, paraplegia and blindness involve symptoms that are often apparent to observers, and people claiming to have these disabilities are rarely viewed as lacking legitimacy. Thus,
Hypothesis 1: Chronic fatigue syndrome, generalized anxiety disorder, ADHD, and chronic migraine will be viewed as less legitimate than paraplegia and blindness.
The current study examines whether coworkers’ perceptions of the fairness of an accommodation for a contested disability and their attributions about the accommodation request are influenced by 1) whether the employee discloses the disability at all, 2) whether the employee uses a strict disclosure vs. a more detailed identity management strategy, and 3) the specific identity management strategy used. Because employees with disabilities cannot change the legitimacy of their condition, effective identity management strategies may provide a feasible way to increase the perceptions regarding the fairness of the accommodation (or the likelihood of receiving the appropriate accommodation at all). Identity management refers to the ways in which people attempt to influence or shape others’ perception of them (Clair et al., 2005). Employees with contested disabilities may use a number of identity management strategies when revealing their disabilities to supervisors or coworkers (Forber-Pratt et al., 2017). For example, normalizing refers to efforts to assimilate into an organization by reducing or eliminating the perceived importance of a stigmatized identity (Clair et al., 2005). Differentiating, on the other hand, involves emphasizing an invisible identity in order to combat associated stigma. Rather than trying to erase the differences associated with an identity, it highlights them in order to reclaim and redefine the identity as something that does not warrant stigmatization (Clair et al., 2005).
Despite the prevalence of invisible and contested disabilities, there has been little research on the effects of different identity management strategies on workplace experiences. In the context of contested disabilities, normalizing may reduce the credibility of requests for accommodation by preventing attributions to physical causes, thereby reducing the perceived fairness of accommodation. Normalizing strategies are likely to be harmful for employees with contested disabilities, who may have symptoms that are often viewed as not substantially different from those experienced in the population of people without disabilities (Bury, 1982; Tarasuk & Eakin (1995)). In support of this, Lyons et al.’s (2017) vignette-based study found that job applicants with disabilities perceived as controllable (which are often contested) are viewed as less hireable and evoke more pity when they de-emphasize their disability. This study extends Lyons et al.’s (2017) findings by 1) testing for differences between the specific identity management strategies of normalizing and differentiating, and 2) looking at the specific context of coworkers’ perceptions of accommodation fairness.
Hypothesis 2: When employees with de-legiti-mized conditions use normalizing (vs. differentiating) identity management strategies, coworkers will view an accommodation as less fair.
Hypothesis 3: When employees with de-legitimized conditions use normalizing (vs. differentiating) identity management strategies, coworkers will make more negative and fewer positive attributions about that employee.
In study 1, we tested hypothesis 1 and verified that our disability exemplars were viewed as de-legitimate. Then, we conducted an online survey (study 2) to test hypotheses 2 and 3 by comparing four identity management strategies (no disclosure, strict disclosure, normalizing, and differentiating).
Method
Study 1
In study 1, we investigated the research question regarding whether people view our hypothesized contested disabilities (chronic migraine, CFS, ADHD, and GAD) as less legitimate compared to prototypical disabilities (blindness and paraplegia).
Participants
Using snowball sampling, we recruited 117 adults who worked full-time (at least 30 hours per week) at the time of the study. The sample was primarily female (61%, n = 71), White/Caucasian (79%, n = 92; 15% Asian, n = 17; 3% Black, n = 4; 3% other, n = 4), and relatively young (77% were ages 18–29, n = 90). Participants were recruited by asking students in an undergraduate subject pool to send the study to friends and family members who met the eligibility criteria. Participants did not receive compensation for participating in the study; however, the students who referred participants to the study received partial course credit.
Procedure
After providing informed consent, participants were asked to take an online survey and answer questions about the degree to which they perceived chronic migraine, CFS, ADHD, GAD, blindness, and paraplegia as legitimate. The online survey was hosted on Qualtrics and took approximately 10 minutes to complete. It consisted of a measure of legitimacy developed by the authors (see below), as well basic demographic questions. Study procedures were approved by the institutional review board at the second author’s university in 2018 under approval number IRB-FY2016-568.
Measures
Participants responded to questions about the legitimacy of each disorder on an 11-point Likert scale from 0 to 10. As we are not aware of any existing measure of disability legitimacy, we generated these items based on concepts discussed in prior work on contested disabilities (Swoboda, 2006; Tarasuk & Eakin (1995)). The measure included the following seven items: “How often do people fake this condition?”, “How often do people use this condition as an excuse?”, “How often do people exaggerate this condition?”, “To what extent is this condition a real disorder?” (reverse-scored), “Compared to other disabilities, how severe is this condition?” (reverse-scored), “To what extent should people with this condition receive accommodations?” (reverse-scored), and “How often do people overuse the term [condition name]?”. For each condition, legitimacy scores were computed by averaging the responses to the seven items. Cronbach’s alpha for the legitimacy scale was acceptable for five of the six conditions: CFS (α= 0.76), paraplegia (α= 0.67), GAD (α= 0.76), ADHD (α= 0.73), and chronic migraine (α= 0.70). Because the reliability of the scale was low for legitimacy ratings provided in the blindness condition (α= 0.33), it was excluded from further analysis.
Analytic strategy
We used a one-way within-subjects ANOVA to analyze the effect of disability type (blindness, paraplegia, chronic migrane, CFS, ADHD, and GAD) on legitimacy scores.
Results
This analysis revealed a significant effect of disability type on legitimacy, F(4, 464) = 166.5, p < 0.001,
Study 1: Means and standard deviations for legitimacy as a function of disability
Study 1: Means and standard deviations for legitimacy as a function of disability
**p < 0.01, ***p < 0.001.
In study 2, we investigated which identity management strategies (control, strict disclosure, normalizing, and differentiating) produced greater ratings of distributive justice and more positive attributions about the employee receiving accommodation. We presented working adults with vignettes describing coworkers receiving accommodations for disability-related reasons. Participants were asked to judge the fairness of the situations and make attributions about their coworker.
Participants
We recruited 184 participants for this study through snowball sampling. They were at least 18 years old and employed full-time (at least 30 hours/week). The sample was primarily female (67%, n = 123) and White/Caucasian (69%, n = 127; 8% Asian, n = 14; 6% Latino, n = 11; 4% Black, n = 8; 13% other, n = 24), with an average age of 36.1 years (SD = 12.7). Similar to Study 1, participants were recruited by students in an undergraduate subject pool, who sent the study to friends and family members.
Procedure
Participants completed an online survey hosted on Qualtrics, which took approximately 15 minutes to complete. It consisted of a standardized measure of distributive justice (see below), a measure of attributions developed by the authors, and demographic questions. Participants read a series of three vignettes about workplace scenarios, consisting of two filler vignettes and one experimental vignette (these were presented in randomized order). Each participant read an experimental vignette from one of the four experimental conditions (control, strict disclosure, normalizing, and differentiating), that was also selected in randomized order. In the strict disclosure, normalizing, and differentiating conditions, participants were randomly assigned to read a vignette about one coworker with either ADHD, GAD, or CFS. In the control condition, participants knew that their coworker received accommodations, but they were given no additional information about the reason for those accommodations. In the strict disclosure condition, coworkers simply stated that they received accommodations for one of the three de-legitimized disabilities. Wording of the normalizing and differentiating strategies were drawn from Clair et al. (2005; see Appendix for full vignettes). After each vignette, participants answered questions about the distributive justice (i.e., fairness in allocation of resources; Cook & Hegtvedt, 1983) of the situation. They also reported their attributions about the coworkers’ behavior. Study procedures were approved by the institutional review board at the second author’s university in 2019 under approval number IRB-FY2016-568.
Measures
Distributive justice
A 4-item measure of distributive justice was drawn from Colquitt (2001). Participants responded to each item on a 7-point Likert-type scale (1 = strongly agree, 7 = strongly disagree; e.g., “This situation had a fair outcome”). Cronbach’s alpha was 0.94 for this measure.
Attributions
Participants indicated the extent to which they believed nine different motivations (see Table 2) contributed to their coworker’s behavior. Participants responded to each attribution item on a 7-point Likert scale (1 = not at all, 7 = very much). As the measure was designed to capture a variety of attributions, we used exploratory factor analysis to identify the underlying factor structure and derive outcome variables for use in the subsequent analysis. An exploratory factor analysis of the attribution measure identified three factors accounting for a combined 70% of the variance. Table 2 contains factor loadings for each item. A loading cut-off of 0.4 was used to assign items to factors, as all items loaded onto exactly one factor using this cut-off. The first factor, inauthenticity (α= 0.83), included whether participants believed selfishness, deception, attempts to gain a performance advantage, and compensation for poor performance contributed to their coworker’s actions. The second factor, legitimacy, (α= 0.72) included the extent to which participants believed a health condition, factors outside their control, and need for assistance contributed to their coworker’s actions. The third factor, positive attributes, (α= 0.60) included the extent to which coworkers believed intelligence and hard work contributed to their coworkers’ actions. Because positive attributes contained two items with a relatively low reliability, it was excluded from further analyses. Thus, the dependent variables used were distributive justice, inauthenticity, and legitimacy.
Study 2: Factor loadings from attributions measures
Study 2: Factor loadings from attributions measures
Note: Factor loadings < 0.2 are suppressed.
We used a between-subjects MANOVA to test the effect of identity management strategy (control, strict disclosure, normalizing, and differentiating) on distributive justice, inauthenticity, and legitimacy.
Results
A MANOVA (chosen because of several significant correlations between these three dependent variables; see Table 3) on distributive justice and the two attribution factors, inauthenticity and legitimacy revealed a significant, omnibus main effect of strategy, F(3,180) = 8.38, p < 0.001,
Study 2: Correlations between dependent variables
Study 2: Correlations between dependent variables
**p < 0.01, ***p < 0.001.
Study 2: Means and standard deviations for distributive justice and legitimacy attributions as a function of strategy
**p < 0.01, ***p < 0.001.
The results of this study indicate that people are willing to question the legitimacy of certain disabilities. Specifically, participants expressed beliefs that people claiming contested disabilities (ADHD, GAD, CFS, and chronic migraine) were significantly more likely to be faking, exaggerating, or using the condition as an excuse than people who had paraplegia (blindness was not reliable). They also indicated that contested disabilities are less severe than other disabilities, and only moderately endorsed the belief that people with contested disabilities should receive accommodations. These results suggest that people with contested disabilities may struggle to establish a legitimate claim to resources and services for people with disabilities, such as workplace accommodations. Study 1 supports previous ethnographic research (e.g.,Norstedt, 2019; Tarasuk & Eakin (1995)) that describes the difficulties people with contested disabilities face when seeking accommodations by providing experimental evidence that employers and coworkers view certain disabilities as less legitimate and deserving of accommodations than others. It also parallels theoretical work on health-related stigma and discrimination, such as Stangl et al.’s (2019) Health Stigma and Discrimination Framework, suggesting that stigmatizing beliefs about people with contested disabilities may drive stigma experiences (e.g., negative attitudes from coworkers) and subsequently negative health and social impacts (e.g., adverse workplace experiences, potentially not receiving appropriate accommodation).
Study 2 suggests that when employees who receive accommodations disclose their disabilities to coworkers there is some benefit. Identity management strategies that include any form of disclosure resulted in significantly higher perceived fairness and greater attributions to legitimate factors than the control condition, in which no disclosure occurred. This finding supports Colella et al.’s (2004) model of factors influencing coworkers’ perceptions of workplace accommodations, which suggests that coworkers who perceive accommodations as inappropriate will view them as less fair. In turn, this may lead to employees with disabilities facing stigma and negative attitudes from their coworkers. By using an identity management strategy that includes disclosure, employees with disabilities may be able to positively influence their coworkers’ perceptions that the accommodations received by the employee are appropriate for their impairment. This finding also parallels past work on disclosures of other identities, such as pregnancy, which suggests that disclosure can increase perceived support from workplace supervisors (Little et al., 2017). Thus, disclosure is likely a beneficial strategy for employees wanting to ensure that their coworkers view their accommodation(s) as fair.
The findings from these studies support the need for employment practices that allow employees to disclose contested disabilities without fear of stigmatization. Specifically, Study 2 findings indicate that any form of disclosure resulted in significantly higher perceived fairness than no disclosure. Yet, the specific type of disclosure did not significantly affect perceived fairness or attributions, with all three forms of disclosure (strict disclosure, normalizing, and differentiating) being fairly (statistically) indistinguishable. The benefits of disclosure may be particularly strong for employees with invisible disabilities, when a lack of disclosure leaves coworkers with no explanation for differences in resources or expectations associated with accommodations (Santuzzi et al., 2014). Creating an organizational culture that embraces diversity and provides reasonable accommodations for a variety of situations (e.g., disability, parenthood, etc.) may encourage employees with contested disabilities to disclose to their coworkers, thereby promoting positive workplace outcomes. Additionally, employers may benefit from educating employees about the ADA and different types of disabilities, including those viewed as contested. This type of program could help employees with contested disabilities feel more comfortable disclosing their disability in the workplace.
In addition to implications for organizations, this study also suggests that there are benefits of disclosure to coworkers. Although employees with disabilities must weigh many factors when making decisions about workplace disclosure, this study suggests that coworkers are more likely to perceive accommodations as fair when they are aware that their coworker has a disability (Colella et al., 2004). This finding has clinical implications for those working with people with contested disabilities, as it suggests that supporting these individuals through the process of accommodation seeking and workplace disclosure may have beneficial outcomes.
The current study did not find significant differences in coworkers’ perceptions of the fairness, legitimacy, and inauthenticity of an accommodation request based on the specific identity management strategy used. This finding conflicts with previous research indicating that the content of a disclosure (e.g., emphasizing vs. de-emphasizing a disability) affects perceptions of an employee with a contested disability (Lyons et al., 2017), and it indicates the need for further research on the effects of different types of identity management or disclosure among employees with contested disabilities.
Additionally, this research suggests that the lack of legitimacy associated with certain disabilities may be a barrier to employees disclosing their disabilities and requesting accommodations. As previous research (e.g., Baldridge, 2005; Baldridge & Veiga, 2001, 2006; Colella et al., 2004) has discussed, employees may choose not to disclose disabilities out of fear of social consequences, particularly stigma and negative attitudes from coworkers. Study 1 indicates that members of the general public view certain invisible disabilities (CFS, ADHD, GAD, and chronic migraine) as less legitimate than the prototypical disability paraplegia. Thus, the legitimacy of a disability is likely an important factor influencing employees’ experiences with workplace accommodations. Workplaces could combat this by providing education about disability accommodations (e.g., the process for acquiring accommodations, different disabilities that may warrant accommodation) to all employees. Such education could challenge the belief that invisible or contested disabilities are evidence of weakness or laziness (Deckoff-Jones & Duell, 2018; Norstedt, 2019; Tarasuk & Eakin, 1995) and improve workplace experiences for employees with these disabilities.
Future research could also delve further into contested disabilities and their impact on workplace experiences by investigating the relationship between visibility and legitimacy. Work on contested disabilities, including this study, has overwhelmingly discussed invisible or concealable conditions, such as mental illnesses, learning disabilities, chronic pain, and chronic fatigue (Elraz, 2018; Jackson, 1992; Kempner, 2014; Swoboda, 2006). One avenue for future research is to assess how visibility may or may not line up with the legitimacy of a disability, as well as factors that can increase the perceived legitimacy of an invisible disability.
Finally, a limitation of this research was the brevity of the identity management strategy manipulation in study 2, which may have limited its potential to affect attributions and perceived fairness. Future research might improve upon this by implementing an in-person, live methodology. Yet, our results suggest that disclosure of any kind is beneficial, regardless of the specific strategies used. Additionally, future research could expand this work into more diverse cultural contexts, as perceptions of specific disabilities are often influenced by specific cultural factors.
Conclusion
This study provides evidence for exploring the construct of legitimacy to the study of disability in organizations and strategies used by employees when requesting accommodations. People with contested disabilities may experience different types of stigmatization than people with more prototypical disabilities. Additionally, this research suggests that disclosure of contested disabilities may contribute to more positive experiences with workplace accommodations. However, this study did not find significant differences in outcomes between different types of disclosures, with a strict disclosure associated with similar levels of perceived fairness as disclosures that used specific identity management strategies (normalizing and differentiating). This research provides a starting point for further inquiry into effective disclosure and identity management strategies for employees with contested disabilities.
Footnotes
Acknowledgments
The authors would like to thank Carlos Moreno and Abby Corrington for their advice and support on this project. They would also like to thank the anonymous reviewers for their helpful feedback on this manuscript.
Conflict of interest
None to report.
Ethical approval
Study procedures were approved by the institutional review board at Rice University in 2018 under approval number IRB-FY2016-568.
Funding
None to report.
Informed consent
All participants provided informed consent before beginning the online surveys.
