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Deaf and Hard of Hearing


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Deaf and Hard of Hearing


It is estimated that there are more than 28 million Americans who are deaf or hard of hearing and approximately 60% are working-age adults (i.e., 21 to 65 years of age).  The workforce includes many individuals with some form and degree of hearing loss who, with the appropriate accommodations, can be both successful and productive on the job.  These employees can bring unique skills and sensitivities that can add considerably to the quality and diversity of the workplace.  Accommodations will not always be necessary, nor will they always be effective.  As with all employees, employers need to assess the qualifications and performance of workers with hearing impairments on an individual basis, and accommodations need to be made on a case-by-case basis, taking in to consideration each employee’s individual limitations and accommodation needs.


Types of Hearing Loss


Hearing loss is the reduced ability to hear sound and may develop for various reasons.  An individual may have a congenital hearing loss, present at birth, due to an inherited medical condition or complications in gestation.  Childhood or adult illness can result in total loss or a degree of hearing loss.  The effects of aging, an acute injury or progressive loss over time due to excessive or prolonged exposure to noise can also result in hearing loss for some people.

According to the National Association of the Deaf (NAD) the term “hard of hearing” refers to individuals who have some hearing and are able to use it to communicate.  Their hearing loss can be from “moderate” to “severe”.  Members of this group are the most difficult to identify since often their hearing loss has been progressive and gradual, they are linguistically and socially adept, and will sometimes intentionally or unintentionally mask their hearing loss.

People who are hard of hearing tend to depend on spoken or written English.  Few know sign language.  Many use hearing aids.

The term “deaf” refers to individuals who, audiologically have a profound hearing loss of greater than 90 decibels.  “Congenitally” deaf people can make little, if any, sense of sounds that hearing people experience.  Also in this category are people who are pre-lingually deaf, which means they lost their hearing before they learned to speak.  For many deaf people, American Sign language (ASL) is their first language, not English, and is often their most effective means of communication.  Many adults in this group have attended schools for the deaf and consider themselves members of the Deaf Community – a recognized socio-linguistic minority.

People who are “late-deafened” are people who have lost their hearing after acquiring language and speech – perhaps because of age, an accident, sickness or other health-related reasons.  Their hearing loss is usually severe to profound.  Their first language is English and they usually identify with the hearing world.  They are most likely to use hearing aids but are unable to understand speech without the use of visual aids, such as speech reading (lip-reading), sign language or Communication Access Realtime Translation (CART).

Within these major categories of hearing impairment there are subcategories, to include:

Oral deaf - these individuals have been taught and have learned to speak and typically express themselves orally.  They have learned to speech read (lip-read) and are less likely to identify with the Deaf Community.  Their first language is English, although many use American Sign Language or some other sign system.  Often they may sign and speak simultaneously, which is known as SimCom, Simultaneous Communication.

Deaf-blind - these individuals present a unique challenge.  The majority of deaf-blind individuals are born deaf and lose their sight later in life.  They are a very diverse group as the degrees of hearing and visual loss vary enormously.  American Sign Language is often the first language of people who are deaf-blind and some know Braille.

People with Minimal Language Competency - these individuals are not fluent in any language, spoken or signed.  Their education is typically minimal and their ability to communicate is very limited, either due to social isolation and poverty or to a developmental disability.  There are interpreters, who have some expertise in this area, but communication is basic and the process is slow.  This is the one exception where using a family member who is familiar with the individual may be appropriate.

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Accommodation solutions

Reasonable accommodations for individuals with disabilities must be determined on a case-by-case basis because workplaces and jobs vary, and so do people with disabilities.  And as usual, the person with the disability will generally be our best resource for identifying potential barriers and the accommodations that eliminate them.

An employer needs to provide an accommodation that will enable an individual to perform the job and communicate effectively.  Individuals with hearing impairments have different communication needs and use different modes of comunication.  It is necessary for the employer to determine the communication needs of the individual in relation to the specific job tasks to be performed.  Effective communication might be provided through alternative options such as written notes, computer assisted note taking, interpreters, or real time captioning, just to mention a few.

Issues employers should consider when beginning to explore the accommodation process include:

  • What is the extent of the individual's hearing loss?

  •  Does the individual have audible and understandable speech?

  •  Is hearing loss the only limitation involved? Secondary issues such as difficulty with balance, vision loss, sensitivity to noise or ringing in the ears can also have an impact on the kinds of accommodations that are going to be most appropriate.

  •  How does the individual communicate with others?  Does the individual rely on other people or use pen and paper to communicate? Can the individual read and write English?

  •  Does the individual use American Sign Language (ASL) or some other form of manual or visual communication?

  • Does the individual use hearing aids?  If hearing aids are being used, the individual may benefit from amplification in other forms as well; to include hearing aid specific assistive listening devices like hearing-aid compatible telephones and personal neck loops.


It is also important to look at the work environment itself.  Is background noise an issue?  Who does the individual need to communicate with (supervisors; co-workers; customers) and how does communication typically take place (face to face, via telephone, or by computer).

When determining the type of accommodation that will be the most effective, the employer needs to consider the length and complexity of the communication.  If the communication is complex in nature, such as informing a new or current employee about a health benefits plan or discussing disciplinary actions, having a qualified interpreter present might be in the best interest of both the employer and the employee.  In situations where miscommunication can lead to serious consequences, it is most important that effective communication occurs.  However, for daily conversation, the use of written notes, e-mail or instant messaging may be sufficient to provide effective communication.  Providing an interpreter may also be necessary in situations where the individual's primary communication occurs through using American Sign Language (ASL) or some other form of manual communication. Some individuals who are deaf may not have English skills because they may have only learned ASL, and a language barrier may be an issue in this case.

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Common forms of reasonable accommodation

One on one communication can be accomplished in a variety of ways depending on the abilities of the individual and the context in which they need to communicate.  The most basic form of daily communication might occur through written notes.  If the individual does not read or write successfully, written communication will not be an effective form of communication.

Computers can also be used to communicate one on one.  Communication might involve individuals sitting side by side taking turns typing on the keyboard, use of email, instant messaging, and chat or voice recognition software.  Communication through a computer may be more convenient than writing notes and should be easier to read than handwriting.  E-mail provides a text method of communication that may be an effective means of communicating one on one with coworkers and supervisors.  Instant messaging is similar to e-mail but allows for real-time communication and eliminates delays in communication.  Internet chat offers the option of real-time communication in a text format but from a remote location.  The benefit to internet chat is the ability to communicate in real-time as if individuals were speaking one-on-one in the same location.

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Assistive Listening Devices

Assistive Listening Devices are devices that transmit amplified speech in a variety of methods.  They enable an individual who benefits from amplification to focus directly on the sound source, reducing distractions from background noise that can make it difficult to concentrate on conversation.  Device options include:

Audio Loop: a permanently-installed wireless technology that can be used with certain types of hearing aids (those with a T-switch) that allows a person who is hard of hearing to pick up the amplified sound that is created by the electromagnetic signal within this loop.  That sound is sent through a cable) the "loop"), which is placed around the perimeter of the room.

Wireless FM System: a system that requires the speaker to wear or hold a microphone and a transmitter unit that sends sound directly to the hard-of-hearing individual who wears a headset or a hearing aid with a T switch and a receiver with either a neck loop or headphones.

Infrared Transmitter and Receiver: a system that transmits audio signals via invisible light waves.  The Infrared receiver contains a photo diode that detects the Infrared light wave and the audio signal is transmitted to the user who is wearing a headset or neck loop.  Since light waves are contained within the boundaries of the room, there is less chance for interference, and for that reason, may be considered more effective.

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Telephone Communication

Teletypewriters (TTY's), sometimes called Telecommunication Devices for the Deaf (TDD's), are special telephones with keyboards and LED displays used by people who are deaf and/or who have disabilities affecting speech.  Similar in appearance to an electric typewriter with a display screen, TTYs transmit and receive electronic signals that the receiving TTY converts to text and prints it on the TTY display screen.  The display screen size varies from about 20 to 40 characters or more, depending on the TTY.  To communicate by TTY, a person types his/her conversation, which is then read on a lighted display and/or paper printout of the TTY of the person receiving the call.  Both parties involved in the communication must have TTY's to communicate.

Click here for answers to frequently asked questions about TTY's and TTY usage.

For a list of TTY manufacturers click here to go to the Deafweb Washington website.

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Telephone Relay Services

If the hearing person (employer, coworker, customer) does not have a TTY and needs to talk to the deaf employee who does, another way of communicating is through the Telephone Relay Service.  The Relay Service is a system through which TTY users are able to communicate with one another with the help of specially trained intermediaries known as Communication Assistants (CA's).  These Communication Assistants complete the link in the telephone conversation by speaking what the TTY user types and typing, via TTY, what the voice telephone user says.

The Washington Relay Service (WRS) is a free service that is part of a nationwide network established under the Americans with Disabilities Act.  Provided by the Washington State Office of the Deaf and Hard of Hearing, WRS ensures equal communication access for people who are deaf, hard of hearing, deaf-blind, or have a speech disability.  All calls are strictly confidential and no records of any conversation are kept. Calls can be made to anywhere in the world 24/7.  To place a call through the relay service dial 7-1-1 to connect with a Communication Assistant who will call the number requested and relay the conversation between the two callers.

For more information on the telephone relay service click here

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Using Sign Language Interpreters

A sign language interpreter is a skilled professional who simultaneously interprets the meaning of spoken words into sign language and from sign language into spoken English.  There are a number of sign language systems used by individuals who use sign language.  The most common systems of sign language are American Sign Language and Signed English.  Individuals who use a particular system may not be able to communicate effectively through an interpreter who uses a different system.  Because of this, when an interpreter is required, it is important that the employer provides a qualified interpreter who is able to sign to the individual who is deaf what is being said by the hearing person and who can voice to the hearing person what is being signed by the individual who is deaf.  This communication needs to be conveyed effectively, accurately, and impartially, through the use of any necessary specialized vocabulary.

An employer has the obligation to provide an accommodation that will enable an individual to perform a job and communicate effectively.  It is necessary for the employer to determine the communication needs of the individual in relation to the specific job tasks to be performed.  It may be necessary to provide a qualified interpreter as an accommodation in situations where the individual's primary communication occurs through using American Sign Language (ASL) or some other form of manual communication.  It is important for an employer to evaluate the length and complexity of the communication in order to determine if an interpreter will be needed.  For lengthy or technical meetings, interviews, explanation of employee benefits, disciplinary meetings or training, an interpreter may be most effective.  Interpreters may also be necessary for staff meetings, conversations with co-workers, or an employee party, so that a hearing-impaired individual can fully participate in these functions.

For an alphabetical listing of Washington State interpreters click here to go to the Deafweb Washington website.

For a list of interpreter referral agencies in Washington State click here to go the Deafweb Washington website.

Qualified sign language interpreters can be an appropriate accommodation for both one-on-one communication and during group situations.  It is important to keep in mind that interpreter costs vary across the country, and most interpreting services require notice in advance and will charge by the hour.  If the group situation or event will last longer than two hours, many interpreting agencies will require that two interpreters be provided.  Some interpreting services offer remote interpreting as an option where the interpreter can be video-conferenced into the meeting/event.  Check with local sign language interpreting services for more information.

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Communication Access Realtime Translation (CART)

Communication Access Realtime Translation is "the instant translation of the spoken word into English text using a stenotype machine, notebook computer, and realtime software.  The text appears on a computer monitor or other display."  (National Court Reporters Association.)  CART offers word for word translation and is provided by a professional who is skilled in using the stenographic equipment.

Individuals who are deaf or hard of hearing might benefit from the use of Communication Access Realtime Translation services during small and large group communication situations when verbatim conversation is essential to effective communication.  Such group situations might include monthly or union meetings, workshops, seminars, or awards ceremonies.

For an alphabetical listing of Washington State Realtime Captioners click here to go to the Deafweb Washington website.

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Additional Resources

The Job Accommodation Network (JAN) is a service of the Office of Disability Employment Policy of the US Department of Labor.  JAN's mission is to facilitate the employment and retention of workers with disabilities by providing employers, employment providers, and people with disabilities with information on job accommodations.  JAN represents the most comprehensive resource for job accommodations available.

Click here to get accommodation and resource information by disability.

The Job Accommodation Network's Searchable Online Accommodation Resource (SOAR) system is designed to assist users in exploring various accommodation options for people with disabilities in work settings.  These accommodation ideas are not all inclusive, however.  The SOAR system allows the user to search by disability to get information on corresponding limitations, job functions, and accommodations.

Click here to begin your accommodation resource search.

The School of Industrial and Labor Relations Program on Employment and Disability, at Cornell University, serves as the Rehabilitation Research and Training Center for economic research on employment policy for persons with disabilities.  Inthat capacity they have developed several informational brochures on working effectively with people with various kinds of disabilities.  Click here to download their brochure on Working Effectively With People Who Are Deaf or Hard of Hearing.

For more information on programs and services available for individuals who are deaf and hard of hearing in Washington State click here to go to the website of the Office of Deaf and Hard of Hearing for Washington State.

For technical assistance questions or to problem-solve about appropriate accommodations in a particular situation, contact the Able Job Seekers Technical Assistance Center toll-free at:

(866) 438-3292 (V)
(360) 438-3207 (TTY)

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