Asking for Accommodations as a Higher-Weight Person - Part 2

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In Part 1 we talked about some general information about asking for accommodations as a higher-weight person. To get more insight into the legalities of this, I reached out to the brilliant folks at The Fat Legal Advocacy, Rights, and Education (FLARE) Project to write this guest column. The rest of this newsletter is their wise words.

FLARE’s approach to health care access: Fat people deserve access to health care. Due to high rates of anti-fat attitudes, lack of universal design in medical equipment, and the failure to train medical personnel in how to work with higher-weight patients, it is very common for fat people to have to advocate vigorously for themselves in medical settings. When advocating, it’s helpful to know if you are in one of the few locations that specifically prohibit weight discrimination. In other locations, higher-weight people may be protected under disability laws even if no “fat laws” exist there. 

Here are some tips from the FLARE Project that may help:

In most locations (where weight discrimination laws have not yet been passed) the following questions or statements might apply:

• What tests or treatments would I be receiving if I was not higher weight?

• What, if any, are the reasons I cannot receive those same tests or treatments?

• If the reason for denial is an objective reason (such as a weight limit for a piece of equipment or a test that does not work on higher-weight bodies):

  • “If I cannot receive a particular test or treatment due to weight, what are the alternative tests or treatments that will result in similar findings or improvements?”

• If the reason for denial is policy-based, rather than an objective reason like a weight limit for a piece of equipment or a test that does not work on higher-weight bodies:

  • “I am requesting a reasonable accommodation so that I can receive equitable, nondiscriminatory treatment. Making a policy exception is a type of reasonable accommodation. If you are not authorized to make a policy exception, please let me talk to your supervisor or someone who is authorized.” 

  • “How can we partner together to ensure that I get the health care that I need, just like I would if I was thin?”

In locations where there is a specific law or court decision (State of Washington) prohibiting weight discrimination:

• What tests or treatments would I be receiving if I was not higher weight?

• What, if any, are the reasons I cannot receive those same tests or treatments?

• If I cannot receive a particular test or treatment due to weight, what are the alternative tests or treatments that will result in similar findings or improvements?

• If the reason for denial is an objective reason (such as a weight limit for a piece of equipment or a test that does not work on higher-weight bodies):

  • “The law requires equitable treatment for people of all sizes. If I cannot receive a particular test or treatment due to weight, what are the alternative tests or treatments that will result in similar findings or improvements?” 

  • If they cannot think of any alternatives try asking:

    • “Before this (test or piece of diagnostic equipment) was invented, what approaches were used for diagnosis (or treatment).”

• If the reason for denial is policy-based, rather than an objective reason (such as a weight limit for a piece of equipment or a test that does not work on higher weight bodies):

  • “In our location weight-related discrimination is unlawful. Let’s work together to be sure I receive fair, lawful treatment and receive the same quality of care as a thin person would here.” 

  • “Reasonable accommodations are required by law. I am requesting a reasonable accommodation so that I can receive equitable, nondiscriminatory treatment. Making a policy exception is a type of reasonable accommodation. If you are not authorized to make a policy exception, please let me talk to your supervisor or someone who is authorized.” 

  • If no other reasonable accommodation is available at this location, it may be reasonable for you to ask for their help in finding a location:

    • “Since you are not able to accommodate me here, I will need your assistance in locating a facility that can accommodate me. Please do some research and let me know where I can be treated, and let’s call together to confirm the arrangements and details.”

Always remember: 

• Take notes, including the name, date, time and exact quotations (which you can indicate by using quotation marks) to the extent possible. Notes may be on paper, on your phone, or otherwise.

• Record: If you are in a state where recording is legal without the consent of both parties, consider recording if you can do so without violating anyone’s right to privacy.

• Have a witness/advocate: Bring an advocate or a witness who can listen and possibly also take notes for you. If COVID or other protocols limit the ability to have an advocate, you may still be legally entitled to having a support person with you if needed for equal access to healthcare as a nondisabled person would have. (For example, if you have a disability that prevents you from understanding or concentrating, you may need a support person to convey information to you in a way that you can understand; you likely have a right to having such a support person present even if there is a policy that prevents guests or visitors.)

• You may choose to call ahead (or have someone call for you) to ask about weight capacity or size capacity of equipment

• You may not want to leave a healthcare setting until you are assured that the place they are sending you can accommodate you. For example, if a healthcare office is trying to send you to another place for imaging, you can ask them to call ahead with you to confirm that the equipment at the place they are trying to send you is adequate. This is especially true if you called ahead and were told the place you originally went could accommodate you.

• Remember that you DESERVE quality healthcare regardless of size.

• Remember that advocating for your own healthcare as a fat person may help the next fat person get treated better than you were treated. You are advocating for not only yourself, but all the future fat people who show up and need equitable treatment. 

• Consider sharing your success stories publicly by sending a summary to The FLARE Project.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.