We need to stop asking people to prove that they can function without accommodation in order to qualify for accommodation.
I keep coming back to this when we talk about brain injury, disability, referrals, treatment systems and access to services.
I have a documented history of brain injury and a diagnosed auditory processing disorder. On the phone, particularly without the visual information of seeing someone speak, my brain does not process language normally. I can hear the words and still not fully assemble what was said until much later.
That is not a preference. It is not avoidance. It is not an excuse.
It is a neurological impairment.
Recently, while dealing with a state system, I explained exactly this. I explained why complicated phone-based processes create a genuine barrier for me.
The person understood.
And then immediately began verbally giving me case numbers, PINs, docket numbers, passwords and multiple sets of instructions.
I had just explained the disability, and the accommodation process required me to perform the very function that is impaired.
There was something almost absurd about it.
But the larger issue is not my experience.
I can identify my impairment. I have a diagnosis. I understand brain injury. I can advocate for myself and explain what is happening.
Many people cannot.
A person with impaired initiation, working memory, attention, processing speed, executive functioning, emotional regulation or self-awareness may not know why they keep missing appointments, avoiding phone calls, losing paperwork, forgetting instructions or shutting down when systems become complicated.
And when we do not identify the neurological piece, we often assign a behavioral explanation instead.
Noncompliant.
Unmotivated.
Manipulative.
Avoidant.
Difficult.
That is one reason screening matters so much.
Screening does not diagnose a brain injury. But it can change the question.
Instead of asking,
“Why won’t this person do what we are asking?”
we can begin asking,
“Is there a neurological reason this person cannot consistently do what we are asking?”
That difference matters in addiction treatment, mental health, homelessness services, probation, disability systems, healthcare and reentry.
A referral is not meaningful access if the neurological demands required to complete the referral exceed the person’s ability to navigate them.
Sometimes accommodation means treatment.
Sometimes it means written instructions, repetition, a warm handoff, help making the call, assistance organizing appointments, simplified steps, follow-up, or another person helping carry the executive load.
That is not doing everything for someone.
It is recognizing the disability accurately enough to stop designing the path to help around the exact functions that disability may have impaired.
We cannot continue punishing people for neurological deficits we have never taken the time to identify.