Worker Functional Abilities, Occupational Requirements, and Job Accommodations: A Close Look at Three Occupations

Published: 2021


This report examines the occupational requirements, physical and mental functioning, and use of accommodations among workers in three key occupations: cashiers, receptionists, and those in nursing fields. These jobs are among the top occupations represented in the work histories of federal disability claimants in the United States (U.S.). We collected survey data from 802 people working in these occupations. The survey collected demographic information, work-related characteristics (including the use of workplace accommodations), and functional assessment information using the self-reported functional assessment using the Work Disability Functional Assessment Battery (WD-FAB). The WD-FAB generates eight scores per respondent, one for each of eight dimensions related to physical function (basic mobility, fine motor function, upper body function, and community mobility) and mental function (resilience and sociability, mood and emotions, self-regulation, and cognition and communication). Results indicated that accommodation use is associated with lower functioning in this population of employed or recently employed adults. In addition, for each occupation, we compared the WD-FAB scores to data from the Occupational Requirements Survey (ORS) using measures that align with these WD-FAB domains. This comparison demonstrates the extent to which functioning in these dimensions is necessary and suggests opportunities for task-specific, occupation-specific accommodations. We discuss implications for disability determination according to SSA guidelines.

Key Findings

    • Using a weighted sample of an online panel survey of 802 adults working as cashiers, receptionists, or nurses/nursing assistants, we find that about half received some type of workplace accommodation for health or mental health problems. An additional 10% of workers in these occupations indicated that they needed an accommodation but did not receive one. Note that we asked about accommodation use prior to asking about health or disability status which likely encouraged reporting of workplace interventions.
    • Using the Work Disability Functional Assessment Battery (WD-FAB), we find that overall levels of functioning were significantly higher for workers across these three occupations who do not receive an accommodation relative to those who do in most physical and mental functioning dimensions. Within each occupation, differences were most pronounced among cashiers. This suggests that accommodation use mitigates limitations in functional ability and may be useful in retaining workers who experience functional decline.
    • Data from the Occupational Requirements Survey (ORS) help to illustrate the relative importance of these differences. We identify requirements of these three occupations as they relate to the specific dimensions of the WD-FAB, and find that some areas of functioning are essential to all three occupations (and all occupations, on average) such as fine motor function and upper body function, whereas other areas of functioning are more essential to certain occupations (e.g., communication and cognition for cashiers relative to others and basic mobility for those in nursing relative to others). This suggests a process that could incorporate the collection of accommodation information into ORS or the Occupational Information Network (O*NET), and could, in turn, inform the Social Security Administration’s disability determination process.


Henly, Megan, Debra L. Brucker, and Andrew J. Houtenville. 2021. “Worker Functional Abilities, Occupational Requirements, and Job Accommodations: A Close Look at Three Occupations.” Ann Arbor, MI. University of Michigan Retirement and Disability Research Center (MRDRC) Working Paper; MRDRC WP 2021-430.