The Pregnant Workers Fairness Act (PWFA), which became effective in June 2023, requires covered employers to provide job-related accommodations to employees for work limitations they experience due to pregnancy, childbirth or related medical conditions. (See our prior coverage here.) Since the PWFA’s enactment, the U.S. Equal Employment Opportunity Commission (EEOC) issued regulations explaining employer obligations under the law, including, in particular, the duty to participate in an interactive dialogue with covered employees in order to identify and implement reasonable accommodations for pregnancy- and childbirth-related limitations.

As employers already should be familiar from the analogous reasonable accommodation obligation for physical and mental health disabilities under the Americans with Disabilities Act (ADA), the interactive process is often facilitated when an employee’s health care provider presents documentation regarding the patient-employee’s need for accommodation, the likely benefit of such accommodation(s) and the anticipated time period for which such accommodations should be provided. Healthcare provider documentation is similarly helpful in crafting reasonable accommodations under the PWFA. Therefore, on December 18, 2024, the EEOC released informal guidance on how healthcare providers can best assist their patients in seeking accommodations under the PWFA.

Highlights from the guidance—which is not the result of notice-and-comment rulemaking but is nonetheless edifying—include the following:

• The EEOC encourages healthcare providers to be informed about, and to tell their patients about, the PWFA, including that patients may be entitled to accommodation for pregnancy- or childbirth-related limitations, even if their condition is “minor, modest, or episodic.”

• The agency also encourages healthcare providers to think flexibly, reminding them that the PWFA does not restrict what patients can ask for as reasonable accommodations. To aid in the process of identifying reasonable accommodations, the EEOC proposes some options to consider, such as policy changes, increased break time, modifying or obtaining new or different work equipment, adjusting dress codes and work schedules, offering telework or light duty and providing leaves of absence to attend healthcare appointments or to recover from childbirth. The EEOC also reminds that, unlike reasonable accommodation under the ADA, which generally does not require this step, the PWFA expressly contemplates the temporary suspension of a main job duty, or “essential function,” as a reasonable accommodation for pregnancy- or childbirth-related limitations.

• The EEOC also offers healthcare providers practical advice on how to complete medical paperwork, if requested by the patient’s employer, including (a) explaining the provider’s professional qualifications; (b) confirming the patient’s physical or mental condition (although no formal diagnosis is required); (c) confirming the condition is related to, affected by, arising out of or exacerbated by pregnancy, childbirth or related medical conditions; (d) describing the adjustment needed at work due to the limitation, including the expected duration of the accommodation, and, if the accommodation is the temporary elimination of a job duty, affirmatively stating the employee will be able to resume such duty after the condition resolves. As to this last point, the agency advises healthcare providers not to “overstate the need for a particular accommodation in case an alternative is necessary,” and to be available to their patients to review alternative accommodations suggested by employers.

• Finally, the EEOC encourages healthcare providers to understand the intersection between the PWFA, the Pregnancy Discrimination Act, the ADA, the Family and Medical Leave Act and the PUMP Act. Each statute provides different remedies, has different coverage and eligibility requirements, provides different employee protection and may require different information from providers.

The EEOC’s guidance imposes no formal legal obligations on healthcare providers but nonetheless underscores the valuable role that medical documentation can play in elucidating employer obligations to assist their pregnant and childbearing employees. It also provides useful information to employers in crafting medical documentation requests, elucidating what types of information can and cannot be requested in connection with a PWFA accommodation request.