Standards for professional documentation

Although the person with the disability is always the first source of information on his or her functional limitations, in some cases, the description of the nature and extent of functional limitations requires the knowledge that only professionals in the field possess. Therefore, it is possible that in addition to the information provided by the person, a document from a recognized professional specialized in the specific disability, would be required. Such document would be expected to detail the extent and nature of the functional limitations specific to the person's condition. It is good practice to require documentation in the following cases:

  • When the functional limitations are not evident, temporary, progressive or cyclical, multiple or complex, and/or subject to interpretation.
    • For example: Disabilities affecting mental functioning, concentration or memory, such as learning disabilities, attention deficit hyperactivity disorder, psychiatric disabilities and head injuries. Disabilities that are complex and may manifest themselves in various ways, such as multiple sclerosis, muscular dystrophy, or cerebral palsy.
  • When an applicant identifies that he or she suspects having a particular disability for which he or she was never assessed professionally in order to determine it and to obtain a clear description of his or her particular functional limitations.
    • For example: An applicant experiences cognitive functional limitations and suspects having a learning disability. This applicant should be assessed by a qualified professional in order to confirm or disconfirm his or her suspicion before assessment accommodations can be determined.

When professional documentation is required, the purpose of this documentation is not to cast doubt on the validity of the person's needs or to get a confirmation of a diagnosis. Rather, the focus is on having an adequate description of the nature and extent of functional limitations to determine appropriate accommodations.

The importance of having documentation where a disability is not confirmed has been underlined by a Federal court decision, which has cast doubt as to the validity of assessment accommodations that were proposed in the absence of documentation to support the existence of a suspected disability (Girouard vs Canada (Attorney General), A-177-01). Thus, if a person suspects that he or she has a disability that may affect his or her performance in the appointment process but has not yet been diagnosed; it is recommended that appointment-related assessment be delayed until the applicant has been assessed by a qualified professional.

It is important to point out that the costs associated with a professional assessment intended to determine and describe functional limitations caused by a disability must not create an additional barrier for applicants who have disabilities. Consequently, hiring organizations are responsible for covering the costs related to professional assessments as required for the determination of the nature and extent of functional limitations.

In order to be deemed adequate, professional documentation should adhere to certain standards as to its source, content and if it is up-to-date.

Who is an appropriate source?

The source or provenance of the professional documentation should be appropriate. This means that the documentation provided should be produced by a professional who is qualified in the specific disability and accredited by an appropriate regulated professional association.

What should the professional documentation include?

The following information is expected in the required professional documentation:

  • a clear description of the nature and extent of the functional limitations that are specific to the applicant and resulting from the disability;
  • although the applicant is not required to share the diagnosis of his or her disability, the documentation detailing his or her functional limitations must be based on a systematic and differential assessment method;
  • when applicable, a description of the variability or of the progression of the person's functional limitations;
  • the person's history, whether educational, developmental or medical, where relevant to understanding the disability for the purpose of providing assessment accommodations;
  • accommodations that the person is currently using, has used or could benefit from, as well as any means by which he or she compensates for the functional limitations;
  • when applicable, for example with learning disabilities, information on professionally-recognized standardized test results, indicating the nature and measuring the extent of the applicant's specific functional limitations; and
  • when applicable, any side effect of medications taken that are specific to the applicant.

Those responsible for assessment have the responsibility to examine the relevance of any suggested accommodations that are provided by the professional, as he or she will not normally be aware of the specific assessment context in which his or her suggestions may be applied. Those responsible for assessment may choose not to implement the accommodations suggested by the professional or expert. In these situations, it may be advisable to first discuss the decision with the professional or expert, or with another professional or expert familiar with both the applicant and the issues involved. The applicant must agree in writing to this further consultation (see step 3 in the section Determining and implementing assessment accommodations).

What is meant by up-to-date?

The timeframe which is accepted as "up-to-date" will depend on the type of disability or disabling condition that is being discussed.

  • For stable disabilities (for example, physical or learning disabilities): Documentation may be a number of years old and still be up-to-date as long as the applicant was 18 years old or older when the document was produced. Assessments that were completed before age 18 are generally not considered up-to-date if more than three years have passed since the assessment, as the abilities and skills of individuals are still changing and developing during these years.
  • For permanent disabilities that are susceptible to change (for example, mental health disabilities): Documentation should be recent enough to cover recent changes to the applicant's condition and should include a prognosis for future change related to the individual's functional limitations.
  • For temporary conditions
  • (for example, recuperation from an operation, a broken bone, or a condition resulting from an accident): Documentation should include the date on which the condition began and the attending professional's estimate of a recovery date.

If those who are responsible for assessment are unsure whether the documentation is current, it is recommended that the applicant be asked to return to a qualified professional to see if a new assessment should be conducted.

More information on appropriate documentation is provided for nine categories of disabilities in the section entitled Issues applicable to specific disabilities.

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