What information should be considered when assessing if an employee with Major Depressive Disorder (MDD) can perform essential job functions with or without accommodation?

Workplace Accommodations for Major Depressive Disorder

Yes, The Hartford should consider specific accommodations for employees with Major Depressive Disorder (MDD) to help them perform essential job functions effectively. While the provided evidence focuses primarily on diabetes accommodations, we can apply similar accommodation principles to MDD, supplemented by research on depression in the workplace.

Key Accommodations for MDD in the Workplace

Flexible Work Arrangements

• Employees with MDD may need flexible work schedules to accommodate therapy appointments, medication management, and periods of symptom exacerbation 1
• Certain work schedules (like rotating or split shifts) can make it difficult for individuals to manage their condition effectively, similar to challenges faced by those with other chronic conditions 2
• Leave or flexible scheduling may be necessary for medical appointments or during periods when symptoms are more severe 1

Medication Management Support

• Employees taking antidepressants like sertraline may experience side effects that interfere with work functioning, including daytime sedation, insomnia, headache, and anxiety 3, 4
• Accommodations may include short breaks during the workday to take medication or manage side effects 2
• Privacy for medication administration may be needed, similar to accommodations provided for other medical conditions 2

Cognitive Function Support

• MDD significantly impacts cognitive abilities that are critical for workplace functioning, including attention, memory, and concentration 4, 5
• The most important work abilities affected in MDD include: taking notice, sustaining attention, focusing attention, completing operations, thinking in a goal-directed manner, remembering, performing routine operations, and undertaking structured work activities 5
• Accommodations might include written instructions, breaking down complex projects into smaller tasks, and providing checklists 1

Environmental Modifications

• Reduced distractions, permission to take short breaks, and ability to keep organizational materials at workstation can help individuals with MDD maintain productivity 1
• Similar to accommodations for other conditions, environmental modifications should be tailored to the individual's specific needs 2

Return-to-Work Support

• Work-related cognitive-behavioral treatment has been shown to reduce days of incapacity to work more effectively than standard CBT for employees with MDD 6
• Antidepressant treatment improves workplace functioning and should be considered in evaluating an employee's ability to perform essential job functions 7

Implementation Considerations

Documentation and Assessment

• Employees should document their diagnosis from a qualified healthcare provider 1
• Employers should establish clear procedures for requesting and implementing accommodations 1
• Assessment should focus on specific functional limitations rather than general diagnosis 5

Common Pitfalls to Avoid

• Inadequate medication management can be addressed by regular follow-up with healthcare providers to optimize medication dosing and timing for workplace demands 1
• Over-reliance on accommodations without skill development can be solved by combining accommodations with active skill-building through coaching or therapy 1
• Failing to recognize that accommodations are typically low-cost and can significantly improve productivity 1

Long-term Considerations

• The efficacy of sertraline in maintaining an antidepressant response for up to 44 weeks following 8 weeks of open-label acute treatment has been demonstrated 3
• Regular reevaluation of accommodations and treatment effectiveness is important for long-term workplace success 3

Conclusion

When assessing whether an employee with MDD can perform essential job functions, The Hartford should consider the specific symptoms affecting the individual, potential medication side effects, and appropriate workplace accommodations. With proper accommodations tailored to individual needs, most employees with MDD can effectively perform their job functions 1, 7.