Ask About the ADA

Reasonable Modification of Polices

Q: I own a dental practice. A patient asked if my staff could fill out their paperwork for them because they have a cognitive disability. Our policy is that they complete this on their own. Do we have to assist them

A: Yes. Healthcare providers are required to make reasonable modifications to policies, practices, and procedures to provide equal access to facilities and services for people with disabilities. The term “reasonable modification” is a broad concept that covers every type of disability. Assisting an individual with a disability to complete paperwork ensures access and equally effective communication to that individual.


My business has requests from time to time to provide for interpreters and other services for people who are deaf or hard of hearing. Are there any tax benefits I can claim to assist me with these costs?

Good news! Assuming that your business counts as a “small business” under Section 44 of the Internal Revenue Code, you can get a tax credit of up to $15,000 for a variety of accessibility-related expenses, including sign language interpreters. Section 44 defines a small business as one that in the previous tax year either had revenues of $1 million or less or had 30 or fewer full-time employees. This tax credit, which is called the Disabled Access Credit, was created in 1990 to help small businesses afford ADA-related expenses. Be sure to familiarize yourself with how this credit is computed—you may want to consult your accountant. Here’s a list (taken from of what can count toward this credit:

  • Provision of readers for customers or employees with visual disabilities
  • Provision of sign language interpreters
  • Purchase of adaptive equipment
  • Production of accessible formats of printed materials (i.e., Braille, large print, audio tape, computer diskette)
  • Removal of architectural barriers in facilities or vehicles (alterations must comply with applicable accessibility standards)
  • Fees for consulting services (under certain circumstances)


Tax Incentives for Business Owners to Improve Accessibility

Q: I own a small business that needs some physical modifications for people who are wheelchair users or have other mobility impairments. Does the federal government have any tax incentives to help me with the costs of making these modifications?

A: Yes. The Disabled Access Credit, IRS form 8826, provides a credit for small businesses that incur expenditures for providing access to persons with disabilities. An eligible small business is one that earned $1 million or less or had no more than 30 full-time employees in the previous year. In addition, the Barrier Removal Tax Deduction encourages businesses of any size to remove architectural and transportation barriers to the mobility of persons with disabilities and the elderly. Businesses may claim a deduction of up to $15,000 a year for qualified expenses for items that normally must be capitalized. Businesses claim the deduction by listing it as a separate expense on their income tax return.

In addition, eligible small businesses may use the Disabled Access Credit and the architectural/transportation tax deduction together in the same tax year, if the expenses meet the requirements of both sections. When using both, the deduction is equal to the difference between the total expenditures and the amount of the credit claimed, up to $15,000 per year.


How has the US Department of Justice helped to ensure equal and effective access for people with disabilities to health care?

Q: How has the US Department of Justice helped to ensure equal and effective access for people with disabilities to health care?

A: The US Department of Justice’s Civil Rights Division, in collaboration with US Attorneys’ offices across the country, have an effort known as the Barrier-Free Health Care Initiative. This partnership expands on their prior work to enforce the rights of people with disabilities by combining their collective resources to increase awareness of the critical importance of equal access to medical services and facilities. The Barrier-Free Health Care Initiative aims to ensure physical access to buildings and facilities for people with mobility disabilities, effective communication of medical information for those who are Deaf or hard-of-hearing, and equal access to treatment for those with HIV/AIDS. It is intended to reflect the Department of Justice commitment to fight discrimination against individuals with disabilities in this essential area of community access.


Do I have to pay for an interpreter for every patient who is Deaf?

Q: I am opening a new dental practice. Do I have to pay for an interpreter for every patient who is Deaf?

A: Covered entities must provide aids and services when needed to communicate effectively with people who have communication disabilities. The key to deciding what aid or service is needed to communicate effectively is to consider the nature, length, complexity, and context of the communication, as well as the person’s normal method(s) of communication.

Auxiliary aids and services can include things such as qualified sign language interpreters and note takers, cued-speech interpreters, and real-time captioning, as well as other methods. Some easy solutions work in relatively simple and straightforward situations, such as the case of a patient coming in to pay a bill. Other situations may be more complex and need broader solutions such as when a patient needs dental procedures done, and financing and options must be discussed.


Can they ask me to bring my companion to interpret?

Q: I made a first-time appointment with an oncologist. When I let them know I was Deaf, they asked if my wife or other family member could provide sign language interpretation, as interpreters are very expensive. Can they ask me to bring my companion to interpret?

A: No, with minor exceptions. The Americans with Disabilities Act (ADA) places responsibility for providing effective communication, including the use of interpreters, directly on covered entities. They cannot require a person to bring an interpreter. A covered entity can rely on a companion to interpret in only two situations. These situations are detailed in the US Department of Justice’s ADA Requirements: Effective Communication:

(1) In an emergency involving an imminent threat to the safety or welfare of an individual or the public, an adult or minor child accompanying a person who uses sign language may be relied upon to interpret or facilitate communication only when a qualified interpreter is not available.

(2) In situations not involving an imminent threat, an adult accompanying someone who uses sign language may be relied upon to interpret or facilitate communication when a) the individual requests this, b) the accompanying adult agrees, and c) reliance on the accompanying adult is appropriate under the circumstances. This exception does not apply to minor children.


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