Abstract
Organizations collect disability-related information from employees to meet legislative requirements, foster inclusion, and respond to employee needs. However, there are likely more employees with disabilities than those who disclose at work. We tested whether altering the response option language on a disclosure form would increase disability disclosures, and whether increases differed by disability type and visibility. Employed adults were asked to identify as having a “disability,” “qualifying impairment,” “qualifying condition,” or “qualifying disability.” Results showed more disclosures when reporting a “qualifying condition” compared to a “disability,” especially among employees with a psychological or invisible disability. The manipulation of a single term on the disclosure form can increase reporting of disabilities, providing an evidence-based step to support inclusive organizational practices.
Organizations are likely underestimating the number of employees who have disabilities. Although many employers provide opportunities to disclose disabilities and request accommodations, data sources indicate employees’ reluctance to disclose. A survey among white-collar workers in the United States (U.S.) showed that approximately 30% have health conditions that could qualify for protection under the Americans with Disabilities Act (ADA, 1990, as amended in, 2008), yet less than 4% of employees disclose to human resources (Sherbin et al., 2017). This uncertainty about the prevalence of disability makes it difficult for employers, researchers, and policy developers to be aware of employee disabilities and take appropriate actions to support them.
One plausible explanation is that, despite recent movements to destigmatize disability (Andrews et al., 2019), many employees are reluctant to label a health condition or limitation as a “disability” on formal disclosure forms. Several individual and social factors might lead employees to not consider their limitations to be disabilities, or effortfully hide but internally acknowledge their disabilities (Watson, 2002). Contributing to the challenge, clinical and legal professionals demonstrate uncertainty about definitions and what limitations qualify for protections (Jette & Badley, 2000). This confusion likely extends into the experiences of employees who must decide for themselves if their limitations qualify as disabilities and are worthy of disclosure.
The terms used by employees to describe disability give us important information about how they define and experience disability (Andrews & Forber-Pratt, 2022). For instance, language conveys if individuals define disability as a personal attribute or group-based identity (Brewer & Gardner, 1996). The term “disability” might imply a shared group identity, accompanied by a susceptibility to disability-based stereotypes (McCrea et al., 2011) and social stigma (von Schrader et al., 2014). Employees might not acknowledge having a “disability” if they only view it as a personal attribute and not a social identity (Santuzzi & Waltz, 2016).
Defining disability as a personal rather than social attribute is not surprising. In fact, the World Health Organization (WHO) relies on the International Classification of Function (ICF) to define disability as an interaction between an individual health condition and environmental factors (World Health Organization, 2024). In this way, disability is defined as an individualized experience of functional challenge rather than a shared or common experience with others. Using personalized terms such as a specific health diagnosis might also legitimize the limitation and need for medical interventions (Mulvany, 2000), which may be especially important to those with invisible or concealable limitations and health conditions.
Qualitative research examined the language used by workers with concealable disabilities when describing them in the workplace. In that study, employees with disabilities did not use the term “disability” and instead used “impairment” or labels for health conditions (e.g., bipolar disorder) when disclosing to co-workers and supervisors (Santuzzi et al., 2019). The terminology in those disclosures provides insight into how employees define their limitations for themselves and others in the workplace. When invited to disclose a disability, employees might be more likely to endorse terms such as “impairment” or “condition” as these terms align with their self-definitions.
There is also reason to expect differences in disclosures based on type and visibility of the disability. Given the option, employees may opt to hide rather than disclose concealable limitations (Santuzzi & Keating, 2020). Moreover, employees with invisible limitations may be less likely to label them as disabilities, even if they are aware of the challenges associated with them (Santuzzi et al., 2014). Thus, we expect fewer invisible and concealable disabilities to be disclosed compared to visible disabilities. However, this also creates an opportunity for employees with invisible disabilities to show a greater increase in disclosures if asked about their “impairment” or “condition” rather than “disability.”
By similar logic, employees with psychological or cognitive disabilities, which are often invisible or concealable, might show a significant increase in disclosures with alternative response options. The severity of social stigma associated with mental illness might contribute to low disclosure rates for psychological disabilities (Colella & Santuzzi, 2022), Employees with psychological disorders also might not connect their conditions to the term “disability,” making it even less likely they will disclose it as such (Dalgin & Gilbride, 2003). Although a unique population, employees with cognitive disabilities show large differences in how individuals build their neurodivergent features into their identities, contributing to widely varying disclosure rates (Lindsay et al., 2021). Giving individuals the opportunity to disclose a “disability” might not yield disclosure as they will not see the term as relevant, even if experiencing challenges that qualify for protections. Thus, employees with either psychological or cognitive disabilities might be more likely to disclose when the term “disability” is replaced with other terms that align better with their self-definitions.
We used an experimental study to test whether terminology in response options affects disclosures among employees with disabilities. We hypothesized that employees will be more likely to disclose a limitation as a “qualifying impairment” or “qualifying condition” than a “disability.” We also explored whether the impact of response options differed depending on the type and visibility of the disability.
Method/Results
Sample Characteristics.
Note. N = response frequency. Missing = number of participants that did not provide a response to that item. Indented characteristic indicates subcategory (level) of characteristic type. Gender “Nonbinary” includes nonbinary, bigendered, and gender neutral. Race “Other” includes 1 “Brazilian,” 1 “Greek,” 1 “Turkish,” 2 “Human,” 2 not specified. Sexual Orientation “Don’t know or other” includes 7 “don’t know,” 1 “bi-curious,” 1 “queer,” and 2 not specified. General disability types (psychological, physical, and cognitive) percentages overlap due to the ability to self-report in multiple categories. Specific health condition = whether or not the participant reported one or more health conditions by the diagnostic label on the provided checklist. Legally qualifying condition represents participants that selected one or more health conditions that were among the 18 provided on the checklist and/or any write-in responses not on the checklist that were subsequently coded by the researchers as matching the ADA definition of a disability.
Disclosure Rates by VSID Form Type.
Note. N = 1580. VSID Form types represent experimental conditions using different VSID response option language. Cell values not in parentheses represent percentages. Cell values in parentheses represent frequencies.
The proportion of employees who preferred not to respond was not significantly different across conditions. However, disclosures on the VSID differed significantly across the four versions of the form, χ2(3) = 8.53, p = .036. The original VSID form (Disability) yielded a disclosure rate (‘Yes’) that was lower but not significantly different from the rate in the qualifying disability (p = .298) or qualifying impairment (p = .219) versions. However, the disclosure rate in the qualifying condition version of the form was significantly higher than the rate for the original disability form (p = .004). Significantly different cells are indicated by *.
Disclosure Rates by VSID Form Type and Disability Type.
Note. Cell values represent percentage (frequencies in parentheses) of participants who selected “Yes” on VSID form among those who reported having a physical, psychological, and/or cognitive disability for each version of the form. Disclosure rates by disability type may overlap due to self-reporting in multiple categories. Employees with psychological limitations were less likely to disclose them on the VSID compared to those reporting a physical (p < .001) or cognitive limitations (p < .001). However, the disclosure rate for cognitive limitations was not significantly different from the rate for physical limitations (p = .567).
The disclosure rate for those who reported a psychological limitation was significantly higher when the response options used qualifying condition in place of disability (p = .003; omnibus χ2(3) = 9.83, p = .020). Neither cognitive (χ2(3) = 3.24, p = .356) nor physical limitations (χ2(3) = 6.51, p = .089) showed significant disclosure differences across the forms. Significantly different cells are indicated by *.
Disclosure Rates by VSID Form Type and Visibility of Health Condition.
Note. Cell values represent percentage (frequencies in parentheses) of participants with visible, invisible, and concealable limitations who selected “Yes” on each version of the VSID form.
Employees with visible limitations were significantly more likely to disclose on the VSID than those with invisible (p < .001) or concealable limitations (p < .001; χ2(2) = 24.79, p < .001).
Employees with invisible limitations showed a lower disclosure rate on the original disability form compared to disclosing a qualifying condition (p = .009; omnibus χ2(3) = 7.99, p = .046). Disclosure rates across forms were not statistically different among employees with visible (χ2(3) = 6.27, p = .099) or concealable limitations (χ2(3) = 1.41, p = .702). Significantly different cells are indicated by *.
Discussion
The words we use in the workplace are critical to the experiences of marginalized employees (Roberson & Stevens, 2006). In our study, altering the response options on a disclosure form to allow employees to report a “qualifying condition” rather than a “disability” increased disclosures. This effect was particularly pronounced for employees with psychological and invisible limitations, although disclosures were generally greater for a “qualifying condition” than a “disability” across visibility and type of disability. The results are impressive given the subtle manipulation of a single term on the response options of the disclosure form. This simple tweak may increase reporting of disabilities, and serves as an evidence-based step to support inclusive organizational practices.
The increase in disclosures on an alternative form aligns with research suggesting that individuals typically do not use the term “disability” when disclosing to others at work (Santuzzi et al., 2019). Providing alternative response options may reduce the impact of uncertainty about disability definitions, eliminate the need to adopt disability as a collective identity, and remove some concerns about disability stigma that interfere with disclosure. Terms such as “qualifying condition” may cue respondents to think more broadly about limitations that might affect work performance and other experiences, and then perhaps disclose them even if they do not adopt the label “disability.” Providing opportunities for employees to disclose in ways that align with their self-definitions also may encourage better well-being (Bosson et al., 2012), which might contribute to higher job satisfaction and organizational commitment, and lower turnover intentions (Hewlin, 2009).
Results also suggest that employees who have psychological or invisible limitations may be especially more likely to disclose when alternative response options are provided. Bearing an invisible or concealable limitation is associated with increased anxiety about others learning about the identity (Quinn & Chaudoir, 2009). These concerns might be especially stressful for those with psychological conditions which are often more stigmatized than many physical limitations (Follmer & Jones, 2018). Using alternate language, such as “qualifying condition,” may help employees reframe the limitation in objective terms (i.e., symptoms, features) rather than the social prescriptions and stigma associated with the term “disability”.
Footnotes
Authors’ Note
All correspondence should be addressed to Alecia Santuzzi (
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We are grateful for the support of Northern Illinois University in funding the data collection for this project.
Data Availability Statement
Note
Appendix
Author Biographies
Associate Editor: James Lemoine