[Federal Register Volume 89, Number 77 (Friday, April 19, 2024)]
[Rules and Regulations]
[Pages 29096-29220]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-07527]



[[Page 29095]]

Vol. 89

Friday,

No. 77

April 19, 2024

Part IV





 Equal Employment Opportunity Commission





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29 CFR Part 1636





Implementation of the Pregnant Workers Fairness Act; Final Rule

  Federal Register / Vol. 89 , No. 77 / Friday, April 19, 2024 / Rules 
and Regulations  

[[Page 29096]]


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EQUAL EMPLOYMENT OPPORTUNITY COMMISSION

29 CFR Part 1636

RIN 3046-AB30


Implementation of the Pregnant Workers Fairness Act

AGENCY: Equal Employment Opportunity Commission.

ACTION: Final rule and interpretive guidance.

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SUMMARY: The Equal Employment Opportunity Commission is issuing this 
final rule and interpretive guidance to implement the Pregnant Workers 
Fairness Act, which requires a covered entity to provide reasonable 
accommodations to a qualified employee's or applicant's known 
limitations related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions, unless the accommodation 
will cause an undue hardship on the operation of the business of the 
covered entity.

DATES: This final rule and interpretive guidance is effective on June 
18, 2024.

FOR FURTHER INFORMATION CONTACT: Sharyn Tejani, Associate Legal 
Counsel, Office of Legal Counsel at 202-900-8652 (voice), 1-800-669-
6820 (TTY), [email protected]. Requests for this final rule and 
interpretive guidance in an alternative format should be made to the 
Office of Communications and Legislative Affairs at (202) 921-3191 
(voice), 1-800-669-6820 (TTY), or 1-844-234-5122 (ASL video phone).

SUPPLEMENTARY INFORMATION: 

Introduction

    The Pregnant Workers Fairness Act (PWFA) \1\ requires a covered 
entity to provide reasonable accommodations to a qualified employee's 
or applicant's known limitations related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions, absent 
undue hardship on the operation of the business of the covered entity. 
The PWFA at 42 U.S.C. 2000gg-3(a) directs the Equal Employment 
Opportunity Commission (EEOC or Commission) to promulgate regulations 
to implement the PWFA.
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    \1\ Consolidated Appropriations Act, 2023, Public Law 117-328, 
Div. II, 136 Stat. 4459, 6084 (2022) (codified at 42 U.S.C. 2000gg 
to 2000gg-6).
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    The Commission issued its notice of proposed rulemaking (NPRM) on 
August 11, 2023, and invited public comment on this proposal from 
August 11, 2023, through October 10, 2023.\2\ Members of the public 
submitted approximately 98,600 comments to the EEOC during this 60-day 
period. Several of those comments were signed by multiple individuals; 
thus, the total number of comments was over 100,000.\3\
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    \2\ 88 FR 54714-94 (proposed Aug. 11, 2023) (to be codified at 
29 CFR part 1636).
    \3\ The vast majority of the comments were form comments that 
were identical or slightly altered versions of a few base form 
comments.
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    Pursuant to 42 U.S.C. 2000gg-3(a), the Commission is issuing this 
final regulation and an appendix entitled ``Appendix A to Part 1636--
Interpretive Guidance on the Pregnant Workers Fairness Act'' 
(Interpretive Guidance). As explained in the NPRM, the Interpretive 
Guidance (a proposed version of which was included in the NPRM) will 
become part of 29 CFR part 1636.\4\ The Interpretive Guidance 
represents the Commission's interpretation of the issues addressed 
within it, and the Commission will be guided by the regulation and the 
Interpretive Guidance when enforcing the PWFA.\5\
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    \4\ 88 FR 54719.
    \5\ Id.
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General Information on Terms Used in the Regulation and Interpretive 
Guidance

    The PWFA at 42 U.S.C. 2000gg(3) uses the term ``employee (including 
an applicant)'' in its definition of ``employee.'' Thus, throughout the 
statute, this preamble, the final regulation, and the Interpretive 
Guidance, the term ``employee'' should be understood to include 
``applicant'' where relevant. Because the PWFA relies on Title VII of 
the Civil Rights Act of 1964 (Title VII), as amended by the Pregnancy 
Discrimination Act of 1978 (PDA), 42 U.S.C. 2000e et seq. for its 
definition of ``employee,'' that term also includes ``former 
employee,'' where relevant.\6\
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    \6\ Robinson v. Shell Oil Co., 519 U.S. 337, 346 (1997).
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    The PWFA defines ``covered entity'' using the definition of 
``employer'' from different statutes, including Title VII.\7\ Thus 
``covered entities'' under the PWFA include public and private 
employers with 15 or more employees, unions, employment agencies, and 
the Federal Government.\8\ In this preamble, the final regulation, and 
the Interpretive Guidance, the Commission uses the terms ``covered 
entity'' and the term ``employer'' interchangeably.
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    \7\ 42 U.S.C. 2000gg(2)(A), (B)(i), (B)(iii), (B)(iv). The other 
statutes are the Congressional Accountability Act of 1995 and 3 
U.S.C. 411(c).
    \8\ The statute at 42 U.S.C. 2000gg(2) provides that the term 
``covered entity'' ``has the meaning given the term `respondent''' 
under 42 U.S.C. 2000e(n) and includes employers as defined in 42 
U.S.C. 2000e(b), 2000e-16c(a), and 2000e-16(a). The statute at 42 
U.S.C. 2000gg-5(b) provides as a rule of construction that ``[t]his 
chapter is subject to the applicability to religious employment set 
forth in section 2000e-1(a) of this title [section 702(a) of the 
Civil Rights Act of 1964].''
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    To track the language of the statute more closely and improve 
readability, the Commission made three global changes from the proposed 
rule and proposed appendix to the final rule and Interpretive Guidance. 
First, the Commission removed most instances of the words ``applicant'' 
and ``former employee'' from the regulation and the Interpretive 
Guidance; based on the statute and Title VII, the term ``employee'' 
covers ``applicant'' and ``former employee'' when relevant. Second, the 
Commission replaced the word ``worker'' with the word ``employee'' 
throughout the regulation and the Interpretive Guidance. Third, the 
Commission removed sections of the proposed rule that pertained solely 
to employees covered by the Congressional Accountability Act of 1995 
because the Commission does not have authority to regulate those 
employees (former Sec. Sec.  1636.2(c)(2) and 1636.5(b)).
    The Interpretive Guidance contains numerous examples to illustrate 
provisions in the regulation. The Commission received some comments 
identifying instances where these examples, in an effort to be simple 
and short, oversimplified situations related to pregnancy, childbirth, 
or related medical conditions. For example, the Commission used the 
term ``bed rest'' in some examples; that is a colloquialism for several 
actions that would be better described as ``rest and reduced 
activity.'' \9\ The Commission agrees that in a real situation, there 
may or may not be more complexity and that describing a restriction may 
require different or more facts than are in an example. However, the 
purpose of these examples is to illustrate legal points, to suggest 
practical actions for covered entities and employees, and to encourage 
voluntary compliance with the law. Thus, while

[[Page 29097]]

the Commission has made some changes to the examples in response to 
these comments, it also has retained simple language in many examples 
to allow for ease of reading and to keep the focus of the examples on 
the PWFA's legal interpretation. The Commission notes that, depending 
on the facts in the examples, the same facts could lead to claims also 
being brought under other statutes that the Commission enforces, such 
as Title VII and the Americans with Disabilities Act of 1990 (ADA), as 
amended by the ADA Amendments Act of 2008 (ADAAA or Amendments Act), 42 
U.S.C. 12101 et seq.\10\ Moreover, the situations in specific examples 
could implicate other Federal laws, including, but not limited to, the 
Family and Medical Leave Act of 1993, as amended (FMLA), 29 U.S.C. 2601 
et seq.; the Occupational Safety and Health Act of 1970, as amended 
(OSH Act), 29 U.S.C. 651 et seq.; and the Fair Labor Standards Act of 
1938 (FLSA), 29 U.S.C. 201 et seq., as amended by the Providing Urgent 
Maternal Protections for Nursing Mothers Act (PUMP Act), Public Law 
117-328, Div. KK, 136 Stat. 4459, 6093 (2022).\11\ Additionally, 
although some examples state that the described actions ``would 
violate'' the PWFA, additional facts not described in the examples 
could change that determination.
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    \9\ Similarly, several examples discuss restrictions on how much 
an employee can lift. The examples in the Interpretive Guidance 
generally refer to these restrictions as ``lifting restrictions'' 
with a specific pound limit. In some situations, the determination 
of such restrictions can depend on the frequency of lifting, the 
height to which the object is lifted, the body position of the 
person, and the distance between the person and the object. See, 
e.g., Leslie A. MacDonald et al., Clinical Guidelines for 
Occupational Lifting in Pregnancy: Evidence Summary and Provisional 
Recommendations, 209 a.m. J. Obstetrics & Gynecology 80-88 (2013), 
https://pubmed.ncbi.nlm.nih.gov/23467051/; U.S. Dep't of Health & 
Hum. Servs., Ctrs. for Disease Control & Prevention, Nat'l Inst. for 
Occupational Safety & Health, Provisional Recommended Weight Limits 
for Lifting at Work During Pregnancy (Infographic), https://www.cdc.gov/niosh/topics/repro/images/Lifting_guidelines_during_pregnancy_-_NIOSH.jpg (last visited Mar. 
18, 2024).
    \10\ References to the ADA throughout the preamble, the 
regulation, and the Interpretive Guidance are intended to apply 
equally to the Rehabilitation Act of 1973, as all nondiscrimination 
standards under Title I of the ADA also apply to Federal agencies 
under section 501 of the Rehabilitation Act. See 29 U.S.C. 791(f).
    \11\ To the extent that an accommodation in an example is 
required under another law, like the OSH Act, the example should not 
be read to suggest that such a requirement is not applicable.
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    Finally, the Commission notes that the examples are illustrative. 
They do not and are not intended to cover every limitation or possible 
accommodation under the PWFA.\12\
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    \12\ In the examples, the preamble, the regulation, and the 
Interpretive Guidance, the Commission uses the terms ``leave'' or 
``time off'' and intends those terms to cover leave however it is 
identified by the specific employer. As stated in the proposed rule, 
the Commission recognizes that different types of employers use 
different terms for time away from work, including leave, paid time 
off (PTO), time off, sick time, vacation, and administrative leave, 
among others. 88 FR 54715 n.19. Similarly, in the examples, the 
preamble, the regulation and the Interpretive Guidance, the 
Commission uses the term ``light duty.'' The Commission recognizes 
that ``light duty'' programs, or other programs providing modified 
duties, can vary depending on the covered entity. As stated in the 
proposed rule, the Commission intends ``light duty'' to include the 
types of programs included in Questions 27 and 28 of the EEOC's 
Enforcement Guidance: Workers' Compensation and the ADA and any 
other policy, practice, or system that a covered entity has for 
accommodating employees, including when one or more essential 
functions of a position are temporarily excused. EEOC, Enforcement 
Guidance: Workers' Compensation and the ADA (1996), https://www.eeoc.gov/laws/guidance/enforcement-guidance-workers-compensation-and-ada; 88 FR 54715 n.20.
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1636.1 Purpose

    The Commission made several minor changes to the Purpose section of 
the regulation to follow the language in the statute more closely. 
Specifically, the phrase ``related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions'' was added after 
``known limitations'' throughout this paragraph, and the descriptions 
of the retaliation and coercion provisions were slightly modified.\13\
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    \13\ For example, the phrase ``Prohibits a covered entity from 
retaliating'' was replaced with ``Prohibits discrimination'' in the 
discussion of retaliation, and the phrase ``Prohibits a covered 
entity from interfering with any individual's rights'' was replaced 
with ``Prohibits coercion of individuals in the exercise of their 
rights'' in the discussion of coercion.
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1636.2 Definitions--General

    The Commission received numerous comments regarding the proposed 
general definitions. For example, many comments encouraged the 
Commission to clarify that restaurant workers are covered by the PWFA. 
Several comments also suggested the Commission clarify that the 
requirements for protection under the FMLA (in terms of how long an 
employee must work for an employer and the number of hours) do not 
apply under the PWFA and suggested the Commission clarify that 
employees need not work for an employer for any specific period of time 
in order to be covered by the PWFA.
    The PWFA relies on definitions from Title VII to describe when an 
employer is covered and who is protected by the law. Employers are 
covered by the PWFA if they have 15 or more employees, regardless of 
the industry. Thus, restaurant workers who work for restaurants with 15 
or more employees are covered. Because the PWFA's approach to coverage 
and protection follows Title VII, rather than the FMLA, employees are 
covered even if they have not worked for a specific employer for a 
specific length of time.
    In the general definitions section of the rule, the Commission 
added ``or the employee of a political subdivision of a State'' in 
Sec.  1636.2(b)(3) and (c)(4) to better describe the employees covered 
by the Government Employee Rights Act of 1991 (GERA), 42 U.S.C. 2000e-
16c(a).

1636.3 Definitions--Specific to the PWFA

1636.3(a) Known Limitation

    The rule reiterates the definition of ``known limitation'' from 42 
U.S.C. 2000gg(4) and then provides definitions for the operative terms.

1636.3(a)(1) Known

    The Commission did not change the definition of ``known'' from the 
proposed rule. Under that definition a limitation is ``known'' to a 
covered entity if the employee, or the employee's representative, has 
communicated the limitation to the covered entity.

1636.3(a)(2) Limitation

    The proposed rule restated the definition of limitation from the 
statute and added that the physical or mental condition may be a modest 
or minor and/or episodic impediment or problem, that it included when 
an employee affected by pregnancy, childbirth, or related medical 
conditions had a need or a problem related to maintaining their health 
or the health of the pregnancy, and that it included when an employee 
affected by pregnancy, childbirth, or related medical conditions sought 
health care related to pregnancy, childbirth, or a related medical 
condition itself.
    The Commission received several comments supporting the definition 
of ``limitation'' and suggesting that the word ``need'' be added to the 
second sentence (in addition to ``impediment'' or ``problem'') so that 
it would read: ``Physical or mental condition is an impediment, 
problem, or need that may be modest, minor, and/or episodic.'' The 
Commission declines to make this change because this sentence as it 
exists (which uses the term ``impediment'' or ``problem'') is 
sufficiently broad, and the third sentence of the definition of 
``limitation'' covers when the employee has a ``need or a problem 
related to maintaining their health or the health of the pregnancy.''
    The Commission received a few comments asserting that this 
definition was too broad and that it should be more restrictive. The 
Commission disagrees. As discussed in the NPRM, the PWFA was intended 
to cover all types of limitations, including those that are minor and 
those that are needed to maintain the employee's health or the health 
of the pregnancy.\14\ Thus,

[[Page 29098]]

creating a higher threshold would not be in keeping with this 
rationale, would be contrary to congressional intent, and would impede 
a qualified employee's ability to stay on the job.
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    \14\ 88 FR 54714-16 (discussing the purpose of the PWFA, 
including that it helps workers with uncomplicated pregnancies and 
minor limitations), 54719-20 (explaining that allowing employees to 
seek health care related to pregnancy, childbirth, or a related 
medical condition itself is consistent with the ADA).
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    A handful of comments asked for clarification as to whether the 
language in the NPRM required employers to provide reasonable 
accommodations to an employee when an employee's partner, spouse, or 
family member--and not the employee themselves--has a physical or 
mental condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions. It does not. To respond to 
these comments, the Commission has included in the final rule's 
definition of ``limitation'' that the limitation must be of the 
specific employee in question. This is essentially the same language 
that was in the NPRM with regard to related medical conditions in Sec.  
1636.3(b).\15\
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    \15\ 88 FR 54767 (providing that related medical conditions are 
``as applied to the specific employee or applicant in question'').
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    The Commission has made one minor change in the language of this 
provision in the regulation. To track the language of the statute in 42 
U.S.C. 2000gg(4), the Commission has changed the last sentence of the 
definition of ``limitation'' regarding the ADA so that it now mirrors 
the language in the statute (``whether or not such condition meets the 
definition of disability'').
    In the Interpretive Guidance, the Commission has added information 
in section 1636.3(a)(2) Limitation calling attention to the possible 
overlap between the PWFA and the ADA and noting that in these 
situations the qualified employee may be entitled to an accommodation 
under either statute, as the protections of both may apply. The 
Commission has added information consistent with the changes in the 
regulation described above to state that the limitation must be of the 
specific employee in question and that the PWFA does not create a right 
to reasonable accommodation based on an individual's association with 
someone else with a PWFA-covered limitation or provide accommodations 
for bonding or childcare. To make the language in the Interpretive 
Guidance consistent with the regulation, the Commission has modified 
language in the Interpretive Guidance regarding accommodations for 
health care to clarify that accommodations may be needed to attend 
health care appointments for a variety of reasons.\16\ Finally, the 
Commission has modified language from the proposed appendix regarding 
the PWFA and the lack of a ``severity'' requirement to avoid giving the 
mistaken impression that the ADA has such a requirement.
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    \16\ The proposed appendix stated: ``The definition also 
includes when the worker is seeking health care related to the 
pregnancy, childbirth, or a related medical condition itself . . . 
and recognizes that for pregnancy, childbirth, or related medical 
conditions the proper course of care can include regular 
appointments and monitoring by a health care professional.'' 88 FR 
54773. The new language in the Interpretive Guidance in section 
1636.3(a)(2) Limitation states: ``Similarly, under the PWFA, an 
employee may require a reasonable accommodation of leave to attend 
health care appointments or receive treatment for or recover from 
their pregnancy, childbirth, or related medical conditions.'' The 
new language more accurately reflects that accommodations are not 
limited to ``regular appointments'' or ``monitoring,'' which is 
consistent with how leave for health care appointments is described 
in the regulation and elsewhere in the Interpretive Guidance.
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Comments and Response to Comments Regarding the Commission's Proposed 
Description of ``Related to, Affected by, or Arising Out of''
    Some comments supported the Commission's reading of the language 
``related to, affected by, or arising out of,'' stating that the 
Commission's reading was textually accurate in that nothing in the 
statutory language requires that the pregnancy, childbirth, or related 
medical conditions be the sole or original cause of the limitation. 
Other comments stated that the language in the NPRM explaining 
``related to, affected by, or arising out of,'' especially when 
combined with the definition of ``related medical conditions,'' could 
require accommodations for known limitations caused by any physical or 
mental condition that has any real, perceived, or potential connection 
to--or impact on--an individual's pregnancy, fertility, or reproductive 
system. These comments asked the Commission to alter the NPRM language 
to counter this interpretation. Some comments asked for additional 
clarification regarding the language ``related to, affected by, or 
arising out of.''
    The PWFA uses the language ``related to, affected by, or arising 
out of'' to explain the connection between the physical or mental 
condition and pregnancy, childbirth, or related medical conditions.\17\ 
As such, the statute does not require that pregnancy, childbirth, or 
related medical conditions be the sole, the original, or a substantial 
reason for the physical or mental condition, and the Commission does 
not have the authority to change this term.
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    \17\ 42 U.S.C. 2000gg(4).
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    To help respond to these comments, in the Interpretive Guidance in 
section 1636.3(a)(2) under Related to, Affected by, or Arising Out of, 
the Commission has added that ``related to, affected by, or arising out 
of'' are inclusive terms and that a pregnancy, childbirth, or related 
medical condition does not need to be the sole, the original, or a 
substantial cause of the physical or mental condition at issue for the 
physical or mental condition to be ``related to, affected by, or 
arising out of'' pregnancy, childbirth, or related medical conditions. 
This is in keeping with the dictionary definition of ``related to,'' 
which is generally defined as ``connected with'' or ``about'' 
something.\18\ It also is consistent with the meaning of ``affected 
by,'' as the dictionary definition of the word ``affect'' is ``to 
cause,'' ``to produce,'' or ``to influence'' something.\19\ Finally, it 
aligns with the meaning of ``arising out of,'' because the dictionary 
definition of ``arise'' includes ``to begin to occur or exist'' or ``to 
originate from a source.'' \20\
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    \18\ Relate To, Merriam-Webster.com, https://www.merriam-webster.com/dictionary/related%20to (last visited Mar. 9, 2024).
    \19\ Affect, Merriam-Webster.com, https://www.merriam-webster.com/dictionary/affect (last visited Mar. 18, 2024).
    \20\ Arise, Merriam-Webster.com, https://www.merriam-webster.com/dictionary/arising (last visited Mar. 14, 2024).
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    The Interpretive Guidance in section 1636.3(a)(2) under Related to, 
Affected by, or Arising Out of further explains that determining 
whether a physical or mental condition is ``related to, affected by, or 
arising out of'' pregnancy, childbirth, or related medical conditions 
should typically be straightforward, particularly in cases where an 
individual is currently pregnant, is experiencing childbirth, or has 
just experienced childbirth. Pregnancy and childbirth cause systemic 
changes that not only create new physical and mental conditions but 
also can exacerbate preexisting conditions and can cause additional 
pain or risk.\21\ Thus, a connection between an employee's physical or 
mental condition and their pregnancy, childbirth, or related medical 
conditions will be readily ascertained when an employee is currently 
pregnant or is experiencing or has just experienced childbirth.
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    \21\ See, e.g., Danforth's Obstetrics & Gynecology 286 (Ronald 
S. Gibbs et al. eds., 10th ed. 2008) (``Normal pregnancy entails 
many physiologic changes . . . .''); Clinical Anesthesia 1138 (Paul 
G. Barash et al. eds., 6th ed. 2009) (``During pregnancy, there are 
major alterations in nearly every maternal organ system.'').
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    The Commission has maintained the list of situations in the 
Interpretive

[[Page 29099]]

Guidance in section 1636.3(a)(2) under Related to, Affected by, or 
Arising Out of that show the connection between pregnancy, childbirth, 
or related medical conditions and the limitation with some minor 
changes.\22\ The Interpretive Guidance also maintains the discussion 
that some conditions (like lifting restrictions) can occur whether or 
not an employee is affected by pregnancy, childbirth, or related 
medical conditions and that the Commission anticipates that confirming 
that a physical or mental condition is related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions 
will usually be straightforward and can be accomplished through the 
interactive process. The Commission has added information to the 
Interpretive Guidance explaining that there may be situations where a 
physical or mental condition may no longer be related to, affected by, 
or arising out of pregnancy, childbirth, or related medical conditions, 
and that in those situations, an employee may seek an accommodation 
under the ADA. The Commission also has added that there may be 
situations where the physical or mental condition exacerbates an 
existing condition that is a disability under the ADA, and in those 
situations, an employee may be entitled to an accommodation under 
either the ADA or the PWFA.
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    \22\ For example, in the proposed appendix, many of the examples 
in this paragraph said that the physical or mental condition was 
``related to'' pregnancy. This has been changed to ``related to, 
affected by, or arising out of'' to match the language in the 
statute. The Commission has added that a lifting restriction may be 
due to lower back pain that may be exacerbated by physical changes 
associated with pregnancy to connect the lifting restriction to 
pregnancy in that example. The Commission has added in this 
paragraph that: ``A lactating employee who seeks an accommodation to 
take breaks to eat has a related medical condition (lactation) and a 
physical condition related to, affected by, or arising out of it 
(increased nutritional needs),'' in order to include an example 
about a ``related medical condition.'' The Commission has changed 
the language in the proposed appendix from ``determining whether'' 
to ``confirming whether,'' where relevant, in order to match the 
language used in Sec.  1636.3(l)(2).
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1636.3(b) Pregnancy, Childbirth, or Related Medical Conditions

    The NPRM explained that the phrase ``pregnancy, childbirth, or 
related medical conditions'' appears in Title VII's definition of 
``sex,'' as amended in 1978 by the PDA.\23\ Because Congress chose to 
write the PWFA using the same phrase as in Title VII, as amended by the 
PDA, and is presumed to have known the meaning given that phrase by the 
courts and the Commission for over 40 years, the Commission gave the 
phrase ``pregnancy, childbirth, or related medical conditions'' the 
same meaning under the PWFA as under Title VII.\24\ When Congress 
chooses to ``use[ ] the same language in two statutes having similar 
purposes, . . . it is appropriate to presume that Congress intended 
that text to have the same meaning in both statutes.'' \25\
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    \23\ 88 FR 54721.
    \24\ See, e.g., Tex. Dep't of Hous. & Cmty. Affs. v. Inclusive 
Cmtys. Project, Inc., 576 U.S. 519, 536 (2015) (``If a word or 
phrase has been . . . given a uniform interpretation by inferior 
courts . . . , a later version of that act perpetuating the wording 
is presumed to carry forward that interpretation.'') (omissions in 
original) (quoting Antonin Scalia & Bryan A. Garner, Reading Law: 
The Interpretation of Legal Texts 322 (2012)); Bragdon v. Abbott, 
524 U.S. 624, 645 (1998) (``When administrative and judicial 
interpretations have settled the meaning of an existing statutory 
provision, repetition of the same language in a new statute 
indicates, as a general matter, the intent to incorporate its 
administrative and judicial interpretations as well.''); Lorillard 
v. Pons, 434 U.S. 575, 581 (1978) (``[W]here, as here, Congress 
adopts a new law incorporating sections of a prior law, Congress 
normally can be presumed to have had knowledge of the interpretation 
given to the incorporated law, at least insofar as it affects the 
new statute.''); Hall v. U.S. Dep't of Agric., 984 F.3d 825, 840 
(9th Cir. 2020) (``Congress is presumed to be aware of an agency's 
interpretation of a statute. We most commonly apply that presumption 
when an agency's interpretation of a statute has been officially 
published and consistently followed. If Congress thereafter reenacts 
the same language, we conclude that it has adopted the agency's 
interpretation.'') (internal citations and quotation marks omitted); 
Antonin Scalia & Bryan A. Garner, Reading Law: The Interpretation of 
Legal Texts 323 (2012) [hereinafter Scalia & Garner, Reading Law] 
(``[W]hen a statute uses the very same terminology as an earlier 
statute--especially in the very same field, such as securities law 
or civil-rights law--it is reasonable to believe that the 
terminology bears a consistent meaning.''); H.R. Rep. No. 117-27, 
pt. 1, at 11-17 (discussing the history of the passage of the PDA; 
explaining that, due to court decisions, the PDA did not fulfill its 
promise to protect pregnant employees; and that the PWFA was 
intended to rectify this problem and protect the same employees 
covered by the PDA).
    \25\ Smith v. City of Jackson, 544 U.S. 228, 233 (2005); see 
Northcross v. Bd. of Ed. of the Memphis City Schs., 412 U.S. 427, 
428 (1973) (per curiam) (observing that ``similarity of language'' 
between statutes is ``a strong indication that the two statutes 
should be interpreted pari passu'').
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    The PWFA's legislative history supports the Commission's reading of 
the phrase ``pregnancy, childbirth, or related medical conditions'' to 
have the same meaning as the phrase in Title VII. The U.S. House of 
Representatives Report accompanying the PWFA recounts the legislative 
steps Congress has taken to protect workers affected by pregnancy, 
childbirth, or related medical conditions. In 1964, Congress passed 
Title VII, which included protection from discrimination based on sex. 
In 1972, the EEOC interpreted the prohibition on sex discrimination to 
include pregnancy, childbirth, or related medical conditions.\26\ In 
1976, the Supreme Court determined that pregnancy discrimination was 
not covered by Title VII.\27\ In 1978, responding to that decision, 
Congress passed the PDA ``to codify the EEOC's original interpretation 
of Title VII.'' \28\ Courts' subsequent interpretations of the 
disparate treatment standard in the PDA, however, left ``[n]umerous 
[g]aps'' in protections, and the Supreme Court's 2015 decision in Young 
v. United Parcel Service, Inc., 575 U.S. 206 (2015), created a standard 
that did not adequately protect the workers that the PDA covered, 
according to the PWFA House Report.\29\ The House concluded that, 
``[t]o remedy the shortcomings of the PDA, Congress must step in and 
act.'' \30\ Congress' discussion of the PDA and identification of 
shortcomings in the PDA as a reason for enacting the PWFA show that in 
the PWFA, Congress sought to protect the same workers who are protected 
by the PDA. By using Title VII's longstanding definition of 
``pregnancy, childbirth, or related medical conditions'' for the PWFA, 
the Commission is following both the text of the statute and its 
legislative history.
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    \26\ H.R. Rep. No. 117-27, pt. 1, at 12 (2021); 29 CFR 
1604.10(b) (1972); 37 FR 6835, 6837 (1972) (addressing Title VII 
coverage of ``[d]isabilities caused or contributed to by pregnancy, 
miscarriage, abortion, childbirth, and recovery therefrom'').
    \27\ Gen. Elec. Co. v. Gilbert, 429 U.S. 125, 135-36 (1976).
    \28\ H.R. Rep. No. 117-27, pt. 1, at 13; see also H.R. Rep. No. 
95-948, at 2 (1978), as reprinted in 1978 U.S.C.C.A.N. 4749, 4750 
(providing that the U.S. House of Representatives' version of the 
PDA ``will amend Title VII to clarify Congress' intent to include 
discrimination based on pregnancy, childbirth or related medical 
conditions in the prohibition against sex discrimination in 
employment'' and stating that the EEOC's 1972 guidelines--which 
``state that excluding applicants or employees from employment 
because of pregnancy or related medical conditions is a violation of 
Title VII'' and ``require employers to treat disabilities caused or 
contributed to by pregnancy, miscarriage, abortion, childbirth and 
recovery therefrom as all other temporary disabilities''--``rightly 
implemented the Title VII prohibition of sex discrimination in the 
1964 [Civil Rights A]ct''); S. Rep. No. 95-331, at 2 (1977) 
(explaining that, in implementing Congress' intent in amending Title 
VII in 1972, the EEOC issued guidelines that ``made clear that 
excluding applicants or employees from employment because of 
pregnancy or related medical conditions was a violation of [T]itle 
VII,'' and ``these guidelines rightly implemented the Congress' 
intent in barring sex discrimination in the 1964 [Civil Rights 
A]ct'').
    \29\ H.R. Rep. No. 117-27, pt. 1, at 14-16.
    \30\ Id. at 17.
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Comments Regarding Temporal Proximity to a Current or Recent Pregnancy
    Some comments requested that the Commission limit the definition of 
``pregnancy, childbirth, or related medical conditions'' under the PWFA 
to situations that met their definition of close temporal proximity to 
a current or recent pregnancy. These comments also

[[Page 29100]]

noted that many of the conditions listed in the NPRM as conditions that 
could qualify as ``pregnancy, childbirth, or related medical 
conditions'' also could impact individuals who have never been pregnant 
or could first arise years before or after pregnancy. Relatedly, 
several comments suggested that only conditions related to a current or 
recent pregnancy (which the comments defined as one occurring 6 or 
fewer months earlier) could be ``related medical conditions.''
Response to Comments Regarding Temporal Proximity to a Current or 
Recent Pregnancy
    The Commission declines to adopt the changes suggested by these 
comments, as they seek to create a definition of ``pregnancy, 
childbirth, or related medical conditions'' that is not supported by 
Title VII case law or the Commission's Enforcement Guidance on 
Pregnancy Discrimination and Related Issues.\31\ Further, adopting such 
a bright-line temporal rule would improperly exclude many employees, 
such as employees with postpartum limitations, who may require 
pregnancy-related accommodations.\32\ That said, ``related medical 
conditions'' must be related to the pregnancy or childbirth of the 
specific employee in question, and whether a specific condition is 
related to pregnancy or childbirth is a fact-specific determination 
that will be guided by existing Title VII precedent and prior relevant 
Commission guidance.
---------------------------------------------------------------------------

    \31\ EEOC, Enforcement Guidance on Pregnancy Discrimination and 
Related Issues, (I)(A) (2015) [hereinafter Enforcement Guidance on 
Pregnancy Discrimination], https://www.eeoc.gov/laws/guidance/enforcement-guidance-pregnancy-discrimination-and-related-issues 
(providing that the term ``pregnancy, childbirth, or related medical 
conditions'' includes current pregnancy, past pregnancy, potential 
or intended pregnancy, and related medical conditions).
    \32\ See, e.g., Am. Coll. of Obstetricians & Gynecologists, 
Comm. Opinion No. 736, Optimizing Postpartum Care (reaff'd 2021), 
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care (discussing the 
importance of postpartum health care, including treatment for 
disorders arising during pregnancy and chronic medical conditions); 
Susanna Trost et al., U.S. Dep't of Health & Hum. Servs., Ctrs. for 
Disease Control & Prevention, Pregnancy-Related Deaths: Data from 
Maternal Mortality Review Committees in 36 U.S. States, 2017-2019 
(2022), https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html (30% of pregnancy-related deaths occurred 
one- and one-half months to one year postpartum).
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Comments Regarding the List of Conditions Included in the Regulation as 
Examples of ``Pregnancy, Childbirth, or Related Medical Conditions''
    Multiple comments supported the Commission's definition of 
``pregnancy, childbirth, or related medical conditions'' and supported 
the inclusion of the list of numerous possible ``related medical 
conditions'' in the regulation. Comments argued that the Commission's 
reading of ``related medical conditions'' best effectuates the purpose 
and goals of the PWFA; is consistent with longstanding law, legislative 
history, agency interpretation, medical understanding, and common 
sense; and appropriately supplements the protections currently afforded 
under the PDA.
    By contrast, several comments stated that the language in the NPRM 
explaining the term ``related medical conditions'' could require 
accommodations for any physical or mental condition that has any real, 
perceived, or potential connection to--or impact on--an individual's 
pregnancy, fertility, or reproductive system. These comments asked the 
Commission to alter the language in the proposed rule to counter this 
interpretation.
    Other comments stated that the broad, non-exhaustive list of 
``related medical conditions'' exceeded the Commission's delegated 
authority as intended by Congress and that such a list would, based on 
sex, improperly privilege employees with gynecological conditions, or 
disadvantage other employees with analogous conditions, and thus 
potentially illegally discriminate under Title VII or the Equal 
Protection Clause.
Response to Comments Regarding the List of Conditions Included in the 
Regulation as Examples of ``Pregnancy, Childbirth, or Related Medical 
Conditions''
    Generally, the question of whether a condition constitutes 
``pregnancy, childbirth, or related medical conditions'' in a 
particular case will be fact-specific and guided by existing Title VII 
precedent and relevant prior Commission guidance. To assist in making 
that determination, the Commission made clarifying changes and 
additions to the language in this section of the regulation and has 
added more information in the Interpretive Guidance in section 
1636.3(b) Pregnancy, Childbirth, or Related Medical Conditions.
    First, the Commission removed the phrase ``relate to, are affected 
by, or arise out of'' with regard to ``related medical conditions'' in 
the proposed Sec.  1636.3(b) in order to track the language of the 
statute and reflect more closely language in the Commission's prior 
enforcement guidance that explains the extent of the PDA and the 
definition of ``pregnancy, childbirth, or related medical conditions.'' 
\33\ This sentence now says ``[r]elated medical conditions are medical 
conditions relating to the pregnancy or childbirth of the specific 
employee in question.''
---------------------------------------------------------------------------

    \33\ 42 U.S.C. 2000gg(4); Enforcement Guidance on Pregnancy 
Discrimination, supra note 31, at (I)(A)(4)(a) (``[A]n employer may 
not discriminate against a woman with a medical condition relating 
to pregnancy or childbirth.'').
---------------------------------------------------------------------------

    Second, the Commission reorganized the list of conditions in Sec.  
1636.3(b) to follow more closely the organization of the Commission's 
Enforcement Guidance on Pregnancy Discrimination explaining the 
definition of ``pregnancy, childbirth, or related medical conditions,'' 
so that the two resources are consistent.\34\
---------------------------------------------------------------------------

    \34\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A).
---------------------------------------------------------------------------

    Third, the Commission addressed concerns raised in the comments 
that conditions in the list of ``related medical conditions'' would 
``always'' be ``related medical conditions'' and thus limitations 
related to, affected by, or arising out of those conditions would 
automatically be entitled to coverage under the PWFA. The Commission 
responded to these concerns and requests by changing the language in 
Sec.  1636.3(b) so that the list is now explained as conditions that 
``are, or may be,'' ``related medical conditions.''
    Fourth, the Commission added that the pregnancy or childbirth must 
be ``of the specific employee in question.'' This language was already 
in the NPRM--in that the NPRM made clear that related medical 
conditions must be related to the pregnancy or childbirth of the 
specific employee in question--and has been added to the definition of 
``limitation'' as well.\35\
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    \35\ Additionally, for consistency, the Commission replaced 
``menstrual cycles'' with ``menstruation'' because menstruation is 
the term used elsewhere in the NPRM and also replaced ``birth 
control'' with ``contraception'' because that is the term used in 
Enforcement Guidance on Pregnancy Discrimination cited throughout 
the NPRM. Compare 88 FR 54767 (listing ``menstrual cycles'' in the 
list of ``related medical conditions''), with 88 FR 54721, 54774 
(explaining that the list in the regulation for the definition of 
``pregnancy, childbirth, or related medical conditions'' includes 
``menstruation''); Enforcement Guidance on Pregnancy Discrimination, 
supra note 31, at (I)(A)(3).
---------------------------------------------------------------------------

    In the Interpretive Guidance in section 1636.3(b) Pregnancy, 
Childbirth, or Related Medical Conditions, the Commission has added 
information

[[Page 29101]]

regarding the Commission's expectation that it will be readily apparent 
that certain medical conditions (e.g., lactation, miscarriage, 
stillbirth, having or choosing not to have an abortion, preeclampsia, 
gestational diabetes, and HELLP (hemolysis, elevated liver enzymes and 
low platelets syndrome)) have a relation to pregnancy or childbirth; 
and that, similarly, a connection between a medical condition and 
pregnancy or childbirth will often be evident when a new medical 
condition occurs or an existing medical condition is exacerbated or 
poses a new risk during a current pregnancy, childbirth, or postpartum 
period.
    The Commission disagrees that creating a list of potential 
``related medical conditions'' that are or may be related to pregnancy 
or childbirth exceeds the Commission's authority. The list includes 
related medical conditions that courts and the Commission, in its 
Enforcement Guidance on Pregnancy Discrimination, have determined can, 
but are not always required to be, related medical conditions, as well 
as a non-exhaustive list of other conditions that, depending on the 
situation, can be related to pregnancy or childbirth.\36\ The list 
clearly states that it consists of examples that ``are or may be'' 
related medical conditions in a specific case. In each case, a 
determination that a medical condition is related to pregnancy or 
childbirth is fact-specific and contingent on whether the medical 
condition at issue is related to the pregnancy or childbirth of the 
specific employee in question. The Commission notes that regardless of 
whether pregnancy, childbirth, or related medical conditions are at 
issue, the provision of 42 U.S.C. 2000gg-5(a)(2) stating that nothing 
in the PWFA shall be construed ``by regulation or otherwise, to require 
an employer-sponsored health plan to pay for or cover any particular 
item, procedure, or treatment'' applies.
---------------------------------------------------------------------------

    \36\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31.
---------------------------------------------------------------------------

    The Commission also disagrees that accommodations under the PWFA 
will potentially discriminate based on sex. The PWFA only provides 
accommodations to qualified employees with limitations related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions. This is in keeping with courts that have found that 
laws and other policies that provide leave for workers affected by 
pregnancy do not discriminate based on sex.\37\ Additionally, in Young 
v. United Parcel Service,\38\ the Supreme Court found that an employer 
could be required by the PDA to provide an accommodation for pregnant 
workers even if the employer's general policy did not provide for 
accommodations for workers except in certain situations. The 
accommodations provided under the PWFA are similar in purpose and 
effect to those that could have been obtained in Young. And, just as 
the accommodations contemplated by the Court in Young did not violate 
Title VII, neither do accommodations under the PWFA.
---------------------------------------------------------------------------

    \37\ See Cal. Fed. Sav. & Loan Ass'n v. Guerra, 479 U.S. 272, 
290 (1987) (holding that, without violating Title VII, the State 
could require employers to provide up to four months of medical 
leave to pregnant women where ``[t]he statute is narrowly drawn to 
cover only the period of actual physical disability on account of 
pregnancy, childbirth, or related medical conditions'') (emphasis in 
original); Johnson v. Univ. of Iowa, 431 F.3d 325, 328 (8th Cir. 
2005) (``If the leave given to biological mothers is granted due to 
the physical trauma they sustain giving birth, then it is conferred 
for a valid reason wholly separate from gender.'').
    \38\ 575 U.S. 206 (2015).
---------------------------------------------------------------------------

    Moreover, Congress expressly intended that in some cases, the PWFA 
would require accommodations for a qualified employee's limitations 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions, even if such accommodations are not 
available to other employees. In fact, Congress observed that the PDA's 
comparator requirement ``is a burdensome and often impossible standard 
to meet'' and thus is ``insufficient to ensure that pregnant workers 
receive the accommodations they need.'' \39\
---------------------------------------------------------------------------

    \39\ See H.R. Rep. No. 117-27, pt. 1, at 11-12.
---------------------------------------------------------------------------

Comments and Response to Comments Requesting Deletions, Additions, or 
Other Modifications to the List of Examples of ``Pregnancy, Childbirth, 
or Related Medical Conditions''
    Many comments requested deletions, additions, or other 
modifications to the list of examples of ``pregnancy, childbirth, or 
related medical conditions'' provided in the proposed definition at 
Sec.  1636.3(b). The Commission declines to modify the provided list. 
As previously explained, the list of examples of ``pregnancy, 
childbirth, or related medical conditions'' is non-exhaustive and 
includes conditions that are commonly--but not always--associated with 
pregnancy or childbirth. The list neither requires blanket 
accommodation for every condition listed nor precludes accommodations 
for conditions that are not listed. Additionally, because ``pregnancy, 
childbirth, or related medical conditions'' has the same definition as 
in Title VII, as amended by the PDA, this phrase's use in the PWFA 
necessarily will continue to reflect Title VII case law regarding that 
phrase.
Comments and Response to Comments Regarding Coverage of Specific 
Conditions--Menstruation
    A number of comments argued for or against the inclusion of 
menstruation in the list of ``related medical conditions.'' While the 
limited number of Federal courts that have addressed the issue of 
whether menstruation falls within the Title VII definition of ``related 
medical conditions'' have not always held that it does, read together, 
the majority of these cases illustrate that, at a minimum, menstruation 
is covered under Title VII when it has a nexus to a current or prior 
pregnancy or childbirth. Accordingly, as with many conditions that can 
be ``related medical conditions,'' this determination will be made on a 
case-by-case basis.\40\
---------------------------------------------------------------------------

    \40\ See EEOC v. Houston Funding II, Ltd., 717 F.3d 425, 429-30 
(5th Cir. 2013) (observing, in a case about whether lactation was a 
``related medical condition,'' that ``as both menstruation and 
lactation are aspects of female physiology that are affected by 
pregnancy, each seems readily to fit into a reasonable definition of 
`pregnancy, childbirth, or related medical conditions' ''); Flores 
v. Va. Dep't of Corr., No. 5:20-CV-00087, 2021 WL 668802, at *4 
(W.D. Va. Feb. 22, 2021) (declining to decide whether heavy 
menstruation due to perimenopause was a ``related medical 
condition,'' but observing that ``there is a strong argument that 
menstruation is a `related medical condition' to pregnancy and 
childbirth under the PDA''); but see Jirak v. Fed. Express Corp., 
805 F. Supp. 193, 195 (S.D.N.Y. 1992) (stating that menstrual cramps 
alone were not a medical condition related to pregnancy or 
childbirth); Coleman v. Bobby Dodd Inst., Inc., No. 4:17-CV-00029, 
2017 WL 2486080, at *2 (M.D. Ga. June 8, 2017) (stating that the 
employee's excessive menstruation was ``related to pre-menopause, 
not pregnancy or childbirth'').
    However, these and other cases suggest that, even if 
menstruation (or another condition) is not found to be ``pregnancy, 
childbirth, or related medical conditions'' in a particular case, 
discrimination based on that condition could nevertheless violate 
Title VII's prohibition on sex discrimination. See, e.g., Harper v. 
Thiokol Chem. Corp., 619 F.2d 489, 492 (5th Cir. 1980) (concluding 
that a policy requiring individuals returning from pregnancy leave 
to have a normal menstrual cycle violated Title VII because it 
denied ``persons of like qualifications equal employment 
opportunities because of their sex,'' as ``company rules which 
single out certain subclasses of women for disparate treatment 
constitute unlawful sex discrimination''); Flores, 2021 WL 668802, 
at *4 (allowing a Title VII claim to proceed ``regardless of 
applying an expanded definition of `because of sex' or `on the basis 
of sex' under the PDA'' where the plaintiff was fired for suspicion 
of contraband due to her use of tampons while menstruating); see 
also Int'l Union, United Auto., Aerospace & Agric. Implement Workers 
of Am., UAW v. Johnson Controls, Inc., 499 U.S. 187, 198-99 (1991) 
(providing that a policy excluding women with childbearing capacity 
from certain jobs was discrimination based on gender under Title 
VII; this conclusion was ``bolstered'' by the PDA, which prohibits 
discrimination ``because of or on the basis of pregnancy, 
childbirth, or related medical conditions''); Phillips v. Martin 
Marietta Corp., 400 U.S. 542, 544 (1971) (per curiam) (opining that 
an employer who refused to take applications from women with 
preschool-age children but hired men with preschool-age children and 
other women would violate Title VII, absent a defense).

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[[Page 29102]]

Comments and Response to Comments Regarding Coverage of Specific 
Conditions--Lactation
    One comment claimed there was a split between courts on the issue 
of whether lactation falls within the scope of the PDA, stating that 
some courts, including the Fourth and Sixth Circuits, found that it 
does not, while other courts have found that it does. One case cited by 
the comment, however, does not address coverage of lactation as a 
related medical condition under Title VII. The case of Derungs v. Wal-
Mart Stores, Inc., 374 F.3d 428 (6th Cir. 2004), involved a question of 
whether a store's ban on public breastfeeding was discriminatory under 
a State public accommodation statute where that statute did not include 
protection on the basis of ``pregnancy, childbirth, or related medical 
conditions.'' \41\ Another case cited by the comment, Barrash v. Bowen, 
846 F.2d 927 (4th Cir. 1988) (per curiam), is similarly inapposite. In 
Barrash, the Fourth Circuit held that a Federal Government employee who 
challenged her termination of employment on grounds of unauthorized 
absence as violative of her constitutional and contractual rights was 
not entitled to 6 months of leave in order to breastfeed her baby. That 
court's statement, that ``[u]nder the [PDA] . . . , pregnancy and 
related conditions must be treated as illnesses only when 
incapacitating,'' \42\ was subsequently recognized by the same court as 
``dicta without any citation of authority.'' \43\ By contrast, EEOC v. 
Houston Funding II, Ltd., held that lactation is a related medical 
condition of pregnancy for purposes of the PDA because it is the 
``physiological process of secreting milk from mammary glands and is 
directly caused by hormonal changes associated with pregnancy and 
childbirth'' and is ``a physiological result of being pregnant and 
bearing a child.'' \44\ Hicks v. City of Tuscaloosa agrees with Houston 
Funding that lactation is a related medical condition and therefore 
covered under the PDA.\45\ Thus, Derungs and Barrash do not foreclose a 
finding that lactation can be a ``related medical condition'' under 
Title VII and do not undercut the Commission's conclusion that 
lactation can be a related medical condition under the PWFA.
---------------------------------------------------------------------------

    \41\ In its analysis, Derungs also discussed Title VII coverage 
for breastfeeding under a comparator analysis and found that 
breastfeeding would not be covered because of an absence of 
comparators (i.e., men who could breastfeed). Derungs, 374 F.3d at 
438-39. Independent of the soundness of that analysis, the case did 
not address whether lactation was or could be a ``related medical 
condition'' to pregnancy and noted in its description of the Ohio 
statute regarding employment that parallels Title VII that ``[t]he 
Legislature made a conscious choice to extend the definition of 
discrimination to include pregnancy even though there cannot be a 
class of similarly situated males.'' Id. at 436.
    \42\ Barrash, 846 F.2d at 931.
    \43\ Notter v. North Hand Protection, 89 F.3d 829, at *5 (4th 
Cir. 1996) (per curiam) (table) (explaining that ``[t]he text of the 
[PDA] contains no requirement that `related medical conditions' be 
`incapacitating' '').
    \44\ 717 F.3d at 428.
    \45\ 870 F.3d 1253, 1259 (11th Cir. 2017).
---------------------------------------------------------------------------

Comments and Response to Comments Regarding Coverage of Specific 
Conditions--Infertility and Fertility Treatments
    Some comments agreed with the Commission's inclusion of infertility 
and fertility treatments in the list of covered conditions in the 
regulation. By contrast, other comments stated that the Title VII case 
law on infertility is inconsistent and thus infertility and fertility 
treatments should not be included in the list of potentially covered 
conditions in the regulation. The Commission concludes that, as with 
other conditions, and consistent with case law and its prior policy, 
whether infertility and fertility treatments are covered by the PWFA 
will be based on the particular circumstances of the situation, thus 
potentially allowing for reasonable accommodations for treatment for 
infertility when an employee with the capacity to become pregnant is 
trying to get pregnant.
    In Johnson Controls, the Supreme Court struck down an employer 
policy that discriminated between workers based on childbearing 
capacity and held that the PDA prohibits discrimination based on 
potential pregnancy.\46\ In accordance with Johnson Controls, 
discrimination based on the potential to be pregnant, not only current 
pregnancy, is covered by Title VII and the PDA. Because Title VII, as 
amended by the PDA, can cover potential pregnancy, several courts have 
found that it protects against discrimination for those undergoing in 
vitro fertilization (IVF) or infertility treatments related to becoming 
pregnant because these actions are related to the capacity to become 
pregnant.\47\ By contrast, notably in the insurance context where the 
challenged restriction excluded all types of infertility treatments 
from coverage, regardless of the insured employee's capacity to become 
pregnant, courts have found such policies did not violate the PDA.\48\ 
Those cases do not stand for the proposition that fertility treatments 
are never covered by the statutory phrase ``pregnancy, childbirth, or 
related medical conditions,'' but instead hold that the particular 
claims in those cases fail based on the lack of differential treatment 
based on sex. The Commission's Enforcement Guidance on Pregnancy 
Discrimination summarizes the law in this regard:
---------------------------------------------------------------------------

    \46\ 499 U.S. at 204-06; see also Kocak v. Cmty. Health Partners 
of Ohio, 400 F.3d 466, 470 (6th Cir. 2005) (reasoning that the 
plaintiff ``cannot be refused employment on the basis of her 
potential pregnancy'').
    \47\ Hall v. Nalco Co., 534 F.3d 644, 649 (7th Cir. 2008) 
(finding an employer's practice of terminating employees who took 
leave for IVF treatment violated the PDA because only women undergo 
IVF); Erickson v. Bd. of Governors of State Colls. & Univs., 911 F. 
Supp. 316, 320 (N.D. Ill. 1995) (finding that a plaintiff who 
underwent infertility treatment, ``although infertile, may have been 
viewed by her employer as potentially pregnant,'' and distinguishing 
between ``infertility [that] does not relate to [the] capacity to 
become pregnant'' and that which does relate to the capacity to 
become pregnant); Pacourek v. Inland Steel Co., 858 F. Supp. 1393, 
1397, 1403-04 (N.D. Ill. 1994) (finding that infertility or its 
treatment were conditions that fell under the umbrella of pregnancy 
(including potential pregnancy), childbirth, or related medical 
conditions).
    \48\ Saks v. Franklin Covey, Inc., 316 F.3d 337, 346 (2d Cir. 
2003) (finding that generally, ``[i]nfertility is a medical 
condition that afflicts men and women with equal frequency,'' but 
leaving open the question of whether an individual ``would be able 
to state a claim under the PDA or Title VII for adverse employment 
action taken against her because she has taken numerous sick days in 
order to undergo surgical implantation procedures''); Krauel v. Iowa 
Methodist Med. Ctr., 95 F.3d 674, 679-680 (8th Cir. 1996) (finding 
the benefits policy at issue did not violate Title VII, reasoning 
that ``the policy of denying insurance benefits for treatment of 
fertility problems applies to both female and male workers and thus 
is gender-neutral''), abrogated on other grounds by Bragdon v. 
Abbott, 524 U.S. 624 (1998). Notably, because of 42 U.S.C. 2000gg-
5(a)(2), nothing in the PWFA can require an employer-sponsored 
health plan to pay for or cover any particular item, procedure, or 
treatment. Thus, PWFA accommodation claims will not involve coverage 
by health care plans.

    Employment decisions related to infertility treatments implicate 
Title VII under limited circumstances. Because surgical impregnation 
is intrinsically tied to a woman's childbearing capacity, an 
inference of unlawful sex discrimination may be raised if, for 
example, an employee is penalized for taking time off from work to 
undergo such a procedure. In contrast, with respect to the exclusion 
of infertility from employer-provided health insurance, courts have 
generally held that exclusions of all infertility coverage for all 
employees is gender neutral and does not violate Title VII. Title 
VII may be implicated by exclusions of particular treatments that 
apply only to one gender.\49\
---------------------------------------------------------------------------

    \49\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A)(3)(c) (footnotes omitted).

    Thus, depending upon the facts of the case, including whether the 
infertility treatments are sought by an employee with the capacity to 
become pregnant

[[Page 29103]]

for the purpose of becoming pregnant, accommodations for an employee 
due to physical or mental conditions related to, affected by, or 
arising out of infertility or fertility treatments may be provided 
under the PWFA, absent undue hardship.
Comments and Response to Comments Regarding Coverage of Specific 
Conditions--Contraception
    Some comments agreed with the Commission's inclusion of 
contraception in the regulation. By contrast, some comments stated that 
the Commission had not properly interpreted Federal case law related to 
the coverage of contraception and that the Eighth Circuit's holding in 
In re Union Pacific Railroad Employment Practices Litigation \50\ 
forecloses accommodations related to contraception under all 
circumstances.
---------------------------------------------------------------------------

    \50\ 479 F.3d 936, 939, 942 (8th Cir. 2007) (concluding that 
Union Pacific's insurance policy--which excluded ``all types of 
contraception, whether prescription, non-prescription or surgical 
and whether for men or women''--did not discriminate against women 
and therefore did not violate the PDA and distinguishing Johnson 
Controls on the ground that, unlike ``potential pregnancy,'' 
``contraception is not a gender-specific term'').
---------------------------------------------------------------------------

    The Commission disagrees that reasonable accommodations regarding 
contraception for an employee who has the capacity to become pregnant 
are foreclosed in all cases by In re Union Pacific. As stated above, 
the Supreme Court has held that Title VII ``prohibit[s] an employer 
from discriminating against a woman because of her capacity to become 
pregnant.'' \51\ Consistent with this holding, the Eighth Circuit and 
other courts, like the Commission, have long recognized that the 
protections of Title VII extend to employees based on the employees' 
potential or intent to become pregnant.\52\
---------------------------------------------------------------------------

    \51\ Johnson Controls, 499 U.S. at 206.
    \52\ See Walsh v. Nat'l Computer Sys., Inc., 332 F.3d 1150, 
1154, 1160 (8th Cir. 2003) (upholding a judgment and award for a 
plaintiff claiming pregnancy discrimination where the plaintiff 
provided evidence that her supervisor's discriminatory behavior was 
based on the supervisor's belief that she was, or was intending to 
become, pregnant a second time); see also Kocak, 400 F.3d at 470 
(reasoning that the plaintiff ``cannot be refused employment on the 
basis of her potential pregnancy''); Batchelor v. Merck & Co., 651 
F. Supp. 2d 818, 830-31 (N.D. Ind. 2008) (holding that the plaintiff 
was protected under the PDA where her supervisor allegedly 
discriminated against her because of her stated intention to start a 
family); Cleese v. Hewlett-Packard Co., 911 F. Supp. 1312, 1317-18 
(D. Or. 1995) (concluding that the plaintiff, who claimed that the 
defendant employer discriminated against her because it knew she 
planned to become pregnant, fell within the PDA's protections and 
noting that the court agreed with ``Pacourek that the purpose of the 
PDA is best served by extending its coverage to women who are trying 
to become pregnant'').
---------------------------------------------------------------------------

    As stated in the Enforcement Guidance on Pregnancy Discrimination, 
interpreting In re Union Pacific as holding that contraception is never 
related to pregnancy for purposes of the PDA because it is used prior 
to pregnancy would be inconsistent with Johnson Controls and many other 
cases.
    In the Commission's view, In re Union Pacific is best understood as 
a case about a specific health insurance policy that excluded coverage 
of both prescription and non-prescription contraceptive methods that 
were used to prevent pregnancy, regardless of the sex of the employee 
who used them.\53\ The gender-neutral nature of the insurance exclusion 
was central to In re Union Pacific's holding that the insurance policy 
did not constitute disparate treatment under Title VII. This is similar 
to the reasoning of courts that have found that denial of insurance 
coverage for infertility generally, which can affect employees 
regardless of their capacity to become pregnant, does not violate the 
PDA, while still leaving open the possibility that the PDA could be 
violated if an employee was penalized for using leave for IVF 
treatments.\54\ As with infertility, the failure of particular Title 
VII claims related to contraception based on the lack of gender-based 
differential treatment does not mean that contraception can never be 
covered by the statutory phrase ``pregnancy, childbirth, or related 
medical conditions.''
---------------------------------------------------------------------------

    \53\ See also Newport News Shipbuilding & Dry Dock Co. v. EEOC, 
462 U.S. 669, 678-79 & n.17, 683-84 (1983) (noting that the 
legislative history of the PDA demonstrates Congress' intent that it 
would be facially discriminatory for an employer to discriminate in 
insurance coverage between persons who face a risk of pregnancy and 
those who do not, and concluding that the employer unlawfully gave 
married male employees a benefit package for their dependents that 
was less inclusive than the dependency coverage provided to married 
female employees). In Newport News, the Court found that the 
benefits that a male employee and his dependents could receive were 
less than what a female employee and her dependents could receive, 
and thus the plan violated the PDA. This rationale further explains 
the decisions in In re Union Pacific and Krauel. In those cases, 
both of which involved insurance benefits, the benefits received by 
employees and their dependents were the same; thus, there was not a 
PDA violation. See Saks, 316 F.3d at 344-345 (describing Newport 
News as ``focused on whether male and female employees received 
equal coverage under their health benefits package'' and finding 
that Newport News would not allow exclusions based on pregnancy); 
id. at 345 n.2 (describing the decision in Saks as looking at 
``whether the exclusion of surgical impregnation procedures result 
in [a] less comprehensive benefits package for female employees'').
    \54\ See Saks, 316 F.3d at 346 & n.4 (concluding that the 
insurance coverage plan at issue, which did not cover treatments for 
infertility regardless of capacity to become pregnant, would not 
violate the PDA, but stating that ``[w]e expressly decline to 
consider whether an infertile female employee would be able to state 
a claim under the PDA or Title VII for adverse employment action 
taken against her because she has taken numerous sick days in order 
to undergo surgical impregnation procedures'').
---------------------------------------------------------------------------

    As stated in the Commission Decision on Coverage of Contraception, 
the PDA can cover discrimination regarding contraception when, unlike 
the facts in In re Union Pacific, the challenged restriction regarding 
contraception coverage is limited to those who have the capacity to 
become pregnant.\55\ Thus, in the Commission Decision on Coverage of 
Contraception, the exclusion of prescription contraception violated the 
PDA's prohibition on sex discrimination because prescription 
contraception could only be used by those who have the capacity to 
become pregnant.\56\ Other courts similarly have concluded that an 
insurance policy's exclusion of contraception coverage that only can be 
used by those with the capacity to become pregnant violates the 
PDA.\57\
---------------------------------------------------------------------------

    \55\ EEOC, Commission Decision on Coverage of Contraception 
(Dec. 14, 2000), https://www.eeoc.gov/commission-decision-coverage-contraception.
    \56\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A)(3)(d) nn.37-38.
    \57\ See Cooley v. DaimlerChrysler Corp., 281 F. Supp. 2d 979, 
984-85 (E.D. Mo. 2003) (determining that, although the defendant 
employer's policy was facially neutral, denying a prescription 
medication that allows an employee to control their potential to 
become pregnant is ``necessarily a sex-based exclusion'' that 
violates Title VII, as amended by the PDA, because only people who 
have the capacity to become pregnant use prescription 
contraceptives, and the exclusion of prescription contraceptives may 
treat medication needed for a sex-specific condition less favorably 
than medication necessary for other medical conditions); Erickson v. 
Bartell Drug Co., 141 F. Supp. 2d 1266, 1271-72 (W.D. Wash. 2001) 
(determining that the selective exclusion of prescription 
contraceptives from an employer's generally comprehensive 
prescription drug plan violated the PDA because only people who have 
the capacity to become pregnant use prescription contraceptives). 
Additionally, the Commission notes that those who can and cannot get 
pregnant face different risks in not having access to contraception 
in that the individual who may actually become pregnant bears the 
exclusive risk of experiencing pregnancy-related complications, 
including a variety of life-threatening conditions. U.S. Dep't of 
Health & Hum. Servs., Ctrs. for Disease Control & Prevention, Urgent 
Maternal Warning Signs (Nov. 17, 2022), https://www.cdc.gov/hearher/maternal-warning-signs/index.html (explaining urgent warning signs 
and symptoms ``during pregnancy and in the year after delivery'' 
that ``could indicate a life-threating situation''); U.S. Dep't of 
Health & Hum. Servs., Ctrs. for Disease Control & Prevention, 
Maternal Mortality Rates in the United States, 2021 (March 2023), 
https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm (discussing the high rates of 
maternal mortality); Am. Coll. of Obstetricians & Gynecologists and 
Physicians for Reproductive Health, Abortion Can Be Medically 
Necessary (Joint Statement) (Sept. 25, 2019), https://www.acog.org/news/news-releases/2019/09/abortion-can-be-medically-necessary 
(``Pregnancy imposes significant physiological changes on a person's 
body. These changes can exacerbate underlying or preexisting 
conditions, like renal or cardiac disease, and can severely 
compromise health or even cause death.'').

---------------------------------------------------------------------------

[[Page 29104]]

    Finally, Congress chose to write the PWFA using the same phrase as 
in Title VII, as amended by the PDA, and directed the Commission to 
issue regulations. Congress is presumed to have known the meaning 
previously given to ``pregnancy, childbirth, or related medical 
conditions'' by courts and the Commission, as well as the established 
principles of statutory construction.\58\ This includes the 
Commission's interpretation in its 2000 Commission Decision on Coverage 
of Contraception and in its 2015 Enforcement Guidance on Pregnancy 
Discrimination. Therefore, it is reasonable to conclude that Congress 
expected the Commission to interpret the language in the PWFA 
consistently with its interpretation of the same language in the PDA.
---------------------------------------------------------------------------

    \58\ See supra note 24.
---------------------------------------------------------------------------

    Thus, under the PWFA, depending on the facts, a limitation related 
to contraception that affects the individual employee's potential 
pregnancy can be the basis for a request for an accommodation.\59\ 
Whether a particular set of facts will support the necessary nexus 
between contraception and an individual employee's potential pregnancy 
is a determination that will be made on a case-by-case basis.
---------------------------------------------------------------------------

    \59\ See H.R. Rep. No. 117-27, pt. 1, at 27 (``Throughout the 
bill's text, the PWFA ensures that workers have access to reasonable 
accommodations for conditions connected with a pregnancy, not just a 
pregnancy itself.'').
---------------------------------------------------------------------------

Comments and Response to Comments Regarding Coverage of Specific 
Conditions--Other Conditions
    Some comments requested that specific conditions be added to the 
list in the regulation. However, inclusion on the list does not make it 
more or less likely that a specific condition in a specific situation 
will be considered pregnancy, childbirth or a related medical 
condition--it is a fact-specific determination. Some comments requested 
that the Commission opine on whether specific conditions (including 
ones on which neither the courts nor the Commission have yet opined) 
would be covered under ``related medical conditions'' under the PWFA. 
Especially in the situations where the courts and the Commission have 
not yet spoken, the Commission believes that this is something best 
left to development on a case-by-case basis within specific factual 
contexts.
Inclusion of Abortion in the Definition of ``Pregnancy, Childbirth, or 
Related Medical Conditions''
Preliminary Considerations
    The Commission received approximately 54,000 comments (most of 
which were form or slightly altered form comments from individuals) 
urging the Commission to exclude abortion from the definition of 
``pregnancy, childbirth, or related medical conditions.'' The 
Commission also received approximately 40,000 comments (most of which 
were form or slightly altered form comments from individuals or sign-on 
letters) supporting the inclusion of abortion in the definition of 
``pregnancy, childbirth, or related medical conditions.'' \60\
---------------------------------------------------------------------------

    \60\ The number of comments does not require the EEOC to adopt a 
specific view. U.S. Cellular Corp. vs. FCC, 254 F.3d 78,87 (D.C. 
Cir. 2001) (``[T]he Commission has no obligation to take the 
approach advocated by the largest number of commenters . . . ; 
indeed, the Commission may adopt a course endorsed by no commenter. 
The Commission's only responsibilities are to respond to comments, 5 
U.S.C. 553, and to choose a reasonable approach backed up by record 
evidence.'') (internal citations omitted).
---------------------------------------------------------------------------

    Many of the comments urging the Commission to exclude abortion from 
the definition of ``pregnancy, childbirth, or related medical 
conditions'' expressed the view that abortion is the destruction of a 
human life, that it is objectionable for moral or religious reasons, 
and that it is not health care.\61\ The Commission recognizes these are 
sincere, deeply held convictions and are often part of an individual's 
religious beliefs. The Commission also received many comments that 
expressed deeply held beliefs, including religious beliefs, that 
abortion is a necessary part of health care and that an employer's 
religious beliefs should not dictate an employee's ability to receive a 
reasonable accommodation under the PWFA.
---------------------------------------------------------------------------

    \61\ Some comments also expressed religious and conscience 
objections to other conditions included in the definition of 
``pregnancy, childbirth, or related medical conditions,'' such as 
infertility treatments and contraception. The Commission has 
addressed these other issues, supra, in the preamble in section 
1636.3(b) Pregnancy, Childbirth, or Related Medical Conditions. 
Responses to comments that object to these procedures for religious 
reasons are addressed infra in the preamble in section 1636.7(b) 
Rule of Construction and in the preamble in section 1636.7 under 
Religious Freedom Restoration Act.
---------------------------------------------------------------------------

    In the final regulation, the Commission includes abortion in its 
definition of ``pregnancy, childbirth, or related medical conditions,'' 
as proposed in the NPRM and consistent with the Commission's and 
courts' longstanding interpretation of the same phrase in Title VII. 
The Commission responds to comments regarding this issue below. 
Preliminarily, the Commission provides the following context to clarify 
the limits of the PWFA.
    First, the PWFA is a workplace anti-discrimination law. It does not 
regulate the provision of abortion services or affect whether and under 
what circumstances an abortion should be permitted. The PWFA does not 
require any employee to have--or not to have--an abortion, does not 
require taxpayers to pay for any abortions, and does not compel health 
care providers to provide any abortions. The PWFA also cannot be used 
to require an employer-sponsored health plan to pay for or cover any 
particular item, procedure, or treatment, including an abortion.\62\ 
The PWFA does not require reasonable accommodations that would cause an 
employer to pay any travel-related expenses for an employee to obtain 
an abortion.\63\ Given these limitations, the type of accommodation 
that most likely will be sought under the PWFA regarding an abortion is 
time off to attend a medical appointment or for recovery. The PWFA, 
like the ADA, does not require that leave as an accommodation be paid 
leave, so leave will be unpaid unless the employer's policies provide 
otherwise.\64\
---------------------------------------------------------------------------

    \62\ 42 U.S.C. 2000gg-5(a)(2) provides that nothing in the PWFA 
shall be construed ``by regulation or otherwise, to require an 
employer-sponsored health plan to pay for or cover any particular 
item, procedure, or treatment.''
    \63\ The PWFA does not prohibit an employer from taking these 
actions, either.
    \64\ See infra in the preamble in section 1636.3(h) under 
Particular Matters Regarding Leave as a Reasonable Accommodation.
---------------------------------------------------------------------------

    Second, the PWFA provides a mechanism for a qualified employee with 
a known limitation related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions to receive 
workplace accommodations. The term ``abortion'' is included in the 
regulation's definition of ``pregnancy, childbirth, or related medical 
conditions'' for the limited purpose of determining whether an employee 
qualifies for a workplace accommodation under the PWFA. As shown in the 
public comments, beliefs about when an abortion may be morally or 
religiously permissible, even within religious traditions, are not 
monolithic.
    Third, despite the large number of comments that the Commission 
received, the Commission's historical experience, in more than four 
decades of enforcing Title VII, is that very few employers have 
actually faced a situation where an employee is expressly requesting 
leave for an

[[Page 29105]]

abortion and the employer declines to grant the leave on religious or 
moral grounds. Since 1978, Title VII has required that employers who 
provide sick leave provide that leave in a non-discriminatory manner to 
women affected by pregnancy, childbirth, or related medical conditions. 
This includes, and has included since 1978, allowing employees affected 
by pregnancy, childbirth, or related medical conditions to use 
employer-provided leave in order to have time off to have an 
abortion.\65\ Yet the public comments the Commission received did not 
cite any Title VII cases that ruled against the employer where a 
request for leave for an abortion was at issue, and the comments did 
not provide evidence that the Title VII requirement has caused problems 
for employers in the past. Nonetheless, under the framework of this 
final rule, accommodations related to abortion--like all 
accommodations--remain subject to applicable exceptions and defenses, 
including both those based on religion and undue hardship.
---------------------------------------------------------------------------

    \65\ See 42 U.S.C. 2000e(k); 124 Cong. Rec. S18,978 (daily ed. 
Oct. 13, 1978) (statement of Sen. Harrison A. Williams, Jr.) (``The 
House-passed bill included a provision which would have excluded 
health insurance benefits, sick leave benefits, and disability leave 
benefits for abortions altogether, except where the life of the 
mother would be endangered if the fetus were carried to term, or in 
case of complications. The legislation which passed this body 
included no such provision. After lengthy debate, and discussion of 
this difficult issue, the conferees have adopted a compromise which 
requires the provision of sick leave and disability benefits in 
connection with an abortion on the same basis as for any other 
illness or disabling condition.''); see also H.R. Rep. No. 95-1786, 
at 3-4 (Conf. Rep.) (explaining the differences between the Senate 
bill, the House amendment, and the substitute agreed to in 
conference).
    Since 1979, the Commission's guidelines have provided that 
``[a]ll fringe benefits other than health insurance, such as sick 
leave, which are provided for other medical conditions, must be 
provided for abortions.'' 29 CFR part 1604, appendix, Question 35 
(1979). This has been the EEOC's consistent interpretation for over 
40 years.
    In 2015, the EEOC reaffirmed that ``pregnancy, childbirth, or 
related medical conditions'' includes abortions. Enforcement 
Guidance on Pregnancy Discrimination, supra note 31, at 
(I)(A)(4)(c); see, e.g., Doe v. C.A.R.S. Prot. Plus, Inc., 527 F.3d 
358, 364 (3d Cir. 2008) (``Clearly, the plain language of the 
statute, together with the legislative history and the EEOC 
guidelines, support a conclusion that an employer may not 
discriminate against a woman employee because she has exercised her 
right to have an abortion. We now hold that the term `related 
medical conditions' includes an abortion.''); DeJesus v. Fla. Cent. 
Credit Union, No. 8:17-CV-2502, 2018 WL 4931817, at *1 (M.D. Fla. 
Oct. 11, 2018) (denying the employer's motion to dismiss in a Title 
VII case where an employee used approved leave to have an abortion 
and was fired shortly thereafter when her supervisor stated that the 
abortion was not an appropriate excuse for her absence).
---------------------------------------------------------------------------

    With this background, the Commission responds to the comments it 
received.
Interpretation of ``Pregnancy, Childbirth, or Related Medical 
Conditions'' as Consistent With Its Meaning in Title VII
Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' as Reflected in Statutory 
Text
    Comments regarding the Commission's decision to include 
``abortion'' in the definition of ``pregnancy, childbirth, or related 
medical conditions'' made several arguments related to the statutory 
text of the PWFA and Title VII.
    Many comments in favor of the Commission's inclusion of abortion in 
the proposed definition of ``pregnancy, childbirth, or related medical 
conditions'' asserted that its inclusion accurately reflects the 
statutory text of the PWFA; that the phrase ``pregnancy, childbirth, or 
related medical conditions'' is taken directly from Title VII and uses 
identical language; that the identical language in the PWFA and Title 
VII must be interpreted consistently; that Congress' drafting the PWFA 
against the backdrop of Title VII strongly suggests that its use of 
Title VII's language would require the language to have the same 
meaning in the PWFA, absent a clear indication to the contrary; and 
that in enacting the PDA, Congress expressly stated that the statute 
applied to employees who obtained abortions, confirming its statutory 
intent to prohibit discrimination against employees for obtaining 
abortion care, and that Congress' use of the term in the PWFA is 
consistent with that underlying interpretation.
    Other comments favoring the Commission's inclusion of abortion in 
the definition of ``pregnancy, childbirth, or related medical 
conditions'' stated that its inclusion is important for consistency and 
clarity, noting that both employers and employees have relied on the 
Commission's longstanding inclusion of this interpretation in guidance 
to understand what constitutes ``pregnancy, childbirth, or related 
medical conditions''; that applying the same definition under the PWFA 
provides important consistency when litigation is brought under Title 
VII and the PWFA simultaneously; and that the PWFA's drafters 
intentionally drew specific terms from Title VII and the ADA to ensure 
employees and employers would have a clear understanding of the meaning 
of those terms.
    By contrast, many comments opposing the Commission's proposed 
definition stated that abortion could not be included in the definition 
of ``pregnancy, childbirth, or related medical conditions'' because the 
PWFA's text does not mention abortion; that Congress' intent to include 
abortion in the definition of ``pregnancy, childbirth, or related 
medical conditions'' cannot be inferred simply because the PWFA uses 
the same language as Title VII; that the PWFA does not direct the 
Commission to construct a broad definition of ``related medical 
conditions''; and that the inclusion of ``pregnant workers'' in the 
statute's title should exclude employees who end their pregnancies via 
an abortion. Comments also stated that, under canons of statutory 
interpretation, the general term ``or related medical conditions'' is 
best read to cover only those concepts akin to the specific terms it 
follows--and that abortion is not related to ``pregnancy'' or 
``childbirth.''
    Comments opposed to the Commission's inclusion of abortion in the 
proposed definition of ``pregnancy, childbirth, or related medical 
conditions'' also asserted that under the text of the PWFA, employers 
should be required only to accommodate employees who are currently 
pregnant or who give birth. For instance, comments asserting that under 
the PWFA a ``related medical condition'' must be related to a current 
or recent pregnancy or childbirth analogized the PWFA's accommodation 
provision to the accommodation provisions under Title VII and the ADA, 
which apply when an employee has a sincerely held religious belief or 
practice, or a disability, respectively.
    Comments also asserted that abortion is the opposite of pregnancy 
and childbirth. For instance, comments stated that an abortion is 
unlike pregnancy because it is a procedure that ends a pregnancy and 
the possibility of childbirth from that pregnancy; and that pregnancy 
is not a medical condition to be treated with an abortion.
    Comments opposed to the Commission's inclusion of abortion in the 
definition of ``pregnancy, childbirth, or related medical conditions'' 
also maintained that ``related medical conditions'' should be construed 
narrowly under the PWFA. For instance, some comments stated that 
Congress' inclusion of the term ``childbirth'' meant that abortion 
could not be included in the regulation; that a broad definition of 
``related medical conditions'' would render the term ``childbirth'' 
superfluous; and that the PWFA's definition should only refer to 
involuntary, detrimental impacts of pregnancy, childbirth, or related

[[Page 29106]]

medical conditions. Comments stated that, in including contraception 
and abortion, the Commission's definition goes beyond medical 
conditions to cover medical interventions; these comments argued, for 
example, that the act of obtaining reproductive health care--including 
contraception and abortion--is not, by definition, a medical, physical, 
or mental condition, and thus it cannot be a PWFA limitation.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' as Reflected 
in Statutory Text
    The Commission agrees with comments expressing support for 
inclusion of abortion in the proposed definition of ``pregnancy, 
childbirth, or related medical conditions'' for which a qualified 
employee could receive an accommodation, absent undue hardship.
    In interpreting a statute, an agency must start with its text. The 
PWFA does not define the phrase ``pregnancy, childbirth, or related 
medical conditions.'' For nearly 45 years, however, consistent with the 
plain language of the statute, congressional intent, and Federal 
courts' interpretation of the statutory text, the Commission has 
interpreted ``pregnancy, childbirth, or related medical conditions'' in 
Title VII to include the decision to have--or not to have--an abortion 
and to prohibit discrimination in employment practices because an 
employee had or did not have an abortion.\66\ Based on well-established 
rules of statutory interpretation, the Commission properly interprets 
``pregnancy, childbirth, or related medical conditions'' to have the 
same meaning in the PWFA as it does under Title VII.\67\ As the Supreme 
Court has stated, ``When administrative and judicial interpretations 
have settled the meaning of an existing statutory provision, repetition 
of the same language in a new statute indicates, as a general matter, 
the intent to incorporate its administrative and judicial 
interpretations as well.'' \68\ The Commission concludes that it would 
not be consistent with Congress' intent, as expressed in its choice of 
this statutory language for the PWFA, to construct a broader or 
narrower definition of ``pregnancy, childbirth, or related medical 
conditions'' than under Title VII. Rather, following the canons of 
statutory interpretation, the Commission is using the definition that 
already exists for this identical phrase under Title VII. Indeed, it is 
likely that defining this phrase differently than it has been defined 
in a parallel statute would exceed the Commission's congressionally 
delegated authority.
---------------------------------------------------------------------------

    \66\ See 29 CFR part 1604, appendix, Questions 34 & 35 (1979); 
see also Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A)(4)(c).
    \67\ These rules include: (1) the Prior-Construction Canon, 
which states that when judicial interpretations have settled the 
meaning of an existing statutory provision, repetition of the same 
language in a new statute is presumed to incorporate that 
interpretation; Tex. Dep't of Hous. & Cmty. Affs., 576 U.S. at 536-
37 (``If a word or phrase has been . . . given a uniform 
interpretation by inferior courts . . ., a later version of that act 
perpetuating the wording is presumed to carry forward that 
interpretation.'') (omissions in original) (quoting Scalia & Garner, 
Reading Law, at 322); Lorillard, 434 U.S. at 581 (``[W]here, as 
here, Congress adopts a new law incorporating sections of a prior 
law, Congress normally can be presumed to have had knowledge of the 
interpretation given to the incorporated law, at least insofar as it 
affects the new statute.''); Hall v. U.S. Dep't of Agric., 984 F.3d 
at 840 (``Congress is presumed to be aware of an agency's 
interpretation of a statute. We most commonly apply that presumption 
when an agency's interpretation of a statute has been officially 
published and consistently followed. If Congress thereafter reenacts 
the same language, we conclude that it has adopted the agency's 
interpretation.'') (internal citations and quotation marks omitted); 
Scalia & Garner, Reading Law at 323 (``[W]hen a statute uses the 
very same terminology as an earlier statute--especially in the very 
same field, such as securities law or civil-rights law--it is 
reasonable to believe that the terminology bears a consistent 
meaning.''); (2) the Related Statutes Canon (In Pari Materia), which 
states that courts do not interpret statutes in isolation, but 
rather in the context of the body of law of which they are a part, 
including later-enacted statutes, so statutes addressing the same 
subject matter generally should be read as if they were one law; 
see, e.g., Wachovia Bank v. Schmidt, 546 U.S. 303, 305 (2006); 
(``[U]nder the in pari materia canon, statutes addressing the same 
subject matter generally should be read as if they were one law . . 
. .'') (internal citations and quotation marks omitted); and (3) the 
Presumption of Legislative Acquiescence Canon, which states that 
statutes adopted after certain prior judicial or administrative 
interpretations may acquiesce in those interpretations; see, e.g., 
Johnson v. Transp. Agency, Santa Clara Cnty., 480 U.S. 616, 629 n.7 
(1987) (``Congress has not amended the statute to reject [the 
Court's] construction [of Title VII], nor have any such amendments 
even been proposed, and we therefore may assume that our 
interpretation was correct.'').
    \68\ Bragdon, 524 U.S. at 645.
---------------------------------------------------------------------------

    As set out in the NPRM, Congress previously used the phrase 
``pregnancy, childbirth, or related medical conditions'' when, in 
enacting the PDA, it amended Title VII to explicitly state that Title 
VII's prohibition against sex discrimination includes a prohibition 
against discrimination on the basis of ``pregnancy, childbirth, or 
related medical conditions.'' \69\ The legislative history of the PDA 
expressly stated that the PDA's protections applied to situations 
involving abortions, and indeed, the statutory text enacted by Congress 
explicitly excluded certain abortion procedures from health insurance 
requirements, since the statute would otherwise have been read to 
require their coverage, while still requiring coverage in certain 
limited circumstances.\70\
---------------------------------------------------------------------------

    \69\ 42 U.S.C. 2000e(k).
    \70\ See id. (``This subsection shall not require an employer to 
pay for health insurance benefits for abortion, except where the 
life of the mother would be endangered if the fetus were carried to 
term, or except where medical complications have arisen from an 
abortion . . . .''); H.R. Rep. No. 95-1786, at 4 (1978) (Conf. 
Rep.).
---------------------------------------------------------------------------

    Congress' express purpose in enacting the PWFA was to supplement 
Title VII's protections for qualified employees affected by pregnancy, 
childbirth, or related medical conditions; in other words, the same 
employees protected by Title VII, as amended by the PDA.\71\ To that 
end, Congress' approach in both laws was to ensure that employers are 
not required to pay for abortions for their employees but that 
employees are not discriminated against in the workplace for having 
them. Further, the Commission agrees with the comments that using the 
same definition that the Commission and courts have used for the same 
phrase in Title VII provides important clarity and consistency for 
employers and employees.
---------------------------------------------------------------------------

    \71\ See supra, preamble section 1636.3(b) Pregnancy, 
Childbirth, or Related Medical Conditions.
---------------------------------------------------------------------------

    Using the same definition also provides clarity and consistency for 
courts and harmonizes the two statutory schemes. Title VII and the PWFA 
cover the same employers and employees. Having two definitions of the 
same term would cause confusion for courts and potentially require them 
to reach conflicting decisions. Moreover, as cases under the PWFA may, 
depending on the circumstances, also be brought under Title VII, courts 
could be asked to decide cases involving both Title VII's prohibition 
of discrimination based on ``pregnancy, childbirth, or related medical 
conditions'' and the PWFA's reasonable accommodation provision.
    Even if the Commission were authorized to ignore the courts' and 
its own prior longstanding, consistent interpretation of ``pregnancy, 
childbirth, or related medical conditions,'' the Commission would reach 
the same conclusion that the 1978 Congress did--that the phrase 
``pregnancy, childbirth, or related medical conditions'' includes 
choosing to have or not to have an abortion, based on the plain meaning 
of the phrase ``pregnancy, childbirth, or related medical conditions.'' 
By definition, individuals who are choosing whether or not to have an 
abortion are pregnant. And the

[[Page 29107]]

condition of being pregnant does not depend on the ultimate outcome of 
the pregnancy, as highlighted by Congress extending coverage to 
``childbirth'' separate from ``pregnancy.'' Thus, the term 
``pregnancy'' naturally includes all of those limitations arising out 
of the pregnancy itself, regardless of whether any particular pregnancy 
ends in miscarriage, live birth, an abortion, or any other potential 
outcome. If an employee is denied an accommodation because they are 
seeking an abortion, or not seeking an abortion, that employee has 
necessarily been denied an accommodation on account of their current 
pregnancy. Accordingly, the decision to have or not to have an abortion 
falls squarely within the ordinary meaning of the phrase ``pregnancy, 
childbirth, or related medical conditions.''
    Given how courts and the Commission have defined ``pregnancy, 
childbirth, or related medical conditions'' in Title VII, the 
Commission disagrees that the PWFA and its implementing regulation only 
would apply to qualified employees who are currently pregnant or who 
recently gave birth, thus implicitly excluding abortion. First, such an 
interpretation would exclude qualified employees who have had 
miscarriages or are otherwise no longer pregnant, which appears to be 
inconsistent with the text of, and does not appear to be the intent of, 
either the PWFA or the PDA.\72\ As stated above, by definition, 
qualified employees who seek an abortion are either currently or 
recently pregnant. Finally, the Commission sees no evidence that the 
inclusion of ``childbirth'' evinces congressional intent to construct a 
narrower definition of ``related medical conditions'' under the PWFA 
than under Title VII, as both statutes contain this identical language. 
As stated above, both the legislative history and the explicit 
exclusion of certain abortion procedures from health insurance 
requirements under the PDA evince Congress' intent to include abortion 
in the definition of ``pregnancy, childbirth, or related medical 
conditions'' under Title VII.
---------------------------------------------------------------------------

    \72\ See, e.g., H.R. Rep. No. 117-27, pt. 1, at 20 (discussing 
the need for the PWFA, citing to a case in which an employee's 
miscarriage was not covered by the ADA, and noting that ``[t]here 
are many cases where courts have found that even severe 
complications related to pregnancy do not constitute disabilities 
triggering [ADA] protection'').
---------------------------------------------------------------------------

Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' as Reflected in the 
Statutory Intent and Structure of the PWFA
    Many comments regarding the Commission's proposed inclusion of 
abortion in the definition of ``pregnancy, childbirth, or related 
medical conditions'' made arguments related to the statutory intent and 
structure of the PWFA.
    Comments in favor of the inclusion of abortion in the definition of 
``pregnancy, childbirth, or related medical conditions,'' including 
from Members of Congress, asserted that the Commission's inclusion of 
abortion in the definition is consistent with the PWFA's statutory 
intent and structure; that Congress' express purpose in enacting the 
PWFA was to supplement Title VII's protections; that Congress adopted 
the PWFA to remedy gaps in existing legal protections, including in 
Title VII, and it understood how ``pregnancy, childbirth, or related 
medical conditions'' is interpreted by the courts; that Congress 
understood that the PWFA could include possible accommodations related 
to an abortion, as evidenced by the statements of legislators who 
opposed the PWFA, showing that they understood it could require 
accommodations related to an abortion; that Congress recognized the 
PWFA as an opportunity for Congress to finally fulfill a promise of 
Title VII; and that Congress intentionally included ``related medical 
conditions'' in the PWFA to encompass conditions beyond simply 
pregnancy and childbirth.
    Many comments in favor of the inclusion of abortion expressed that 
including abortion furthers Congress' policy goal of protecting 
pregnant workers from harm; that it accurately reflects the range of 
needs and conditions that workers may experience that require 
reasonable workplace accommodations in relation to pregnancy; that 
abortion care is a safe, common, and essential component of 
reproductive health care; that decisions regarding abortion are private 
medical matters and should be made by patients in consultation with 
their clinicians and without undue interference by outside parties; and 
that providing accommodations for abortion would mean that employees 
would not have to risk their health, lives, or livelihoods to access 
care. Many such comments focused on specific positive health and social 
outcomes that employees would enjoy if they had access to 
accommodations for abortion, such as the ability to maintain personal 
bodily autonomy; to choose when to have or not have children; to 
receive necessary health care in the event of intimate partner 
violence, rape, incest, fetal anomalies, and exposure to teratogenic 
medications; and to receive necessary health care in the event of 
pregnancy complications that may be so severe that abortion is the only 
measure that will preserve a pregnant employee's health or save their 
life--including placental abruption, bleeding from placenta previa, 
preeclampsia or eclampsia, and cardiac or renal conditions.
    Comments opposed to the inclusion of abortion in the definition of 
``pregnancy, childbirth, or related medical conditions'' asserted that 
including abortion does not reflect Congress' generally expressed 
intent for the PWFA. For instance, comments stated that the PWFA's 
intent only is to ensure that pregnant and postpartum women can receive 
reasonable accommodations to safely work; that the PWFA's intent only 
is to support mothers during pregnancy and childbirth and only to 
protect and benefit the health of mothers and their fetuses, as well as 
to provide accommodations for miscarriage, stillbirth, treatment of an 
ectopic pregnancy, or emergency treatment intended to preserve the life 
of the pregnant employee, but not an abortion; that the Commission's 
interpretation turns the PWFA into a general reproductive health care 
statute, defying Congress' intent; that the PWFA was intended by its 
supporters to be like the ADA, which the comments construed not to 
require accommodations for abortion; that Congress did not intend to 
make forays into controversial social policy by enacting the PWFA; that 
including abortion ignores that Congress cited statistics about working 
mothers in support of the PWFA and talked about the health of the 
mother and baby; and that Congress does not hide ``elephants in 
mouseholes,'' and abortion is an elephant in the mousehole of 
``pregnancy, childbirth, or related medical conditions.''
    Some comments opposed to the inclusion of abortion also asserted 
that the definition does not reflect congressional intent as expressed 
by the PWFA's structure. These comments noted that Congress chose not 
to amend Title VII by incorporating the PWFA. Such comments inferred 
from this choice that Congress implicitly declined to import Title 
VII's definition of ``pregnancy, childbirth, or related medical 
conditions'' and its abortion-related requirements into the PWFA. These 
comments stated that the PWFA

[[Page 29108]]

does not specifically require the same definition of ``pregnancy, 
childbirth, or related medical conditions'' as Title VII, as it does 
with other terms from the ADA and Title VII, and if Congress wanted the 
Commission to provide examples of ``related medical conditions'' it 
would have expressly said so.
    Finally, some comments opposed to the proposed definition stated 
that Title VII's insurance exclusion provision, which addresses 
abortion and has been used to suggest that Title VII otherwise covers 
abortion, is different from the PWFA's similar exclusion provision.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' as Reflected 
in the Statutory Intent and Structure of the PWFA
    As stated above, the Commission's inclusion of abortion in the 
definition of ``pregnancy, childbirth, or related medical conditions'' 
is supported by the plain text of the statute and by statutory intent 
and structure and is in keeping with the well-established rules of 
statutory construction.\73\ Congress chose to write the PWFA using an 
identical phrase, ``pregnancy, childbirth, or related medical 
conditions,'' from Title VII and did not define the phrase in the PWFA. 
Nor did it place any limitations or rules of construction on the 
definition of the phrase in the PWFA. Accordingly, the Commission gives 
the phrase the same meaning under the PWFA as it has under Title VII 
for nearly 45 years. The Commission agrees that the PWFA's focus is 
accommodation, but, as the text of the PWFA and the ADA state and the 
Supreme Court has reiterated, accommodations are a form of 
nondiscrimination.\74\ Thus, the fact that the PWFA provides 
accommodations does not make it a different type of statute from Title 
VII. Additionally, although Congress specifically incorporated certain 
definitions into the PWFA from the ADA and Title VII, such as those for 
``reasonable accommodation,'' ``undue hardship,'' ``employer,'' and 
``employee,'' in those situations, the terms appear in more than one 
other statute enforced by the Commission, and some of their definitions 
vary across statutes.\75\ In incorporating certain terms, the 
Commission understands Congress' intent as specifying which definition 
it chose to adopt in the PWFA to avoid confusion. By contrast, there is 
only one other statute that the Commission enforces that uses the 
phrase ``pregnancy, childbirth, or related medical conditions,'' and 
that is Title VII, as amended by the PDA. Therefore, Congress' intent 
to use the Title VII definition in the PWFA is clear.
---------------------------------------------------------------------------

    \73\ See supra note 67.
    \74\ 42 U.S.C. 2000gg-1 (titled ``Nondiscrimination with regard 
to reasonable accommodations related to pregnancy''); 42 U.S.C. 
12112(b)(5)(A) (``[T]he term `discriminate against a qualified 
individual on the basis of disability' includes . . . not making 
reasonable accommodations . . . .''); see also 29 CFR part 1630, 
appendix, 1630.9 (``The obligation to make reasonable accommodation 
is a form of non-discrimination.''); US Airways, Inc. v. Barnett, 
535 U.S. 391, 396 (2002) (``[T]he ADA says that `discrimination' 
includes an employer's not making reasonable accommodations to the 
known physical or mental limitations of an otherwise qualified . . . 
employee, unless [the employer] can demonstrate that the 
accommodation would impose an undue hardship on the operation of 
[its] business.' '') (citing 42 U.S.C. 12112(b)(5)(A)) (emphasis in 
original) (omission in original).
    \75\ 42 U.S.C. 2000e(b) (defining ``employer'' under Title VII), 
(f) (defining ``employee'' under Title VII), (j) (defining 
``religion'' with regard to an employer's obligation to ``reasonably 
accommodate'' an employee's religious observance or practice absent 
``undue hardship'' under Title VII); 42 U.S.C. 12111(4) (defining 
``employee'' under the ADA), (5) (defining ``employer'' under the 
ADA), (9) (defining ``reasonable accommodation'' under the ADA), 
(10) (defining ``undue hardship'' under the ADA).
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    Further supporting the Commission's interpretation of the phrase 
``pregnancy, childbirth, or related medical conditions'' is the fact 
that the PWFA passed as part of the Consolidated Appropriations Act, 
2023 (CAA), in which Congress included several provisions explicitly 
limiting the use of Federal funds for abortion.\76\ Where Congress 
includes particular language in one section of a law but omits it in 
another, it is generally presumed that Congress acts intentionally and 
purposely in including or excluding certain language.\77\ Given that 
Congress explicitly included exclusions regarding abortion in certain 
sections of the CAA but omitted any such exclusion in the PWFA, the 
Commission concludes that the omission was an intentional act.
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    \76\ See, e.g., sec. 613, Public Law 117-328, 136 Stat. 4459, 
4699 (2022) (providing that: ``No funds appropriated by this Act 
shall be available to pay for an abortion, or the administrative 
expenses in connection with any health plan under the Federal 
employees health benefits program which provides any benefits or 
coverage for abortions.'').
    \77\ Keene Corp. v. United States, 508 U.S. 200, 208 (1993) 
(quoting Russello v. United States, 464 U.S. 16, 23 (1983)). Of 
note, in the debate surrounding the PWFA before its passage in the 
Senate, the Senators discussed abortion. See 168 Cong. Rec. S7,049-
50 (daily ed. Dec. 8, 2022); 168 Cong. Rec. S10,071, S10,081 (daily 
ed. Dec. 22, 2022). The House Report also discusses abortion. See 
H.R. Rep. No. 117-27, pt. 1, at 60. Thus, both chambers were 
seemingly aware of this issue, but the law does not include the type 
of abortion exclusion found in other parts of the CAA.
---------------------------------------------------------------------------

    The Commission's interpretation also is consistent with the 
legislative history of the PDA, the statute that is the source of the 
phrase, ``pregnancy, childbirth, or related medical conditions.'' The 
Congressional Conference Report accompanying the PDA provides: 
``Because [the PDA] applies to all situations in which women are 
`affected by pregnancy, childbirth, and related medical conditions,' 
its basic language covers decisions by women who chose to terminate 
their pregnancies. Thus, no employer may, for example, fire or refuse 
to hire a woman simply because she has exercised her right to have an 
abortion.'' \78\ By including the same key phrase in the PWFA and not 
articulating a different meaning than in the PDA, Congress is presumed 
to know and intend that the same definition will be applied.\79\ And 
given the longstanding and public interpretation of this phrase, by 
both the Commission and the courts, the Commission disagrees that 
adopting the same interpretation as Title VII amounts to Congress 
``hiding'' an elephant in a mousehole.
---------------------------------------------------------------------------

    \78\ See H.R. Rep. No. 95-1786, at 4 (1978) (Conf. Rep.).
    \79\ See supra note 67.
---------------------------------------------------------------------------

    Furthermore, the second sentence of the PDA states that employers 
do not have to pay for health insurance benefits for abortion, except 
where necessary to preserve the life of the mother or where medical 
complications have arisen from an abortion.\80\ The inclusion of this 
limited language regarding abortion coverage, coupled with clear 
statements in the legislative history, supports the conclusion that 
Congress intended for Title VII, as amended by the PDA, to protect 
employees against discrimination based on abortion and that Congress 
provided an exception, largely motivated by religious freedom concerns, 
for employers to opt out of providing health benefits to cover the 
procedure itself.\81\ Of note, the PWFA has a similar structure--it 
requires employers not to discriminate against protected qualified 
employees by failing to provide them reasonable accommodations, but it 
does not require, or permit the Commission to

[[Page 29109]]

require, ``an employer-sponsored health plan to pay for or cover any 
particular item, procedure, or treatment.'' \82\
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    \80\ See 42 U.S.C. 2000e(k).
    \81\ See H.R. Rep. No. 95-948, at 7 (1978), as reprinted in 1978 
U.S.C.C.A.N. 4749, 4755 (``Many members of the committee were 
troubled . . . by any implication that an employer would have to pay 
for abortions not necessary to preserve the life of the mother 
through medical benefits or other fringe benefit programs, even if 
that employer--a church organization for example--harbored religious 
or moral objections to abortion; such a requirement, it was felt, 
could compromise the religious freedom of such employers. The 
committee, therefore, amended the language of the bill to deal with 
the problem, by making clear that such employers will not be 
required to pay for abortions except where the life of the mother 
would be endangered if the fetus was carried to term.'' (emphasis in 
original)).
    \82\ 42 U.S.C. 2000gg-5(a)(2).
---------------------------------------------------------------------------

    As a matter of the PWFA's plain text, therefore, the Commission 
determines that the decision to have, or not to have, an abortion is 
encompassed within the phrase ``pregnancy, childbirth, or related 
medical conditions.'' Because this conclusion follows from the 
statutory text, the Commission does not believe that other concerns 
raised by commenters are relevant. The Commission's determination is 
not based on the potential health or social outcomes related to 
abortion; rather, the Commission's determination is based on the 
statutory text. Moreover, it bears emphasizing that this rulemaking 
does not require abortions or affect the availability of abortion; it 
simply ensures that employees who choose to have (or not to have) an 
abortion are able to continue participating in the workforce, by 
seeking reasonable accommodations from covered employers, as needed and 
absent undue hardship.
Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and Statements From Members 
of Congress and the White House About the PWFA
    Some comments pointed to statements made by Members of Congress to 
either support or dispute the idea that the definition of ``pregnancy, 
childbirth, or related medical conditions'' in the PWFA includes 
abortion. Comments also noted the absence of certain statements from 
Members of Congress and the White House.
    First, comments that supported the inclusion of abortion in the 
definition of ``pregnancy, childbirth, or related medical conditions'' 
pointed to statements by opponents of the bill, whose opposition was 
based on the lawmakers' views that abortion would be covered.\83\ Some 
comments also pointed to an amendment proposed by Senator James 
Lankford that the Senate rejected, which stated that ``[t]his division 
shall not be construed to require a religious entity described in 
Section 702(a) of the Civil Rights Act of 1964 to make an accommodation 
that would violate the entity's religion'' \84\ as evidence that 
Senators knew that abortion would be covered.
---------------------------------------------------------------------------

    \83\ See, e.g., 168 Cong. Rec. S7049 (daily ed. Dec. 8, 2022) 
(statement of Sen. Thomas (Thom) Tillis); 167 Cong. Rec. H2325, 
H2330, H2332 (daily ed. May 14, 2021) (statements of Rep. Julia 
Letlow, Rep. Robert George (Bob) Good, and Rep. Mary Miller).
    \84\ 168 Cong. Rec. S10,069-70 (daily ed. Dec. 22, 2022).
---------------------------------------------------------------------------

    Comments that did not support the inclusion of abortion in the 
definition of ``pregnancy, childbirth, or related medical conditions'' 
pointed to statements made during floor debate by two of the co-
sponsors of the PWFA in the Senate, Senator Robert P. Casey, Jr.\85\ 
and Senator William Cassidy.\86\ These comments also mentioned that, in 
a statement on the House floor, Representative Jerrold Nadler, lead 
sponsor of the PWFA, explained that the PWFA should be interpreted 
consistently with Title VII, stating: ``The Pregnant Workers Fairness 
Act aligns with Title VII in providing protections and reasonable 
accommodations for `pregnancy, childbirth, and related medical 
conditions,' like lactation.'' \87\
---------------------------------------------------------------------------

    \85\ 168 Cong. Rec. S7,050 (daily ed. Dec. 8, 2022).
    \86\ See, e.g., id. at S7,049-50.
    \87\ 168 Cong. Rec. H10,527-28 (daily ed. Dec. 23, 2022).
---------------------------------------------------------------------------

    Second, comments that disagreed with the Commission's proposed 
inclusion of abortion in the definition of ``pregnancy, childbirth, or 
related medical conditions'' pointed to statements made by Senator 
Steven Daines and Senator Cassidy after the Senate voted to add the 
PWFA to the CAA, both of which stated that accommodations related to 
abortion should not be covered. In addition, comments that disagreed 
with the Commission's position pointed to the lack of statements by 
supporters of the bill in Congress and the White House, and by advocacy 
groups, regarding its coverage of abortion. Comments stated that the 
PWFA would not have enjoyed bipartisan support, if the intent of the 
law were to include abortion, and including abortion as a related 
medical condition in the rule would make the political parties less 
likely to work together.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and Statements 
From Members of Congress and the White House About the PWFA
    The PWFA's text, structure, and intent support the Commission's 
proposed definition. Even if the Commission's interpretation were 
inconsistent with the cited statements of individual Members of 
Congress during the PWFA's passage, statements made by individual 
Members of Congress during floor debate do not justify a departure from 
an interpretation that Congress, courts, and the Commission have 
consistently adhered to since the PDA was enacted more than four 
decades ago. Again, the Commission's interpretation must start with the 
text of the statute. Relying on the text, rather than the individual 
statements of Members of Congress, follows the Supreme Court's 
requirements when interpreting a statute; as the Court has noted, 
``[p]assing a law often requires compromise, where even the most firm 
public demands bend to competing interests. What Congress ultimately 
agrees on is the text that it enacts, not the preferences expressed by 
certain legislators.'' \88\
---------------------------------------------------------------------------

    \88\ NLRB v. SW Gen., Inc., 580 U.S. 288, 306 (2017) (citations 
omitted); see also March v. United States, 506 F.2d 1306, 1314 n.31 
(D.C. Cir. 1974) (citing NLRB v. Plasterers' Loc. Union, 404 U.S. 
116, 129-30 n.24 (1971) (providing that, where congressional debates 
``reflect individual interpretations that are contradictory and 
ambiguous, they carry no probative weight'')).
---------------------------------------------------------------------------

    In addition, the Commission does not agree that the PWFA's 
legislative history counsels for a different interpretation of 
``pregnancy, childbirth, or related medical conditions'' than in the 
PDA. For example, according to the House PWFA Committee Report, Members 
knew that abortion would be covered as a pregnancy-related condition 
for which some employers would need to provide accommodation.\89\ 
Additionally, the Commission's definition is consistent with the full 
floor statement of Senator Casey and the comment that the Senator 
submitted during the public comment period.\90\ Consistent with the 
statutory text and Congress' intent, the PWFA does not impose a 
categorical mandate on an employer to provide leave for an abortion. 
Leave, like any accommodation, is subject to applicable exceptions and 
defenses, including both those based on religion and on undue hardship. 
Nothing in the PWFA requires an employer to pay for an abortion or 
provide health care benefits for abortion in violation of State 
law.\91\
---------------------------------------------------------------------------

    \89\ H.R. Rep. No. 117-27, pt. 1, at 60 (stating under minority 
views that ``if an employee working for a religious organization 
requests time off to have an abortion procedure, H.R. 1065 could 
require the organization to comply with this request as a reasonable 
accommodation of known limitations related to pregnancy, childbirth, 
or related medical conditions'').
    \90\ 168 Cong. Rec. S7,050 (daily ed. Dec. 8, 2022); Comment 
EEOC-2023-0004-98384, Sen. Robert P. Casey, Jr. (Oct. 10, 2023) 
(stating that in drafting the PWFA, legislators intentionally used 
terms from other laws, including ``pregnancy, childbirth, or related 
medical conditions,'' and supporting the definition in the proposed 
rule).
    \91\ See 42 U.S.C. 2000gg-5(a)(2); 88 FR 54745 (stating that 
``nothing in the PWFA requires or forbids an employer to pay for 
health insurance benefits for an abortion''). Covered entities, 
however, may separately be subject to the PDA's provisions regarding 
abortion coverage in certain circumstances. See 42 U.S.C. 2000e(k).
---------------------------------------------------------------------------

    Finally, numerous legislators submitted comments during the public

[[Page 29110]]

comment period that supported or opposed the inclusion of abortion in 
the definition of ``pregnancy, childbirth, or related medical 
conditions.'' As these were statements made by Members of Congress 
after the passage of a bill, the Commission gave them due consideration 
as statements of the views of each particular Member who signed 
them.\92\
---------------------------------------------------------------------------

    \92\ Cf. Nat'l Woodwork Mfrs. Ass'n v. NLRB, 386 U.S. 612, 639 
n.34 (1967) (observing that statements inserted into the record 
after passage of a bill are regarded as ``represent[ing] only the 
personal views of the[ ] legislators'' involved). Senator Patricia 
Murray, joined by 24 Senators, endorsed the Commission's 
interpretation regarding the definition of ``pregnancy, childbirth, 
or related medical conditions,'' Comment EEOC-2023-0004-98257, Sen. 
Patricia (Patty) Murray and 24 U.S. Senators (Oct. 10, 2023); as did 
Representative Jerrold Nadler, joined by 82 House Representatives, 
Comment EEOC-2023-0004-98470, Rep. Jerrold (Jerry) Nadler and 82 
Members of Congress (Oct. 10, 2023); and Representative Robert 
Scott, Comment EEOC-2023-0004-98339, Rep. Robert C. (Bobby) Scott, 
Ranking Member of the House Committee on Education and the Workforce 
(Oct. 10, 2023). By contrast, Senator James Lankford's comment, 
which was joined by 19 Senators, including Senator Bill Cassidy, and 
41 House Representatives, disagreed with the Commission's 
interpretation. Comment EEOC-2023-0004-98436, Sen. James Lankford, 
19 U.S. Senators, and 41 Members of Congress (Oct. 10, 2023). 
Similarly, Senator Michael Braun's comment disagreed with the 
Commission's interpretation. Comment EEOC-2023-0004-98486, Sen. 
Michael (Mike) Braun (Oct. 10, 2023).
---------------------------------------------------------------------------

    In response to the comments regarding the political process, the 
Commission cannot speculate on counterfactual scenarios such as what 
might have triggered a filibuster of the PWFA in Congress, nor what 
would diminish bipartisan support for future legislation. And the 
Commission cannot reinterpret the definition of ``pregnancy, 
childbirth, or related medical conditions'' based on the purported 
absence of certain statements by Members of Congress, advocates, or the 
executive branch during the bill's passage.
    As explained above, the Commission must rely on the plain text of 
the statute. Given the meaning of the words that Congress chose to use 
in the PWFA, and the Commission's and courts' long history of 
interpreting those identical words to include abortion, the Commission 
will interpret those words the same way in the PWFA.
Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and Administrative and 
Judicial Interpretation
    Many comments in favor of the Commission's inclusion of abortion in 
the definition of ``pregnancy, childbirth, or related medical 
conditions'' asserted that the Commission's inclusion of abortion in 
the definition accurately reflects longstanding judicial and 
administrative interpretations under Title VII. Comments stated that 
the Commission's interpretation is correct and consistent with decades 
of authority under Title VII, including legislative history, Federal 
case law, and Commission guidance; that existing case law supports the 
Commission's interpretation that Title VII protects employees from 
discrimination for contemplating or obtaining an abortion or refusing 
to submit to an employer's demand that they obtain an abortion; and 
that the Commission's Enforcement Guidance on Pregnancy Discrimination 
reaffirmed that choosing whether to have or not to have an abortion is 
covered under the PDA.
    Some comments opposed to the Commission's proposed inclusion of 
abortion in the definition of ``pregnancy, childbirth, or related 
medical conditions'' asserted that the Commission's definition is 
contrary to judicial and administrative interpretations under Title 
VII.
    Some comments disputed the Commission's statement that existing 
case law under Title VII supports the Commission's definition, claiming 
that the decisions do not apply to the PWFA and are distinguishable; 
that there is not a widespread judicial consensus about the meaning of 
``related medical conditions''; and that the Commission should not rely 
on lower court decisions.
    Some comments took issue with the Commission's reliance on its 2015 
Enforcement Guidance on Pregnancy Discrimination to interpret the 
phrase ``pregnancy, childbirth, or related medical conditions'' under 
the PWFA, as the Enforcement Guidance on Pregnancy Discrimination does 
not receive binding judicial deference; only addresses pregnancy 
discrimination, not accommodation; and was issued many years after the 
PDA's enactment.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and 
Administrative and Judicial Interpretation
    The Commission disagrees with the comments that dispute the case 
law it cited and its reliance on its Enforcement Guidance on Pregnancy 
Discrimination. The Title VII decisions the Commission cited involve 
situations where employers discriminated against employees because they 
contemplated having, or chose to have, an abortion. These decisions 
include Doe v. C.A.R.S. Protection Plus, a Third Circuit decision 
relating to leave holding that an employer may not discriminate against 
an employee because she had an abortion.\93\ As stated above, refusal 
to provide reasonable accommodation is a form of discrimination.\94\ 
Finally, the Commission's reliance on its Enforcement Guidance on 
Pregnancy Discrimination is appropriate because it represents and 
demonstrates the consistent position of the Commission. It is 
immaterial that the guidance was voted on and approved by the 
Commission years after the passage of the PDA, especially given that 
the year after the PDA was enacted, the Commission issued its Questions 
& Answers about the PDA stating that abortion is covered under the PDA 
and prohibiting discrimination in employment practices because an 
employee had or did not have an abortion.\95\ Thus, the Enforcement 
Guidance on Pregnancy Discrimination reconfirmed and still reflects the 
Commission's decades-long position.
---------------------------------------------------------------------------

    \93\ 527 F.3d at 363-64 (citing, inter alia, Turic v. Holland 
Hosp., Inc., 85 F.3d 1211, 1214 (6th Cir. 1996)); see also DeJesus, 
2018 WL 4931817, at *1 (denying the employer's motion to dismiss in 
a Title VII case where an employee used approved leave to have an 
abortion and was fired shortly thereafter when her supervisor stated 
that the medical procedure was not an appropriate excuse for her 
absence).
    \94\ See supra note 74.
    \95\ 29 CFR part 1604, appendix, Question 34 (``Q. Can an 
employer discharge, refuse to hire or otherwise discriminate against 
a woman because she has had an abortion?/A. No. An employer cannot 
discriminate in its employment practices against a woman who has had 
an abortion.''), Question 35 (``Q. Is an employer required to 
provide fringe benefits for abortions if fringe benefits are 
provided for other medical conditions?/A. All fringe benefits other 
than health insurance, such as sick leave, which are provided for 
other medical conditions, must be provided for abortions. Health 
insurance, however, need be provided for abortions only where the 
life of the woman would be endangered if the fetus were carried to 
term or where medical complications arise from an abortion.''); see 
also supra note 28 (noting that in the PWFA Congress was seeking to 
protect the same employees who are protected by the PDA).
---------------------------------------------------------------------------

Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and Other Laws
    Some comments pointed to other laws to dispute the Commission's 
definition of ``pregnancy, childbirth, or related medical conditions.'' 
The comments pointed to the provisions in annual appropriations 
legislation, for example, the Hyde and Weldon Amendments, limiting the 
use of Federal funds for abortion except in certain circumstances. The 
comments also stated that Congress has never passed a law explicitly 
promoting the right to abortion. Similar comments noted that

[[Page 29111]]

some States such as West Virginia and Louisiana have adopted their own 
versions of the PWFA, and no court appears to have interpreted State or 
local PWFAs to include abortion. Comments also stated that the 
Commission should clarify whether its regulation supersedes abortion 
funding restrictions in the Hyde Amendment and similar amendments, and 
how the Federal Government will ensure that Federal agencies do not pay 
for abortion accommodations and ensure that the same rules that apply 
to the ADA regarding taxpayer funding for abortion apply to the PWFA.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and Other Laws
    In interpreting the identical language from Title VII in the 
context of the PWFA, the Commission cannot infer congressional intent 
in a manner contrary to the plain text interpretation, particularly not 
based on what Congress could have said, but chose not to say. There is 
no evidence to suggest that the other Federal statutes cited by the 
comments should be considered by the Commission as interpreting the 
PWFA, nor is there any persuasive reason to give controlling weight to 
these statutes (instead of interpreting the PWFA consistently with 
Title VII, as Congress intended). Rather, the fact that Congress chose 
to provide express exclusions related to abortion in the cited 
statutes, including in the CAA, but did not choose to do so in the 
PWFA, suggests that if Congress wanted to exclude abortion from the 
definition of ``pregnancy, childbirth, or related medical conditions'' 
in the PWFA, it would have done so expressly.
    Moreover, the PWFA, as interpreted by the Commission in this rule, 
does not in any way promote abortion; it simply provides for the 
possibility of an accommodation related to a qualified employee seeking 
an abortion, absent undue hardship, and there is only a narrow context 
in which this protection would likely apply--when an employee is 
seeking leave--given the prohibitions of 42 U.S.C. 2000gg-5(a)(2).\96\ 
The PWFA also provides for accommodations for employees who choose not 
to have an abortion, absent undue hardship.
---------------------------------------------------------------------------

    \96\ 42 U.S.C. 2000gg-5(a)(2) provides that ``[n]othing in this 
chapter shall be construed . . . by regulation or otherwise, to 
require an employer-sponsored health plan to pay for or cover any 
particular item, procedure, or treatment or to affect any right or 
remedy available under any other Federal, State, or local law with 
respect to any such payment or coverage requirement.''
---------------------------------------------------------------------------

    Further, the interpretation of State laws is not as persuasive as 
the interpretation of Title VII when Congress used the same words in 
both Federal statutes. Comments addressing State laws did not address 
whether cases regarding abortion arose under these PWFA-analogous laws. 
As stated above, despite the large number of comments on this issue, 
the Commission's practical experience under Title VII shows that 
litigation regarding this issue is not common. Finally, as stated 
previously, the Commission's rule does not require any employer to pay 
for an abortion.
Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and the Dobbs Decision
    Some comments stated that the Supreme Court's decision in Dobbs v. 
Jackson Women's Health Org., 597 U.S. 215 (2022), which concluded that 
there is no Federal constitutional right to abortion and overruled Roe 
v. Wade, 410 U.S. 113 (1973), and Planned Parenthood of Southeastern 
Pennsylvania v. Casey, 505 U.S. 833 (1992), affects the Commission's 
rulemaking.
    First, some comments said that, because the PWFA was enacted soon 
after the Court issued its Dobbs decision, Congress should have stated 
more clearly in the PWFA any protection for an employee seeking an 
accommodation related to an abortion, if that was its intent. Second, 
some comments asserted that, because of the Dobbs decision, abortion is 
a State issue, not a Federal issue, that there is no Federal right to 
abortion, that including abortion accommodations in the PWFA would 
circumvent Dobbs, and that under Dobbs, abortion is not health care. 
Comments also stated that the Title VII case law cited by the 
Commission involved substantial reliance on the constitutional right to 
abortion now undone by Dobbs.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and the Dobbs 
Decision
    Given the language that Congress used in the PWFA and the use and 
interpretation of that same language in Title VII, the Dobbs decision 
does not suggest a different definition of the phrase ``pregnancy, 
childbirth, or related medical conditions.'' First, Congress is not 
required to speak directly to a specific issue when it legislates. ``In 
some cases, Congress intends silence to rule out a particular statutory 
application, while in others Congress' silence signifies merely an 
expectation that nothing more need be said in order to effectuate the 
relevant legislative objective.'' \97\ Congress' choice to use the same 
phrase in the PWFA as in Title VII, coupled with Congress' decision to 
enact limitations with respect to abortion in other portions of the CAA 
but not in the PWFA, supports the Commission's interpretation that 
``pregnancy, childbirth, or related medical conditions'' has the same 
meaning in the PWFA that it does in Title VII, and it includes 
abortion. Thus, the conclusion the Commission draws from Congress' lack 
of an explicit mention of abortion in the PWFA is that Congress did not 
express its intent for the phrase to have any different meaning than it 
has under Title VII.
---------------------------------------------------------------------------

    \97\ Burns v. United States, 501 U.S. 129, 136 (1991), abrogated 
on other grounds as recognized by Dillon v. United States, 560 U.S. 
817 (2010).
---------------------------------------------------------------------------

    As stated at the beginning of this discussion, the Commission's 
rule does not regulate abortion or abortion procedures, nor does it 
require an employer to pay for, promote, or endorse abortion. 
Additionally, although Dobbs held that the U.S. Constitution's Due 
Process Clause does not provide a right to abortion, that 
interpretation of the Constitution does not address Congress' authority 
to regulate potential employment discrimination by providing for 
reasonable accommodations for pregnancy, childbirth, or related medical 
conditions absent undue hardship, as Congress has done in the PWFA. 
Dobbs did not involve, and the Court did not discuss, employment 
protections under Title VII, and Dobbs did not purport to interpret the 
meaning of the phrase ``pregnancy, childbirth, or related medical 
conditions'' in Title VII. Ultimately, Dobbs concerned a matter of 
constitutional interpretation and not one of statutory interpretation, 
and the cases cited by the Commission in support of the inclusion of 
abortion in the definition of ``pregnancy, childbirth, or related 
medical conditions'' may still be relied on. Indeed, Congress enacted 
the PWFA after the Dobbs decision and chose to retain the phrase 
``pregnancy, childbirth, or related medical conditions'' that it had 
used in Title VII without any modification or instruction. Thus, even 
if Dobbs could be construed as an invitation for Congress to reevaluate 
that language from Title VII, Congress did not do so.

[[Page 29112]]

Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and Policy Arguments 
Regarding Abortion
    Many comments supported the inclusion of abortion in the definition 
of ``pregnancy, childbirth, or related medical conditions'' for various 
policy reasons. As discussed at length above, such reasons included, 
for example, stating that it would help employees access essential 
health care and have autonomy about their reproductive decisions.
    By contrast, other comments stated that, as a policy matter, the 
Commission should not include abortion in the definition of 
``pregnancy, childbirth, or related medical conditions.'' First, some 
comments speculated that including abortion in the definition will 
result in employers encouraging their pregnant workers to have 
abortions. Some of these comments suggested that employers might even 
require pregnant workers to take leave to have an abortion instead of 
another available accommodation. Second, some comments stated that 
there should be no accommodations for abortion because, according to 
the comments, abortion causes mental health issues for women.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and Policy 
Arguments Regarding Abortion
    As explained above, the Commission must rely on the plain text of 
the statute. Given the words that Congress chose to use in the PWFA, 
and the Commission's and courts' long history of interpreting those 
identical words to include abortion, the Commission will interpret 
those words the same way in the PWFA. The Commission disagrees with 
commenters who argued that excluding abortion from the definition 
serves the policy goals expressed by Congress in the PWFA. On the 
contrary, as discussed above, the Commission concludes that including 
abortion in the definition best serves the policy goals expressed by 
Congress in the PWFA in that it will allow qualified employees with 
known limitations related to pregnancy, childbirth, or related medical 
conditions to obtain accommodations to address their needs, absent 
undue hardship. While the comments make policy arguments opposed to the 
inclusion of abortion in the definition of ``pregnancy, childbirth, or 
related medical conditions,'' these policy objections are not a reason 
for the Commission to change its interpretation and deviate from the 
text of the statute and established rules of statutory construction. 
Additionally, the Commission notes that some of the claims in the 
comments that argued against abortion for policy reasons have been 
disputed by health care professionals.\98\
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    \98\ For example, the contention that abortion causes mental 
health issues for women is refuted by major mental health 
organizations. Am. Psych. Ass'n, Abortion (2024), https://www.apa.org/topics/abortion; see also Healthline, Understanding the 
Relationship Between Abortion and Mental Health (July 6, 2023), 
https://www.healthline.com/health/abortion-and-mental-health; M. 
Antonia Biggs et al., Women's Mental Health and Well-Being 5 Years 
After Receiving or Being Denied an Abortion: A Prospective, 
Longitudinal Cohort Study, 74 JAMA Psychiatry 169 (Feb. 2017), 
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2592320.
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    With regard to concerns that employers will force their employees 
to have abortions, Title VII prohibits covered entities from taking 
adverse employment actions against an employee based on their decisions 
to have, or not to have, an abortion.\99\ Consistent with this 
interpretation, the Commission's definition of ``pregnancy, childbirth, 
or related medical conditions'' includes both having an abortion and 
choosing not to have an abortion, thus protecting pregnant employees 
who decide to continue their pregnancies.\100\
---------------------------------------------------------------------------

    \99\ See, e.g., EEOC v. Ryan's Pointe Houston, LLC, No. 19-
20656, 2022 WL 4494148, at *7 (5th Cir. Sept. 27, 2022); Velez v. 
Novartis Pharms. Corp., 244 FRD. 243, 267 (S.D.N.Y. 2007) (including 
a declaration by a female employee that she was encouraged by a 
manager to get an abortion as anecdotal evidence supporting a class 
claim of pregnancy discrimination); Enforcement Guidance on 
Pregnancy Discrimination, supra note 31, at (I)(A)(4)(c).
    \100\ See, e.g., Ryan's Pointe Houston, 2022 WL 4494148, at *7; 
Press Release, EEOC, Best Western Hotels in Tacoma and Federal Way 
To Pay $365,000 To Settle EEOC Suit for Harassment (July 5, 2012) 
(announcing settlement of a harassment case by the EEOC that 
included allegations that the harasser belittled the religious 
beliefs of employees, including telling a pregnant employee she 
should have an abortion even though she said it was against her 
religious beliefs).
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Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and the Interaction Between 
State Laws Regarding Abortion and the PWFA
    Some comments asserted that covered entities cannot be required to 
provide accommodations relating to an abortion because some State laws 
prohibit abortion under certain circumstances. Some comments also noted 
that some State laws provide that an individual may sue another 
individual for conduct that aids in the performance of an abortion in 
violation of State law. A few comments stated that the rule will compel 
State and local governments to provide accommodations contrary to State 
law, and that doing so transgresses limits of federalism; one comment 
asserted that certain Senators were concerned about litigation against 
the States and voted to remove the PWFA's text that waives State 
immunity to lawsuits.
Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and the 
Interaction Between State Laws Regarding Abortion and the PWFA
    The Commission does not agree with comments that the inclusion of 
abortion in the definition of ``pregnancy, childbirth, or related 
medical conditions'' requires covered entities, including State and 
local governments, to violate State laws that limit access to abortion, 
nor does the rule transgress limits of federalism. The rule does not 
prescribe when, where, or under what circumstances an abortion can be 
obtained or what procedures may be used. If the issue of a PWFA 
accommodation regarding abortion arises, it will likely concern only a 
request by a qualified employee for leave from work.\101\ Accordingly, 
State laws that regulate the provision of abortions in certain 
circumstances do not conflict with covered entities' obligations under 
the PWFA.
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    \101\ 42 U.S.C. 2000gg-5(a)(2) provides that ``[n]othing in this 
chapter shall be construed . . . by regulation or otherwise, to 
require an employer-sponsored health plan to pay for or cover any 
particular item, procedure, or treatment or to affect any right or 
remedy available under any other Federal, State, or local law with 
respect to any such payment or coverage requirement.'' Some comments 
speculated that employers, including State and local governments, 
could violate State laws restricting abortion access if they 
provided leave to employees who then traveled across State lines to 
obtain abortion care. The Commission notes that employees can 
currently use their leave to do so, and the comments did not explain 
why the leave being a reasonable accommodation under the PWFA would 
create a different set of circumstances or a different result.
---------------------------------------------------------------------------

    Any potential interaction or conflict between PWFA and State laws, 
including State laws that allow civil suits to challenge actions that 
private individuals claim aid in the provision of an abortion, will be 
addressed on a case-by-case basis. Of note, the PWFA does not require 
an employer to pay for an abortion, and neither does the 
regulation.\102\
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    \102\ See 42 U.S.C. 2000gg-5(a)(2); 88 FR 54745 (stating that 
``nothing in the PWFA requires or forbids an employer to pay for 
health insurance benefits for an abortion''). Covered entities may, 
however, be subject to Title VII's provisions regarding abortion 
coverage in certain circumstances. See 42 U.S.C. 2000e(k).

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[[Page 29113]]

    The Commission agrees that State and local governments are covered 
employers and are required to provide accommodations under the PWFA, 
absent undue hardship. As stated above, any potential interaction or 
conflict between a State law and the PWFA will be addressed on a case-
by-case basis. Further, States and local governments that are covered 
by the PWFA are covered by Title VII, which has protected employees' 
rights to be free from discrimination in employment for having, or for 
not having, an abortion for nearly 45 years, and yet comments on this 
topic did not point to a situation where a State was forced to violate 
its own laws. Finally, Congress did not vote to remove the section of 
the PWFA that waives State sovereign immunity; that provision is in 42 
U.S.C. 2000gg-4.
    Ultimately, whether any particular action taken by an employer 
pursuant to the PWFA could potentially implicate State law is dependent 
on the content of each individual State's laws, including how those 
laws are interpreted by each State's courts. As noted above, commenters 
did not identify any real-world scenarios in which Title VII's 
protections for employees' rights with regard to abortion have led to 
employer concerns about liability under State law. To the extent any 
such issues arise in connection with the PWFA, the Commission believes 
they are best addressed on a case-by-case basis, particularly given the 
State- and fact-specific nature of these issues.
Comments Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and the Major Questions 
Doctrine
    Some comments argued that to include abortion in the definition of 
``pregnancy, childbirth, or related medical conditions'' implicates the 
major questions doctrine.\103\
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    \103\ The major questions doctrine applies to ``extraordinary 
cases that call for a different approach--cases in which the history 
and the breadth of the authority that [the agency] has asserted, and 
the economic and political significance of that assertion, provide a 
reason to hesitate before concluding that Congress meant to confer 
such authority.'' West Virginia v. EPA, 597 U.S. 697, 721 (2022) 
(internal quotation marks omitted). Under this doctrine, the Court 
has rejected agency claims of statutory authority when: (1) the 
underlying claim of authority concerns an issue of ``vast economic 
and political significance,'' and (2) Congress has not clearly 
empowered the agency with authority over the issue. Util. Air Regul. 
Grp. v. EPA, 573 U.S. 302, 324 (2014) (internal quotation marks 
omitted).
---------------------------------------------------------------------------

    In claiming that the major questions doctrine applies, comments 
stated that abortion has been a heated political topic or a source of 
moral controversy; that the Dobbs majority and dissent both found 
abortion to have important economic consequences; and that the 
possibility of reasonable accommodations for an abortion meets the 
threshold of deep political significance, implicating the major 
questions doctrine. Comments also stated that the Commission must show 
that the decision to allow for possible reasonable accommodations for 
an abortion, absent undue hardship, was clear in the text of the PWFA 
at the time of enactment; that if Congress wanted to put paid abortion 
leave into the PWFA, it would have done so explicitly; and that the 
Commission may not issue regulations with vast political significance 
unless clearly directed by Congress.
    By contrast, other comments disputed whether the major questions 
doctrine applies to the PWFA and the Commission's definition of 
``pregnancy, childbirth, or related medical conditions.'' For instance, 
one detailed comment noted that the Supreme Court has limited the major 
questions doctrine to a narrow category of extraordinary paradigm cases 
that are very different from the posture of the PWFA rulemaking.\104\ 
The comment stated that none of the indicia of a major question exist 
in this rulemaking--the Commission is merely interpreting a phrase the 
same way it did in Title VII, with no change to the prevailing 
interpretation of this longstanding statutory text. Additionally, the 
comment asserted the rule does not address questions of such vast 
economic and political significance as to raise a presumption against 
congressional delegation of authority and the comment supported the 
rule as an exercise of agency authority to interpret and implement a 
statute, using the same long-established textual interpretation as in a 
related statute.
---------------------------------------------------------------------------

    \104\ See Comment EEOC-2023-0004-98328, Professors Greer Donley, 
David S. Cohen, Rachel Rebouche, Kate Shaw, Melissa Murray, and Leah 
Litman (Oct. 10, 2023).
---------------------------------------------------------------------------

Response to Comments Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and the Major 
Questions Doctrine
    The Commission disagrees that inclusion of abortion in the 
definition of ``pregnancy, childbirth, or related medical conditions'' 
implicates the major questions doctrine. The inclusion of abortion in 
the definition of ``pregnancy, childbirth, or related medical 
conditions'' is for the limited purpose of qualifying for a workplace 
accommodation under the PWFA, which is subject to defenses and case-by-
case assessment. Moreover, the Commission anticipates that any requests 
for accommodations related to abortion will typically involve the 
provision of unpaid leave. Thus, including abortion in the definition 
of ``pregnancy, childbirth, or related medical conditions'' is not the 
type of ``extraordinary case[ ]'' that implicates the major questions 
doctrine.\105\ The Commission is simply implementing Congress' intent 
by confirming that the term ``related medical conditions'' has the same 
meaning given to the term in Title VII for over four decades. Thus, the 
Commission is effectuating a policy decision made by Congress itself, 
not claiming a ``newfound power'' that would ``represent[ ] a 
transformative expansion in its regulatory authority'' or ``make a 
radical or fundamental change to a statutory scheme.'' \106\ And no 
court has applied the major questions doctrine to the Commission's 
identical interpretation of Title VII's identical text.
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    \105\ See West Virginia, 597 U.S. at 721.
    \106\ Id. at 723-24 (internal quotation marks omitted).
---------------------------------------------------------------------------

    The provision of possible reasonable accommodations for known 
limitations related to an abortion does not have the type of economic 
impact found in other cases that successfully invoked the major 
questions doctrine. Because the PWFA prohibits any requirement ``by 
regulation or otherwise . . . [for] an employer-sponsored health plan 
to pay for or cover a particular item, procedure, or treatment,'' the 
Commission anticipates that most requests for accommodations related to 
an abortion will involve only the provision of leave, which will likely 
be unpaid.\107\ Thus, any economic impact will be minimal.
---------------------------------------------------------------------------

    \107\ See 42 U.S.C. 2000gg-5(a)(2).
---------------------------------------------------------------------------

    Further, the Commission's use of the term does not ``effec[t] a 
`fundamental revision of the statute, changing it from [one sort of] 
scheme of . . . regulation' into an entirely different kind''; \108\ 
rather, it implements a new statute by harmonizing the meaning of 
``pregnancy, childbirth, or related medical conditions'' in Title VII 
and the PWFA. The ``consistency of [an agency's] prior position is 
significant'' when it comes to the major questions doctrine, because 
``[i]t provides important context'' about what Congress ``understood'' 
the statute to permit.\109\

[[Page 29114]]

``Congress must be taken to have been familiar with the existing 
administrative interpretation.'' \110\ The relevant statutory 
language--``pregnancy, childbirth, or related medical conditions''--has 
a well-documented, consistent, and historical definition, and the 
Commission is within its authority to use that definition in 
implementing a new statute.
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    \108\ Biden v. Nebraska, 600 U.S. _, 143 S. Ct. 2355, 2373 
(2023) (quoting West Virginia, 597 U.S. at 728).
    \109\ FDA v. Brown & Williamson Tobacco Corp., 529 U.S. 120, 157 
(2000).
    \110\ McFeely v. Comm'r of Internal Revenue, 296 U.S. 102, 110 
(1935).
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    By contrast, were the Commission to stray from Title VII's 
interpretation of ``pregnancy, childbirth, or related medical 
conditions'' for the purpose of adopting a definition that excluded 
abortion, the Commission would be taking a novel stance, contrary to 
the language of the PWFA and the intent expressed by Congress in using 
the language of Title VII.
Comment Regarding the Commission's Proposed Definition of ``Pregnancy, 
Childbirth, or Related Medical Conditions'' and Separation of Powers 
Concerns
    One comment raised a constitutional objection to the Commission's 
structure, asserting that the President can remove Commissioners ``only 
for cause.''
Response to Comment Regarding the Commission's Proposed Definition of 
``Pregnancy, Childbirth, or Related Medical Conditions'' and Separation 
of Powers Concerns
    The Commission disagrees that there is any constitutional defect in 
the agency's structure, and, in any event, the comment provides no 
basis to believe that anything about the rule or its implementation 
would be different if the Commission had a different structure.

1636.3(c) Employee's Representative

    Several comments suggested additions to the definition of 
``employee's representative,'' including ``union representative,'' 
``co-worker,'' and ``manager.'' The Commission has added ``union 
representative'' to the list, which is further illustrated in Example 
#31. The addition reflects an important kind of representative and 
differs from the other illustrative third parties listed. The 
Commission has not made further changes to the list. The list in the 
proposed regulation mirrors that set out in ADA \111\ policy and is not 
exhaustive. Further, the Commission believes that the addition of 
``manager'' would not add clarity to the definition and would risk 
confusing management officials about their roles and obligations under 
the PWFA.
---------------------------------------------------------------------------

    \111\ See EEOC, Enforcement Guidance on Reasonable Accommodation 
and Undue Hardship under the ADA, Question 2 (2002) [hereinafter 
Enforcement Guidance on Reasonable Accommodation], http://www.eeoc.gov/laws/guidance/enforcement-guidance-reasonable-accommodation-and-undue-hardship-under-ada.
---------------------------------------------------------------------------

    Other comments proposed changing ``other representative'' to what 
they believe to be more descriptive language, such as ``any other 
person who communicates.'' The Commission is maintaining 
``representative'' because it is the language used in the statute.
    Several comments recommended that the rule require the employee's 
representative to have the employee's permission to communicate the 
employee's limitation. The Commission expects that normally the 
representative will have the employee's permission but notes that there 
may be situations, for example when the employee is incapacitated, 
where that may not be possible. The Commission has added this 
information in the Interpretive Guidance in section 1636.3(c) 
Employee's Representative. The Commission declines to delineate a 
specific form or manner for an individual to be considered a 
representative because this would unnecessarily increase the burden on 
employees and potentially delay the processing of an accommodation 
request. The PWFA intends to make seeking and obtaining an 
accommodation efficient and effective. Requiring an employee to submit 
evidence of their authorization to enable a third party to request an 
accommodation on their behalf would thwart the PWFA's efforts to make 
such communication a simple task.
    Several comments proposed that once the employee's representative 
has made the need for an accommodation known, the employer must then 
engage in the interactive process directly with the employee. Again, 
the Commission expects that this will be the normal situation but 
notes, for example, that when the employee is incapacitated or the 
representative is the employee's attorney, the employer may need to 
continue to engage with the representative rather than the employee. 
The Commission has added information to this effect in the Interpretive 
Guidance in 1636.3(c) Employee's Representative. Finally, the 
Commission has removed the word ``known'' before ``limitation'' in the 
Interpretive Guidance for this section because the limitation is not 
``known'' until it has been communicated.

1636.3(d) Communicated to the Employer

    The Commission received numerous comments regarding the definition 
of ``communicated to the employer,'' what information the employee 
should have to provide to the employer, with whom the employee should 
communicate, and what the employer can or cannot require the employee 
to do after the initial request.
    Several comments correctly pointed out that the statutory 
definition of ``communicated to the employer'' in the PWFA does not 
include a description or requirement of how the employee must request a 
reasonable accommodation. Thus, the Commission has moved the 
information regarding how an employee requests a reasonable 
accommodation (formerly in proposed Sec.  1636.3(d)(3)) to the section 
of the rule regarding reasonable accommodations (Sec.  1636.3(h)(2)). 
Although these sections are now separate and therefore follow the 
statutory text more closely, they have many important commonalities. 
Specifically, both communicating to the employer regarding the 
limitation and requesting a reasonable accommodation should be simple 
processes that do not require any specific language; both can be made 
to the same people at the covered entity at the same time; and for both 
there are limitations as to the information the covered entity can 
require. In practice, the Commission recognizes that in most cases 
these communications will occur simultaneously: an employee will 
communicate about their limitation in the process of informing the 
employer that they need an adjustment or change at work for reasons 
related to the limitation.
    Thus, the final regulation's definition of ``communicated to the 
employer'' consists only of Sec.  1636.3(d) introductory text and 
(d)(1) and (2) from the NPRM. Paragraph (d)(3), with some 
modifications, has been moved to Sec.  1636.3(h)(2).
    Section 1636.3(d) of the proposed regulation stated that 
``communicated to the employer'' means to make known to the covered 
entity either by communicating with a supervisor, manager, someone who 
has supervisory authority for the employee (or the equivalent for an 
applicant), or human resources personnel, or by following the covered 
entity's policy to request an accommodation. Several comments suggested 
that this list include someone ``who directs the employee's tasks'' in 
order to better reflect circumstances where a workplace may not use a 
supervisory structure or specific job titles. The Commission agrees 
that this additional language will help employees and covered entities 
better understand that such communication also is appropriately 
directed to those

[[Page 29115]]

individuals whom an employee would normally consult if they had a 
question or concern. Thus, the final rule includes the addition of ``or 
who regularly directs the employee's tasks.'' Some comments also 
suggested that the Commission clarify that the entity with whom the 
employee may communicate could include any agents of the employer such 
as a search firm, staffing agency, or third-party benefits 
administrator. The Commission has included that information in the 
Interpretive Guidance in section 1636.3(d) Communicated to the Employer 
and 1636.3(h)(2) How To Request a Reasonable Accommodation and has 
covered these entities in the regulation by adding ``another 
appropriate official,'' a term that also serves to cover other entities 
with authority for the employee who may not have one of the titles used 
in the rest of this portion of the regulation.
    Paragraph (d)(1) has not changed from the NPRM. In paragraph 
(d)(2), the Commission has added that the communication regarding the 
limitation need not use specific words in order for it to be considered 
``communicated to the employer.'' The Commission also has changed the 
structure of this sentence so that it matches that of paragraph (d)(1) 
and refers to the communication, rather than what a covered entity may 
or may not require and has slightly changed the wording of the 
prohibitions. For example, the proposed rule said, ``any specific 
format'' and the final rule says, ``in a specific format''; and the 
proposed rule said, ``any particular form'' and the final rule says, 
``on a specific form.''
    In the Interpretive Guidance in section 1636.3(d) Communicated to 
the Employer and 1636.3(h)(2) How To Request a Reasonable 
Accommodation, the Commission has combined the information for Sec.  
1636.3(d) and (h)(2) to emphasize that the communication of the 
limitation and the request for an accommodation will usually happen at 
the same time, that both should be simple tasks, and that both are 
governed by the same rules regarding with whom the employee may 
communicate, and the lack of a requirement for any specific words or 
forms (Sec.  1636.3(d)). The Commission also has added information 
explaining that, because many situations that may qualify for coverage 
under the PWFA could be classified as either a ``limitation'' (a 
physical or mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions) or ``pregnancy, 
childbirth, or related medical conditions,'' employees do not need to 
identify a specific part of the regulation under which they believe 
they are entitled to coverage in order to make a request. Employers 
should not decide that an employee is not covered by the PWFA or 
otherwise restrict an employee's rights under the PWFA because the 
employer thinks the employee has improperly labeled something a 
``limitation'' when it is better characterized as a ``related medical 
condition,'' or the reverse. For example, if an employee needs bed rest 
because they are pregnant and have placenta previa, the placenta previa 
could be the ``physical or mental condition'' related to, affected by, 
or arising out of pregnancy, or the placenta previa could be a 
``related medical condition'' to pregnancy and the physical or mental 
condition could be the need to limit walking or standing. In either 
instance, the employee is covered by the PWFA and can request an 
accommodation.
    The Interpretive Guidance in section 1636.3(d) Communicated to the 
Employer and 1636.3(h)(2) How To Request a Reasonable Accommodation 
also has been modified to explain that an employee is not required to 
identify the statute under which they are requesting a reasonable 
accommodation (e.g., the ADA, the PWFA, or Title VII). Doing so would 
require that employees seeking accommodations use specific words or 
phrases, which the regulation prohibits.
    Finally, the Commission has added information to the Interpretive 
Guidance that explains the types of people with whom the employee may 
communicate as set out in the final rule. The Commission has moved the 
examples that were in Sec.  1636.3(d) in the NPRM to section 
1636.3(h)(2) How To Request a Reasonable Accommodation in the 
Interpretive Guidance and has added an explanation at the start of the 
list of examples regarding the communications, rather than having an 
explanation after each example.

1636.3(e) Consideration of Mitigating Measures

    The Commission received very few comments concerning mitigating 
measures. The language in the final rule is unchanged from the proposed 
rule and is the same as the language in the ADA regulation, except that 
the Commission made a minor edit for accuracy to remove the word 
``known'' from Sec.  1636.3(e)(1). This edit is necessary because the 
consideration of mitigating measures would only affect the 
determination of whether an employee has a limitation and not whether 
that limitation is ``known.'' The Commission further changed language 
in the Interpretive Guidance in section 1636.3(e) Consideration of 
Mitigating Measures slightly to point out that the ameliorative effects 
of mitigating measures can be considered when determining the 
appropriate reasonable accommodation.\112\
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    \112\ The Commission notes that ``mitigating measures'' for the 
purposes of the PWFA are not the same as ``mitigation measures'' 
taken as part of occupational safety and health which refer to 
actions taken by employers. See, e.g., U.S. Dep't of Health & Hum. 
Servs., Ctrs. for Disease Control & Prevention, Nat'l Inst. for 
Occupational Safety & Health, Hierarchy of Controls (Jan. 17, 2023), 
https://www.cdc.gov/niosh/topics/hierarchy/default.html.
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1636.3(f) Qualified Employee

1636.3(f)(1) With or Without Reasonable Accommodation

    The Commission received very few comments concerning the definition 
of ``qualified employee'' as an employee who, with or without 
reasonable accommodation, can perform the essential functions of the 
job. The final rule maintains the language from the proposed rule, 
which uses the language from the ADA.
    The Commission also did not receive many comments regarding the 
definition of ``qualified'' for the reasonable accommodation of leave 
and has maintained that definition and the language in Sec.  
1636.3(f)(1) and in the Interpretive Guidance in section 1636.3(f)(1) 
under ``Qualified'' for the Reasonable Accommodation of Leave. The 
Commission addresses other comments it received regarding leave as a 
reasonable accommodation in the preamble in section 1636.3(h) under 
Particular Matters Regarding Leave as a Reasonable Accommodation.

1636.3(f)(2) Temporary Suspension of an Essential Function(s)

    The Commission received numerous comments regarding the definition 
of ``qualified'' with regard to the temporary suspension of essential 
function(s), the definition of ``temporary,'' the definition of ``in 
the near future,'' how different periods of temporary suspension of 
essential function(s) should be considered, whether more than one 
essential function can be suspended, and the meaning of ``can be 
reasonably accommodated.''
    Preliminarily, it is important to emphasize that the definition of 
``qualified'' that includes the temporary suspension of an essential 
function is taken directly from the text of the statute. It is not a 
creation of the Commission, and the Commission could not ignore it or 
read it out of the statute, as some comments suggested. Second,

[[Page 29116]]

as noted in the NPRM, this definition of ``qualified'' is relevant only 
when an employee cannot perform one or more essential functions of the 
job in question, with or without a reasonable accommodation, due to a 
known limitation. It is not relevant in any other circumstance. If the 
employee can perform the essential functions of the position with or 
without a reasonable accommodation, the first definition of 
``qualified'' applies (i.e., able to do the job with or without a 
reasonable accommodation). Third, this definition is relevant solely to 
determining whether an employee is ``qualified.'' An employer may still 
defend the failure to provide a reasonable accommodation based on undue 
hardship. Thus, the Commission responds to concerns regarding the 
possible disruption of production or scheduling or difficulties in 
accommodating the temporary suspension of an essential function(s) that 
a certain employer may face in the discussion of undue hardship (in the 
preamble in section 1636.3(j)(3) Undue Hardship--Temporary Suspension 
of an Essential Function(s)) rather than in the discussion of the 
definition of ``qualified.''

1636.3(f)(2)(i) Temporary

    The Commission received several comments regarding the definition 
of ``temporary.'' Some asserted that the Commission's definition was 
subsumed by the definition of ``in the near future,'' while others 
argued that the definitions of ``temporary'' and ``in the near future'' 
should be the same. The Commission has not changed the definition of 
``temporary.'' As Congress set out two terms (``temporary'' and ``in 
the near future''), the Commission should define both and not assume 
that they are the same. The definition that the Commission proposed in 
the NPRM for ``temporary'' is consistent with the dictionary definition 
of this term and the legislative history of the provision.\113\
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    \113\ 88 FR 54777.
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1636.3(f)(2)(ii) In the Near Future

    The Commission's proposed definition of ``in the near future'' had 
four parts: (1) how long this would be for a current pregnancy 
(generally 40 weeks); (2) how long this should be for conditions other 
than a current pregnancy (generally 40 weeks); (3) how leave should not 
count in the determination of the time for which an essential 
function(s) is temporarily suspended; and (4) how to address successive 
periods of suspension of essential function(s). As discussed below, the 
Commission is maintaining the provisions in the NPRM for issues 1, 3, 
and 4.
Comments and Response to Comments Regarding the Definition of ``In the 
Near Future''
    The NPRM proposed that for both a current pregnancy and conditions 
other than a current pregnancy it would be presumed that the employee 
could perform the essential functions of the position ``in the near 
future'' if they could do so within generally 40 weeks.
    Many comments supported the idea that for a current pregnancy, an 
employee would be considered qualified if they could perform the 
essential function(s) generally within 40 weeks of the suspension of 
the essential function(s). As these comments pointed out, this would 
allow a pregnant employee the ability to continue working and earning a 
paycheck during their pregnancy, even if due to a known limitation they 
had to temporarily suspend an essential function(s). As one comment 
noted, a shorter time could lead to ``dangerous and perverse 
consequences'' such as employees ``saving up'' their ability to request 
the temporary suspension of essential function(s), leading to potential 
risks to their health or the health of their pregnancy early in the 
pregnancy, or employees being temporarily excused from essential 
function(s) early in their pregnancy only to have to resume them later 
in their pregnancy in order to keep earning a paycheck.\114\
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    \114\ Comment EEOC-2023-0004-98298, A Better Balance 29-30 (Oct. 
10, 2023).
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    Several comments argued against the definition of ``generally 40 
weeks'' for a current pregnancy, stating that such a long time was not 
within the intent of Congress, was outside the scope of the 
Commission's regulatory authority, and was not in keeping with how 
courts have defined this term in cases regarding leave and the ADA.
    For conditions other than a current pregnancy, including post-
pregnancy, the NPRM also proposed ``in the near future'' to mean 
generally 40 weeks. Several comments, based on the health care studies 
cited in the NPRM, recommended that for post-pregnancy reasons the 
definition of ``in the near future'' should be 1 year. These comments 
also recommended that the definition of ``in the near future'' for 
lactation-related accommodations that require the temporary suspension 
of an essential function(s) be 2 years, based on the recommendation of 
the American Academy of Pediatrics.
    Other comments pointed out that although pregnancy has a generally 
accepted length, other conditions do not. As a result, these comments 
asserted, an individualized assessment, akin to when a person with a 
disability is having surgery and then must go on leave, is more 
appropriate. Other comments suggested that the definition should be 
less than 6 months, based on an ADA case cited in the House Report on 
the PWFA.\115\
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    \115\ H.R. Rep. No. 117-27, pt. 1, at 28 (citing Robert v. Bd. 
of Cnty. Comm'rs of Brown Cnty., 691 F.3d 1211, 1218 (10th Cir. 
2012)). However, the Commission notes that the House Report does not 
assign a definition to ``in the near future.'' Although Robert notes 
an Eighth Circuit case that found that a 6-month leave request ``was 
too long to be a reasonable accommodation,'' it stated that with 
respect to the durational element of in the ``near future,'' ``this 
court has not specified how near that future must be'' and declined 
to address whether a more than 6-month accommodation ``exceeded 
reasonable durational bounds.'' Robert, 691 F.3d at 1218.
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    In the final rule, the Commission has changed the provision in the 
regulation defining ``in the near future'' at Sec.  1636.3(f)(2)(ii) so 
that the determination will be made on a case-by-case basis. This 
determination, however, includes the concept from the NPRM's definition 
of ``in the near future,'' which explained that, if the employee is 
pregnant, it is assumed that the employee could perform the essential 
function(s) in the near future because they could perform the essential 
function(s) within generally 40 weeks of their suspension.
    The Commission is retaining ``generally 40 weeks'' \116\ in the 
final regulation's definition of ``in the near future'' for pregnant 
employees for several reasons. First, one of the purposes of the PWFA 
is to provide pregnant employees with the ability to keep working while 
they are pregnant in order to protect their economic security as well 
as their health and the health of their pregnancy. Given the 
established length of pregnancy, this goal cannot be met if the 
employee is not considered qualified simply because they have to 
suspend an essential function(s) for generally 40 weeks. Second, 
Congress did not provide a definition for ``in the near future'' but 
did give the Commission rulemaking authority for the statute.\117\ 
Defining terms within a statute that have not been defined by Congress 
is well within the rulemaking authority of the agency directed by the 
law to write rules for it.\118\ Furthermore,

[[Page 29117]]

as explained below, courts have generally determined that indefinite 
amounts of time cannot be ``in the near future.'' Because pregnancy by 
definition is not indefinite, defining ``in the near future'' to be the 
length of a pregnancy is consistent with the views of courts and with 
the purpose of the PWFA.
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    \116\ One comment noted that pregnancy can last 42 weeks or 
longer. To account for this, the EEOC is using the phrase 
``generally 40 weeks.''
    \117\ 42 U.S.C. 2000gg-3(a).
    \118\ See AT&T Corp. v. Iowa Utils. Bd., 525 U.S. 366, 397 
(1999) (``Congress is well aware that the ambiguities it chooses to 
produce in a statute will be resolved by the implementing 
agency.''); Smiley v. Citibank (South Dakota), N.A., 517 U.S. 735, 
740-41 (1996) (``[T]hat Congress, when it left ambiguity in a 
statute meant for implementation by an agency, understood that the 
ambiguity would be resolved, first and foremost, by the agency, and 
desired the agency (rather than the courts) to possess whatever 
degree of discretion the ambiguity allows.''); Chevron, U.S.A., Inc. 
v. Nat. Res. Def. Council, Inc., 467 U.S. 837, 843 (1984) (``The 
power of an administrative agency to administer a congressionally 
created . . . program necessarily requires the formulation of policy 
and the making of rules to fill any gap left, implicitly or 
explicitly, by Congress.'') (omission in original) (citation 
omitted).
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    Those who opposed generally 40 weeks as the definition of ``in the 
near future'' for pregnant employees did not explain how a shorter 
definition would impact pregnant employees or why the definition should 
change from workplace to workplace, given the established length of 
pregnancy. Given that there is a history of employers failing to 
provide pregnant employees light duty positions to the severe detriment 
of those employees, even after the Supreme Court's decision in Young v. 
United Parcel Service,\119\ and Congress' awareness of this 
problem,\120\ the Commission believes it is necessary to define ``in 
the near future'' for the PWFA's second definition of ``qualified'' as 
the full length of a pregnancy. The Commission agrees with comments 
stating that a shorter period of time could create situations where an 
employee continues to perform an essential function(s) in order to save 
time when they are not required to perform the essential function(s) 
for later in their pregnancy or following childbirth, thus imperiling 
their health or the health of the pregnancy, or where an employee is 
forced to return to the performance of an essential function(s) later 
in their pregnancy, despite the health risks. The Commission reiterates 
that this rule does not mean that a pregnant employee is automatically 
entitled to the temporary suspension of one or more essential functions 
for 40 weeks, or that the employee will need the suspension of one or 
more essential functions for 40 weeks. The temporary suspension must be 
able to be reasonably accommodated, and the employer retains the 
ability to establish that the reasonable accommodation causes an undue 
hardship.
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    \119\ 575 U.S. 206; see, e.g., EEOC v. Wal-Mart Stores E., L.P., 
46 F.4th 587 (7th Cir. 2022); Legg v. Ulster Cnty., 820 F.3d 67 (2d 
Cir. 2016).
    \120\ H.R. Rep. No. 117-27, pt. 1, at 14-17.
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    The Commission agrees that there should not be a presumptively 
consistent measure of the term ``in the near future'' for issues other 
than current pregnancy. The physical or mental conditions related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions faced by employees other than those who are 
currently pregnant certainly may be serious and may, in some cases, 
mean that an employee may seek to have one or more essential functions 
of the job temporarily suspended. Unlike a current pregnancy, however, 
there is not a consistent measure of how long these diverse conditions 
generally will last or, thus, of what ``in the near future'' might mean 
in these instances.
    In explaining the inclusion of this additional definition of 
``qualified,'' the House Report analogized the suspension of an 
essential function under the PWFA to cases under the ADA regarding 
leave.\121\ Thus, ADA leave cases provide some helpful guideposts for 
employers and employees to understand this term in the context of 
whether an employee is ``qualified'' under the PWFA in situations not 
involving a current pregnancy. First, an employee who needs indefinite 
leave (that is, leave for a period of time that they cannot reasonably 
estimate under the circumstances) cannot perform essential job 
functions ``in the near future.'' \122\ Similarly, a request to 
indefinitely suspend an essential function(s) cannot reasonably be 
considered to meet the standard of an employee who could perform the 
essential function(s) ``in the near future.'' However, the Commission 
notes that the temporary suspension of an essential function(s) is not 
``indefinite'' simply because the employee cannot pinpoint the exact 
date when they expect to be able to perform the essential function(s) 
or can provide only an estimated range of dates.\123\ Nor do these 
circumstances mean that the employee cannot perform the job's essential 
functions ``in the near future.'' \124\
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    \121\ Id. at 27-28.
    \122\ Id.; see also, e.g., Herrmann v. Salt Lake City Corp., 21 
F.4th 666, 676-77 (10th Cir. 2021); Cisneros v. Wilson, 226 F.3d 
1113, 1129 (10th Cir. 2000), overruled on other grounds by Bd. of 
Trs. of Univ. of Ala. v. Garrett, 531 U.S. 356 (2001).
    \123\ See, e.g., Randall v. Smith & Edwards Co., 1:20-CV-00183, 
2023 WL 3742818, at *33-*34 (D. Utah May 31, 2023) (determining that 
the employee, who requested leave to undergo liver transplant 
surgery, presented enough evidence to allow a reasonable jury to 
conclude that his leave request was not indefinite where evidence 
indicated that the employer understood that he could undergo the 
transplant ``any day'' and ``would return to work within, at most, 
12 weeks of his surgery''); Ellis v. Salt Lake City Corp., 2:17-CV-
00245, 2023 WL 2742756, at *11-*12 (D. Utah Mar. 31, 2023) 
(concluding that the employee's request to remain on leave until the 
appeal of her demotion was resolved was not a request for indefinite 
leave, as she ``provided a general timeframe for her return in the 
near future''), appeal filed (10th Cir. May 2, 2023); Johnson v. 
Del. Cnty. Cmty. Coll., 2:15-CV-01310, 2015 WL 8316624, at *1, *5 
(E.D. Pa. Dec. 9, 2015) (determining that a custodian, who was on 
medical leave for nearly 5 months due to a knee injury and requested 
``a brief extension of medical leave'' to undergo surgery and 
physical therapy, ``did not request an indefinite leave''); Criado 
v. IBM Corp., 145 F.3d 437, 443-44 (1st Cir. 1998) (concluding that 
an employee's request for additional leave to ``allow her physician 
to design an effective treatment program'' with no specific return 
date given could be a reasonable accommodation); Graves v. Finch 
Pryun & Co., 457 F.3d 181, 185-86 (2d Cir. 2006) (reasoning that an 
employee's request ``for `more time' to get a doctor's appointment'' 
that would take ``maybe a couple weeks'' was not a request for 
indefinite leave).
    \124\ The fact that an exact date is not necessary is supported 
by the definition in the statute, which requires that the essential 
function(s) ``could'' be performed in the near future. 42 U.S.C. 
2000gg(6)(B).
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    Beyond an agreement that an indefinite amount of time does not meet 
the standard of ``in the near future,'' courts' definitions of how long 
a period of leave may be under the ADA and still be a reasonable 
accommodation (thus, allowing the individual to remain qualified) 
vary.\125\ The Commission

[[Page 29118]]

believes, however, that depending on the facts of a case ``in the near 
future'' may extend beyond the 6-month limit suggested by some comments 
under the PWFA for three reasons.
---------------------------------------------------------------------------

    \125\ See, e.g., Robert, 691 F.3d at 1218 (citing a case in 
which a 6-month leave request was too long to be a reasonable 
accommodation but declining to address whether, in the instant case, 
a further exemption following the 6-month temporary accommodation at 
issue would exceed ``reasonable durational bounds'') (citing Epps v. 
City of Pine Lawn, 353 F.3d 588, 593 (8th Cir. 2003)); see also 
Blanchet v. Charter Commc'ns, LLC, 27 F.4th 1221, 1225-26, 1230-31 
(6th Cir. 2022) (determining that a pregnant employee who developed 
postpartum depression and requested a 5-month leave after her 
initial return date and was fired after requesting an additional 60 
days of leave could still be ``qualified,'' as additional leave 
could have been a reasonable accommodation); Cleveland v. Fed. 
Express Corp., 83 F. App'x 74, 76-81 (6th Cir. 2003) (declining ``to 
adopt a bright-line rule defining a maximum duration of leave that 
can constitute a reasonable accommodation'' and determining that a 
6-month medical leave for a pregnant employee with systemic lupus 
could be a reasonable accommodation); Garcia-Ayala v. Lederle 
Parenterals, Inc., 212 F.3d 638, 641-42, 646-49 (1st Cir. 2000) 
(reversing the district court's finding that a secretary was not a 
``qualified individual'' under the ADA because additional months of 
unpaid leave could be a reasonable accommodation, even though she 
had already taken over year of medical leave for breast cancer 
treatment, and rejecting per se rules as to when additional medical 
leave is unreasonable); Nunes v. Wal-Mart Stores, Inc., 164 F.3d 
1243, 1245-1247 (9th Cir. 1999) (holding that, because extending 
leave to 9 months to treat a fainting disorder could be a reasonable 
accommodation, an employee's inability to work during that period of 
leave did not automatically render her unqualified); Cayetano v. 
Fed. Express Corp., No. 1:19-CV-10619, 2022 WL 2467735, at *1-*2, 
*4-*7 (S.D.N.Y. July 6, 2022) (determining that an employee who 
underwent shoulder surgery could be ``qualified'' because 6 months 
of leave is not per se unreasonable as a matter of law); Durrant v. 
Chemical/Chase Bank/Manhattan Bank, N.A., 81 F. Supp. 2d 518, 519, 
521-22 (S.D.N.Y. 2000) (concluding that an employee who was on leave 
for nearly 1 year due to a leg injury and extended her leave to 
treat a psychiatric condition could be ``qualified'' under the ADA 
with the accommodation of additional leave of reasonable 
duration).The Commission is aware of and disagrees with ADA cases 
that held, for example, that 2 to 3 months of leave following a 12-
week FMLA period was presumptively unreasonable as an accommodation. 
See, e.g., Severson v. Heartland Woodcraft, Inc., 872 F.3d 476, 481 
(7th Cir. 2017).
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    First, what constitutes ``in the near future'' may differ depending 
on factors including, but not limited to, the known limitation and the 
employee's position. For example, an employee whose essential job 
functions require lifting during only the summer months would remain 
qualified even if unable to lift during a 7-month period over the fall, 
winter, and spring months because the employee could perform the 
essential function ``in the near future'' (in this case, as soon as the 
employee was required to perform that function). Second, the 
determination of whether the employee could resume the essential 
function(s) of their position in the near future is only one aspect of 
establishing that an employee is qualified despite not being able to 
perform an essential function(s). If the temporary suspension cannot be 
reasonably accommodated or if the temporary suspension causes an undue 
hardship, the employer is not required to provide a reasonable 
accommodation. Third, as detailed in the NPRM, especially in the first 
year after giving birth, employees may experience serious health issues 
related to pregnancy, childbirth, or related medical conditions that 
may prevent them from performing the essential function(s) of their 
positions.\126\ Accommodating these situations and allowing employees 
to stay employed is one of the key purposes of the PWFA. To assist 
employers and employees in making this determination, the Commission 
has added several examples in the Interpretive Guidance in section 
1636.3(f)(2) Qualified Employee--Temporary Suspension of an Essential 
Function(s) regarding ``in the near future'' and non-pregnancy 
conditions.
---------------------------------------------------------------------------

    \126\ See Susanna Trost et al., U.S. Dep't of Health & Hum. 
Servs., Ctrs. For Disease Control & Prevention, Pregnancy-Related 
Deaths: Data from Maternal Mortality Review Committees in 36 U.S. 
States, 2017-2019 (2022), https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html (stating that 53% of 
pregnancy-related deaths occurred from one week to one year after 
delivery, and 30% occurred one- and one-half months to one year 
postpartum).
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    Additionally, the Commission disagrees that the terms ``temporary'' 
and ``in the near future'' should be defined using the definition of 
``transitory'' under the ADA.\127\ Congress knew of this definition but 
decided not to incorporate it into the PWFA and used different terms 
(``temporary'' and ``in the near future,'' not ``transitory'').
---------------------------------------------------------------------------

    \127\ 42 U.S.C. 12102(3)(B).
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Comments and Response to Comments Regarding Leave Not Being Part of the 
Calculation of the Temporary Suspension of an Essential Function(s)
    The Commission did not receive many comments regarding whether 
leave should be counted as part of the definition of ``qualified'' for 
the suspension of an essential function(s). Those comments it did 
receive supported the Commission's view that it should not be counted; 
the Commission has maintained that position.
Comments and Response to Comments Regarding Resetting the Clock for the 
Temporary Suspension of an Essential Function(s)
    The Commission received several comments regarding the proposal 
that the clock for determining ``in the near future'' should reset 
after childbirth. Some comments supported this for the reasons set out 
in the NPRM, specifically, that a pregnant employee cannot know whether 
or for how long they will need the temporary suspension of an essential 
function(s) after they give birth. Further, not resetting the clock 
could create the same issues discussed above of creating dangerous or 
perverse incentives for employees to ``save'' the temporary suspension 
of an essential function(s) for later in their pregnancy or post-
pregnancy, even when it could lead to potential risks to their health 
or the health of their pregnancy. Conversely, several comments argued 
that allowing the clock to reset would permit employees to ``stack'' 
the temporary suspension of essential functions to get more than 40 
weeks of an essential function(s) suspended. Given that the definition 
of ``in the near future'' for non-pregnancy issues has changed, this is 
less of a concern for the final rule. Additionally, as stated above, 
employees are not automatically granted 40 weeks of suspension of an 
essential function(s) during pregnancy under the regulation. Rather, 
they are merely considered ``qualified.'' Many employees will need less 
than 40 weeks of a temporary suspension of an essential function(s).
    The Commission also received comments recommending that resetting 
the clock be added to the regulation itself. Because this general 
rule--that the determination of ``qualified'' is made at the time of 
the employment decision \128\--applies to all accommodations, the 
Commission has not added it to this part of the regulation. The 
Commission has included this general rule in the Interpretive Guidance 
in section 1636.3(f) Qualified Employee and has added a specific 
reference to when essential functions are being temporarily suspended 
to state that determining ``in the near future'' should start at the 
time of the employment decision in the Interpretive Guidance in section 
1636.3(f)(2)(ii) In the Near Future.
---------------------------------------------------------------------------

    \128\ See 29 CFR part 1630, appendix, 1630.2(m).
---------------------------------------------------------------------------

    The Commission also received comments interpreting the statute to 
say that only one essential function could be temporarily suspended in 
a given pregnancy. The Commission disagrees. First, the Commission 
notes that in interpreting acts of Congress, ``words importing the 
singular apply to several persons, parties, or things'' unless the 
context indicates otherwise.\129\ Further, such a rule would undercut 
the purpose of the PWFA and lead to lengthy delays for litigation about 
what specific essential function was being suspended and whether it was 
the same or a different function. Such a rule also does not reflect 
that a pregnant employee may need more than one essential function 
suspended or different essential functions suspended at different 
times.
---------------------------------------------------------------------------

    \129\ 1 U.S.C. 1.
---------------------------------------------------------------------------

1636.3(f)(2)(iii) Can Be Reasonably Accommodated

    The Commission received a few comments on its proposed definition 
of ``can be reasonably accommodated'' that claimed that the NPRM had 
conflated this provision with undue hardship. Other comments suggested 
that this provision required a new definition, with a lower standard 
than ``undue hardship,'' that a covered entity could meet to show that 
the temporary suspension of the essential function(s) could not be 
reasonably accommodated. The Commission disagrees with these comments 
and is retaining the definition of this section set forth in the NPRM. 
The Commission expects that the language that the temporary suspension 
of an essential function(s)

[[Page 29119]]

``can be reasonably accommodated'' will be interpreted similarly to the 
idea that an individual is ``qualified'' if they can do the job with or 
without a reasonable accommodation. If, under the first definition of 
``qualified,'' an employee cannot perform the essential functions of 
the position without a reasonable accommodation, and there is no 
reasonable accommodation, the employee is not qualified. Similarly, if 
the temporary suspension of the essential function(s) cannot be 
``reasonably accommodated,'' the employee is not qualified. Thus, the 
definition of ``can be reasonably accommodated'' provides suggested 
means by which the temporary suspension of an essential function(s) can 
be reasonably accommodated. Whether granting the accommodation would 
impose undue hardship on the operation of the business of the covered 
entity is a separate analysis.\130\ The Commission has removed the 
reference to undue hardship from this section in the Interpretive 
Guidance in order to avoid any confusion.
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    \130\ See, e.g., Barnett, 535 U.S. at 401-02 (describing ADA 
accommodations cases where, to defeat summary judgment, a worker 
must show that the accommodation ``seems reasonable on its face''; 
after such a showing, the employer must show specific circumstances 
to prove an undue hardship).
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    The Commission made a few changes to the examples in this section 
in the Interpretive Guidance. The Commission deleted former Example #7 
from this section. In former Examples #8 and #9 (now Examples #1 and 
#2), the Commission added: facts to clarify that there is work for the 
employees to accomplish; the phrase ``affected by, or arising out of'' 
after ``related to''; and that the employees need an accommodation 
``due to'' their limitation. The Commission removed the sentences 
regarding undue hardship in order to focus the examples on the issue of 
``qualified.'' The Commission also added three additional examples to 
this section.

1636.3(g) Essential Functions

    The NPRM adopted the definition of ``essential functions'' 
contained in the ADA regulation and sought comment on whether there 
were additional factors that should be considered in determining 
whether a function is ``essential'' for the purposes of the PWFA. 
Several comments suggested clarifications or departures from the 
definition of ``essential functions'' set forth in the ADA. These 
suggestions included proposed additions to the overall definition of 
``essential functions''; a request to add a factor to Sec.  
1636.3(g)(1) to further explain when a particular function is 
``essential''; and requests to delete, add, combine, or reorganize the 
factors in Sec.  1636.3(g)(2) that can establish whether a particular 
function is ``essential.''
    First, a few comments suggested adding language to Sec.  1636.3(g) 
that would define essential functions as discrete tasks and clarify 
that essential functions are not conditions of employment regarding 
when, where, and how discrete tasks are performed. The Commission 
declines to adopt this proposal. The term ``essential functions'' in 
the PWFA is the same term used in the ADA, and therefore the definition 
of ``essential functions'' in the ADA regulation is instructive.\131\ 
The Commission concludes that the suggested departure from the language 
and definition used in the ADA regulation is not appropriate. Although 
in the Commission's view, conditions of employment that are completely 
divorced from any job duties (e.g., a requirement of ``regular 
attendance'' or ``in-person work'') are not essential functions in and 
of themselves, certain essential functions may need to be performed in 
a particular manner, time, or location.\132\ For example, a 
neurosurgeon hired to perform surgeries may have to perform those 
surgeries in a sterile operating room; a receptionist hired to greet 
clients and answer calls during business hours may need to be available 
at certain times of day; and a truck driver responsible for 
transporting hazardous materials may need to use a specific type of 
vehicle. The final regulation, therefore, maintains the ADA regulatory 
language from 29 CFR 1630.2(n)(1).\133\
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    \131\ H.R. Rep. No. 117-27, pt. 1, at 28.
    \132\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 111, at Questions 22 & 34.
    \133\ For completeness, the Commission has added ``with a known 
limitation under the PWFA'' after the word ``employee'' in the 
regulation.
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    Second, the Commission received comments requesting that it add a 
factor to those listed in Sec.  1636.3(g)(1) examining whether the 
function was essential during the limited time for which the 
accommodation is needed. As described in the next paragraph, the 
Commission has added this consideration to Sec.  1636.3(g)(2). Because 
the list of factors in Sec.  1636.3(g)(1) is non-exhaustive, the 
Commission has retained the factors in Sec.  1636.3(g)(1).
    Third, the Commission received comments requesting modification, 
addition, reorganization, or deletion of factors in Sec.  1636.3(g)(2) 
that can be used to show a function is ``essential.'' Because the 
factors in Sec.  1636.3(g)(2) are not exhaustive, the Commission 
declines to delete any factors, as this could incorrectly suggest that 
those factors are not relevant to PWFA accommodations. Additionally, 
the Commission declines to reorder any factors to emphasize their 
importance, as the factors in Sec.  1636.3(g)(2) are not set forth in 
order of importance and the significance of any particular factor will 
vary by case. However, in response to comments that essential functions 
may change over time (or even by season), and that variations in 
essential functions are particularly important where the need for 
accommodation is temporary (as is the case for most known limitations), 
the Commission has made changes to Sec.  1636.3(g)(2)(iii) to clarify 
that seasonal or other temporal variations in essential functions 
should be considered.
    Some comments asked for clarification on whether the employer's 
judgment on essential functions is given priority and whether an 
employer's framing of the essential job functions can undermine or 
limit an individual's right to accommodation under the PWFA. First, as 
in the ADA, an employer's judgment as to which functions are 
``essential'' is given due consideration among various types of 
relevant evidence but is not dispositive.\134\ Therefore, evidence that 
is contrary to the employer's judgment may be presented and used to 
demonstrate the employer's judgment is incorrect. To this point, the 
Commission also has revised the language in the Interpretive Guidance 
in section 1636.3(g) Essential Functions to reinforce that the listed 
factors in Sec.  1636.3(g)(2) are non-exhaustive and fact-specific, 
which further underscores that no single factor is dispositive, that 
not all factors apply in each case, and that additional factors may be 
considered.
---------------------------------------------------------------------------

    \134\ See 29 CFR part 1630, appendix 1630.2(n).
---------------------------------------------------------------------------

    Finally, some comments questioned the effect of a temporary 
suspension of an essential function(s) as a reasonable accommodation on 
future determinations of whether the function was essential. Temporary 
suspension of an essential function(s) as a reasonable accommodation 
pursuant to the PWFA does not mean that the function(s) is no longer 
essential. Whether something is an essential function(s) remains a 
fact-specific determination, and the employer's temporary suspension of 
a job function(s) does not bar the employer from contending that the 
function(s) is essential for other accommodation requests in the 
future.

[[Page 29120]]

1636.3(h) Reasonable Accommodation--Generally

1636.3(h)(1) Definition of Reasonable Accommodation

    The Commission received very few comments regarding the definition 
of reasonable accommodation, which uses the language from the ADA with 
certain changes to account for the differences in statutes. The 
Commission is retaining the definition of reasonable accommodation from 
the NPRM, with the following technical edits to Sec.  1636.3(h)(1): 
insertion of the term ``qualified'' in the definition of reasonable 
accommodation relating to applicants; \135\ and removal of the term 
``qualified'' and addition of the phrase ``as are enjoyed by its other 
similarly situated employees without known limitations'' in the 
definition of reasonable accommodation related to benefits and 
privileges of employment.\136\ These technical edits are necessary so 
that the definition of reasonable accommodation parallels the ADA 
definition, as required by the PWFA.
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    \135\ As under the ADA, the term ``qualified'' in relation to 
applicants that are entitled to reasonable accommodation under the 
PWFA refers to whether the applicant meets the initial requirements 
for the job in order to be considered and not whether the applicant 
is able to perform the essential functions of the position with or 
without an accommodation. See Enforcement Guidance on Reasonable 
Accommodation, supra note 111, at Question 13, Example A and B.
    \136\ As under the ADA, reasonable accommodation to enable 
employees to enjoy equal benefits and privileges under the PWFA does 
not turn on whether an employee is qualified but on whether the 
benefit or privilege is available to those who are similarly 
situated. See 29 CFR 1630.2(o)(1)(iii).
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    The Commission also has moved the explanation of how to request a 
reasonable accommodation, which was formerly part of Sec.  1636.3(d), 
to Sec.  1636.3(h)(2). As a result, the parts of Sec.  1636.3(h) have 
been renumbered so that the definition of reasonable accommodation is 
at Sec.  1636.3(h)(1)(i) through (iv), and information regarding the 
interactive process is located at Sec.  1636.3(h)(3).\137\
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    \137\ The Commission has not included the section from the 
proposed appendix ``Additions to the Definition of Reasonable 
Accommodation'' in the Interpretive Guidance because its explanation 
of the PWFA and ADA rule regarding the definition of reasonable 
accommodation is not necessary for the final Interpretive Guidance.
---------------------------------------------------------------------------

1636.3(h)(2) How To Request a Reasonable Accommodation

    The final rule contains a new section, Sec.  1636.3(h)(2), that 
explains how an employee may request a reasonable accommodation. This 
information was proposed to appear at Sec.  1636.3(d).
    The Commission received several comments regarding this section 
when it was part of the ``Communicated to the Employer'' definition in 
the NPRM. First, comments expressed concern that the Commission's 
original language (that this was the process to ``request'' a 
reasonable accommodation) would add a requirement that employees phrase 
this as a ``request'' and that employees may not know that they have 
the right to make such a request. The Commission declines to change 
this provision. The examples in the NPRM (now Examples #6 to #11 in the 
Interpretive Guidance in section 1636.3(h)(2) How To Request a 
Reasonable Accommodation) do not require that the communication be 
phrased as a request. Additionally, ``request for accommodation'' is 
the language the Commission uses in its ADA guidance,\138\ and the 
Commission believes that changing the language on this point would 
create confusion. However, to respond to the comments, the Commission 
has added in the Interpretive Guidance in section 1636.3(h)(2) How To 
Request a Reasonable Accommodation that a request for a reasonable 
accommodation need not be formulated as a ``request.''
---------------------------------------------------------------------------

    \138\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 111, at Question 1.
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    Second, many comments suggested alternative language to proposed 
Sec.  1636.3(d)(3)(i) and (ii) (Sec.  1636.3(h)(2)(i) and (ii) in the 
final rule), stating that the emphasis should be that the limitation 
necessitates a change (rather than the employee needing a change), that 
the rule should require a limitation ``or'' needing a change (rather 
than ``and''), or that communicating the limitation was sufficient. The 
Commission declines to make these changes. First, the Commission does 
not think it is appropriate or accurate to require that the limitation 
``necessitates'' a change; this may increase the burden on what an 
employee would have to show and would complicate what should be simple 
communication. Second, while the Commission agrees that the statute 
provides for accommodations for known limitations, having the process 
start simply because the employee communicated a known limitation could 
lead to situations where the accommodation process begins when it was 
not the employee's intention, or it could lead to covered entities 
assuming that an accommodation is necessary which could result in 
violations of 42 U.S.C. 2000gg-1(2).
    Finally, some comments recommended including that the employee must 
connect the need for the change with the limitation. The Commission 
agrees with this change and has added that idea to Sec.  1636.3(h)(2) 
(``needs an adjustment or change at work due to the limitation''). As 
with the ADA and as shown in Examples #6 to #11, this is a simple 
communication that does not require specific words.
    The Commission also has moved the point that was in Sec.  1636.3(b) 
in the proposed regulation--that the employee need not mention a 
specific medical condition from the list in Sec.  1636.3(b), or indeed 
any medical condition, or use medical terms--to Sec.  1636.3(h)(2)(ii) 
so that all of the information about requesting an accommodation is in 
one place.
    Many comments addressed with whom the employee must communicate in 
order to start the process. As with the definition of ``Communicated to 
the Employer'' (Sec.  1636.3(d)), the employer should permit an 
employee to request an accommodation through multiple avenues and 
means. Thus, the individuals at the covered entity to whom an employee 
may communicate to start the reasonable accommodation process are the 
same as those in Sec.  1636.3(d), and the Interpretive Guidance 
language for that provision applies to requesting a reasonable 
accommodation as well. Some comments recommended against allowing for a 
broad range of individuals at the covered entity who could receive such 
requests because those who receive such requests require training; 
other comments stated that an employer should be able through its 
policy to limit the individuals who can receive such a request. The 
Commission did not make changes to support these views because the 
steps to request a reasonable accommodation should not be made more 
difficult and the individuals identified in Sec.  1636.3(d) should be 
able to receive and direct the requests if they are not able to grant 
them independently.
    Several comments also addressed whether the employer could require 
the process to start by the employee filling in a form and whether, if 
the employer had a process, the employee was required to follow it so 
that a request would be considered only when made to the entity 
identified in the employer's policy. The Commission did not adopt 
either of these views. First, requiring an employee to create a written 
request or to follow a specific provision to begin the reasonable 
accommodation process is contrary to the idea that this should not be a 
difficult or burdensome task for employees. Second, as one comment 
pointed out, some employees, such as those facing intimate partner 
violence, may be cautious or afraid of putting into

[[Page 29121]]

writing their need for an accommodation.\139\ Third, many of the 
limitations and accommodations under the PWFA will be small or minor; 
the Commission expects that most accommodations will be provided 
following nothing more than a conversation or email between the 
employee and their supervisor, and there will not be any other forms or 
processes. If an employer does have a process to confirm what was 
stated in the initial request and that process uses a form, the form 
should be a simple one that does not deter the employee from making the 
request and does not delay the provision of an accommodation.
---------------------------------------------------------------------------

    \139\ Am. Coll. Of Obstetricians & Gynecologists, Comm. Opinion 
No. 518, Intimate Partner Violence (Feb. 2012; reaff'd 2022), 
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/02/intimate-partner-violence (``Approximately 324,000 
pregnant women are abused each year in the United States. . . . 
[T]he severity of violence may sometimes escalate during pregnancy 
or the postpartum period.'').
---------------------------------------------------------------------------

Alleviating Increased Pain or Risk to Health Due to the Known 
Limitation
    First, the Commission received numerous comments recommending that 
the amelioration of pain or risk be added to the list in Sec.  
1636.3(h) for the definition of the term ``reasonable accommodation.'' 
The Commission is not making this change. The statute at 42 U.S.C. 
2000gg(7) states that the term ``reasonable accommodation'' shall have 
the same meaning under the PWFA as it has in the ADA and the regulation 
under the PWFA. Section 1636.3(h) uses the same definition as in the 
ADA and adds one paragraph regarding the temporary suspension of 
essential functions, which is necessary pursuant to 42 U.S.C. 
2000gg(6). As explained in the NPRM and in the Interpretive Guidance in 
section 1636.3(h) under Alleviating Increased Pain or Risk to Health 
Due to the Known Limitation, accommodations to alleviate increased pain 
or risk fit under the current paragraphs in Sec.  1636.3(h)(1)(i) 
through (iv).\140\ This includes situations where an employee can do 
the essential functions of the position, and the accommodation is to 
alleviate increased pain or risk due to the known limitation.\141\ This 
is because the reasonable accommodations operate to ``remove[ ] or 
alleviate[ ]'' a covered individual's ``barriers to the equal 
employment opportunity,'' which may include making reasonable 
accommodations that mitigate the increased pain or a health risk a 
qualified employee experiences related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions when performing 
their job.\142\
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    \140\ 88 FR 54727 n.85 (``Depending on the facts of the case, 
the accommodation sought will allow the employee to apply for the 
position, to perform the essential functions of the job, to enjoy 
equal benefits and privileges of employment, or allow the temporary 
suspension of an essential function of the job.'').
    \141\ Many Federal circuit courts to have considered this issue 
have agreed that under the ADA, an accommodation needed to enable an 
employee to work without pain or risk to health may be required, 
even if the employee can perform the essential job functions without 
the accommodation. See Burnett v. Ocean Props., Ltd., 987 F.3d 57, 
68-69 (1st Cir. 2021) (observing that the plaintiff's ability to 
perform the essential functions of his job, albeit at the risk of 
bodily injury, ``does not necessarily mean he did not require an 
accommodation or that his requested accommodation was 
unreasonable''); Bell v. O'Reilly Auto Enters., LLC, 972 F.3d 21, 24 
(1st Cir. 2020) (``An employee who can, with some difficulty, 
perform the essential functions of his job without accommodation 
remains eligible to request and receive a reasonable 
accommodation.''); Hill v. Ass'n for Renewal in Educ., 897 F.3d 232, 
239 (D.C. Cir. 2018) (rejecting the argument that no accommodation 
was required because the plaintiff ``could perform the essential 
functions of his job without accommodation, `but not without 
pain'''); Gleed v. AT&T Mobility Servs., 613 F. App'x 535, 538-39 
(6th Cir. 2015) (rejecting the argument that ``if Gleed was 
physically capable of doing his job--no matter the pain or risk to 
his health--then it had no obligation to provide him with any 
accommodation, reasonable or not''); Feist v. La. Dep't of Justice, 
730 F.3d 450, 453 (5th Cir. 2013) (``[T]he language of the ADA, and 
all available interpretive authority, indicate[s] that'' 
``reasonable accommodations are not restricted to modifications that 
enable performance of essential job functions.''); Sanchez v. 
Vilsack, 695 F.3d 1174, 1182 (10th Cir. 2012) (rejecting the 
argument that the Rehabilitation Act requires accommodation ``only 
if an employee cannot perform the essential functions of her job''); 
Buckingham v. United States, 998 F.2d 735, 740 (9th Cir. 1993) 
(stating that, under the Rehabilitation Act, ``employers are not 
relieved of their duty to accommodate when employees are already 
able to perform the essential functions of the job''). Even cases 
that have rejected this idea have done so on a very limited basis. 
See Hopman v. Union Pac. R.R., 68 F.4th 394, 402 (8th Cir. 2023) 
(refusing to endorse the employer's argument that the ADA ``requires 
employers to provide reasonable accommodations only when necessary 
to enable employees to perform the essential functions of their 
jobs'' in all cases and observing that the requirement to 
accommodate will be fact-specific); Brumfield v. City of Chicago, 
735 F.3d 619, 632 (7th Cir. 2013) (holding that ``an employer need 
not accommodate a disability that is irrelevant to an employee's 
ability to perform the essential functions of her job,'' but not 
addressing whether alleviating pain is ``irrelevant'' to essential 
job functions).
    \142\ See 29 CFR part 1630, appendix, 1630.9 (``The reasonable 
accommodation requirement [under the ADA] is best understood as a 
means by which barriers to the equal employment opportunity of an 
individual with a disability are removed or alleviated.'').
---------------------------------------------------------------------------

    Second, the Commission received several comments suggesting an edit 
to Sec.  1636.3(i)(2) in the proposed regulation, which listed examples 
of possible reasonable accommodations. The comments pointed out that 
``adjustments to allow an employee or applicant to work without 
increased pain or risk to the employee's or applicant's health or the 
health of the employee's or applicant's pregnancy'' are the only 
accommodations listed that are expressly required to be ``due to the 
employee's or applicant's known limitation,'' even though that is 
obviously true for any of the other listed accommodations. The 
Commission agrees and has made this edit.
    Third, the Commission received numerous suggestions of additional 
examples to include in this section to illustrate modifications to 
alleviate increased pain or risk. The Commission has added additional 
examples and information in the Interpretive Guidance in section 
1636.3(h) under Alleviating Increased Pain or Risk to Health Due to the 
Known Limitation, including, as suggested by some comments, examples 
involving exposure to chemicals, commuting, excessive heat, and 
contagious diseases. The Commission also has deleted one example.
    Finally, the Commission received some comments expressing concern 
that the proposed appendix examples' focus on what was and what was not 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions would lead to employers focusing on this 
issue, requiring documentation regarding this issue, and denying 
accommodations. These comments also pointed out that, given pregnancy's 
effect on the whole body, the situations set out in the examples, 
especially former Examples #10 and #13 (now Examples #12 and #15 in the 
Interpretive Guidance in section 1636.3(h) under Alleviating Increased 
Pain or Risk to Health Due to the Known Limitation), were unrealistic 
and could cause covered entities and employees to waste time trying to 
determine whether a limitation was related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions. The 
Commission appreciates the concerns raised regarding these examples. At 
the same time, it is important that covered entities and employees 
understand the principles illustrated in the examples so that voluntary 
compliance with the PWFA is maximized. The Commission has edited these 
examples to account for these concerns by, for example, changing or 
deleting language regarding the limitations that in the example may not 
have been related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions. Finally, in order to 
highlight different reasons for accommodations, the Commission has 
changed one of the examples to include lactation.

[[Page 29122]]

Ensuring That Employees Are Not Penalized for Using Reasonable 
Accommodations
    The Commission received many comments agreeing with the general 
principle that covered entities must ensure that their workplace 
policies or practices do not operate to penalize employees for 
utilizing accommodations under the PWFA. Many of these comments also 
asked for additional clarification and examples.
    First, numerous comments suggested that the Commission explicitly 
state that the general rule that a covered entity does not have to 
waive a production standard as a reasonable accommodation does not 
apply when an employee has received the temporary suspension of an 
essential function(s) as a reasonable accommodation and the production 
standard would normally apply to the performance of that function. 
Applying such a production standard when the essential function(s) is 
temporarily suspended would penalize the employee for using the 
reasonable accommodation. The Commission agrees and has made this 
clarification in the Interpretive Guidance in section 1636.3(h) under 
Ensuring That Employees Are Not Penalized for Using Reasonable 
Accommodations.
    One comment recommended clarifying that the definition of 
``production standards'' includes not penalizing an employee for lower 
``productivity,'' ``focus,'' ``availability,'' or ``contributions'' if 
the employee's lower production in those areas is due to the employee's 
reasonable accommodation. The Commission agrees. For example, if, as a 
reasonable accommodation, an employee is not working overtime, and 
``availability'' or ``contribution'' is measured by an employee's 
working overtime, an employee should not be penalized in these 
categories. This concept has been added to the Interpretive Guidance in 
section 1636.3(h) under Ensuring That Employees Are Not Penalized for 
Using Reasonable Accommodations.
    A few comments noted that in addition to potentially violating 42 
U.S.C. 2000gg-1(5) and 2000gg-2(f), penalizing an employee for using a 
reasonable accommodation could violate 42 U.S.C. 2000gg-1(1), because 
by doing so the covered entity would not be providing an effective 
accommodation. The Commission agrees and has made this change in the 
Interpretive Guidance in section 1636.3(h) under Ensuring That 
Employees Are Not Penalized for Using Reasonable Accommodations.
    Several comments suggested examples for this section focusing on 
no-fault attendance policies and electronic productivity monitoring. 
The Commission added two examples to this section and moved Example #30 
from the NPRM (now Example #22) to this section with some edits. The 
Commission also added language to the Interpretive Guidance in section 
1636.3(h) under Ensuring That Employees Are Not Penalized for Using 
Reasonable Accommodations about the types of rules that may need to be 
considered.
    One comment stated that allowing employers to not pay for break 
time was, in effect, penalizing employees for taking those breaks. For 
the reasons explained in the section on leave, the Commission is 
adhering to the approach under the ADA that whether or not leave or 
breaks are paid depends on how the employer normally treats such time 
away from work and the requirements of other laws.
    A final set of comments on this issue requested clarification 
regarding whether specific situations would be seen as penalizing an 
employee for using a reasonable accommodation. Specifically, comments 
asked whether pay could be lowered or whether merit-based incentives 
tied to the performance of the essential function(s) could be omitted 
if the employee was not performing an essential function(s). One 
comment asked whether an employee could be required to work extra time 
to make up for time spent on breaks.
    Whether these situations regarding the temporary suspension of an 
essential function(s) would be viewed as penalizing a qualified 
employee in violation of the PWFA depends on certain factors. As stated 
in Sec.  1636.4(a)(4), if a covered entity is choosing between 
accommodations, it must select the one that provides the qualified 
employee with equal employment opportunity, which includes no reduction 
in pay, advancement, or bonuses. If the only accommodation available 
for the temporary suspension of the essential function(s) requires the 
temporary reassignment of the qualified employee to a job that pays 
less, and the employer's practice in these situations is to lower the 
pay of employees temporarily assigned to such a position, the employer 
may make the temporary reassignment and the PWFA does not prohibit the 
employer from reducing the qualified employee's pay. Both conditions 
must be true: (1) that there is no other reasonable accommodation that 
does not pose an undue hardship and (2) that this is the employer's 
normal practice in these situations. Similarly, an employer could limit 
bonuses related to the performance of an essential function(s) that has 
been temporarily suspended if there is not another accommodation that 
provides equal employment opportunity, and this is the employer's 
normal practice in these situations.
    For situations where the reasonable accommodation is additional 
breaks, a qualified employee may be given the opportunity to make up 
the additional time and may choose to do so. However, if making up the 
time renders the accommodation ineffective (for example, because the 
breaks are due to fatigue), the employer may not require the qualified 
employee to do so.
Personal Use
    The Commission received very limited comments on this section. The 
Commission has made one minor change to the language in the 
Interpretive Guidance for this section (removing reference to a ``white 
noise machine'').
Particular Matters Regarding Leave as a Reasonable Accommodation
    The Commission received numerous comments on its discussion of 
leave as a reasonable accommodation, including requests for 
clarification regarding the purpose and length of leave as a reasonable 
accommodation, as well as the application of the undue hardship 
standard to leave. Other comments recommended changes to the rules for 
paid leave and the continuation of health insurance while on leave. 
Some suggested that the PWFA explicitly provide coverage for ``extended 
leave.''
    As set out in the NPRM, the Commission has long recognized the use 
of leave as a potential reasonable accommodation under the ADA.\143\ 
Leave as a reasonable accommodation under the PWFA can be for any known 
limitation and includes leave for health care and treatment of 
pregnancy, childbirth, and related medical conditions and recovery from 
pregnancy, childbirth, and related medical conditions. The Commission 
declines to include the term ``extended leave'' in the regulation or 
Interpretive Guidance. The amount of leave under the PWFA depends on 
the employee and the known limitation and thus the term ``extended'' in 
this context does not have a uniform definition. In response to a few 
comments, the Commission has changed the language in Sec.  
1636.3(i)(3)(i) slightly to specifically provide that leave is 
available to recover

[[Page 29123]]

from any related medical condition. This was implied by the language in 
the NPRM, which stated that leave for recovery was available and 
described an explicitly non-exhaustive list of specific conditions. The 
Commission has also removed the word ``receive'' before ``unpaid 
leave'' in Sec.  1636.3(i)(3)(i) to be consistent with how it refers to 
unpaid leave.
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    \143\ 88 FR 54728.
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    Two groups of comments sought clarifications regarding leave and 
undue hardship. First, some comments agreed with proposed Sec.  
1636.3(i)(3)(iv), which states that concerns about the length, 
frequency, or unpredictable nature of leave are questions of undue 
hardship. However, the comments also suggested that the Commission make 
clear that it is not merely the fact that leave is long, frequent, or 
unpredictable that makes it an undue hardship. Rather, those factors 
may be considered to the extent that they impact the established undue 
hardship considerations. Thus, the fact that leave is unpredictable is 
not sufficient--standing alone--to make it an undue hardship; rather, 
the employer would have to show the unpredictable leave caused 
significant difficulty or expense on the operation of the business. The 
Commission agrees with these comments. Because this concept sets out 
how undue hardship and leave should interact, the Commission has 
determined that it is more appropriately discussed in the Interpretive 
Guidance rather than the regulation itself. Section 1636.3(i)(3)(iv) 
has, therefore, been removed from the regulation and the issue is 
instead discussed in the Interpretive Guidance in section 1636.3(h) 
under Particular Matters Regarding Leave as a Reasonable Accommodation.
    The other set of comments regarding undue hardship stated that the 
mere fact that an employee has taken leave should not be determinative 
in assessing undue hardship, but rather the impact of that leave should 
be determined by using the undue hardship factors in Sec.  
1636.3(j)(2). The Commission agrees and has added this information to 
the Interpretive Guidance in section 1636.3(h) under Particular Matters 
Regarding Leave as a Reasonable Accommodation because proposed Sec.  
1636.3(i)(3)(iv) has been removed from the regulation.
    Many comments recommended that, instead of looking to an employer's 
policies for individuals in similar situations, paid leave and 
continuation of health insurance should be designated as possible 
accommodations under the PWFA. The Commission declines to make this 
change. The current language in the Interpretive Guidance in section 
1636.3(h) under Particular Matters Regarding Leave as a Reasonable 
Accommodation is the same as under the ADA. The PWFA at 42 U.S.C. 
2000gg(7) provides that the term ``reasonable accommodation'' should 
have the same meaning as in the ADA and the PWFA regulations. Thus, the 
Commission is maintaining this definition.
    Finally, a few comments recommended that a short amount of leave 
(e.g., 2 days) could be a reasonable accommodation while the covered 
entity determines what other reasonable accommodations are possible or 
during the interactive process. The response to this suggestion is 
discussed in the preamble in section 1636.3(h) under Interim Reasonable 
Accommodations.
All Services and Programs
    The Commission received very limited comments on this section. The 
Commission has added language in the Interpretive Guidance in section 
1636.3(h) under All Services and Programs to clarify that the term 
``all services and programs'' includes situations where a qualified 
employee is traveling for work and may need, for example, 
accommodations at a different work site.
Interim Reasonable Accommodations
    The Commission received numerous comments regarding interim 
reasonable accommodations, including requests to provide examples of 
when interim reasonable accommodations are needed, recommendations that 
the provision be strengthened or made mandatory, discussion of the 
provision of leave as an interim reasonable accommodation, and 
suggestions of alternative definitions for ``interim reasonable 
accommodations.''
    Some comments provided helpful real-world examples of when interim 
reasonable accommodations are needed. For example, one comment stated 
that after asking for an accommodation, some pregnant employees are 
required to ``continue to lift, push, and pull heavy objects'' and 
``drive when not fit to do so'' in violation of the recommendations of 
their health care providers as they wait for the decision about their 
reasonable accommodation from their employer.\144\ The same comment 
noted that some employees have been fired while waiting to hear whether 
they can receive a reasonable accommodation because the employee cannot 
do the job without one.\145\ Another comment described a situation 
where an employee was put on leave after asking for a reasonable 
accommodation because the request occurred on a Friday afternoon, the 
employee was scheduled to work on Sunday, and the staff to address the 
provision of reasonable accommodations were not available until the 
beginning of the next week.\146\ A comment from an organization noted 
that employees call their hotline after weeks of waiting for a response 
on a request for an accommodation, and during that time ``they must 
continue to perform duties that put their health or the health of their 
pregnancy at risk so they can earn a paycheck and maintain their health 
insurance.'' \147\
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    \144\ Comment EEOC-2023-0004-98479, The Center for WorkLife Law, 
at 11 (Oct. 10, 2023).
    \145\ Id. at 2.
    \146\ Comment EEOC-2023-0004-34728, Cloquet Area Fire District 
(Sept. 12, 2023).
    \147\ Comment EEOC-2023-0004-98479, The Center for WorkLife Law, 
at 2 (Oct. 10, 2023).
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    The Commission understands the dilemma facing both employers and 
employees in circumstances where the accommodation is needed 
immediately but cannot be provided immediately. Requiring an employee 
to take leave (whether paid or unpaid) in this situation can be harmful 
to the employee, either because it will require the employee to exhaust 
their paid leave or because it will require an employee to go without 
income. In the face of these reasonable reactions to what is, based on 
comments received, a common situation, the Commission has added 
information regarding interim reasonable accommodations to the 
Interpretive Guidance in section 1636.3(h) under Interim Reasonable 
Accommodations.
    An interim reasonable accommodation can be used when there is a 
delay in providing the reasonable accommodation. For example, an 
interim reasonable accommodation may be needed when there is a sudden 
onset of a known limitation under the PWFA, including one that makes it 
unsafe, risky, or dangerous to perform the normal tasks of the job, 
when the interactive process is ongoing, when the parties are waiting 
for a piece of equipment, or when the employee is waiting for the 
employer's decision on the accommodation request.
    Interim reasonable accommodations are not required. However, 
providing an interim reasonable accommodation is a best practice under 
the PWFA and may help limit a covered entity's exposure to liability 
under 42 U.S.C. 2000gg-1(1) and Sec.  1636.4(a)(1) (``An unnecessary 
delay in providing a reasonable accommodation to the known limitations 
related to pregnancy, childbirth, or related medical conditions

[[Page 29124]]

of a qualified employee may result in a violation of the PWFA if the 
delay constitutes a failure to provide a reasonable accommodation.''). 
Furthermore, depending on the circumstances, requiring an employee to 
take leave as an interim reasonable accommodation may violate 42 U.S.C. 
2000gg-2(f). To help illustrate these principles, the Commission has 
added additional examples regarding this issue to the Interpretive 
Guidance in section 1636.3(h) under Interim Reasonable Accommodations.
    Finally, in response to several comments, the Commission declines 
to define ``interim reasonable accommodation'' differently than 
``reasonable accommodation.'' The term ``reasonable accommodation'' is 
already defined under the ADA and the PWFA.\148\ The Commission 
declines to create a new definition for such a similar term because it 
will create confusion.
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    \148\ 29 CFR 1630.2(o) (ADA); Sec.  1636.3(h) (PWFA).
---------------------------------------------------------------------------

1636.3(i) Reasonable Accommodation--Examples

    The Commission received numerous requests for additional examples 
and suggested edits for existing examples in this section. In response, 
the Commission has added a few examples to explain specific points, 
using a variety of employees to illustrate that the PWFA applies to all 
types of occupations and professions. Further, the Commission has made 
minor edits to the language in the examples from the NPRM to 
standardize the language and format used in these examples. For 
example, the Commission added ``affected by, or arising out of'' after 
``related to,'' added ``pregnancy, childbirth, or related medical 
conditions,'' and added that the adjustment or change at work is ``due 
to'' the limitation.
    The Commission did not receive comments related to Sec.  
1636.3(i)(1) from the NPRM. Comments the Commission received regarding 
Sec.  1636.3(i)(2) and (4) from the NPRM are discussed below. Comments 
regarding Sec.  1636.3(i)(3) from the NPRM (addressing leave as a 
reasonable accommodation) are discussed supra in the preamble in 
section 1636.3(h) under Particular Matters Regarding Leave as a 
Reasonable Accommodation. Comments received regarding Sec.  
1636.3(i)(5) from the NPRM (regarding the suspension of an essential 
function(s) as a reasonable accommodation) are discussed supra in the 
preamble in section 1636.3(f)(2) Temporary Suspension of an Essential 
Function(s) and infra in the preamble in section 1636.3(j)(3) Undue 
Hardship--Temporary Suspension of an Essential Function(s).

1636.3(i)(2) List of Possible Accommodations

    The Commission received a few comments recommending that in 
addition to listing telework in Sec.  1636.3(i)(2), the Commission 
include ``remote work'' and the ability to change work sites and add 
that telework is a possible accommodation to avoid heightened health 
risks, such as from communicable diseases. The Commission has added 
remote work and change in worksites to the non-exhaustive list of 
possible accommodations in Sec.  1636.3(i)(2) and to the Interpretive 
Guidance. The Commission also deleted the word ``additional'' before 
``unpaid leave'' in Sec.  1636.3(i)(2) because unpaid leave can be an 
accommodation whether or not it is additional.\149\
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    \149\ These changes are in addition to the change noted in the 
preamble in section 1636.3(h) under Alleviating Increased Pain or 
Risk to Health Due to the Known Limitation.
---------------------------------------------------------------------------

    In the Interpretive Guidance in section 1636.3(i) Reasonable 
Accommodation--Examples, the Commission added within the possible 
accommodation of ``frequent breaks'' the situation where the regular 
location of the employee's workplace makes nursing during work hours a 
possibility because the child is within close proximity. This concept 
has also been added to the regulation in Sec.  1636.3(i)(4)(iii). It 
also is described, in more detail, infra in the preamble in section 
1636.3(i)(4) Examples of Reasonable Accommodations Related to Lactation 
in the Commission's response to the comments for Sec.  1636.3(i)(4).

1636.3(i)(4) Examples of Reasonable Accommodations Related to Lactation

    As an initial matter, some comments suggested the Commission 
include additional conditions related to lactation, such as 
``difficulty with attachment'' or ``inability to pump milk,'' in the 
illustrative, non-exhaustive list of related medical conditions in 
Sec.  1636.3(b). As explained elsewhere, the Commission has not added 
or deleted any terms from its non-exhaustive list. The fact that these 
terms have not been added to the non-exhaustive list in Sec.  1636.3(b) 
should not be interpreted to deny coverage for those conditions.
    With regard to Sec.  1636.3(i)(4), many comments expressed concern 
over the wording used in proposed Sec.  1636.3(i)(4) which, in 
describing examples of accommodations related to lactation, referenced 
the Providing Urgent Maternal Protections for Nursing Mothers Act (PUMP 
Act) (Pub. L. 117-328, Div. KK, 136 Stat. 4459, 6093). Specifically, 
comments cautioned that the existing language could inadvertently 
create the impression that the PUMP Act does not require certain 
measures to ensure an adequate lactation space. To clarify this matter, 
the Commission has incorporated the suggested edits, both removing the 
introductory phrase in Sec.  1636.3(i)(4)(ii) (``Whether the space for 
lactation is provided under the PUMP Act or paragraph (i)(4)(i) of this 
section'') and adding the phrase ``shielded from view and free from 
intrusion,'' which is utilized in the PUMP Act, in an effort to 
emphasize the PUMP Act's requirements and what can be a reasonable 
accommodation under the PWFA. For the same reason, the Commission has 
added the phrase ``a place other than a bathroom,'' also from the PUMP 
Act, to Sec.  1636.3(i)(4)(ii).
    Also related to the PUMP Act, some comments asserted that leave and 
breaks under the PWFA could improperly exceed those provided under the 
PUMP Act. The Commission does not agree. The PUMP Act provides covered 
employees with a reasonable break each time the employee has a need to 
express milk, for up to 1 year after giving birth.\150\ There is not a 
maximum number of breaks.\151\ The frequency, duration, and timing of 
breaks can vary; \152\ thus, there is no defined number of breaks under 
the PUMP Act.
---------------------------------------------------------------------------

    \150\ 29 U.S.C. 218d; U.S. Dep't of Lab., Fact Sheet #73: FLSA 
Protections for Employees to Pump Breast Milk at Work (Jan. 2023), 
https://www.dol.gov/agencies/whd/fact-sheets/73-flsa-break-time-nursing-mothers; U.S. Dep't of Lab., Field Assistance Bulletin No. 
2023-02: Enforcement Protections for Employees to Pump Breast Milk 
at Work (May 17, 2023), https://www.dol.gov/sites/dolgov/files/WHD/fab/2023-2.pdf.
    \151\ See supra note 150.
    \152\ Id.
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    Another comment suggested that the Commission should not include 
accommodations related to lactation because the PUMP Act provides for 
breaks to pump at work and should be the exclusive mechanism for 
accommodations related to lactation. The Commission declines to make 
this change. The PUMP Act applies to almost all employees covered under 
the Fair Labor Standards Act of 1938, as amended (FLSA), 29 U.S.C. 201 
et seq., with exemptions created for specifically identified 
transportation-related jobs, and allows for employers with 50 or fewer 
employees to seek an exemption based on undue hardship.\153\ The PWFA 
applies to all employers with 15 or more

[[Page 29125]]

employees.\154\ Congress passed both laws at the same time and decided 
which entities would be covered; the Commission has a responsibility to 
follow the text of the statute it has been charged with enforcing. 
Furthermore, an employer that is covered under the PWFA but not under 
the PUMP Act does not automatically have to provide a reasonable 
accommodation related to pumping; under the PWFA, the covered entity, 
regardless of size or industry, does not have to provide the 
accommodation if it causes an undue hardship in the specific situation. 
Additionally, while the PWFA provides that it does not ``invalidate or 
limit the powers, remedies, or procedures under any Federal law . . . 
that provides greater or equal protection for individuals affected by 
pregnancy, childbirth, or related medical conditions,'' \155\ nothing 
in the PWFA prohibits it from providing more or additional protections.
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    \153\ Id.
    \154\ 42 U.S.C. 2000gg(2)(A), (B)(1).
    \155\ 42 U.S.C. 2000gg-5(a)(1).
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    Other comments suggested adding a new subsection, Sec.  
1636.3(i)(4)(iii), to specify additional examples of reasonable 
accommodations related to lactation such as modifications that would 
remove barriers to breastfeeding or pumping and avoid or alleviate 
lactation-related health complications. The Commission does not find 
the proposed additions, which reiterate the broader goals of the law, 
necessary in the list of accommodations. However, the Commission has 
added language in a new paragraph (i)(4)(iv) to Sec.  1636.3 to clarify 
that the types of accommodations listed in this section are not the 
only ones available for lactation.
    Some comments urged the Commission to make clear that it could be a 
violation of the PWFA to ``prohibit an employee from pumping milk in a 
space where they otherwise have permission to work or to be present'' 
unless it creates an undue hardship, and that coworker discomfort about 
being in the same room while an employee is pumping is not a valid 
ground for failing to provide an accommodation. The Commission is not 
making this addition. While it may be that the situation described in 
this comment could be a reasonable accommodation, as set out in Sec.  
1636.4(a)(4), an employer has the ultimate discretion in choosing 
between effective accommodations. The Commission agrees that generally 
coworker discomfort does not establish undue hardship and has added 
that point in the Interpretive Guidance in section 1636.3(j)(1) Undue 
Hardship--In General.\156\
---------------------------------------------------------------------------

    \156\ See 29 CFR part 1630, appendix, 1630.15(d).
---------------------------------------------------------------------------

    Another comment suggested that the Commission explicitly state that 
certain accommodations, such as telework, are not available for 
lactation. The Commission declines to add which accommodations may 
cause an undue hardship in a specific situation, as such a 
determination is fact-specific. Under the PWFA, as under the ADA, 
employers should conduct an individualized assessment in response to 
each request for a reasonable accommodation.
    Some comments recommended that the Commission also include nursing 
at work for those circumstances where the employee works in close 
proximity to their child and can easily nurse during the workday. The 
Commission agrees that in situations where the regular location of the 
qualified employee's workplace makes nursing during work hours a 
possibility because the child is in close proximity, allowing breaks 
for nursing would be a possible reasonable accommodation (e.g., an 
employee who regularly works from home and has their child at home or 
an employee whose child is at a nearby or onsite daycare center). The 
Commission has added this to the regulation in Sec.  1636.3(i)(4)(iii). 
The Commission cautions that this provision is intended to address 
situations where the qualified employee and child are in close 
proximity in the normal course of business. It is not intended to 
indicate that there is a right to create proximity to nurse because of 
an employee's preference. Of course, there may be known limitations 
that would entitle a qualified employee to the creation of proximity as 
a reasonable accommodation, absent undue hardship (e.g., a limitation 
that made pumping difficult or unworkable).
    Some comments sought reassurances that lactation accommodations 
also may include not only breaks to pump, but also refrigeration to 
store milk. Section 1636.3(i)(4)(ii) specifically references 
refrigeration for storing milk.

1636.3(j) Undue Hardship and 1636.3(j)(1) Undue Hardship--In General

    The Commission did not receive comments regarding Sec.  
1636.3(j)(1), which defines ``undue hardship'' using the language from 
the ADA. The Commission has not made changes to the regulation on this 
point. Because undue hardship under the PWFA is defined as in the ADA, 
the Commission has added information from the appendix to 29 CFR part 
1630 (Interpretive Guidance on Title I of the Americans With 
Disabilities Act) regarding undue hardship generally to the PWFA 
Interpretive Guidance in section 1636.3(j)(1) Undue Hardship--In 
General so that information is easily available to covered entities and 
employees.

1636.3(j)(2) Undue Hardship Factors

    The Commission did not receive comments that disagreed with the 
Commission's use of the ADA's undue hardship factors in the PWFA and 
has maintained the proposed language in the final regulation.
    The Commission received many comments regarding what facts should 
and should not be considered when an employer is determining undue 
hardship.
    First, the Commission received many comments discussing how 
previously granted accommodations should affect the undue hardship 
analysis. Undue hardship is a broad concept in terms of what may go 
into determining whether a particular reasonable accommodation imposes 
a significant difficulty or expense. An employer may consider the 
current impact of cumulative costs or burdens of accommodations that 
have already been granted to other employees or the same employee when 
considering whether a new request for the same or similar accommodation 
imposes an undue hardship. However, as the comments emphasized, and the 
Commission has stated, ``[g]eneralized conclusions will not suffice to 
support a claim of undue hardship. Instead, undue hardship must be 
based on an individualized assessment of current circumstances that 
show that a specific reasonable accommodation would cause significant 
difficulty or expense.'' \157\ Additionally, in some circumstances, 
rather than supporting a possible contention of an undue hardship based 
on cumulative burden, the fact that an employer has provided the same 
or similar accommodations in the past can weigh against an argument 
that granting it will impose an undue hardship. Ultimately, whether a 
particular accommodation will impose an undue hardship for an employer 
is determined on a case-by-case basis. This information has been added 
to the Interpretive Guidance in section 1636.3(j) under Undue 
Hardship--Consideration of Prior or Future Accommodations.
---------------------------------------------------------------------------

    \157\ Enforcement Guidance on Reasonable Accommodation, supra 
note 111, text at n.113.
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    Second, several comments stated that an employer should not be able 
to rely

[[Page 29126]]

solely on the fact that an employee previously received an 
accommodation to assert undue hardship. The Commission agrees and 
reiterates that although an employer may consider the impact of prior 
accommodations granted to the employee currently seeking an 
accommodation, the mere fact that an employee previously received an 
accommodation or, indeed, several accommodations, does not establish 
that it would impose an undue hardship on the employer to grant a new 
accommodation. This information has been added to the Interpretive 
Guidance in section 1636.3(j) under Undue Hardship--Consideration of 
Prior or Future Accommodations.
    The Commission received several comments regarding whether or how 
other employees should play a role in the undue hardship determination. 
The factors considered in the undue hardship analysis under the PWFA 
mirror those under the ADA. Accordingly, an employer cannot assert 
undue hardship based on employees' fears or prejudices toward the 
individual's pregnancy, childbirth, or related medical condition, nor 
can an undue hardship defense be based on the possibility that granting 
an accommodation would negatively impact the morale of other employees. 
Employers, however, may be able to show undue hardship where the 
provision of an accommodation would be unduly disruptive to other 
employees' ability to work.\158\ This information has been added to the 
Interpretive Guidance in section 1636.3(j)(1) Undue Hardship--In 
General.
---------------------------------------------------------------------------

    \158\ See 29 CFR part 1630, appendix, 1630.15(d); Enforcement 
Guidance on Reasonable Accommodation, supra note 111, at text after 
n.117; cf. Groff v. DeJoy, 600 U.S. 447, 472-73 (2023) (opining 
that, under the Title VII undue hardship standard, the employer may 
not justify refusal to accommodate based on other employees' bias or 
hostility).
---------------------------------------------------------------------------

    A few comments requested more examples of when an employer does 
meet the burden of showing undue hardship. An additional example has 
been added in the Interpretive Guidance in section 1636.3(j)(2) Undue 
Hardship Factors and the examples from the proposed appendix have been 
edited to include additional facts to help better explain why the 
situation creates an undue hardship.
Undue Hardship and Safety
    A few comments asked for clarification on which standard applies 
when an employee requests an accommodation that the covered entity 
asserts would cause a safety risk to co-workers or clients and whether 
there is a ``direct threat'' affirmative defense as in the ADA.\159\ 
Congress did not include a ``direct threat'' defense in the PWFA. Thus, 
as explained in the NPRM, the undue hardship analysis is the 
controlling framework for evaluating accommodation requests by 
employees with limitations related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions, including with 
regard to considerations of safety.\160\ Additionally, as stated in the 
NPRM, Title VII's bona fide occupational qualification (BFOQ) standard, 
rather than the PWFA's undue hardship standard, applies to assertions 
by employers that employees create a safety risk merely by being 
pregnant.\161\ The Commission has included this information in the 
Interpretive Guidance in section 1636.3(j) under Undue Hardship and 
Safety.
---------------------------------------------------------------------------

    \159\ See 42 U.S.C. 12111(3) (defining ``direct threat''), 
12113(b) (providing that the qualification standard can include a 
condition that a person not pose a direct threat); 29 CFR 
1630.2(r)(1) through (4) (outlining factors to be considered in 
whether an employee poses a direct threat).
    \160\ 88 FR 54733.
    \161\ Id.
---------------------------------------------------------------------------

1636.3(j)(3) Undue Hardship--Temporary Suspension of an Essential 
Function(s)

    The Commission received numerous comments describing the potential 
difficulties that employers may face in providing accommodations to 
employees who temporarily cannot perform one or more essential 
functions, pointing to specialized functions in certain industries and 
the burden of training employees. The Commission understands that in 
certain situations, providing the accommodation of the temporary 
suspension of an essential function(s) may cause an undue hardship. The 
difficulties addressed in the comments can be raised under the undue 
hardship defense and are all part of the individualized assessment 
under the PWFA. The Commission notes that employees seeking 
accommodations under the PWFA are not unlike other employees who are 
temporarily unable to perform one or more essential functions for 
various reasons and have received job modifications without a 
significant difficulty imposed on business operations under similar 
circumstances.
    The Commission received a comment suggesting the deletion of Sec.  
1636.3(j)(3)(iv) (``Whether the covered entity has provided other 
employees in similar positions who are unable to perform the essential 
function(s) of their position with temporary suspensions of essential 
functions'') because, the comment asserted, it inappropriately imports 
a ``comparative'' approach into the PWFA, which was enacted in part to 
address similar challenges experienced under Title VII. In the 
Interpretive Guidance in section 1636.3(j)(3) Undue Hardship--Temporary 
Suspension of an Essential Function(s), the Commission clarifies that 
under Sec.  1636.3(j)(3)(iv) an employer not having provided an 
accommodation previously does not tend to demonstrate that doing so 
now, for the qualified employee with a known limitation, would cause an 
undue hardship because making a change to a workplace procedure or rule 
can itself be a reasonable accommodation. Instead, if this factor is 
relevant, it will tend to demonstrate the lack of an undue hardship. 
For example, if an employer has consistently provided light duty 
assignments to those who are temporarily unable to perform a certain 
essential function(s) for reasons other than pregnancy, it will be 
difficult for the employer to prove that it is an undue hardship to 
provide a light duty assignment to a qualified pregnant employee who is 
similarly unable to perform such an essential function(s).
    Finally, the Commission also has added to the Interpretive Guidance 
in section 1636.3(j)(3) Undue Hardship--Temporary Suspension of an 
Essential Function(s) that for the undue hardship factor laid out in 
Sec.  1636.3(j)(3)(ii) (whether there is work for the employee to 
accomplish), the employer is not required to invent work for an 
employee.

1636.3(j)(4) Undue Hardship--Predictable Assessments

    In response to the Commission's directed question regarding the 
adoption of the predictable assessment approach and whether the list of 
accommodations should be modified, a large number of comments agreed 
with the method, and many suggested expanding the list. Several 
comments specifically requested the addition of: modifications to 
uniforms or dress codes; minor physical modifications to a workstation 
(e.g., a fan or a chair); permitting the use of a workstation closer to 
a bathroom or lactation space, or farther away from environmental 
hazards (e.g., heat, fumes, or toxins); use of a closer parking space 
in an employer-provided parking facility; permitting eating or drinking 
at a workstation or nearby location where food or drink is not usually 
permitted; rest breaks as needed; and providing personal protective 
equipment (e.g., gloves, goggles, earplugs, hardhats, or

[[Page 29127]]

masks). The Commission acknowledges that several of the recommended 
additions also are common and simple, and employers should be able to 
provide these, and, in fact, many accommodations under the PWFA, with 
little difficulty. However, the Commission declines to make these 
additions to the list of predictable assessments, because they are not 
the accommodations frequently mentioned in the legislative history, 
some may not be easily applied across a broad category of jobs or 
workplaces, others also are provided under other laws and employee 
protections,\162\ and certain modifications are not so commonly needed. 
This is not to say that such accommodations should not be granted when 
requested, but simply that the Commission will not categorize them as 
the type of change that in ``virtually all cases'' is a reasonable 
accommodation that does not create an undue hardship.
---------------------------------------------------------------------------

    \162\ See, e.g., 29 CFR 1910.132(a); U.S. Dep't of Lab., OSHA 
Personal Protective Equipment, https://www.osha.gov/personal-protective-equipment/standards (last visited Mar. 18, 2024); U.S. 
Dep't of Lab., OSHA Factsheet--Personal Protective Equipment, 
https://www.osha.gov/sites/default/files/publications/ppe-factsheet.pdf (last visited Mar. 18, 2024).
---------------------------------------------------------------------------

    In seeking the inclusion of these accommodations as predictable 
assessments, some comments asserted that other States and localities do 
not allow employers to assert undue hardship for some of these specific 
modifications. The Commission acknowledges the similarities between the 
PWFA and certain State laws, having referenced them in support of the 
predictable assessment approach.\163\ However, given the differences in 
State laws on this issue, with some having a version of predictable 
assessments and others having none, the Commission declines to expand 
the list of predictable assessments.
---------------------------------------------------------------------------

    \163\ 88 FR 54785-86.
---------------------------------------------------------------------------

    Some comments recommended that predictable assessments include, 
specifically, 16 health care appointments. The comments reasoned that 
this number represents the typical recommended number of prenatal and 
postnatal care visits for an uncomplicated pregnancy. The Commission is 
not adding this to the list of predictable assessments because the 
Commission acknowledges that the timing of an appointment and the 
length of an appointment may differ for each employee. The Commission 
also is concerned that setting a number of appointments could 
erroneously imply that additional appointments would necessarily create 
an undue hardship. However, the Commission emphasizes that employers 
should expect such requests, that such requests are covered by the 
PWFA, and that granting such requests should be a straightforward 
process, absent undue hardship.
    Another comment suggested that 8 weeks of leave to recover from 
childbirth be added as a predictable assessment, noting that despite 
the regularity of such a request, it is routinely rejected by 
employers. The Commission recognizes it is predictable that pregnant 
employees will need leave to recover from childbirth. However, given 
the differences in workplaces and the possibility that the employee has 
access to leave through the FMLA, State law, or an employer's program, 
the Commission is not making this change.
    Citing the number of pregnancies affected by gestational diabetes, 
one comment recommended the addition of short breaks to monitor blood 
glucose levels. As with breaks to hydrate, eat, or use the restroom, 
the Commission recognizes that these types of breaks should be simple 
for employers to provide. However, because this is a less universal 
need and was not repeatedly mentioned in the legislative history of the 
PWFA, the Commission does not believe it is appropriate to include it 
in the list of predictable assessments.
    The Commission also received numerous comments claiming that the 
identification of predictable assessments violates the statutory text 
of the PWFA and is beyond the Commission's authority because, according 
to these comments, ``predictable assessments'' create a category of 
``per se'' reasonable accommodations. Comments also stated that 
predictable assessments undercut the individualized assessment 
principles of the ADA, that there are differences among various jobs 
and workplaces, and that Congress intended for individualized 
assessments to be used. The Commission disagrees with these comments as 
they are misreading the NPRM. As stated in the NPRM, ``the adoption of 
predictable assessments . . . does not change the requirement that, as 
under the regulation implementing the ADA, employers must conduct an 
individualized assessment'' and ``[t]he identification of certain 
modifications as `predictable assessments' does not alter the 
definition of undue hardship or deprive a covered entity of the 
opportunity to bring forward facts to demonstrate a proposed 
accommodation imposes an undue hardship for its business under its own 
particular circumstances.'' \164\
---------------------------------------------------------------------------

    \164\ Id.
---------------------------------------------------------------------------

    In a similar vein, the Commission received comments stating that 
certain industries would have a more difficult time providing the 
accommodations that the Commission has identified as predictable 
assessments. As the Commission has stated, in those industries (as in 
any others), an employer may assert that the requested accommodation 
causes an undue hardship.
    Some comments suggested the Commission include additional language 
in Sec.  1636.3(j)(4)(i) to encompass circumstances where it may not be 
reasonable for the employee to ``carry'' water. The Commission agrees 
and has added ``keep water near'' to Sec.  1636.3(j)(4)(i). In 
explaining the predictable assessments in the Interpretive Guidance, 
the Commission also has clarified that, depending on the worksite, the 
employee may be able to eat or drink at their workstation without 
taking a break.
    In the regulation, the Commission has removed the following 
language from the proposed rule (Sec.  1636.3(j)(4)): ``Although a 
covered entity must assess on a case-by-case basis whether a requested 
modification is a reasonable accommodation that would cause an undue 
hardship . . .''; ``[g]iven the simple and straightforward nature of 
these modifications, they will, as a factual matter, virtually always 
be found to be reasonable accommodations that do not impose significant 
difficulty or expense (i.e., undue hardship)''; and ``[i]t should 
easily be concluded that the following modifications will virtually 
always be reasonable accommodations that do not impose an undue 
hardship.'' While all of these sentences remain true, including this 
information in the regulation is repetitive and unnecessary. These 
concepts have been moved to the Interpretive Guidance in section 
1636.3(j)(4) Undue Hardship--Predictable Assessments.
    Finally, the Commission made a few minor changes to the language in 
Sec.  1636.3(j)(4).\165\
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    \165\ For example, for consistency the Commission added ``as 
needed'' to Sec.  1636.3(j)(4)(ii) and (iii); removed ``through the 
workday'' from Sec.  1636.3(j)(4)(i); and added ``to take'' in Sec.  
1636.3(j)(4)(ii) and (iv).
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Formerly Proposed 1636.3(j)(5) Undue Hardship--Future Accommodations

    Several comments recommended that the Commission clarify that the 
potential for future accommodation requests from other employees cannot 
serve as a basis for failing to provide an accommodation. The 
Commission agrees and has added language in the Interpretive Guidance 
to the effect that an employer may not fail to provide an accommodation 
based on the

[[Page 29128]]

possibility--whether speculative or nearly certain--that it will have 
to provide the accommodation to other employees in the future. Because 
this point is relevant to how a covered entity should consider other 
accommodations, it has been added in the Interpretive Guidance in 
section 1636.3(j) under Undue Hardship--Consideration of Prior or 
Future Accommodations, which also includes more information about the 
consideration of prior and future accommodations. Accordingly, Sec.  
1636.3(j)(5) of the NPRM has been removed from the regulation.

1636.3(k) Interactive Process

    The NPRM largely adopted the explanation of the interactive process 
in the regulation implementing the ADA.
    The Commission has made one change in the regulatory language of 
Sec.  1636.3(k). The final rule states that the adjustment or change at 
work must be ``due to the limitation.'' This is intended to clarify 
that there is a connection between the limitation and the requested 
adjustment or change at work.
    Numerous comments suggested that the Commission highlight that in 
many instances the interactive process may occur in a very abbreviated 
form, given that most accommodations employees are likely to seek under 
the PWFA are simple and easy to provide and have little to no cost to 
covered entities, and because the temporary nature of pregnancy, 
childbirth, and related medical conditions makes expediency in 
responding to and providing requested accommodations crucial.
    The Commission, in enforcing the ADA, has acknowledged that in many 
instances both the need for an accommodation and the accommodation 
required will be obvious, leaving ``little or no need to engage in any 
discussion.'' \166\ In advising Federal agencies on creating their 
disability reasonable accommodation procedures, the Commission 
recommends that they process requests ``in a manner that imposes the 
fewest burdens on the individuals . . . and permits the most 
expeditious consideration and delivery of the reasonable 
accommodation.'' \167\ The same is true for the PWFA. Where an employee 
has requested a simple and easy accommodation under the PWFA, such as 
using a portable fan in the office, engaging in a lengthy back-and-
forth would be unwarranted.
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    \166\ Enforcement Guidance on Reasonable Accommodation, supra 
note 111, at Question 5.
    \167\ EEOC, Policy Guidance on Executive Order 13164: 
Establishing Procedures to Facilitate the Provision of Reasonable 
Accommodation, Question 7 (2000), https://www.eeoc.gov/laws/guidance/policy-guidance-executive-order-13164-establishing-procedures-facilitate-provision.
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    Some comments recommended that the Commission modify its guidance 
for the interactive process. The modifications, these comments 
explained, will better ensure that covered entities recognize the 
differences in the interactive process under the PWFA and the ADA. 
According to these comments, during the short time the PWFA has been in 
effect, covered entities have used their ADA policies to process 
pregnancy-related accommodation requests. Some employers have 
purportedly required their employees to fill out lengthy forms and 
medical certifications, which seek unnecessary information, leading to 
lengthy delays and denials.\168\
---------------------------------------------------------------------------

    \168\ See Comment EEOC-2023-0004-98479, The Center for WorkLife 
Law, at 23 (Oct. 10, 2023).
---------------------------------------------------------------------------

    The Commission agrees with the suggestions to emphasize that most 
requests for accommodations under the PWFA can be provided quickly and 
typically will consist of nothing more than brief conversations or 
email exchanges and has added language to this effect in the 
Interpretive Guidance in section 1636.3(k) Interactive Process. 
However, the Commission disagrees that this is meaningfully different 
than the ADA; under both statutes, the interactive process should focus 
on finding an appropriate reasonable accommodation.
    In order to further highlight the flexible, individualized nature 
of the interactive process, in the Interpretive Guidance in section 
1636.3(k) Interactive Process the Commission has added information 
about how the process does not have to follow specific steps and has 
changed the title of the possible steps in the interactive process in 
the Interpretive Guidance in section 1636.3(k) to Recommendations for 
an Interactive Process, while maintaining the substance from the ADA 
guidance. The Commission also has added that information provided by 
the employee in the interactive process does not need to be in any 
specific format, include specific words, or be on a specific form.
    The Commission received a few comments regarding the omission of 
the word ``precise'' from the description of the interactive process in 
the proposed appendix. As set out in Sec.  1636.3(a)(2), limitations 
may be modest, minor, and/or episodic. A limitation also may be a need 
or a problem related to maintaining the health of the employee or the 
health of the pregnancy. A process that tries to determine the 
``precise'' limitation is in tension with the idea that limitations can 
be minor impediments.
    Another comment questioned whether the absence of the word 
``precise'' limited whether the covered entity could, for example, 
require information about how many breaks an employee needs and for how 
long. It does not. The Commission's view is that under such 
circumstances, the employer could ask such follow-up questions in order 
to craft an effective accommodation that is not an undue hardship.
    One comment suggested that the Commission clarify that to initiate 
the interactive process the employee does not need to identify what the 
specific limitation is, but only that they have such a limitation and 
need an adjustment or change at work. Section 1636.3(h)(2) describes 
how an employee begins the reasonable accommodation process.
    To ensure that employees and covered entities understand that any 
medical information obtained during the interactive process under the 
PWFA is subject to the ADA's confidentiality rules and restrictions on 
disability-related inquiries, the Interpretive Guidance in section 
1636.3(k) Interactive Process includes a brief overview of these 
topics, with further information provided in the Interpretive Guidance 
in section 1636.7(a)(1) under Prohibition on Disability-Related 
Inquiries and Medical Examinations and Protection of Medical 
Information. Of particular relevance to the PWFA, that an employee is 
pregnant, has recently been pregnant, or has a medical condition 
related to pregnancy or childbirth is medical information.\169\ The ADA 
requires that employers keep such information confidential and only 
disclose it within the confines of the ADA's limited disclosure 
rules.\170\

[[Page 29129]]

Similarly, disclosing that an employee is receiving or has requested a 
reasonable accommodation under the PWFA usually amounts to a disclosure 
that the employee is pregnant, has recently been pregnant, or has a 
related medical condition.\171\
---------------------------------------------------------------------------

    \169\ 88 FR 54744.
    \170\ 42 U.S.C. 12112(d)(3)(B); 29 CFR 1630.14(b)(1), (c)(1), 
(d)(4); EEOC, Enforcement Guidance on Disability-Related Inquiries 
and Medical Exams of Employees Under the ADA, at text accompanying 
nn.9-10 (2000) [hereinafter Enforcement Guidance on Disability-
Related Inquiries], http://www.eeoc.gov/laws/guidance/enforcement-guidance-disability-related-inquiries-and-medical-examinations-employees (``The ADA requires employers to treat any medical 
information obtained from a disability-related inquiry or medical 
examination . . . as well as any medical information voluntarily 
disclosed by an employee, as a confidential medical record. 
Employers may share such information only in limited circumstances 
with supervisors, managers, first aid and safety personnel, and 
government officials investigating compliance with the ADA.''); 
EEOC, Enforcement Guidance: Preemployment Disability-Related 
Questions and Medical Examinations, at text accompanying n.6 (1995) 
[hereinafter Enforcement Guidance: Preemployment Disability-Related 
Questions], https://www.eeoc.gov/laws/guidance/enforcement-guidance-preemployment-disability-related-questions-and-medical (``Medical 
information must be kept confidential.'').
    \171\ 88 FR 54744.
---------------------------------------------------------------------------

    Many comments described the difficulty pregnant employees may 
experience obtaining appointments with health care providers, 
especially early in pregnancy. To help address this concern, the 
Commission has added language to the Interpretive Guidance in section 
1636.3(k) under Engaging in the Interactive Process \172\ to the effect 
that when a covered entity is permitted to seek supporting 
documentation from a health care provider under the parameters outlined 
in Sec.  1636.3(l), the covered entity should be aware that it may take 
time for the employee to find a health care provider and provide the 
documentation. Delay caused by the difficulty faced by an employee in 
obtaining information from a health care provider in these 
circumstances should not be considered a withdrawal from or refusal to 
participate in the interactive process. If there is such a delay, an 
employer should consider providing an interim reasonable accommodation.
---------------------------------------------------------------------------

    \172\ In the proposed appendix, this heading was entitled 
``Failure to Engage in Interactive Process.'' 88 FR 54787.
---------------------------------------------------------------------------

    Several comments requested that the Commission specifically address 
the need for reasonable accommodations in unforeseen, urgent, emergency 
situations when the employee has not already requested a reasonable 
accommodation. One comment described instances where employees 
experienced bleeding or passed out due to their pregnancies and had to 
immediately leave their worksites to obtain emergency care, only to 
return to work and find they were charged with violating the covered 
entities' attendance policy. In response, the Commission has added 
information and an example in the Interpretive Guidance in section 
1636.3(k) under Engaging in the Interactive Process. This example 
involves a situation where the employee, who has not asked for an 
accommodation or informed their employer that they are pregnant, 
experiences an emergency that is a physical or mental condition related 
to, affected by, or arising out of pregnancy, childbirth, or related 
medical conditions. The example explains that by informing the employer 
that they are experiencing an emergency related to pregnancy, 
childbirth, or related medical conditions and need leave immediately, 
the employee has made a request for a reasonable accommodation. The 
example goes on to explain that, if it is later determined that the 
employee is entitled to a reasonable accommodation, the employer should 
not penalize the employee because the emergency required a pause in the 
interactive process.
    In the Interpretive Guidance, the information regarding delay and 
emergencies explained in the preceding paragraphs has been added to 
section 1636.3(k) under the heading formerly titled Failure to Engage 
in the Interactive Process. To reflect these additions, the title of 
that heading has been changed to Engaging in the Interactive Process.
    One comment asked that the Commission clarify whether the 
``interactive process'' requirements can be met by using software. 
There are no required steps or methodology for the interactive process; 
thus, the Commission has not taken a position on whether such a system 
will meet the requirements of the interactive process. The Commission 
does remind covered entities that they are responsible for their part 
of the interactive process, regardless of how they meet that 
obligation.
    A comment requested that the Commission oversee the interactive 
process between covered entities and employees, suggesting a system of 
monitoring and evaluation. While the Commission issues guidance, 
provides technical assistance, and engages in litigation, the 
Commission is unable to offer the level of monitoring proposed. 
Generally, the employee and employer are in the best position to 
understand the limitations, affected job functions, and possible 
accommodations involved in the interactive process.
    Finally, the Commission has included additional examples in the 
Interpretive Guidance in section 1636.3(k) Interactive Process to 
illustrate how accommodations may be granted through the interactive 
process.

1636.3(l) Limits on Supporting Documentation

    The Commission received numerous comments about the NPRM's approach 
to supporting documentation and the extent to which the final 
regulation should permit covered entities to seek such documentation in 
support of an employee's request for a reasonable accommodation under 
the PWFA. The proposed rule provided that a covered entity could 
require supporting documentation that is reasonable under the 
circumstances for the covered entity to determine whether to grant the 
accommodation. Further, the rule provided that when it was reasonable 
under the circumstances, the employer could only require reasonable 
documentation.

1636.3(l)(1) Seeking Supporting Documentation Only When Reasonable 
Under the Circumstances

Comments and Response to Comments That Were Generally Supportive or 
Generally Unsupportive of the Commission's Approach
    The Commission received many comments that were generally 
supportive of the approach to documentation set forth in the proposed 
rule, although most had suggestions for further limiting the ability of 
employers to seek supporting documentation.
    Many comments agreed with the Commission that employees who are 
pregnant may experience limitations and, therefore, require 
accommodations before they have had any medical appointments, and that 
it may be difficult for a pregnant employee to obtain an immediate 
appointment with a health care provider early in a pregnancy, 
especially for those living in certain regions of the country where 
there are limited resources for maternal health. These and other 
comments also provided numerous additional reasons for limiting the 
amount of documentation that covered entities may seek under the PWFA, 
including: the burden and corresponding reduction in quality of care 
that administrative duties (such as paperwork) place on health care 
professionals; the possibility that the notes doctors provide are 
``overprotective'' and result in a person who wants to work being 
placed on leave; the costs in time and money employees face when they 
must obtain medical documentation; \173\ the concern that a doctor may 
feel uncomfortable certifying that a condition is completely due to 
pregnancy; \174\ the fact that these

[[Page 29130]]

burdens may deter employees who need accommodations from asking for 
them; and the possibility that employers will not maintain the 
confidentiality of medical documentation they obtain, among other 
reasons. These comments agreed with the overall structure of the 
proposed rule's documentation provision but also offered suggestions 
for further limiting the circumstances in which documentation could be 
sought, as explained in more detail below. Some comments, generally 
supportive of the proposed rule's approach, urged the Commission to 
ensure that there is a broad understanding among covered entities and 
employees of the PWFA's rules limiting the ability of covered entities 
to seek supporting documentation.
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    \173\ Some comments that were generally sympathetic to the idea 
that it is difficult for pregnant employees to obtain supporting 
documentation in some circumstances argued that rather than limiting 
employers' ability to seek supporting documentation in those 
circumstances, employers could provide interim accommodations while 
waiting for supporting documentation. The Commission agrees 
providing interim reasonable accommodations is a possibility and has 
expanded the section regarding interim reasonable accommodations in 
the Interpretive Guidance in section 1636.3(h) under Interim 
Reasonable Accommodations, although providing an interim reasonable 
accommodation is not required.
    \174\ This concern is misplaced, as the PWFA requires 
accommodation for physical or mental conditions ``related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions'' and not that the physical or mental condition 
solely be due to pregnancy, childbirth, or related medical 
conditions. 42 U.S.C. 2000gg(4); see also section 1636.3(a)(2) under 
Related to, Affected by, or Arising Out of in the Interpretive 
Guidance.
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    Other comments, however, were generally unsupportive of the 
proposed rule's approach, arguing that before deciding whether to grant 
requests for reasonable accommodations, employers need to be able to 
seek supporting documentation beyond what the proposed rule would 
allow. Such comments expressed concern about employee fraud, including 
employees who might seek accommodations with no relation to a PWFA-
covered limitation.\175\ Others said that the proposed rule did not 
allow employers to request sufficient justification for a requested 
accommodation and that this aspect of the proposal violated the spirit 
of mutually beneficial cooperation that the PWFA represents. Concerns 
about vague requests, employees who did not know what sort of 
accommodation they needed, and the absence of a concrete rule also were 
mentioned in these comments.
---------------------------------------------------------------------------

    \175\ Another comment noted, however, that the fact that covered 
entities are permitted to request supporting documentation ``when 
necessary'' to determine if a limitation is ``related to, affected 
by, or arising out of'' pregnancy overcame any concerns that the 
employer will have to provide an accommodation for a condition not 
related to a PWFA limitation.
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    In drafting the final rule on supporting documentation, the 
Commission took these comments into consideration, as well as the more 
specific suggestions discussed below.
Comments and Response to Comments Suggesting That the PWFA's Rule on 
Supporting Documentation Should Follow the ADA
    Some comments that generally were unsupportive of the proposed 
rule's approach to supporting documentation argued that the PWFA 
regulation should follow the approach employers use under the ADA. Some 
argued that this approach should be followed because it provides a 
familiar bright line that is more useful to employers than a general 
``reasonableness'' standard. These comments also asserted that 
difficulties pregnant employees have obtaining documentation are faced 
equally by those with disabilities and, therefore, should not be a 
factor in the drafting of a final rule.
    The Commission disagrees with the comments that argued that it 
automatically can or should apply the ADA's approach to supporting 
documentation under the PWFA in all circumstances. The ADA's statutory 
restrictions on disability-related inquiries apply to all disability-
related inquiries, whether or not an employee has a disability,\176\ 
including when such inquiries are made in response to a request for an 
accommodation under the PWFA, as discussed in detail in the 
Interpretive Guidance in section 1636.7(a)(1) under Prohibition on 
Disability-Related Inquiries and Medical Examinations and Protection of 
Medical Information. These restrictions limit an employer's ability to 
ask employees questions that are likely to elicit information about a 
disability to situations when doing so is job-related and consistent 
with business necessity.\177\
---------------------------------------------------------------------------

    \176\ 42 U.S.C. 12112(d). See also Enforcement Guidance on 
Disability-Related Inquiries, supra note 170 (``The ADA's 
restrictions on inquiries and examinations apply to all employees, 
not just those with disabilities.'').
    \177\ 42 U.S.C. 12112(d).
---------------------------------------------------------------------------

    The PWFA does not have a similar statutory provision regarding 
pregnancy-related inquiries.\178\ However, the PWFA does make it 
unlawful for a covered entity not to make reasonable accommodation to 
the known limitations related to the pregnancy, childbirth, or related 
medical conditions of a qualified employee, unless such covered entity 
can demonstrate that the accommodation would impose an undue 
hardship.\179\ Adopting a reasonableness standard for when employers 
can seek supporting documentation to determine coverage and the need 
for an accommodation ensures that covered entities can meet the 
statute's requirements without overly broad documentation requests that 
could result in the failure to provide accommodations that should be 
granted or could lead to claims of retaliation. Additionally, the 
Commission concludes that it is critical to limit inquiries and the 
supporting documentation that a covered entity can seek when an 
employee requests an accommodation under the PWFA so that covered 
entities do not obtain sensitive information that they do not need when 
making employment decisions and employees are not dissuaded from asking 
for accommodations out of concern that such requests will lead to 
probing questions unrelated to their ability to do the job. Thus, the 
Commission has retained the reasonableness standard from the proposed 
rule.
---------------------------------------------------------------------------

    \178\ However, in the context of Title VII, the Commission has 
stated, ``Because Title VII prohibits discrimination based on 
pregnancy, employers should not make inquiries into whether an 
applicant or employee intends to become pregnant. The EEOC will 
generally regard such an inquiry as evidence of pregnancy 
discrimination where the employer subsequently makes an unfavorable 
job decision affecting a pregnant worker.'' Enforcement Guidance on 
Pregnancy Discrimination, supra note 31, at (I)(A)(3)(b). And, as 
stated, supra, the ADA's restrictions on disability-related 
inquiries apply to individuals seeking accommodations under the 
PWFA.
    \179\ 42 U.S.C. 2000gg-1(1).
---------------------------------------------------------------------------

    The Commission notes that the rule it is adopting about seeking 
supporting documentation for the PWFA is similar to the Commission's 
guidance regarding the ADA in some ways. The most important similarity 
is that a covered entity is not required to seek supporting 
documentation from an employee who requests an accommodation under the 
PWFA, as is true under the ADA. For example, if an employee, early in 
their pregnancy, informs the employer that they are pregnant, have 
morning sickness, and need a later start time, the employer and the 
employee can discuss what type of schedule changes are needed and 
implement them. Because of the difficulty employees may face in finding 
care, the fact that many health care providers will not see employees 
until later in their pregnancies,\180\ and the fact that many 
accommodations under the PWFA will be simple and temporary, the 
Commission encourages employers to engage in this simple type of 
interactive process to determine appropriate accommodations under the 
PWFA.
---------------------------------------------------------------------------

    \180\ 88 FR 54736, 54787.
---------------------------------------------------------------------------

    The final PWFA rule contains five examples of when it is not 
reasonable under the circumstances to seek supporting documentation. 
Two of these examples build on the Commission's ADA policy guidance 
(Sec.  1636.3(l)(1)(i) (obvious) and (ii) (known)); and a third example 
is based on disparate treatment principles that apply equally under the 
ADA (Sec.  1636.3(l)(1)(v)) (it would not be reasonable under the 
circumstances to seek documentation when the requested

[[Page 29131]]

accommodation is available to employees without PWFA limitations 
pursuant to a covered entity's policies or practices without submitting 
supporting documentation.). The two other examples involve pregnancy 
and predictable assessments, and lactation, nursing, and pumping. They 
are described in detail below.
    Reorganization of Sec.  1636.3(l) and Changes in the Language 
Describing the Reasonableness Standard
    The Commission has made several changes in the regulation for Sec.  
1636.3(l).
    First, the Commission has changed the language in Sec.  
1636.3(l)(1) regarding when it is reasonable under the circumstances 
from ``reasonable under the circumstances for the covered entity to 
determine whether to grant the accommodation'' to ``reasonable under 
the circumstances for the covered entity to determine whether the 
employee has a physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions (a 
limitation) and needs an adjustment or change at work due to the 
limitation.'' The Commission believes that, given the context, ``to 
determine whether to grant the accommodation'' would be understood to 
mean ``to determine whether the employee has a physical or mental 
condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions (a limitation) and needs an 
adjustment or change at work due to the limitation.'' However, the 
Commission also recognizes that there may be other factors involved in 
an effort ``to determine whether to grant the accommodation'' that do 
not involve supporting documentation. Thus, the Commission has changed 
the language to be more precise.
    Second, throughout the regulation and the Interpretive Guidance, 
references to an employer ``requiring'' documentation in the proposed 
rule have been changed to an employer ``seeking'' documentation. This 
change was made to account for situations where an employer's request 
for supporting documentation is effectively a requirement even if it 
does not contain the word ``requirement.''
    Third, the Commission has moved the information regarding 
confidentiality from Sec.  1636.3(l)(4) of the proposed regulation to 
section 1636.7(a)(1) under Prohibition on Disability-Related Inquiries 
and Medical Examinations and Protection of Medical Information in the 
Interpretive Guidance. The Commission has made this change because the 
prohibition on disability-related inquiries and the confidentiality 
provisions that apply to medical information obtained under the PWFA 
arise from the ADA, not the PWFA, and therefore are enforceable under 
the ADA, not the PWFA. Accordingly, they are more appropriately 
addressed in the Interpretive Guidance's discussion of the application 
of the ADA's rules and exceptions regarding the confidentiality of 
medical information than in the PWFA regulation itself.
    Fourth, the Commission has moved information regarding how 
documentation requests that violate Sec.  1636.3(l) also may be a 
violation of 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f) (prohibition on 
retaliation and coercion)) to the Interpretive Guidance in section 
1636.5(f) under Possible Violations of 42 U.S.C. 2000gg-2(f) 
(1636.5(f)) Based on Seeking Supporting Documentation During the 
Reasonable Accommodation Process and Disclosure of Medical Information.
    Fifth, the final rule contains a new paragraph (new paragraph 
(l)(4) of Sec.  1636.3) regarding self-confirmation for the purposes of 
Sec.  1636.3(l)(1)(i), (iii), and (iv). The NPRM stated that, in 
certain circumstances, an employer could not request documentation to 
confirm pregnancy when an employee ``states or confirms'' that they are 
pregnant.\181\ Some comments discussed the question of what kind of 
confirmation should be allowed and, in particular, when covered 
entities should be permitted to seek documentation to confirm that an 
employee is pregnant. Some argued that self-attestation should always 
suffice, others argued that covered entities should be allowed to seek 
supporting documentation confirming pregnancy unless the pregnancy is 
``obvious,'' while still others discussed the types of tests that 
should or should not be allowed to confirm pregnancy. As explained in 
detail below, the final rule provides two circumstances in which 
covered entities must accept self-confirmation of pregnancy: when the 
pregnancy is obvious, or when the request for a change at work involves 
one of the modifications listed under Sec.  1636.3(j)(4) due to 
pregnancy. As explained in the Interpretive Guidance in section 
1636.3(l)(2) Reasonable Documentation, when the covered entity is 
permitted to seek confirmation of pregnancy other than through self-
confirmation, it may not require a specific test or method.
---------------------------------------------------------------------------

    \181\ 88 FR 54737, 54788 (``For example, when an obviously 
pregnant worker states or confirms they are pregnant and asks for a 
different size uniform . . . the employer may not require supporting 
documentation.'').
---------------------------------------------------------------------------

    Additionally, the Commission has included new subsections in the 
Interpretive Guidance: in section 1636.3(l) under Interaction Between 
the PWFA and the ADA; and in section 1636.7(a)(1) under The PWFA and 
the ADA.
Comments and Response to Comments Regarding Examples of When It Is Not 
Reasonable To Seek Supporting Documentation
    As noted above, the NPRM explained that if an employer decided to 
seek supporting documentation, it was only permitted to do so if it was 
reasonable under the circumstances in order for the employer to 
determine whether to grant the accommodation. The NPRM provided four 
examples of when it is not reasonable under the circumstances.
    The Commission received comments seeking additional factual 
scenarios illustrating circumstances when it would, as well as when it 
would not, be reasonable under the circumstances to seek documentation. 
Some of these comments provided suggestions for desired examples. The 
Commission agrees that further illustrations would be useful and 
therefore has added further illustrations to the Interpretive Guidance 
in section 1636.3(l)(1) Seeking Supporting Documentation Only When 
Reasonable Under the Circumstances.
    Other comments suggested that the final rule should state that 
covered entities that seek documentation must provide paid leave for 
the employee to obtain the documentation, as well as cover any costs 
incurred to obtain it. To the extent that these comments intended to 
suggest that it would not be reasonable under the circumstances to seek 
documentation unless the covered entity provides paid leave for the 
employee to obtain the documentation and covers any costs incurred, the 
Commission disagrees and declines to adopt this suggestion.
Not Reasonable To Seek Supporting Documentation--Obvious
    The first example in the proposed rule of when it would not be 
reasonable under the circumstances to seek supporting documentation is 
when: (1) the known limitation and need for reasonable accommodation 
are obvious; and (2) the employee confirms the obvious limitation and 
need for reasonable accommodation through self-attestation. This 
example is retained in the final rule, although the language has been 
modified to reflect changes in the description of what documentation 
may be sought.
    Thus, the language in the final rule regarding this example has 
been changed from ``when the known limitation and the need for 
reasonable accommodation are obvious and the

[[Page 29132]]

employee confirms the obvious limitation and need for reasonable 
accommodation through self-attestation'' to ``[w]hen the physical or 
mental condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions (a limitation) and the 
adjustment or change at work needed due to the limitation are obvious, 
and the employee provides self-confirmation as defined in paragraph 
(l)(4) of this section.'' The Interpretive Guidance for this section, 
in section 1636.3(l)(1)(i)--Obvious, has generally remained the same 
with some minor language edits.
    Many comments expressed concerns with the meaning of the word 
``obvious.'' Comments noted, among other things, that a rule that 
envisions employers making decisions based on whether someone is 
``obviously'' pregnant will lead employers to subject employees' bodies 
to invasive scrutiny. This, in turn, might lead employers to 
unilaterally impose restrictions based on gendered and racialized 
stereotypes about what pregnant and postpartum people need. Other 
comments argued that it is irrelevant whether a pregnancy is 
``obvious'' because if the individual in question is seeking an 
accommodation for which the employer is permitted to seek 
documentation, that documentation will automatically include a 
confirmation that the person is pregnant. Another comment pointed out 
that it will be very difficult for covered entities to determine if a 
pregnancy is ``obvious,'' and that attempting to do so might expose 
employers to liability if a manager judges incorrectly.
    In response to these comments, the Commission first notes that the 
idea of prohibiting requests for supporting documentation when the 
condition is ``obvious'' is similar to the Commission's guidance 
regarding the ADA although, unlike the ADA, the PWFA regulation 
includes a self-confirmation requirement. The Commission also has used 
the concept of ``obvious'' previously regarding pregnancy 
discrimination.\182\ An ``obvious'' pregnancy is one where the 
pregnancy is showing, and onlookers easily notice by observation. 
Importantly, as several comments noted, not everyone who is pregnant 
looks the same.
---------------------------------------------------------------------------

    \182\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A)(1)(a) (discussing the ``obviousness'' of 
pregnancy and how that can play into a discrimination claim).
---------------------------------------------------------------------------

    Moreover, the Commission concludes that concerns about this 
provision encouraging employers to force employees to accept 
unnecessary accommodations based on stereotypes are misplaced. Whether 
a pregnancy is obvious will only be relevant after an employee requests 
a reasonable accommodation. Other parts of the PWFA prohibit employers 
from requiring employees to accept reasonable accommodations.\183\
---------------------------------------------------------------------------

    \183\ 42 U.S.C. 2000gg-1(2); 29 CFR 1636.4(b).
---------------------------------------------------------------------------

    The requirement that obviously pregnant employees must self-confirm 
that they are pregnant (new Sec.  1636.3(l)(4)) is intended to address 
the concerns expressed by comments about managers being uncertain 
whether someone is pregnant. Although there may be circumstances in 
which a pregnant employee asks for an accommodation and considers 
themselves to be ``obviously'' pregnant, but the employer disagrees and 
requests supporting documentation, the Commission believes such cases 
will be rare. Finally, although the Commission understands concerns 
about an employer's possible scrutiny of an employee's body, it is 
impractical to suggest that an employer in such circumstances should 
not consider the obvious physical condition of the employee requesting 
accommodation and instead seek documentation.
    Some comments also requested more details about and examples of 
what would be considered an ``obvious'' limitation and/or an 
``obvious'' need for accommodation (for example, asking when a 
limitation would be obvious based on something other than physical 
appearance). These comments suggested, for instance, that if someone 
self-attested to pregnancy and then was seen frequently vomiting, the 
limitation (vomiting due to pregnancy) should be considered obvious, 
and no documentation would be needed because vomiting is a common 
symptom of pregnancy.
    Under these circumstances, the comments suggested, the need for an 
accommodation of a temporary relocation of a workstation closer to the 
bathroom also would be obvious. These comments recommended that the 
Commission, in the final rule, identify the following conditions as 
``obvious'': morning sickness, edema, fatigue, back pain, medical 
visits, lifting restrictions, and time to recover from childbirth, 
among others. Comments additionally recommended that the final rule 
make clear that the need for accommodation is obvious when a pregnant 
employee requests removal from exposure to certain harmful chemicals or 
infectious diseases.
    Under the final rule, the first example of when it is not 
reasonable under the circumstances for an employer to seek supporting 
documentation is when the employee's limitation (physical or mental 
condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions) and the adjustment or change 
at work that is needed due to the limitation are obvious and the 
employee confirms the limitation and the adjustment or change at work 
needed due to the limitation. As stated in the Interpretive Guidance in 
section 1636.3(l)(1)(i)--Obvious, the Commission expects this example 
will usually apply when the employee is obviously pregnant. ``Obvious'' 
means that the condition is apparent without being mentioned. In terms 
of pregnancy itself, this may depend on physical appearance, i.e., 
whether the pregnancy is ``showing.''
    In response to comments suggesting that additional circumstances 
will always fall within the parameters of ``obvious'' limitations and/
or ``obvious'' accommodations, the Commission does not have enough 
information to agree with those comments maintaining, for example, that 
there should be a nationwide standard establishing that it always is 
obvious that all pregnant employees need accommodations due to lifting 
restrictions, avoiding certain chemicals, or back pain, such that it 
would never be reasonable for employers to seek supporting 
documentation when someone requests accommodation due to these 
limitations. Although there may be circumstances under which these and 
other limitations or accommodations are obvious, when accompanied by 
self-confirmation, the Commission does not view these sorts of 
limitations or types of accommodations as ``obvious'' in the way that 
it is obvious that a pregnant employee late in pregnancy needs a larger 
uniform or properly fitting safety equipment. Thus, the Commission did 
not make any changes to the proposed rule based on comments concerning 
limitations or accommodations that should be considered ``obvious.''
Not Reasonable To Seek Supporting Documentation--Known
    Although fewer comments mentioned the proposed rule's second 
example of when it would not be reasonable for a covered entity to seek 
documentation in support of a request for PWFA accommodation, some did 
suggest that the term ``sufficient information'' was too vague and 
asked if ``information'' was intended to encompass something broader 
than ``documentation.''

[[Page 29133]]

    This example is intended to prevent covered entities from seeking 
supporting documentation unnecessarily. In the NPRM, the Commission 
explained that information is sufficient if it substantiates that the 
employee has a known PWFA limitation and needs a change or adjustment 
at work. The word ``information'' was intentionally used to make clear 
that it does not have to be documentation from a health care provider 
but can be information provided by the employee or their 
representative, such as a self-confirmation of pregnancy, when 
permitted, or confirmation from the employee that the need, explained 
by previously submitted documentation, has occurred again. The example 
provided in one of the comments illustrates the need for this 
provision--in this example, an employee who had already provided 
documentation from her health care provider was required to provide a 
new doctor's note for each absence due to morning sickness, an 
impossible requirement given that no one would be able to see a doctor 
every time they were too nauseous to go to work. If an employee already 
has provided documentation that because of morning sickness they need 
to use intermittent leave as necessary for the next 2 months, the 
covered entity may not seek new documentation from a health care 
provider every time the employee needs to use leave due to morning 
sickness.
    To ensure that this example is not misunderstood to be broader than 
intended, the Interpretive Guidance makes clear in section 
1636.3(l)(1)(ii)--Known that when it is otherwise reasonable under the 
circumstances to seek supporting documentation, an employer is not 
prohibited from doing so simply because the employee has stated that 
they have a PWFA limitation and need an adjustment or change at work.
    The language in the final rule about this example has been changed 
to follow the language in the final rule regarding the supporting 
documentation that may be sought and to clarify that the example 
applies whenever the employer has sufficient information to determine 
that the employee has a PWFA limitation and needs an adjustment or 
change at work, regardless of how the employer obtains that 
information. Thus, the Commission changed ``When the employee or 
applicant already has provided the covered entity with sufficient 
information to substantiate that the employee or applicant has a known 
limitation and that a change or adjustment at work is needed;'' to 
``When the employer already has sufficient information to determine 
whether the employee has a physical or mental condition related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions (a limitation) and needs an adjustment or change at 
work due to the limitation.'' Additionally in the Interpretive Guidance 
for this section, the Commission has added how this provision may apply 
to episodic conditions.
Not Reasonable To Seek Supporting Documentation--Predictable 
Assessments
    The proposed rule provided a third example of when it is not 
reasonable for an employer to seek supporting documentation: when an 
employee at any time during their pregnancy states or confirms that 
they are pregnant and seeks one of the modifications described as 
``predictable assessments'' under Sec.  1636.3(j)(4)(i) through (iv).
    Many comments suggested that this example be expanded to include 
modifications beyond those recognized as ``predictable assessments'' 
under Sec.  1636.3(j)(4)(i) through (iv). Some of these comments argued 
that the list should be expanded because the principles underlying 
whether a particular accommodation warrants medical certification 
differ from concerns related to undue hardship. The Commission declines 
to expand this example. The recognized ``predictable assessments'' 
reflect a small set of simple, inexpensive, commonly sought 
accommodations that are widely known to be needed during an 
uncomplicated pregnancy, and where documentation would not be easily 
obtained or necessary. In the Commission's view, the examples suggested 
for the possible expansion of the rule do not fall within this same 
category, although the Commission agrees that in some situations the 
modifications offered in the comments would not require supporting 
documentation and reminds employers that they are not obligated to seek 
supporting documentation.\184\ Moreover, because the proposed list of 
accommodations that fit within this example are limited to 
modifications already singled out in Sec.  1636.3(j)(4), the example is 
clear and easy to apply.
---------------------------------------------------------------------------

    \184\ The comments suggested the following additions: time off, 
up to 8 weeks (or 12 weeks in some comments) to recover from 
childbirth; time off to attend up to 16 health care appointments 
while pregnant; flexible scheduling or remote work for nausea or 
bleeding; modifications to uniforms or dress codes; minor physical 
modifications to the workstation; relocation of the workstation; 
reprieve from lifting over 20 pounds; and access to a closer parking 
space, among others.
---------------------------------------------------------------------------

    One comment, focused more on the proposed regulation's discussion 
of predictable assessments in an undue hardship context, noted that 
employers should be able to seek documentation to confirm that the 
requested ``predictable assessments'' modifications are needed due to 
pregnancy, as opposed to some other reason. The Commission agrees that 
this example is limited to pregnancy. Thus, under the final rule, the 
employer is not permitted to seek supporting documentation if the 
employee asks for one of these modifications due to a physical or 
mental condition related to, affected by, or arising out of pregnancy 
(a limitation) and provides self-confirmation as defined in Sec.  
1636.3(l)(4).\185\
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    \185\ A minor edit has been made to the final rule to correctly 
identify the items listed in Sec.  1636.3(j)(4) as ``modifications'' 
and not ``reasonable accommodations.'' As noted in the rule, these 
modifications will virtually always be determined to be reasonable 
accommodations that do not impose an undue hardship.
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Not Reasonable To Seek Supporting Documentation--Lactation
    The fourth example in the proposed rule regarding when it is not 
reasonable under the circumstances to seek documentation concerns 
lactation and pumping. A few comments noted that, as written, the 
example suggests it is not reasonable to seek additional supporting 
documentation, as opposed to making clear that no supporting 
documentation may be requested. The Commission has reworded this 
example for purposes of clarification, in the final rule, as explained 
below.
    Another comment noted that the example as written was overly broad 
because it prohibits an employer from asking for documentation anytime 
the requested accommodation relates to lactation. The comment noted 
that if, for example, an individual requests to work from home while 
breastfeeding or requests accommodations due to anxiety over a child's 
difficulties learning to bottle feed, the employer would be prohibited 
from seeking supporting documentation regarding such requested 
accommodations.
    The Commission agrees that the language in the proposed rule could 
be interpreted too broadly. The final rule makes clear that it is not 
reasonable under the circumstances for a covered entity to seek 
supporting documentation in response to a request for reasonable 
accommodations involving lactation and a time and/or place to pump at 
work or any other modification related to pumping at work. In response 
to comments raising questions regarding nursing during work hours, the 
final

[[Page 29134]]

rule also explains that when the regular location of the employee's 
workplace makes nursing during work hours a possibility because the 
child is in close proximity, it would not be reasonable to seek 
supporting documentation in response to a request for reasonable 
accommodations involving a time to nurse during work hours.\186\ This 
example does not extend, however, to accommodations involving lactation 
beyond these modifications. Thus, for example, if a lactating employee 
requests full-time remote work due to a condition that makes pumping 
difficult, it may be reasonable for the covered entity to seek 
reasonable documentation about the limitation and need for remote work, 
although it is not required to do so.
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    \186\ ``Nursing during work hours'' is where the regular 
location of the employee's workplace makes nursing during work hours 
a possibility because the child is in close proximity and could 
include, for example, when an employee who always teleworks from 
home has their child at home and takes a break to nurse the child, 
or when an employee takes a break to travel to a nearby or onsite 
daycare center to nurse.
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    The final rule is, therefore, modified to clarify that when the 
reasonable accommodation is related to a time and/or place to pump, or 
any other modification related to pumping at work, and the employee has 
provided self-confirmation as defined in paragraph (l)(4), it is not 
reasonable to request supporting documentation. Likewise, it would not 
be reasonable to seek documentation when the accommodation is related 
to a time to nurse when the regular location of the employee's 
workplace makes nursing during work hours a possibility because the 
child is in close proximity and the employee has provided self-
confirmation of the fact, as defined in paragraph (l)(4). The 
Commission has added information regarding nursing during work hours in 
the Interpretive Guidance in section 1636.3(l)(1)(iv)--Lactation and 
made other minor modifications.
Not Reasonable To Seek Supporting Documentation--Employer's Own 
Policies or Practices (New Sec.  1636.3(l)(1)(v))
    The final rule contains a new example of when it is not reasonable 
under the circumstances for the employer to seek supporting 
documentation. New Sec.  1636.3(l)(1)(v) states that seeking supporting 
documentation is not reasonable under the circumstances when the 
requested modification is one that employees without known limitations 
under the PWFA would receive pursuant to the employer's policy or 
practice without submitting supporting documentation. For example, if 
an employer has a policy or practice of only seeking supporting 
documentation for the use of leave if the leave is for 3 or more 
consecutive days, it would not be reasonable for the employer to seek 
supporting documentation from someone who needs leave due to a known 
limitation under the PWFA when they request leave for 2 or fewer 
days.\187\ The Commission has added information from this paragraph in 
the Interpretive Guidance in section 1636.3(l)(1)(v)--Employer's Own 
Policies or Practices.
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    \187\ Conversely, if regular employer practices would require 
documentation when the PWFA would not, or would require more 
documentation than the PWFA would allow, in a situation where the 
employee is requesting an accommodation under the PWFA, the PWFA 
restrictions on supporting documentation would apply.
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Comments and Response to Comments Regarding Self-Confirmation and 
Concerns About Fraudulent Requests
    Several comments requested that the Commission provide a definition 
of ``self-attestation.'' Others argued that, when it comes to pregnancy 
itself, self-attestation should always be sufficient to avoid deterring 
requests for accommodations, stigmatizing those who need accommodations 
due to pregnancy, or violating rights to privacy. Yet other comments 
agreed that self-attestation of pregnancy should usually be sufficient 
but suggested that the final rule allow requests for documentation when 
the employer has reason to believe that there is ``abuse.'' Some argued 
that self-attestation of pregnancy should only be adequate when the 
pregnancy is obvious and, in all other circumstances, documentation of 
pregnancy should be required. Still others suggested that, while self-
attestation was sufficient to establish pregnancy, employers should 
develop policies to address situations where they have reason to 
believe an employee who claimed to be pregnant is not being honest.
    The Commission agrees that a definition of ``self-attestation'' is 
necessary and also has determined that the word ``attestation'' 
suggests too formal a requirement. Instead, the final rule uses the 
term ``self-confirmation'' and provides a definition at Sec.  
1636.3(l)(4). As explained above, the final rule permits self-
confirmation of pregnancy when the pregnancy is obvious and at any 
stage in a pregnancy when the employee is requesting one of the 
modifications outlined in Sec.  1636.3(j)(4)(i) through (iv) due to 
pregnancy. When the reasonable accommodation is related to a time and/
or place to pump at work, a time to nurse during work hours (where the 
regular location of the employee's workplace makes nursing during work 
hours a possibility because the child is in close proximity), or any 
other modification related to pumping at work, the final rule permits 
self-confirmation of the fact that the employee is pumping at work or 
nursing during work hours.
    In addition to comments arguing that self-confirmation of pregnancy 
should not be allowed when an employer has ``reason to believe'' there 
is abuse, several comments expressed fear that limiting an employer's 
ability to seek supporting documentation will lead to fraudulent 
requests and prevent employers from punishing those who lie about 
limitations or the need for accommodations.
    In response, the Commission notes that the final regulation permits 
employers to seek supporting documentation when it is reasonable under 
the circumstances to determine that the employee has a physical or 
mental condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions (a limitation) and needs an 
adjustment or change at work due to the limitation. Moreover, the PWFA 
itself does not prohibit employers from taking disciplinary action 
against those who make false claims about limitations or the need for 
accommodations. The Commission urges covered entities to follow the 
advice of the comment proposing that employers should have clear 
policies in place regarding how to address fraud, dishonesty, and 
abuse. It is, of course, also the case that an employee may not be 
punished for seeking an accommodation even if it is ultimately 
determined that they are not entitled to one under the law.
    The Commission declines to implement the suggestion that the final 
rule include a provision stating it would not violate the PWFA's anti-
retaliation and anti-coercion provisions if a covered entity punished 
someone who falsely claimed to need a reasonable accommodation. The 
final rule, like the proposed rule, explains the requirements for 
establishing that a covered entity has retaliated against or coerced 
someone in violation of the PWFA. Moreover, it would not violate the 
PWFA to fail to provide an accommodation to an individual who failed to 
establish they were entitled to one, assuming the covered entity abided 
by the requirements and prohibitions of the PWFA. Of course, the 
Commission cautions that neither those seeking

[[Page 29135]]

accommodations under the PWFA nor those charged with responding to such 
requests may lie during their interactions.
Comments and Response to Comments Suggesting Other Frameworks for the 
Final Rule on Supporting Documentation
    Another documentation framework suggested by comments was that 
covered entities may seek supporting documentation except when: (1) the 
need for accommodation is obvious; and (2) the covered entity's 
requirement conflicts with their stated policy on non-pregnancy-related 
requests for accommodations. Another comment argued that while covered 
entities should not typically be able to seek supporting documentation, 
they should be able to do so if someone claims to be pregnant but never 
gives birth or supplies a birth certificate or is requesting 
accommodations for fertility treatments.
    The Commission declines to adopt either of these suggestions. The 
first suggestion appears to be a combination of the proposed rule's 
example of ``obvious'' conditions and an acknowledgment that employers 
already provide accommodations to employees in certain situations 
without seeking supporting documentation. The Commission declines to 
make this change, although the first example of when it would not be 
reasonable under the circumstances to seek documentation in the final 
rule is based on the ``obvious'' conditions and accommodations, as 
explained above.
    The Commission declines to make the changes in the other comment 
because it does not account for many situations, such as where an 
employer may need details about a lifting restriction or need for 
remote work during pregnancy or any type of limitation post-partum.

1636.3(l)(2) Reasonable Documentation

    The proposed rule explained that when it is reasonable under the 
circumstances to require supporting documentation to determine whether 
to grant the accommodation, the covered entity is permitted only to 
require ``reasonable documentation.'' The proposed rule defined 
``reasonable documentation'' as documentation that is sufficient to 
describe or confirm: (1) the physical or mental condition; (2) that it 
is related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions; and (3) that an adjustment or change at 
work is needed.
    Many comments argued that the definition of ``reasonable 
documentation'' should be revised to state that the documentation does 
not need to identify the nature of, or provide a detailed description 
of, the physical or mental condition that is the known limitation. 
These comments suggested that reasonable documentation be limited to 
documentation that: (1) confirms the individual has a limitation that 
is related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions, and (2) explains that a change at work is 
needed due to the limitation. Some comments expressed concern about 
protecting the privacy of employees and urged that ``reasonable 
documentation'' be limited to the ``minimum information'' necessary to 
assess the condition's nexus to pregnancy, childbirth, or a related 
medical condition. The comments noted, for example, that supporting 
documentation need not state that an employee has to attend a medical 
appointment related to a miscarriage, but can simply state that the 
employee needs to attend a medical appointment during work hours due to 
pregnancy, childbirth, or a related medical condition and thus needs a 
modified start time on a particular day; or the employee has a 
prohibition on lifting more than 50 pounds in connection with a 
condition related to pregnancy and thus needs an accommodation that 
eliminates the need to lift more than 50 pounds. In support of this 
suggestion, the comments explained that asking employees to disclose 
detailed medical information to their employers, especially information 
related to reproductive and mental health, which can be particularly 
sensitive or stigmatizing, may deter employees from seeking 
accommodations.\188\ Comments also noted that limiting reasonable 
documentation to confirming the related medical condition would help 
protect patient privacy, which the comments said could be especially 
important for employees obtaining abortions or facing intimate partner 
violence.
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    \188\ Although not directly on point, one comment suggested that 
allowing employers to request supporting documentation about an 
employee's anticipated or actual abortion, i.e., information about 
the specific condition that is the known limitation or the specific 
related medical condition, would potentially conflict with a 
proposed rule currently under consideration by the U.S. Department 
of Health and Human Services concerning the Health Insurance 
Portability and Accountability Act (HIPAA) and heightened 
confidentiality requirements for information related to reproductive 
health care. In response, the Commission notes that HIPAA applies to 
health care providers, employers are not required to obtain 
supporting documentation under the PWFA, and any such documentation 
must be kept confidential, as explained in the Interpretive Guidance 
in section 1636.7(a)(1) under Prohibition on Disability-Related 
Inquiries and Medical Examinations and Protection of Medical 
Information.
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    The Commission agrees that protecting patient privacy is an 
important goal and that covered entities should be limited to seeking 
the minimum documentation needed to determine if an employee is 
entitled to a reasonable accommodation under the PWFA. However, the 
Commission also recognizes that there may be situations when an 
employer needs documentation to determine whether the employee has a 
PWFA limitation and the adjustment or change at work is needed due to 
the limitation.
    To take account of these interests, the Commission made several 
changes to the definition of ``reasonable documentation.''
    First, the Commission modified the proposed definition of 
``reasonable documentation'' to clarify that reasonable documentation 
means ``the minimum that is sufficient,'' rather than merely stating 
that reasonable documentation means documentation that is 
``sufficient.''
    Second, because all that is required is the minimum documentation 
that is sufficient, the Commission has changed the language in the 
regulation to specify that the supporting documentation need only 
confirm (rather than ``describe or confirm'') the physical or mental 
condition. The Commission has included the language from Sec.  
1636.3(a)(2) in Sec.  1636.3(l)(2)(i) defining a physical or mental 
condition (i.e., an impediment or problem that may be modest, minor, 
and/or episodic; a need or a problem related to maintaining the 
employee's health or the health of the pregnancy; or an employee 
seeking health care related to pregnancy, childbirth, or a related 
medical condition itself). Finally, in the Interpretive Guidance in 
section 1636.3(l)(2) Reasonable Documentation, the Commission has 
explained that this confirmation can be accomplished through a simple 
statement and that it does not need to include a diagnosis.
    Third, again because all that is required is the minimum 
documentation that is sufficient, the Commission has changed the 
language in the regulation to specify that the supporting documentation 
need only confirm (rather than ``describe or confirm'') that the 
physical or mental condition is related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions and has 
explained in the Interpretive Guidance in section 1636.3(l)(2) 
Reasonable Documentation that pregnancy, childbirth, or related medical 
conditions

[[Page 29136]]

need not be the sole, the original, or a substantial cause of the 
physical or mental condition given that the statutory language only 
requires that physical or mental condition be ``related to, affected 
by, or arising out of'' ``pregnancy, childbirth, or related medical 
conditions.''
    Fourth, the final rule provides that the supporting documentation 
should describe (rather than ``describe or confirm'') the adjustment or 
change needed at work and has added that the adjustment or change 
needed at work must be ``due to the limitation'' in order to ensure 
that the documentation connects the physical or mental condition with 
the adjustment or change at work.
    In the Interpretive Guidance in section 1636.3(l)(2) Reasonable 
Documentation, the Commission has added information explaining how 
seeking more documentation than is set out in Sec.  1636.3(l) can 
violate 42 U.S.C. 2000gg-1(1) (Sec.  1636.4(a)(3)) (if the employer 
fails to provide the accommodation based on lack of documentation) and 
how seeking additional documentation or information beyond what is 
permitted in Sec.  1636.3(l) when an employee requests a reasonable 
accommodation may violate the PWFA's prohibitions on retaliation in 42 
U.S.C. 2000gg-2(f) (Sec.  1636.5(f)).\189\
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    \189\ The Commission has moved the examples that were in the 
proposed appendix (formerly Examples #36 and #37) to Sec.  
1636.5(f).
---------------------------------------------------------------------------

    The Commission also has added examples in the Interpretive Guidance 
in section 1636.3(l)(2) Reasonable Documentation to illustrate when 
documentation from a health care provider is sufficient.
    Generally, as explained in the Interpretive Guidance in section 
1636.3(l)(2) Reasonable Documentation, confirming the physical or 
mental condition requires only a simple statement that the physical or 
mental condition meets the first part of the definition of 
``limitation'' at Sec.  1636.3(a)(2) (i.e., the physical or mental 
condition is: an impediment or problem, including ones that are modest, 
minor, or episodic; a need or a problem related to maintaining the 
health of the employee or the pregnancy; or that the employee is 
seeking health care related to pregnancy, childbirth, or a related 
medical condition itself). Because the physical or mental condition can 
be something like fatigue or vomiting, there is no need for the 
statement to contain a medical diagnosis. Thus, as set out in the 
Interpretive Guidance in section 1636.3(l)(2) Reasonable Documentation, 
documentation is sufficient under Sec.  1636.3(l)(2) even if it does 
not contain a medical diagnosis, as long as it has a simple statement 
of the physical or mental condition.
    The physical or mental condition must be related to, affected by, 
or arising out of pregnancy, childbirth, or related medical conditions. 
The supporting documentation need not state that the pregnancy, 
childbirth, or related medical conditions are the sole, the original, 
or a substantial cause of the physical or mental condition at issue, 
because the statute only requires that the physical or mental condition 
be ``related to, affected by, or arising out of pregnancy, childbirth, 
or related medical conditions.'' If relevant, the documentation should 
include confirmation that the ``related medical condition'' is related 
to pregnancy or childbirth.
    The documentation should describe what adjustment or change at work 
is needed due to the limitation. The Interpretive Guidance in section 
1636.3(l)(2) Reasonable Documentation provides examples of these.
    Other comments pointed out that reasonable documentation should 
include information about the duration of the limitation. These 
comments observed that while some limitations may continue for the 
entire length of a pregnancy, the duration of other limitations, such 
as a postpartum limitation that requires leave, may be less definite. 
The comments also noted that the expected duration of the limitation 
and corresponding accommodation can be a key factor in determining 
whether the accommodation would impose an undue hardship, or whether an 
essential function(s) could be performed ``in the near future.'' The 
Commission generally agrees with this point but concludes that it would 
be more useful for covered entities to have information about the 
expected duration of the needed modification, rather than the duration 
of the limitation itself. The Commission also believes including 
information about the duration of the modification could address 
concerns other comments raised about the need for periodic updates of 
documentation. If, for example, supporting documentation indicates that 
a pregnant employee would need an hour of leave every morning due to 
morning sickness for the first 3 months of the pregnancy, the employer 
would be permitted to request updated documentation at the end of those 
3 months if the employee requested that the accommodation continue. 
Thus, the Interpretive Guidance states that an estimate of the expected 
duration of the modification may be part of the supporting 
documentation sought by the employer, if necessary.\190\
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    \190\ The Commission is aware of case law under the ADA 
indicating that, when determining whether the reasonable 
accommodation of leave will enable an employee to perform the 
essential functions of a position ``in the near future,'' the focus 
should be on the expected duration of the impairment, as opposed to 
the expected duration of the needed leave. See, e.g., Punt v. Kelly 
Servs., 862 F.3d 1040, 1051 (10th Cir. 2017); Aubrey v. Koppes, 975 
F.3d 995, 1010-11 (10th Cir. 2020); Herrmann, 21 F.4th at 676-77. In 
those cases, courts appear to be concerned about situations where 
the end of the leave and the ability to return to work are not 
coterminous. Because many accommodations under the PWFA will be for 
temporary conditions, the Commission expects that this issue will 
not arise with frequency. For example, if an employee needs an 
essential function temporarily suspended until the end of their 
pregnancy, the end of the suspension and the end of their pregnancy 
are the same time. The Commission also is concerned that using the 
duration of the limitation could lead to inaccurate information. An 
employee may, for example, have a limitation that will last for an 
entire pregnancy, such as an inability to be around certain 
chemicals, but only needs a change at work for the 2-month period 
during which the job in question involves proximity to those 
chemicals.
---------------------------------------------------------------------------

    Numerous comments argued that covered entities may not require 
employees to use a specific form for supporting documentation, as long 
as the necessary information is provided. These and other comments also 
expressed concern about employers who require employees seeking 
accommodations under the PWFA to submit specific forms that call for 
extensive medical information. One comment submitted, as attachments, 
several examples of forms that employees requesting accommodations 
under the PWFA have been required to use. These forms require 
information beyond the description of ``reasonable documentation'' 
presented in the proposed rule and adopted by this final rule. The 
forms submitted sought extensive information, including: whether the 
individual had previously requested an accommodation; validation that 
the individual could perform a long list of essential functions, 
irrespective of the accommodation being requested; identification of 
any diagnoses, impairments, or conditions that might affect the 
individual's ability to perform essential job functions or major life 
activities; description of side effects of any treatment received; the 
length of time the impairment or condition had been treated; the 
expected duration of each impairment or condition; and whether the 
health care practitioner considered the condition in question to be a 
disability. The comments also noted that some covered entities reject 
supporting documentation based on

[[Page 29137]]

technical issues, such as use of the wrong form.
    Other comments argued that instead of prohibiting the use of 
specific forms to request documentation, the final rule should create a 
PWFA certification form, similar to the FMLA certification form, that 
covered entities could use to request documentation and that would 
provide what comments called a ``safe harbor.''
    The final rule provides that when a covered entity is permitted to 
seek supporting documentation under this rule, it may not require that 
supporting documentation be submitted on a specific form. This is 
consistent with similar rules under the FMLA \191\ and the ADA \192\ 
and recognizes that although employers may seek supporting 
documentation, they should not burden employees or health care 
providers with unnecessary technical requirements in their efforts to 
obtain the information.
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    \191\ See U.S. Dep't of Lab., Wage & Hour Division, The 
Employer's Guide to the Family and Medical Leave Act 32, https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/employerguide.pdf 
(last visited Mar. 18, 2024) (``The employer must accept a complete 
and sufficient medical certification, regardless of the format. The 
employer cannot reject a medical certification that contains all the 
information needed to determine if the leave is FMLA-qualifying.'').
    \192\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 111, at Question 6 (explaining that employers may only 
request reasonable documentation).
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    Finally, the final rule does not include a ``PWFA certification 
form.'' Covered entities should comply with the PWFA's rule on 
supporting documentation by only seeking supporting documentation when 
it is reasonable under the circumstances and, in those cases, 
requesting only reasonable documentation, as defined in the final rule. 
The Commission fears that designing a PWFA certification form will 
create an assumption that supporting documentation is necessary in 
every case. It is not, and indeed it is barred in many circumstances. 
Employers are not required to obtain documentation for any reasonable 
accommodation under the PWFA and are encouraged to minimize 
documentation burdens on employees seeking accommodation under the PWFA 
whenever possible.
    The final rule therefore states, at new Sec.  1636.3(l)(2)(i), that 
when it is reasonable under the circumstances, as established in 
paragraph (l)(1), to seek supporting documentation, the covered entity 
is limited to seeking reasonable documentation. Reasonable 
documentation means the minimum that is sufficient to: (A) confirm the 
physical or mental condition (i.e., an impediment or problem that may 
be modest, minor, and/or episodic; a need or a problem related to 
maintaining the employee's health or the health of the pregnancy; or an 
employee seeking health care related to pregnancy, childbirth, or a 
related medical condition itself) whether or not such condition meets 
the definition of disability specified in the ADA; (B) confirm that the 
physical or mental condition is related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions (together with 
paragraph (l)(2)(i)(A), ``a limitation''); and (C) describe the 
adjustment or change at work that is needed due to the limitation.
    Furthermore, new Sec.  1636.3(l)(2)(ii) states that covered 
entities may not require that supporting documentation be submitted on 
a specific form.

1636.3(l)(3) Limitations on a Covered Entity Seeking Supporting 
Documentation From a Health Care Provider

    The proposed rule explained that if a covered entity decides to 
seek supporting documentation and meets the requirements set forth in 
the rule, the covered entity may require that the reasonable 
documentation come from a health care provider. Comments suggested one 
additional type of health care provider, an industrial hygienist, and 
also questioned whether ``doula'' should be included. The Commission 
has added ``industrial hygienist'' to the list and has moved the 
reference to ``doula'' to a place on the list closer to health care 
providers who offer similar services. Many comments also recommended 
that the Commission affirmatively state that the health care provider 
could be one that provides services through telehealth; the Commission 
has made that addition in the regulation. The final rule also slightly 
reorders the listed health care providers so that those focused on 
mental health care are listed together, adds ``psychiatrist,'' which 
was unintentionally left out of the proposed list, and changes the term 
``providers'' in ``mental health care providers'' to ``professionals,'' 
to parallel the term used in the Commission's ADA policy guidance.\193\
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    \193\ See id.
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    Some comments focused on the first part of the proposed rule's list 
of health care providers, i.e., ``A covered entity may require 
documentation comes from an appropriate health care provider, in a 
particular situation,'' and suggested that the words ``appropriate'' 
and ``in a particular situation'' be removed in the final rule. The 
comments argued that these words give covered entities unnecessary 
power over the type of health care provider an employee should visit. 
The Commission concludes that these qualifiers are unnecessary and that 
it should be up to the employee seeking care and the health care 
provider providing care to determine what type of health care provider 
can best serve the person's needs. The final rule therefore removes 
these words.
    Other comments suggested that the final rule make clear that the 
treating physician does not need to be the one to provide the 
reasonable documentation, pointing to privacy concerns in relation to 
certain kinds of medical care; these comments cited the example of 
abortion care. The comments stated that a health care provider familiar 
with the employee's circumstances should be allowed to provide the 
necessary information even if they are not the person treating the 
condition in question. As noted above, when an employer is permitted to 
seek supporting documentation, they are only permitted to seek 
reasonable documentation, which means the minimum that is sufficient 
to: (A) confirm the physical or mental condition (i.e., an impediment 
or problem that may be modest, minor, and/or episodic; a need or a 
problem related to maintaining the employee's health or the health of 
the pregnancy; or an employee seeking health care related to pregnancy, 
childbirth, or a related medical condition itself) whether or not such 
condition meets the definition of disability specified in the ADA; (B) 
confirm that the physical or mental condition is related to, affected 
by, or arising out of pregnancy, childbirth, or related medical 
conditions (together with paragraph (l)(2)(i)(A), ``a limitation''); 
and (C) describe the adjustment or change at work that is needed due to 
the limitation. Any health care provider familiar enough with the 
individual's circumstances to provide the described information may do 
so under the final rule, whether or not they are treating the 
individual for the condition at issue.
Comments and Response to Comments Regarding Prohibition on Examinations 
by Employer's Health Care Provider
    The NPRM stated that it is not practical or necessary for a covered 
entity to request or require that an employee be examined by a health 
care provider of the covered entity's choosing.

[[Page 29138]]

    Most of the comments on this proposal agreed that covered entities 
should never be able to require individuals requesting accommodation 
under the PWFA to be examined by a health care provider of the covered 
entity's choosing. Comments explained that this would cause an 
unnecessary invasion of privacy, have a chilling effect, burden 
employees unnecessarily, and cause delay. Some comments noted that such 
a requirement would have a particularly negative effect on individuals 
seeking abortion care and women of color who face racism in health care 
and may be particularly reluctant to go to a new provider selected by 
their employer. A few comments disagreed with the proposed rule, noting 
that second opinions should be permitted since they are permitted under 
the FMLA, that some employees may not have a doctor, and/or that 
employers who do not want to provide the accommodation supported by the 
employee's doctor will need to seek the opinion of their own doctor.
    The final rule prohibits covered entities from requiring that an 
employee be examined by a health care provider of the covered entity's 
choosing. Although such a practice is allowed in certain cases under 
the ADA and the FMLA, even under those laws the practice is 
limited.\194\ The PWFA covers many common physical or mental conditions 
for which there will never be a need for a medical diagnosis, and 
accommodations under the PWFA will usually be temporary. This supports 
a final rule under the PWFA that prohibits examinations by the 
employer's health care provider, even in the limited situations in 
which the practice is permitted under the ADA.
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    \194\ Under the FMLA, an employer can only require a second 
opinion (at the employer's expense) if it has ``reason to doubt the 
validity of a medical certification.'' 29 CFR 825.307(b). The 
employer can choose the health care provider to provide the second 
opinion but generally may not select a health care provider that it 
employs or contracts with on a regular basis. For the third opinion 
(also at the employer's expense), if one is sought, the health care 
provider must be jointly designated or approved by the employer and 
the employee. 29 CFR 825.307(c). Under the ADA, the practice is 
allowed only if the individual provides insufficient information 
from their own health care provider and, even in those 
circumstances, ADA guidance explains that the employer should 
explain why the documentation is insufficient and allow the 
individual an opportunity to provide the missing information in a 
timely manner. The ADA also requires the employer to pay all costs 
associated with the visit and requires that the examination be 
limited to determining the existence of an ADA disability and the 
functional limitations that require reasonable accommodation. See 
Enforcement Guidance on Reasonable Accommodation, supra note 111, at 
Question 7.
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    The final rule, for these reasons and to avoid the chilling effect, 
burdens, and potential delays outlined in the comments, states that a 
covered entity may not require that the employee seeking the 
accommodation be examined by a health care provider selected by the 
covered entity.

1636.3(l)(4) Formerly Proposed Confidentiality/New Final Self-
Confirmation of Pregnancy or Lactation

    As explained supra in the preamble in section 1636.3(l)(1) Seeking 
Supporting Documentation Only When Reasonable Under the Circumstances, 
the final rule at Sec.  1636.3(l)(4) provides a definition for self-
confirmation of pregnancy or lactation. The corresponding section in 
the Interpretive Guidance, 1636.3(l)(4) Self-Confirmation of Pregnancy 
or Lactation, explains how this is a simple procedure that can occur in 
the same conversation where the employee requests an accommodation.
    The proposed rule, Sec.  1636.3(l)(4), and the corresponding 
discussion in the proposed appendix, described the ADA's prohibition on 
disclosure of confidential medical information, including medical 
information obtained under the PWFA. Because these legal protections 
arise from the ADA and not the PWFA, the Commission removed reference 
to them in the PWFA regulation itself. The relevant protections are now 
described in the Interpretive Guidance in section 1636.7(a)(1) under 
Prohibition on Disability-Related Inquiries and Medical Examinations 
and Protection of Medical Information. This section explains, as did 
the NPRM, that while the PWFA does not have its own provision requiring 
the protection of medical information, employees covered by the PWFA 
also are covered by the ADA, and, under the ADA, covered entities are 
required to keep medical information confidential, with limited 
exceptions.\195\ The NPRM also stated that intentional disclosure of 
medical information obtained through the PWFA's reasonable 
accommodation process may violate the PWFA's prohibition on retaliation 
and/or coercion.\196\ Information regarding how the disclosure of 
medical information also may violate the retaliation provision of the 
PWFA is in the Interpretive Guidance in section 1636.5(f) under 
Possible Violations of 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) Based on 
Seeking Supporting Documentation During the Reasonable Accommodation 
Process and Disclosure of Medical Information.
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    \195\ 88 FR 54738, 54789.
    \196\ Id. at 54744, 54789, 54793.
---------------------------------------------------------------------------

1636.4 Formerly Proposed Prohibited Practices/New Final 
Nondiscrimination With Regard to Reasonable Accommodations Related to 
Pregnancy

    The Commission changed the title of Sec.  1636.4 in the regulation 
and the corresponding section of the Interpretive Guidance to match the 
title of this section in the statute.

1636.4(a) Failing To Provide Reasonable Accommodation

    The Commission did not receive comments suggesting changes to Sec.  
1636.4(a). The Commission made only one minor change to that part of 
the regulation, to change the terminology used there (and throughout 
the preamble, regulation, and Interpretive Guidance) from ``denial'' of 
reasonable accommodation to ``failure to provide'' reasonable 
accommodation. This better reflects the language in 42 U.S.C. 2000gg-
1(1), which makes it ``an unlawful employment practice for a covered 
entity to'' ``not make reasonable accommodations.'' Throughout the 
preamble, regulation, and the Interpretive Guidance, the Commission 
uses ``failure to provide a reasonable accommodation'' and ``not make 
reasonable accommodation'' interchangeably. In Sec.  1636.4(a)(1) 
through (4) in the regulation, in addition to the changes described 
below, the Commission has added language to the effect that these 
sections apply to ``qualified employees'' with ``known limitations 
related to pregnancy, childbirth, or related medical conditions'' so 
that they use the same language as 42 U.S.C. 2000gg-1(1) and Sec.  
1636.4(a).

1636.4(a)(1) Formerly Proposed Unnecessary Delay in Responding to a 
Request for Reasonable Accommodation/New Final Unnecessary Delay in 
Providing a Reasonable Accommodation

    The Commission received several comments regarding the importance 
of making delay in the provision of a reasonable accommodation 
actionable.
    First, numerous comments recommended that the Commission clarify 
that ``unnecessary delay in responding to the request for a reasonable 
accommodation'' (the language in Sec.  1636.4(a)(1) in the proposed 
rule) would cover delay in all parts of the reasonable accommodation 
process, including delay in responding to the initial request, engaging 
in the interactive process, or providing the reasonable accommodation. 
The Commission agrees that the intent of the phrase ``delay in 
responding to the

[[Page 29139]]

request for a reasonable accommodation'' encompasses delay in any part 
of the reasonable accommodation process. To clarify this point, the 
Commission has changed the language in the rule to ``unnecessary delay 
in providing a reasonable accommodation,'' has changed the title of 
this provision in the Interpretive Guidance in section to 1636.4(a)(1) 
Unnecessary Delay in Providing a Reasonable Accommodation and has added 
examples of the different ways this could manifest in the Interpretive 
Guidance for this section.
    Second, one comment recommended clarifying that a delay by a third-
party administrator acting for the covered entity is attributable to 
the covered entity. The Commission agrees and has added that 
information in the Interpretive Guidance in section 1636.4(a)(1) 
Unnecessary Delay in Providing a Reasonable Accommodation.
    Third, numerous comments suggested adding that the ``urgency'' of 
the need for the accommodation be included as a factor, to account for 
situations where the need for the accommodation is an emergency. The 
Commission declines to add this as a factor because defining 
``urgency'' would be difficult and could lead to unnecessary litigation 
regarding whether or not something was ``urgent.'' However, the 
Commission has added information regarding emergencies in the 
Interpretive Guidance in section 1636.3(k) under Engaging in the 
Interactive Process.
    Numerous comments also suggested removing the factor in paragraph 
(a)(1)(vi) of the proposed rule (the factor in paragraph (a)(1)(vii) of 
the final rule), which provides that delay in providing a reasonable 
accommodation is more likely to be excused where an interim reasonable 
accommodation is offered and that the interim reasonable accommodation 
cannot be leave, unless certain circumstances apply. Comments argued 
that the factor in paragraph (a)(1)(vi) of the proposed rule could 
encourage covered entities to rely on interim accommodations and engage 
in delay. The Commission recognizes this risk, but, given the numerous 
comments that argued in favor of requiring employers to provide interim 
reasonable accommodations, the Commission believes that creating an 
incentive for the provision of interim reasonable accommodations is 
important. Responding to the comments, the Commission has limited the 
use of leave to excuse an unnecessary delay to the situations where an 
employee requests or selects leave as an interim reasonable 
accommodation. The Commission also has removed the sentence, ``[i]f an 
interim reasonable accommodation is offered, delay by the covered 
entity is more likely to be excused'' from proposed Sec.  
1636.4(a)(1)(vi) (now Sec.  1636.4(a)(1)(vii)). The language in Sec.  
1636.4(a)(1) stating that these are factors to be considered in 
determining whether there has been unnecessary delay already explains 
this concept.
    The Commission has included an additional factor for determining 
whether delay is unnecessary--how long the accommodation may be 
required. This factor accounts for situations where the accommodation 
is a short-term matter, and, by unnecessarily delaying the response, 
the covered entity, in effect, fails to provide the accommodation. This 
factor is in keeping with the discussion of delay in the NPRM, which 
noted that ``[g]iven that pregnancy-related limitations are frequently 
temporary, a delay in providing an accommodation may mean that the 
period necessitating the accommodation could pass without action simply 
because of the delay.'' \197\
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    \197\ 88 FR 54739, 54789.
---------------------------------------------------------------------------

1636.4(a)(2) Refusing an Accommodation

    The Commission received a few comments regarding Sec.  
1636.4(a)(2), which provides that a qualified employee does not have to 
accept an accommodation. If the employee cannot perform the essential 
functions of the position without the accommodation, the employee is 
not qualified. The proposed rule required employers also to consider 
whether the employee could be qualified with the temporary suspension 
of an essential function(s). The comments stated that the proposed rule 
created a situation where the employee could refuse the reasonable 
accommodation that allowed them to perform the essential functions of 
the position because the employee would prefer an accommodation that 
allowed them to suspend an essential function(s) and this, in effect, 
would remove the employer's ``ultimate discretion'' in choosing between 
effective accommodations. In order to address this issue, the 
Commission changed this paragraph in the final regulation so that it 
does not give the impression that an employee can reject a reasonable 
accommodation that allows them to do the essential function(s) of their 
position in order to have an essential function(s) of the position 
temporarily suspended.

1636.4(a)(3) Covered Entity Failing To Provide a Reasonable 
Accommodation Due to Lack of Supporting Documentation

    The Commission has made four changes to this section of the 
regulation in order to make it align with Sec.  1636.3(l), the 
provision regarding the limits on supporting documentation, and has 
reflected these changes in the Interpretive Guidance in section 
1636.4(a)(3) Covered Entity Failing To Provide a Reasonable 
Accommodation Due to Lack of Supporting Documentation. First, the 
Commission has added as Sec.  1636.4(a)(3)(i) that the covered entity 
must have sought the supporting documentation. The Commission has 
maintained as Sec.  1636.4(a)(3)(ii) that seeking supporting 
documentation must be reasonable under the circumstances as set out in 
Sec.  1636.3(l)(1). Second, the Commission has added at Sec.  
1636.4(a)(3)(iii) that the supporting documentation sought must be 
``reasonable documentation'' as defined by Sec.  1636.3(l)(2). Third, 
the Commission has added at Sec.  1636.4(a)(3)(iv) that the employer 
must provide the employee sufficient time to obtain and provide the 
supporting documentation. Fourth, the Commission has added the word 
``unnecessary'' before the word ``delay'' because an employer only has 
to justify unnecessary delay.
    Finally, the Commission has reformatted this section to indicate 
the different requirements.

1636.4(a)(4) Choosing Among Possible Accommodations

    The Commission received several comments about this provision. 
These comments pointed out that ``similarly situated'' is a term that 
courts have narrowly construed and that its use here could impede 
ensuring that employees receive the accommodations that provide equal 
opportunity. Some comments suggested adding that equal employment 
opportunity can be determined based on evidence of the opportunities 
that would have been available to the employee had they not identified 
a known limitation or sought an accommodation.
    The Commission agrees that modifications should be made in this 
section to protect qualified employees and to minimize the need for 
litigation. Thus, the regulation provides that the ``average employee'' 
who is ``similarly situated'' without a known limitation can include 
the qualified employee themselves, and the Interpretive Guidance in 
section 1636.4(a)(4) Choosing Among Possible

[[Page 29140]]

Accommodations contains additional information regarding evidence about 
possible comparators. Other comments suggested adding that the 
similarly situated employees should be similar in material respects, 
not all respects; the Commission agrees that this is true for similarly 
situated employees in general but did not add this concept to the 
regulation.
    The Commission also received some comments recommending the 
addition of another standard, requiring employers to choose an option 
that most effectively meets the employee's needs and provides the 
employee with equal employment opportunity. The Commission declines to 
make this change. Employers must provide an accommodation that is 
effective. The employer does not have to provide the ``most effective'' 
accommodation or the accommodation that is the choice of the qualified 
employee. The Commission also received a comment recommending that the 
Commission add a provision to the rule stating that employers may not 
select any accommodation that negatively affects an employee's terms or 
conditions of employment at any time. The Commission did not add this 
because adopting a requirement that employers may not select an 
accommodation that ``negatively affects'' terms or conditions would be 
a new standard, and the general concept of this comment is covered by 
the provision requiring equal employment opportunity.
    One comment suggested an employer should provide the employee with 
a choice of options that are responsive to the employee's needs and 
allow the employee to choose from the options. This comment asserted 
that doing so would decrease litigation for the employer. While the 
Commission agrees that this is a best practice and may help the covered 
entity avoid litigation, the Commission did not add this idea to the 
regulation or the Interpretive Guidance.
    Finally, the Commission reordered the sentences in this provision 
in the regulation and removed the phrase ``that do not cause an undue 
hardship'' from this section of the regulation because it is redundant. 
The covered entity does not have to provide an accommodation that 
causes an undue hardship.

1636.4(b) Requiring a Qualified Employee To Accept an Accommodation

    The Commission received a few comments regarding this provision. 
One comment argued that the interactive process is not always 
necessary. The Commission agrees that for some simple accommodations, 
the interactive process can be a very quick conversation where the 
employee provides information to the covered entity and the covered 
entity provides the accommodation. However, covered entities may not 
require a qualified employee to accept an accommodation other than one 
arrived at through the interactive process under 42 U.S.C. 2000gg-1(2). 
Thus, employers should not provide employees with an accommodation 
because the covered entity thinks the accommodation is ``obvious.'' 
Rather, the covered entity should engage the employee in the 
interactive process, even if it is very abbreviated.
    The Commission received a few comments suggesting changes to the 
description of damages that could be available in Example #39 in the 
proposed rule. The Commission agrees that the damages suggested by the 
comments could be available and has made changes to the example, which 
is now Example #57 in the Interpretive Guidance in section 1636.4(b) 
Requiring a Qualified Employee To Accept an Accommodation.

1636.4(c) Denying Opportunities to Qualified Employees

    The Commission did not receive comments regarding this provision. 
The Commission maintained the language from the proposed rule for this 
provision. The Commission also has made minor changes in the 
Interpretive Guidance in section 1636.4(c) Denying Opportunities to 
Qualified Employees for this provision.

1636.4(d) Requiring a Qualified Employee To Take Leave

    The Commission maintained the language from the proposed rule for 
this provision. The Commission also has made minor changes in the 
Interpretive Guidance in section 1636.4(d) Requiring a Qualified 
Employee To Take Leave for this provision.
    Some comments involving this section raised questions about whether 
an employer may temporarily require the employee to take leave in 
situations when the employee cannot work without an accommodation. The 
Commission has responded to these comments in the preamble in section 
1636.3(h) under Interim Reasonable Accommodations. Other comments 
expressed concerns that this provision would prohibit an employee from 
requesting leave as a reasonable accommodation. As explained in the 
proposed rule, the proposed appendix, and the Interpretive Guidance in 
section 1636.4(d) Requiring a Qualified Employee To Take Leave, this is 
incorrect--the prohibition on requiring a qualified employee to take 
leave does not prohibit an employee from requesting leave as a 
reasonable accommodation.

1636.4(e) Adverse Action on Account of Requesting or Using a Reasonable 
Accommodation

    The Commission received a few comments regarding the definition of 
``adverse action,'' including comments that disagreed with the 
Commission's definition and instead recommended using the definition of 
``adverse employment action''; comments that suggested that the 
Commission include its proposed definition in the regulation itself; 
and a few comments agreeing with its definition of ``terms, conditions, 
or privileges of employment.''
    The Commission disagrees that ``adverse action in terms, 
conditions, or privileges of employment'' should have the same meaning 
as courts have given the term ``adverse employment action.'' Given the 
divergent views of the circuits at the time of this writing, adopting 
the definition of ``adverse employment action'' in interpreting 42 
U.S.C. 2000gg-1(5) would lead to different outcomes in different 
circuits and could reduce protections for employees covered by the 
PWFA.\198\
---------------------------------------------------------------------------

    \198\ Compare, e.g., Muldrow v. City of St. Louis, 30 F.4th 680 
(8th Cir. 2022) (concluding that a transfer is not an adverse 
employment action absent materially significant disadvantage), cert. 
granted in part, 143 S. Ct. 2686 (2023), with Threat v. City of 
Cleveland, 6 F.4th 672, 678-79 (6th Cir. 2021) (concluding that an 
``adverse employment action'' may include shift changes and 
reassignments).
---------------------------------------------------------------------------

    The Commission has retained the language in the proposed 
regulation, as well as the language from the proposed appendix, with 
minor changes. Specifically, the Commission has removed language from 
the proposed appendix about this standard not appearing in Title VII or 
the ADA, and the reference to the basic dictionary definition 
``adverse,'' because it has determined that this information is not 
necessary to the explanation of this provision. The Commission also has 
reorganized the paragraphs in the Interpretive Guidance in section 
1636.4(e) Adverse Action on Account of Requesting or Using a Reasonable 
Accommodation and made a few minor edits to the examples for this 
section. The Commission has added language to Example #58 in section 
1636.4(e) Adverse Action on Account of Requesting or Using a Reasonable 
Accommodation (proposed Example #40) to clarify that when an employee 
receives leave as a reasonable accommodation, production standards such 
as sales quotas may need to be

[[Page 29141]]

prorated to ensure that leave is an effective accommodation, as 
discussed infra in the Interpretive Guidance in section 1636.3(h) under 
Ensuring That Employees Are Not Penalized for Using Reasonable 
Accommodations.

1636.5 Remedies and Enforcement

    Some comments expressed general concerns regarding enforcement, 
including a concern that employees would find it too difficult to 
enforce their rights under the law, a suggestion that the Commission 
find a way to enforce the law quickly, and a recommendation that the 
Commission create a safe harbor for small businesses that would allow 
businesses with 15 to 50 employees the opportunity to fix a violation 
once it was brought to their attention and that would permit a finding 
of liability only following repeated or willful violations.
    The Commission agrees that it is important that employees be able 
to enforce their rights; to that end, the Commission conducts outreach 
with employees on a regular basis. The Commission shares the desire for 
expeditious compliance; this regulation is one step in furtherance of 
that goal. The Commission conducts significant outreach to small 
businesses to help them with compliance; employers can obtain more 
information about these opportunities at: https://www.eeoc.gov/employers/small-business. Finally, the Commission does not have the 
authority to create an exemption for small employers; however, the 
Commission notes that damages in cases regarding the provision of a 
reasonable accommodation can be limited by the employer's good-faith 
efforts.\199\
---------------------------------------------------------------------------

    \199\ 42 U.S.C. 2000gg-2(g).
---------------------------------------------------------------------------

    In the final rule, the Commission has removed section Sec.  
1636.5(b) because it applies to employees protected by the 
Congressional Accountability Act. Throughout this section of this 
regulation, the Commission has replaced references to ``this section'' 
with ``the PWFA'' to clarify that the powers, remedies, and procedures 
referenced in this section are provided by the statute itself.

1636.5(a) Remedies and Enforcement Under Title VII

    The final rule at Sec.  1636.5(a) is the same as the proposed rule. 
The Commission has added information in the Interpretive Guidance in 
section 1636.5(a) Remedies and Enforcement Under Title VII to inform 
employees and covered entities regarding the time limit for filing 
charges under the PWFA, based on how the Commission enforces other 
statutes for which it is responsible.

1636.5(e) Remedies and Enforcement Under Section 717 of the Civil 
Rights Act of 1964

    In the Interpretive Guidance in section 1636.5(e) Remedies and 
Enforcement Under Section 717 of the Civil Rights Act of 1964, the 
Commission has added information from the NPRM regarding the 
application of Sec.  1636.5(e).\200\
---------------------------------------------------------------------------

    \200\ 88 FR 54742.
---------------------------------------------------------------------------

Damages
    In the Interpretive Guidance in section 1636.5 under Damages, the 
Commission has added information regarding the damages available under 
the PWFA pursuant to 1977A of the Revised Statutes of the United 
States, 42 U.S.C. 1981a.

1636.5(f)(1) and (2) Prohibition Against Retaliation

    The Commission received some comments regarding the prohibitions on 
retaliation and coercion.
    First, one comment questioned whether the regulation's prohibition 
of an employer seeking documentation when it is not reasonable to do so 
would create a new standard for retaliation that does not require 
intent; it does not. To minimize any misunderstanding and provide a 
fuller explanation of when going beyond the regulatory limits on 
seeking supporting documentation set out in Sec.  1636.3(l) may violate 
42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)), the Commission removed 
proposed rule Sec.  1636.5(f)(1)(iv) and (v) and proposed rule Sec.  
1636.5(f)(2)(iv) and (v) and, instead, explained the interaction 
between the limitations on supporting documentation and the PWFA's 
retaliation provision in detail in the Interpretive Guidance in section 
1636.5(f) Prohibition Against Retaliation.
    Second, as part of these changes, the Commission has created a new 
section in the Interpretive Guidance in section 1636.5(f) entitled 
Possible Violations of 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) Based on 
Seeking Supporting Documentation During the Reasonable Accommodation 
Process and Disclosure of Medical Information and has moved the 
explanation of how seeking supporting documentation or disclosing 
medical information may violate 42 U.S.C. 2000gg-2(f) to this section. 
The Commission also has added an additional example regarding the 
unauthorized disclosure of medical information to the examples of 
retaliation in the Interpretive Guidance in section 1636.5(f) 
Prohibition Against Retaliation.
    Third, the Commission removed language that a request for a 
reasonable accommodation constitutes ``protected activity'' in the 
coercion section of the regulation, at proposed rule Sec.  
1636.5(f)(2)(ii), because ``protected activity'' is not a phrase used 
in the analysis of coercion claims.
    The Commission received several comments requesting additional 
examples involving the prohibition on retaliation. The Commission 
agrees that more examples could be helpful and has included a few more 
in the Interpretive Guidance in section 1636.5(f) Prohibition Against 
Retaliation, including some related to requests for supporting 
documentation. Other comments suggested edits to certain examples in 
the proposal, and the Commission incorporated some of those 
modifications. For example, in addition to adding descriptive titles to 
the examples in this section, the Commission has added facts to certain 
examples to strengthen the connection between the covered entity's 
actions and the protected activity. The Commission added explanations 
to clarify how certain actions that may violate this provision of the 
PWFA, also may violate 42 U.S.C. 2000gg-1(1) (because these actions may 
make the accommodation ineffective) and 2000gg-1(5) (prohibiting 
adverse actions), rather than merely including the relevant statutory 
citation.
    The Commission also has included in the Interpretive Guidance in 
section 1636.5(f) Prohibition Against Retaliation additional 
information about retaliation and coercion from its Enforcement 
Guidance on Retaliation and Related Issues so that this information is 
more easily accessible.
    One comment requested that information regarding neutral work 
rules, such as fixed leave policies, be moved from the Interpretive 
Guidance to the regulation. The Commission declines to make this change 
but has added examples regarding this type of policy to the 
Interpretive Guidance in section 1636.5(f) Prohibition Against 
Retaliation.
    The Commission received a few comments expressing concern that 
mission statements, statements regarding religious beliefs of an 
employer, or statements in employee handbooks would be seen as 
violating Sec.  1636.5(f)(2). Whether a statement violates 42 U.S.C. 
2000gg-2(f)(2) will depend on the language of the statement, but, as 
the examples provided in the NPRM and the final rule

[[Page 29142]]

for this provision show, the making of general statements regarding an 
employer's mission or religious beliefs is not the type of conduct that 
the Commission previously has determined would be prohibited by this 
provision.\201\
---------------------------------------------------------------------------

    \201\ Certain types of employer statements or policies, of 
course, may violate 42 U.S.C. 2000gg-2(f). Cf. EEOC v. Morgan 
Stanley & Co., Inc., No. 01-CIV-8421-RMBRLE, 2002 WL 31108179, at *2 
(S.D.N.Y. Sept. 20, 2002) (finding that the portion of the 
employer's code of conduct that required employees to notify the 
employer before contacting a governmental or regulatory body 
violated public policy because it chilled employee communications 
with the EEOC).
---------------------------------------------------------------------------

    Additionally, the Commission made minor changes to Sec.  1636.5(f). 
The proposed rule at Sec.  1636.5(f)(1) referred to ``employee, 
applicant, or former employee'' and ``individual'' to refer to this 
group; the final rule uses only ``employee'' as that is the language in 
the statute. The removal of the words ``applicant'' and ``former 
employee'' and ``individual'' is a minor change. The statute at 42 
U.S.C. 2000gg(3) provides that ``employee'' in the statute includes 
``applicant''; the same is true for the regulation and the Interpretive 
Guidance. The statute at 42 U.S.C. 2000gg(3)(A) refers to the Title VII 
definition of employee; that definition includes former employees when 
relevant.\202\ Finally, the proposed rule in Sec.  1636.5(f)(2) used 
the word ``because''; this has been changed to ``on account of'' to 
match the statute.
---------------------------------------------------------------------------

    \202\ See supra note 6.
---------------------------------------------------------------------------

1636.5(g) Limitation on Monetary Damages

    Several comments recommended that the Commission clarify that the 
good faith defense to money damages is limited to damages for a covered 
entity's failure to make reasonable accommodations under 42 U.S.C. 
2000gg-1(1) (Sec.  1636.4(a)) only. The Commission agrees that this 
clarification would be helpful and has added it to the Interpretive 
Guidance in section 1636.5(g) Limitation on Monetary Damages.

1636.6 Waiver of State Immunity

    A few comments recommended that the Commission either exempt State 
employers from the PWFA or create exceptions in the PWFA for certain 
State laws to provide States greater protection from the PWFA. The 
Commission declines to make these changes. The statute at 42 U.S.C. 
2000gg-4 provides that ``A State shall not be immune under the 11th 
Amendment to the Constitution from an action in a Federal or State 
court of competent jurisdiction for a violation of [the PWFA].'' A 
decision by the Commission to modify this waiver would be in violation 
of the statute.\203\
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    \203\ An amendment was introduced and defeated in the Senate 
that would have eliminated the PWFA's waiver of State immunity. See 
Roll Call 415, Bill Number: H.R. 2617, U.S. Senate (Dec. 22, 2022), 
https://www.senate.gov/legislative/LIS/roll_call_votes/vote1172/vote_117_2_00415.htm (setting out the Senate vote tally for S. 
Amend. 6569 to S. Amend. 6558 to S. Amend. 6552 to H.R. 2617, 
Consolidated Appropriations Act, 2023) (40 yeas, 57 nays, 3 not 
voting); 168 Cong. Rec. S10,070 (daily ed. Dec. 22, 2022) (setting 
out the Senate vote tally for S. Amend. 6569 to the Pregnant Workers 
Fairness Act).
---------------------------------------------------------------------------

1636.7 Relationship to Other Laws

1636.7(a)(1) Relationship to Other Laws in General

    Many comments addressed the PWFA and its relationship to other 
laws, some suggesting the inclusion of additional laws in the 
discussion in the Interpretive Guidance and others asking whether 
accommodations under the PWFA would lead to violations of other laws. 
The Commission has maintained the rule language from the NPRM and has 
made changes and additions to the Interpretive Guidance in section 
1636.7(a)(1) Relationship to Other Laws in General in response to the 
comments. These changes and the Commission's responses to specific 
comments are discussed below.
    Some comments recommended that collective bargaining agreements 
(CBAs) and workplace safety laws be added to the list of laws in Sec.  
1636.7(a)(1), to clarify that the PWFA does not invalidate CBAs or 
workplace safety laws that provide greater or equal protection for 
individuals affected by pregnancy, childbirth, or related medical 
conditions. The Commission agrees with this suggestion and has added 
language to this effect in the Interpretive Guidance in section 
1636.7(a)(1) Relationship to Other Laws in General.
    Other comments asked how the PWFA will interact with the FMLA. The 
FMLA provides job-protected unpaid leave for serious health conditions, 
including pregnancy. As set out in 2000gg-5(a)(1), nothing in the PWFA 
invalidates or limits the powers, remedies, and procedures under other 
Federal laws that provide greater or equal protection for individuals 
affected by pregnancy, childbirth, or related medical conditions. Thus, 
the PWFA does not invalidate or limit the rights of employees covered 
by the FMLA or State versions of it. The Department of Labor's 
regulations set out how the FMLA interacts with other civil rights 
laws, including leave as a reasonable accommodation under the ADA.\204\
---------------------------------------------------------------------------

    \204\ See 29 CFR 825.702.
---------------------------------------------------------------------------

    Some comments asked the Commission whether breaks under the PWFA 
must be paid, either under the PUMP Act or the FLSA.\205\ As the 
Commission explained in the discussion of reasonable accommodations in 
the NPRM, ``Breaks may be paid or unpaid depending on the employer's 
normal policies and other applicable laws. Breaks may exceed the number 
that an employer normally provides because reasonable accommodations 
may require an employer to alter its policies, barring undue 
hardship.'' \206\
---------------------------------------------------------------------------

    \205\ See U.S. Dep't of Lab., Field Assistance Bulletin No. 
2023-02: Enforcement of Protections for Employees to Pump Breast 
Milk at Work (May 17, 2023), https://www.dol.gov/sites/dolgov/files/WHD/fab/2023-2.pdf (discussing compensability of breaks under the 
FLSA).
    \206\ 88 FR 54730 n.102, 54781 n.60.
---------------------------------------------------------------------------

    One comment suggested that the Commission create a safe harbor 
provision for covered entities similar to one created by the Department 
of Labor for wage deductions. The PWFA does not provide the Commission 
with this authority.
    The Commission received some comments regarding the requirements 
for Federal agencies under Executive Order 13164. The Commission will 
respond to those through its work with Federal agencies.
Comments and Response to Comments Regarding the Relationship With Title 
VII
    The Commission did not receive many comments regarding the 
discussion in the proposed appendix concerning Sec.  1636.7(a)(1), 
about the relationship between the PWFA and Title VII. The Commission 
has maintained the discussion from the proposed appendix with some 
edits for style and clarity and added it in the Interpretive Guidance 
in section 1636.7(a)(1) under The PWFA and Title VII.
    A few comments questioned whether providing an accommodation under 
the PWFA would violate Title VII's prohibition on sex discrimination. 
This issue is discussed in more detail above.\207\ The employees 
covered by the

[[Page 29143]]

PWFA also are covered by Title VII. Title VII, as amended by the PDA, 
provides for accommodations for employees affected by pregnancy, 
childbirth, or related medical conditions under certain circumstances, 
even when all employees do not receive the same accommodations.\208\ 
Providing these accommodations under Title VII does not violate Title 
VII even if they are not provided to all employees; the same is true 
under the PWFA.
---------------------------------------------------------------------------

    \207\ See supra, Response to Comments Regarding the Commission's 
Proposed Definition of ``Pregnancy, Childbirth, or Related Medical 
Conditions'' as Reflected in Statutory Text; see, e.g., Enforcement 
Guidance on Pregnancy Discrimination, supra note 31, at (I)(C)(3); 
Cal. Fed. Sav. & Loan Ass'n, 479 U.S. at 290 (concluding that the 
State could require employers to provide up to four months of 
medical leave to pregnant women where ``[t]he statute is narrowly 
drawn to cover only the period of actual physical disability on 
account of pregnancy, childbirth, or related medical conditions.''); 
Johnson, 431 F.3d at 328 (``If the leave given to biological mothers 
is granted due to the physical trauma they sustain giving birth, 
then it is conferred for a valid reason wholly separate from 
gender.'').
    \208\ See, e.g., Enforcement Guidance on Pregnancy 
Discrimination, supra note 31, at (I)(C)(3); Young, 595 U.S. 206.
---------------------------------------------------------------------------

Comments and Response to Comments Regarding the Relationship With the 
ADA
    The Commission received some comments with questions regarding the 
interaction between the ADA and the PWFA. One comment recommended that 
the Commission state that if an employee might be covered by both the 
ADA and the PWFA, an employer should consider the ADA first. The 
Commission disagrees that it should make this determination or that 
employers should necessarily consider the ADA first. While it will 
depend on the specific facts of the situation, generally, when an 
employee might be covered by both the ADA and the PWFA, an employer's 
analysis should begin with the PWFA because the definition of ``known 
limitation'' means that under the PWFA an employer is required to 
provide reasonable accommodations in situations in which it may not be 
required to do so under the ADA. This is consistent with 42 U.S.C. 
2000gg-5(a)(1), which states that when multiple State or Federal laws 
provide protection, a covered entity should consider all applicable 
laws and follow the principles that provide the broadest protections 
and impose the smallest burden on the employee. This has been added in 
the Interpretive Guidance in section 1636.7(a)(1) under The PWFA and 
the ADA.
    A few comments questioned whether providing an accommodation under 
the PWFA would result in violations of the ADA if doing so made 
granting the accommodation to an individual covered by the ADA an undue 
hardship or because the PWFA provides for accommodations in situations 
that may not be covered by other laws. As an initial matter, the 
Commission disagrees that accommodations should be viewed as a zero-sum 
game. Under both the ADA and the PWFA, an individualized assessment 
occurs; there is no guarantee that an accommodation for one employee 
will result in another employee receiving or not receiving one. As data 
from the Job Accommodation Network show, most accommodations under the 
ADA are no-cost or low-cost.\209\ If there is truly a situation where 
there are limits--for example, if there are only 10 parking spaces--the 
employer can provide the accommodation until the limit is reached on a 
first-come, first-served or another neutral basis. Further, the fact 
that an employee is able to receive an accommodation under the PWFA 
that an employee cannot receive under the ADA does not violate the ADA 
because in that case, the employer is not refusing the accommodation to 
the person because of their disability. Rather, the employer is 
complying with its obligations under a different Federal law.
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    \209\ Job Accommodation Network, Costs and Benefits of 
Accommodation (May 4, 2023) [hereinafter Costs and Benefits of 
Accommodation], https://askjan.org/topics/costs.cfm.
---------------------------------------------------------------------------

    The Commission has provided additional information and examples 
regarding the interaction between the PWFA and the ADA, in the 
Interpretive Guidance in section 1636.7(a)(1) under The PWFA and the 
ADA, including examples of that relationship.
    Within section 1636.7(a)(1) of the Interpretive Guidance, as set 
out below, the Commission has included information about two critical 
ADA protections that apply to employees covered by the PWFA: the rules 
that limit covered entities from making disability-related inquiries 
and requiring medical exams and the rules protecting confidential 
medical information.\210\ The information explains how the ADA's 
provisions that restrict the ability of employers to make disability-
related inquiries interact with the PWFA and how the ADA's rules 
regarding confidential medical information and restrictions on sharing 
confidential medical information apply to medical information collected 
under the PWFA.
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    \210\ The ADA confidentiality rule was included in the NPRM in 
Sec.  1636.3(l)(4).
---------------------------------------------------------------------------

Comments and Response to Comments Regarding the Confidentiality of 
Medical Information
    As explained in the NPRM, the PWFA does not include a provision 
specifically requiring covered entities to maintain the confidentiality 
of medical information obtained in support of accommodation requests 
under the PWFA. However, applicants, employees, and former employees 
covered by the PWFA also are covered by the ADA.\211\ Under the ADA, 
covered entities are required to keep medical information of all 
applicants, employees, and former employees (whether or not those 
individuals have disabilities) confidential, with limited 
exceptions.\212\ The Commission has long held that these ADA rules on 
confidentiality apply to all medical information, whether obtained 
through the ADA process or otherwise; thus this protection applies to 
medical information obtained under the PWFA, including medical 
information voluntarily provided and medical information provided as 
part of the reasonable accommodation process.\213\ Moreover, as a 
practical matter, in many circumstances under the PWFA the medical 
information obtained by an employer may involve a condition that could 
be a disability; rather than an employer attempting to parse out 
whether to keep certain information confidential or not, all medical 
information should be kept confidential.\214\ Additionally, an 
employer's disclosure of medical information obtained through the 
PWFA's reasonable accommodation process beyond what is permitted under 
the ADA may violate the PWFA's prohibition on retaliation.
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    \211\ See 42 U.S.C. 12111(4), (5) (ADA); 42 U.S.C. 
2000gg(2)(B)(i), (3) (PWFA).
    \212\ 42 U.S.C. 12112(d)(3)(B); 29 CFR 1630.14(b)(1), (c)(1), 
(d)(4); Enforcement Guidance on Disability-Related Inquiries, supra 
note 170, at text accompanying nn.9-10 (``The ADA requires employers 
to treat any medical information obtained from a disability-related 
inquiry or medical examination . . . as well as any medical 
information voluntarily disclosed by an employee, as a confidential 
medical record. Employers may share such information only in limited 
circumstances with supervisors, managers, first aid and safety 
personnel, and government officials investigating compliance with 
the ADA.''); Enforcement Guidance: Preemployment Disability-Related 
Questions, supra note 170, at text accompanying n.6 (``Medical 
information must be kept confidential.'').
    \213\ See supra note 212. This policy also appears in numerous 
EEOC technical assistance documents. See, e.g., EEOC, Visual 
Disabilities in the Workplace and the Americans with Disabilities 
Act, text preceding n.43 (2023), https://www.eeoc.gov/laws/guidance/visual-disabilities-workplace-and-americans-disabilities-act#q8 
(``With limited exceptions, an employer must keep confidential any 
medical information it learns about an applicant or employee.'').
    \214\ Requests for accommodation under the PWFA also may overlap 
with FMLA issues, and the FMLA requires medical information to be 
kept confidential as well. 29 CFR 825.500(g).
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    Many comments expressed support for the proposed rule's position 
that the ADA rules regarding medical confidentiality apply to medical 
information obtained by covered entities under the PWFA. Some of these

[[Page 29144]]

comments urged the Commission to specifically state in the final rule 
that employers must store an employee's medical information separate 
from personnel files and may not share it with anyone other than the 
supervisor implementing the accommodation. Another comment suggested 
that the final rule require employers to obtain an employee's written 
consent before disclosing medical information received under the PWFA 
in all circumstances. Finally, some comments expressed concern that 
State law enforcement agencies may seek medical information from 
covered entities regarding abortion care and requested that the final 
rule address this issue.
    Because these confidentiality provisions arise from a statute other 
than the PWFA, and the violation of these provisions, if one occurred, 
would be of the ADA and not the PWFA, the Commission has decided not to 
include them in the regulation itself. Rather, this information has 
been included in the Interpretive Guidance in section 1636.7(a)(1) 
under The PWFA and the ADA and under Prohibition on Disability-Related 
Inquiries and Medical Examinations and Protection of Medical 
Information.
    In response to concerns about State law enforcement agencies 
seeking medical information related to abortion care from PWFA-covered 
entities, the Commission reminds employers that the PWFA rules do not 
require employers to seek supporting documentation regarding requested 
reasonable accommodations. The Commission further reminds employers 
that when the employer is permitted to seek supporting documentation, 
it is limited to the minimum that is sufficient to confirm that the 
employee has a physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions (a 
limitation), and describe the adjustment or change at work that is 
needed due to the limitation. Moreover, as noted above, the ADA's 
confidentiality provisions and limits on disclosure of medical 
information, reiterated in the Interpretive Guidance in section 
1636.7(a)(1) under The PWFA and the ADA and under Prohibition on 
Disability-Related Inquiries and Medical Examinations and Protection of 
Medical Information, apply to medical information, including medical 
information collected by the employer under the PWFA, and thus the ADA 
prohibits an employer from releasing medical information except in five 
specified circumstances.
    Further, the Commission has reorganized section 1636.5(f) in the 
Interpretive Guidance to highlight the potential retaliation claims 
that could arise regarding a covered entity seeking or releasing 
supporting documentation in situations where it would not be 
permissible under the regulation. These situations are now addressed in 
the Interpretive Guidance in section 1636.5(f) under Possible 
Violations of 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) Based on Seeking 
Supporting Documentation During the Reasonable Accommodation Process 
and Disclosure of Medical Information.

1636.7(a)(2) Limitations Related to Employer-Sponsored Health Plans

    The Commission has not changed the regulation for this provision.

1636.7(b) Rule of Construction

    The Commission received thousands of comments supporting the 
Commission's case-by-case approach to considering employer defenses 
asserting religious or constitutional considerations. The Commission 
also received tens of thousands of comments asserting that giving 
certain accommodations for pregnancy, childbirth, or related medical 
conditions, such as providing leave for abortion, infertility 
treatments, or contraception, would infringe upon the employer's 
religious freedom and therefore the employer should not be required to 
provide such accommodations. As explained below, employers who assert 
that the provision of such accommodations infringes upon their 
religious exercise may assert numerous statutory and constitutional 
defenses. Because the facts of each case will differ, the Commission 
will apply these defenses using a case-by-case analysis,\215\ using the 
framework provided here and consistent with the Commission's approach 
to other statutes that the Commission enforces.\216\
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    \215\ See EEOC, Compliance Manual on Religious Discrimination, 
(12-I)(C) (2021) [hereinafter Compliance Manual on Religious 
Discrimination], https://www.eeoc.gov/laws/guidance/section-12-religious-discrimination.
    \216\ In accordance with the Commission's Compliance Manual on 
Religious Discrimination and the Commission's long-standing polices, 
the Commission will consider these defenses, when asserted, in all 
parts of its investigation and enforcement process.
---------------------------------------------------------------------------

    Section 107(b) of the PWFA, codified at 42 U.S.C. 2000gg-5(b), 
provides a ``rule of construction'' stating that the law is ``subject 
to the applicability to religious employment'' set forth in section 
702(a) of the Civil Rights Act of 1964, 42 U.S.C. 2000e-1(a). The 
relevant portion of section 702(a) provides that ``[Title VII] shall 
not apply . . . to a religious corporation, association, educational 
institution, or society with respect to the employment of individuals 
of a particular religion to perform work connected with the carrying on 
by such corporation, association, educational institution, or society 
of its activities.'' \217\ The final rule reiterates this PWFA 
statutory language and adds that nothing in the regulation limits the 
rights of a covered entity under the U.S. Constitution, and nothing in 
42 U.S.C. 2000gg-5(b) or the regulation limits the rights of an 
employee under other civil rights statutes.
---------------------------------------------------------------------------

    \217\ 42 U.S.C. 2000e-1(a).
---------------------------------------------------------------------------

Comments Regarding the Rule of Construction
    The Commission received comments that expressed a broad range of 
interpretations of the PWFA's ``rule of construction'' provision in 
section 107(b). Numerous comments agreed with the Commission's proposed 
rule to consider the provision's application to employers on a case-by-
case basis. Many such comments reasoned that the provision should be 
interpreted consistent with section 702(a) of the Civil Rights Act of 
1964 to avoid confusion regarding its application, especially because 
the same facts may underlie Title VII and PWFA claims. Those comments 
further observed that section 702(a) strikes the correct balance 
between the rights of employees and the rights of employers. Other 
comments focused on one or more of three of section 107(b)'s 
components: (1) which entities qualify under the provision; (2) the 
scope of employment decisions to which the provision applies; and (3) 
the extent to which the provision limits the application of the PWFA's 
requirements as to qualifying religious entities. The Commission 
describes the range of comments received as to each component in turn.
    Many comments asserted that section 107(b) covers religious 
entities only if they are qualifying entities under section 702(a). 
Conversely, many other comments asserted that section 107(b) should 
apply more broadly to entities owned and operated by religious 
employers. A few such comments stated that the provision should assess 
whether entities qualify under section 702(a) using the definition of a 
``religious'' organization articulated in a 2017 Memorandum issued by 
the U.S. Attorney General.\218\ Other comments

[[Page 29145]]

said that the provision should be redefined to include employers that 
object to accommodations on conscience, moral, ethical, scientific, 
health or medical, or any other secular grounds.
---------------------------------------------------------------------------

    \218\ Memorandum from the Attorney General to All Executive 
Departments and Agencies, Federal Law Protections for Religious 
Liberty (Oct. 6, 2017), 82 FR 49668, 49670, 49677 (Oct. 26, 2017) 
[hereinafter Attorney General Religious Liberty Memorandum], https://www.justice.gov/opa/press-release/file/1001891/download.
---------------------------------------------------------------------------

    Comments varied regarding their view of the scope of employment 
decisions to which section 107(b) applies. Some comments asserted that 
section 107(b) applies only to hiring and firing coreligionists, and 
other comments asserted that it applies only to providing PWFA 
accommodations. By contrast, some comments asserted that the provision 
broadly covers all aspects of the employment relationship.
    Furthermore, comments varied regarding the extent to which section 
107(b) limits the application of the PWFA's requirements as to 
qualifying religious entities. Some comments stated that the provision 
allows qualifying entities to prefer coreligionists only in providing 
accommodation but does not otherwise exempt qualifying religious 
organizations from providing accommodations or permit them not to 
provide accommodations based on religious beliefs. Such comments noted 
that Congress demonstrated its intent not to broadly exempt religious 
employers from PWFA compliance when, prior to the law's passage, it 
rejected an amendment that would have done so.\219\ A few such comments 
maintained that an overly broad religious exemption would permit 
employers to impede employees' autonomy over decision-making regarding 
pregnancy, freedom of religion, and freedom from the religious beliefs 
of others. Further, some comments asserted that the provision, like 
section 702(a), does not allow a qualifying entity to discriminate on 
other protected bases, such as sex. Some comments stated that, in their 
view, when an employer is a qualifying entity under section 702(a), the 
employer is exempt from all of Title VII's requirements, and the same 
rule should apply to the PWFA.
---------------------------------------------------------------------------

    \219\ See 168 Cong. Rec. S10,069-70 (daily ed. Dec. 22, 2022) 
(S. Amend. 6577).
---------------------------------------------------------------------------

    Other comments argued that section 107(b) exempts religious 
organizations more broadly than section 702(a). Some of these comments 
stated that limiting the exemption only to allow qualifying 
organizations to prefer coreligionists is at odds with Title VII's text 
and Bostock v. Clayton County; \220\ that this reasoning does not 
follow given that the PWFA does not prohibit religious discrimination; 
that it ignores the Supreme Court's expressed concerns about such an 
interpretation; and that it ignores the PWFA's legislative history 
indicating that Members of Congress were concerned about religious 
organizations' rights. Such comments therefore concluded that a 
qualifying organization should be able both to prefer coreligionists 
and to abstain from making an accommodation that would violate the 
organization's religion under section 107(b).
---------------------------------------------------------------------------

    \220\ 590 U.S. 644, 682 (2020) (describing section 702(a) of the 
Civil Rights Act of 1964).
---------------------------------------------------------------------------

    Comments urging the Commission to interpret section 107(b) more 
broadly than section 702(a) recommended that the provision be 
interpreted consistent with the religious entities provision in Title I 
of the ADA; \221\ those comments asserted that an employer should be 
permitted to require conformity to its religious tenets but 
acknowledged that the ADA provision does not allow employers to 
discriminate on other grounds.
---------------------------------------------------------------------------

    \221\ See 42 U.S.C. 12113(d).
---------------------------------------------------------------------------

    The Commission also received comments that either directly or 
indirectly responded to five directed questions about how the rule of 
construction would apply in concrete factual scenarios. These comments 
offered a few fact patterns and expressed concerns that employers may 
be required to provide leave for medical procedures to which they have 
religious objections, and that employers may be liable under the PWFA's 
retaliation and coercion provisions for objecting to medical procedures 
for religious reasons. Comments expressed concern that employers would 
violate the law's coercion provision if they informed their employees 
of their religious objections to certain medical procedures, or that 
they would violate the law's retaliation provision if they terminated 
the employment of an employee who requested or received an 
accommodation for such a medical procedure.
Response to Comments Regarding the Rule of Construction
    The Commission will interpret the applicability of the PWFA's rule 
of construction provision on a case-by-case basis as it does with 
section 702(a) of the Civil Rights Act of 1964. The Commission's 
decision is based on several considerations. First, section 107(b) of 
the PWFA expressly states that the PWFA is ``subject to the 
applicability to religious employment'' set forth in section 702(a) of 
the Civil Rights Act of 1964, 42 U.S.C. 2000e-1(a). Courts and the 
Commission always have considered defenses raised under section 702(a) 
on a case-by-case basis.\222\ Second, comments suggesting a different 
approach provided conflicting recommendations and few concrete factual 
scenarios as to how the provision would apply under these different 
rules, thereby creating ambiguity and, as detailed below, failing to 
provide sufficient justification for deviating from the established 
case-by-case approach. Third, this case-by-case approach will enable 
employers, employees, the Commission, and courts to consider the 
circumstances of each case to the fullest extent under both Title VII--
should accommodation claims for pregnancy, childbirth, or related 
medical conditions be raised under that statute--and the PWFA.\223\
---------------------------------------------------------------------------

    \222\ See, e.g., Compliance Manual on Religious Discrimination, 
supra note 215, at (12-I)(C)(1) (stating that whether an 
organization is covered by section 702 ``depend[s] on the facts''; 
``Where the religious organization exemption is asserted by a 
respondent employer, the Commission will consider the facts on a 
case-by-case basis; no one factor is dispositive in determining if a 
covered entity is a religious organization under Title VII's 
exemption.''); id. at n.60 (discussing court decisions when a 
defendant has asserted section 702(a) as a defense); Newsome v. 
EEOC, 301 F.3d 227, 229-30 (5th Cir. 2002) (per curiam) (addressing 
a case in which EEOC dismissed a charge where the employer offered 
evidence that it fell under the religious organization exception).
    \223\ For example, an employee can bring a failure to 
accommodate claim under 42 U.S.C. 2000gg-1(1); the same facts could 
be the subject of a discrimination claim under Title VII. See 
generally Young, 575 U.S. 206 (concerning the Title VII claim of a 
pregnant employee who was denied a light duty position). Likewise, 
depending on the facts, an employee who was terminated after 
requesting or using a reasonable accommodation under the PWFA could 
have a claim under both the PWFA (42 U.S.C. 2000gg-1(5), 2000gg-
2(f)) and Title VII for pregnancy discrimination or retaliation.
---------------------------------------------------------------------------

    The Commission declines to adopt the religious entities provision 
set forth in Title I of the ADA because the ADA's provision contains an 
additional clause not found in section 702(a) of the Civil Rights Act, 
and Congress explicitly referenced section 702(a)--not the ADA 
religious entities provision--in enacting the PWFA. As stated above, 
the Commission must rely on the text of the law that Congress enacted.
    In support of the idea that the Commission should adopt a broader 
interpretation of section 107(b) than section 702(a), many comments 
cited to the legislative history of the PWFA. Although the Commission's 
interpretation is driven by the statute's text,\224\ given the many 
comments that cited to the legislative history and the comments 
submitted by legislators, the Commission reviews the legislative

[[Page 29146]]

history of section 107(b) and responds to these comments.
---------------------------------------------------------------------------

    \224\ See supra note 67.
---------------------------------------------------------------------------

    The PWFA, as it passed the U.S. House of Representatives, did not 
include the language now contained in section 107(b). The House also 
had voted against including similar language in section 107(b) in the 
definition of ``employer.'' \225\ In the U.S. Senate, the language now 
contained in section 107(b) was first offered as an amendment by one of 
the bill's principal sponsors, Senator William Cassidy.\226\ Senator 
James Lankford then offered a different amendment that would have 
provided even broader protection for religious organizations using 
language that differed from both the ultimately enacted language of 
section 107(b) and Title VII's section 702(a).\227\ Senator Cassidy 
spoke against that broader amendment, stating that language referring 
to section 702(a) would be broad enough--he noted the initial section 
107(b) language ``was drafted by House Republican Virginia Foxx. . . . 
[and] addresses the issue,'' and asserted that Senator Lankford's 
amendment ``would increase the likelihood of changing previous [Title 
VII] jurisprudence.'' \228\ Ultimately, the section 107(b) language 
offered by Senator Cassidy and adopted in the final bill was added to a 
rule of construction, rather than to the definition of ``employer.'' 
\229\ Prior to the House vote on the final omnibus bill, Representative 
Jerrold Nadler, the principal sponsor of the PWFA in the House, and 
Representative Robert Scott, the Chair of the House committee that had 
jurisdiction over the PWFA, issued statements regarding the 
interpretation of section 107(b); both statements interpreted the 
provision's protections differently than Senator Cassidy had 
interpreted them.\230\
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    \225\ H.R. Rep. No. 117-27, pt. 1, at 11.
    \226\ See 168 Cong. Rec. S10,063, 10,070-71 (daily ed. Dec. 22, 
2022) (S. Amend. 6558).
    \227\ See 168 Cong. Rec. S10,069-70 (daily ed. Dec. 22, 2022) 
(statement of Sen. James Lankford on S. Amend. 6577).
    \228\ Id. (statement of Sen. William (Bill) Cassidy).
    \229\ See 42 U.S.C. 2000gg-5(b).
    \230\ See 168 Cong. Rec. H10,527-28 (daily ed. Dec. 23, 2022) 
(statement of Rep. Jerrold (Jerry) Nadler); 168 Cong. Rec. E1361-62 
(daily ed. Dec. 27, 2022) (statement of Rep. Robert C. (Bobby) 
Scott).
---------------------------------------------------------------------------

    The Commission also reviewed the post-enactment statements of 
legislators.\231\ After enactment, and during this proposed rule's 
public comment period, Senator Lankford submitted a comment that 
included a legal analysis of why he believed the language in section 
702(a) applied more broadly than hiring and firing.\232\ Senator 
Patricia Murray and Senator Robert Casey both submitted comments that 
agreed with the Commission's proposed case-by-case approach.\233\ 
Representatives Nadler and Scott also submitted comments; 
Representative Nadler's comment endorsed the Commission's proposed 
case-by-case approach and restated the views he had expressed earlier 
about section 107(b)--namely, that section 107(b) allows religious 
employers to prefer people who practice their religion in hiring and 
firing, and in making comparable pregnancy accommodations, but it does 
not otherwise exempt employers from their obligations under the PWFA to 
provide reasonable accommodations that do not pose an undue hardship; 
\234\ Representative Scott also endorsed the case-by-case 
approach.\235\
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    \231\ The post-enactment statements of legislators reflect the 
personal views of the legislators, not the legislative history of 
the bill. See supra note 92.
    \232\ Comment EEOC-2023-0004-98436, Sen. James Lankford, 19 U.S. 
Senators, and 41 Members of Congress (Oct. 10, 2023).
    \233\ Comment EEOC-2023-0004-98257, Sen. Patricia (Patty) Murray 
and 24 U.S. Senators (Oct. 10, 2023); Comment EEOC 2023-0004-98384, 
Sen. Robert P. (Bob) Casey, Jr. (Oct. 10, 2023).
    \234\ Comment EEOC-2023-0004-98470, Rep. Jerrold (Jerry) Nadler 
and 82 Members of Congress (Oct. 10, 2023).
    \235\ Comment EEOC-2023-0004-98339, Rep. Robert C. (Bobby) 
Scott, Ranking Member of the House Committee on Education and the 
Workforce (Oct. 10, 2023).
---------------------------------------------------------------------------

    Taken together, the statements prior to the enactment of the PWFA 
show that some Members of Congress disagreed about the extent of the 
protection they were conferring on religious organizations. This does 
not contradict the Commission's decision to apply section 107(b) on a 
case-by-case basis; in fact, a case-by-case approach will allow 
employers, employees, the Commission, and courts to evaluate in 
concrete situations the way in which section 107(b) should apply.
    The Commission has made minor changes to the regulation to clarify 
the rights of covered entities and employees by providing parallel 
language in each subsection of Sec.  1636.7(b). Specifically, Sec.  
1636.7(b)(1) previously stated: ``Nothing in this provision limits the 
rights under the U.S. Constitution of a covered entity''; in the final 
regulation, it states: ``Nothing in 42 U.S.C. 2000gg-5(b) or this part 
should be interpreted to limit a covered entity's rights under the U.S. 
Constitution.'' This language now parallels the language in Sec.  
1636.7(b)(2) regarding employees' rights.
The Commission's Interpretation of Section 107(b) of the PWFA Applied
    Under the Commission's interpretation of section 107(b) of the 
PWFA, analogous to the Commission's interpretation of section 702(a) of 
the Civil Rights Act of 1964, an employer meets the definition of a 
``religious corporation, association, educational institution, or 
society'' \236\ if its ``purpose and character are primarily 
religious.'' \237\ When a respondent employer asserts that it qualifies 
as a religious organization under section 107(b), the Commission will 
use the same factors it uses to make the determination under section 
702(a). These factors include, but are not limited to: (1) whether the 
entity operates for a profit; (2) whether it produces a secular 
product; (3) whether the entity's articles of incorporation or other 
pertinent documents state a religious purpose; (4) whether it is owned, 
affiliated with, or financially supported by a formally religious 
entity such as a church or synagogue; (5) whether a formally religious 
entity participates in the management, for instance by having 
representatives on the board of trustees; (6) whether the entity holds 
itself out to the public as secular or sectarian; (7) whether the 
entity regularly includes prayer or other forms of worship in its 
activities; (8) whether it includes religious instruction in its 
curriculum, to the extent it is an educational institution; and (9) 
whether its membership is made up by coreligionists.\238\ No one factor 
is dispositive in making this determination.
---------------------------------------------------------------------------

    \236\ See 42 U.S.C. 2000e-1(a).
    \237\ See Compliance Manual on Religious Discrimination, supra 
note 215, at (12-I)(C)(1) & n.58. Because the Commission has already 
defined the type of employer that is covered by section 702(a), and 
the PWFA references section 702(a), the Commission is maintaining 
this definition rather than adopting the language in the Attorney 
General Religious Liberty Memorandum, supra note 218, which does not 
have the force of law.
    \238\ LeBoon v. Lancaster Jewish Cmty. Ctr. Ass'n, 503 F.3d 217, 
226 (3d Cir. 2007); Compliance Manual on Religious Discrimination, 
supra note 215, at (12-I)(C)(1).
---------------------------------------------------------------------------

    Under the Commission's interpretation of section 107(b), the PWFA 
does not fully exempt qualifying religious organizations from making 
reasonable accommodations. This is analogous to section 702(a), which 
likewise does not operate as a total exemption from Title VII's 
requirements.
    Under section 702(a), for example, qualifying religious 
organizations are exempt from Title VII's prohibition against 
discrimination on the basis of religion, but, as U.S. courts of appeals 
have recognized, qualifying religious organizations are still subject 
to the law's prohibitions against discrimination on the basis of race, 
color, sex, and national origin, and they

[[Page 29147]]

may not engage in related retaliation.\239\ If a qualifying religious 
organization asserts as a defense to a claim under the PWFA that it 
took the challenged action on the basis of religion and that section 
107(b) should apply, the merits of any such asserted defense will 
therefore be determined on a case-by-case basis consistent with the 
facts presented and applicable law.
---------------------------------------------------------------------------

    \239\ See Kennedy v. St. Joseph's Ministries, Inc., 657 F.3d 
189, 192 (4th Cir. 2011) (observing that the exemption ``does not 
exempt religious organizations from Title VII's provisions barring 
discrimination on the basis of race, gender, or national origin''); 
Boyd v. Harding Acad. of Memphis, Inc., 88 F.3d 410, 413 (6th Cir. 
1996) (stating that the exemption ``does not . . . exempt religious 
educational institutions with respect to all discrimination''); 
DeMarco v. Holy Cross High Sch., 4 F.3d 166, 173 (2d Cir. 1993) 
(``[R]eligious institutions that otherwise qualify as `employer[s]' 
are subject to Title VII provisions relating to discrimination based 
on race, gender and national origin.''); Rayburn v. Gen. Conf. of 
Seventh-Day Adventists, 772 F.2d 1164, 1166 (4th Cir. 1985) (``While 
the language of Sec.  702 makes clear that religious institutions 
may base relevant hiring decisions upon religious preferences, Title 
VII does not confer upon religious organizations a license to make 
those same decisions on the basis of race, sex, or national origin. 
. . .'') (citations omitted); cf. Garcia v. Salvation Army, 918 F.3d 
997, 1004-05, 1011 (9th Cir. 2019) (holding that Title VII 
retaliation and hostile work environment claims related to religious 
discrimination were barred by the religious organization exception 
but adjudicating the disability discrimination claim on the merits). 
The Commission recognizes that a few judges have recently suggested 
otherwise. See Starkey v. Roman Catholic Archdiocese of 
Indianapolis, Inc., 41 F.4th 931, 946 (7th Cir. 2022) (Easterbrook, 
J., concurring); Bear Creek Bible Church v. EEOC, 571 F. Supp. 3d 
571, 590-91 (N.D. Tex. 2021). However, this is not a common 
understanding of Title VII's religious exemption. See 88 FR 12852-
54.
    Typically, courts have accepted an employer's defense under this 
provision with regard to hiring or firing claims, rather than terms 
or conditions of employment. Compare EEOC v. Miss. Coll., 626 F.2d 
477, 485-86 (5th Cir. 1980) (holding that the college may prefer a 
Baptist to a non-Baptist in hiring), with EEOC v. Fremont Christian 
Sch., 781 F.2d 1362, 1365-66 (9th Cir. 1986) (holding that the 
section 702(a) exemption did not apply where a religious school 
provided ``head of household'' health insurance benefits only to 
single persons and married men).
---------------------------------------------------------------------------

    In response to comments that discussed potential religious defenses 
to the PWFA's requirements, the Commission notes that its statutory 
authority to investigate alleged unlawful employment practices under 
the statutes it enforces, including the PWFA, starts only after an 
aggrieved individual (or a Commissioner) files a charge of 
discrimination against a specific covered entity.\240\ The PWFA does 
not provide a mechanism for the Commission to provide legally binding 
responses to employer inquiries about the potential applicability of 
religious or other defenses before this point. Moreover, the Commission 
does not believe it is capable of providing such responses in the 
abstract, in the absence of a concrete factual context presented by a 
specific charge of discrimination.
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    \240\ See 42 U.S.C. 2000e-5(b).
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    In the event that a charge alleging one or more violations of the 
PWFA \241\ is filed against a particular employer, the employer can 
raise religious and other defenses at any time during the Commission's 
administrative process \242\--from as early as when the employer first 
receives a Notice of Charge of Discrimination, pursuant to 42 U.S.C. 
2000e-5(b), or even after the EEOC has found reasonable cause and 
attempted to resolve the matter through conciliation, and is 
considering potential litigation.\243\ Although defenses can be 
asserted at any time during the EEOC's administrative process, the 
Commission encourages employers to raise defenses as early as possible 
after receiving a notice of a charge of discrimination. This will allow 
the EEOC to promptly consider asserted defense(s) that, if applicable, 
would result in dismissal of the charge. The Commission will ``take 
great care'' in evaluating the asserted religious or other defense(s) 
based on the facts presented and applicable law, regardless of when in 
the administrative process it is raised.\244\
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    \241\ The procedures described in this paragraph apply to 
charges filed under any of the statutes that the Commission 
enforces.
    \242\ The Commission's administrative process typically begins 
when an individual, referred to as the charging party, files a 
charge of employment discrimination with the Commission. See 42 
U.S.C. 2000e-5(b). The statute requires that within 10 days of the 
date a charge is filed, the Commission inform the employer, also 
referred to as the respondent, that a charge has been filed, see 
id., and, if appropriate, the parties are invited to participate in 
the Commission's robust voluntary mediation program. This is an 
opportunity for the parties to resolve the charge early and before 
the Commission completes its investigation.
    If there is no mediated resolution of the charge, the Commission 
requests a position statement from the employer and proceeds with 
the investigation. An employer may raise any applicable defenses in 
the position statement, including religious defenses. If the 
Commission determines that further investigation is not warranted, 
the agency will dismiss the charge and the employee may file suit in 
Federal court.
    Otherwise, the Commission may request additional information 
from the employer during the investigation. At any point during the 
investigation, the employer may assert any religious defenses, 
including under section 107(b). The Commission generally relies on 
voluntary compliance with its investigation requests, although it 
does have statutory authority to examine or copy evidence relevant 
to its investigation. 42 U.S.C. 2000e-8(a); 42 U.S.C. 2000e-9; 29 
U.S.C. 161(1)-(2).
    Based on the evidence obtained during its investigation, the 
Commission makes a determination. The agency may dismiss the charge 
and the employee may file suit in Federal court.
    If, however, the Commission makes a determination that there is 
``reasonable cause'' to believe discrimination occurred, it 
endeavors to resolve the charge through conciliation, which is an 
informal process through which the Commission works with the parties 
in an attempt to develop an appropriate remedy for the 
discrimination and reach a final resolution administratively. See 42 
U.S.C. 2000e-5(b). Participation in conciliation is voluntary, and 
it is another step in the statutorily-required administrative 
procedure where an employer may raise section 107(b) defenses. A 
finding of ``reasonable cause'' does not lead to any fines or 
penalties for the employer. If conciliation is not successful, the 
Commission either files a lawsuit or issues the charging party a 
notice of conciliation failure and closes the charge; under the 
Commission's current procedure, the notice of conciliation failure 
includes a notice informing the employee of their right to file suit 
in Federal court. See generally 29 CFR part 1601 (Procedural 
Regulations).
    \243\ Indeed, the Commission will consider religious defenses 
even when they are raised for the first time in the context of an 
EEOC enforcement action in court. See, e.g., EEOC v. R.G. & G.R. 
Harris Funeral Homes, Inc., 201 F. Supp. 3d 837, 846 (E.D. Mich. 
2016) (noting that the defendant raised its RFRA defense for the 
first time in answer to the EEOC's amended complaint, which simply 
corrected a typographical error in the spelling of the aggrieved 
employee's first name), rev'd and remanded sub nom. EEOC v. R.G. &. 
G.R. Harris Funeral Homes, Inc., 884 F.3d 560 (6th Cir. 2018), aff'd 
sub nom. Bostock v. Clayton Cnty., Ga., 590 U.S. 644 (2020).
    \244\ Compliance Manual on Religious Discrimination, supra note 
215, at (12-I)(C)(3) (counseling EEOC investigators to ``take great 
care'' in situations involving the First Amendment and RFRA); see 
also Newsome, 301 F.3d at 229-30 (addressing a case in which the 
EEOC dismissed a charge where the employer offered evidence that it 
fell under the religious organization exception).
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    To further assist employers with potential religious defenses in 
the context of individual charge investigations, the Commission is 
enhancing its administrative procedures to provide additional 
information to facilitate the submission of information regarding 
potential religious defenses.\245\ Specifically, the Commission will 
revise materials accompanying the Notice of Charge of Discrimination 
letter and related web pages to identify how employers can raise 
defenses, including religious defenses, in response to the charge. 
These updates will be public and viewable by any employer with 
questions or concerns about how to raise a defense, including a 
religious defense, in the event that one of its employees files a 
charge of discrimination. In addition, as it is currently the case, the 
Notice of Charge will continue to direct employers to the EEOC 
Respondent Portal, where the employer can view and download the 
underlying charge of discrimination and submit documents to the EEOC

[[Page 29148]]

electronically. The Commission will update the Respondent Portal to 
encourage an employer to raise in its position statement (or as soon as 
possible after a charge is filed) any factual or legal defenses it 
believes apply, including ones based on religion. The Portal also will 
direct employers to the Commission's website, which provides detailed 
instructions with examples on what a position statement should include, 
which will allow the employer to easily inform the Commission of a 
potential defense, including a religious defense. The Commission will 
update other resources to provide additional, clear instructions about 
how the employer should submit factual or legal support for any 
asserted defenses, including religious ones.
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    \245\ These enhancements will apply to charges filed under any 
of the statutes that the EEOC enforces. Covered entities will be 
able to learn about the PWFA, this rule, and the enhancements 
outlined in this section at EEOC public outreach events and through 
the EEOC's website and publications. See, e.g., EEOC, Outreach, 
Education & Technical Assistance, https://www.eeoc.gov/outreach-education-technical-assistance (last visited Mar. 23, 2024).
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    As appropriate, the Commission will resolve the charge based on the 
information submitted in support of asserted defenses, including 
religious defenses, in order to minimize the burden on the employer and 
the charging party. The Commission may contact the employer and/or the 
charging party if it needs additional information to evaluate the 
applicability of any asserted defenses. The employer or charging party 
may also voluntarily submit additional information regarding the 
applicability of any asserted defenses and may request that the EEOC 
prioritize the consideration of a particular defense that could be 
dispositive and obviate the need to investigate the merits of a charge. 
As with the EEOC's reasonable cause determinations, the EEOC's decision 
to close or continue investigating a particular charge is not entitled 
to deference in any subsequent litigation, where a religious or other 
defense will receive de novo review if raised by the employer.\246\ 
Thus, regardless of whether the Commission agrees with the employer's 
asserted defenses, those defenses are entitled to de novo review by a 
court in any subsequent litigation.
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    \246\ Alexander v. Gardner-Denver Co., 415 U.S. 36, 60 (1974) 
(providing that private-sector employees have a right to a trial de 
novo for consideration of their Title VII claims).
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Application of Section 107(b) of the PWFA to Retaliation and Coercion 
Claims
    Some comments specifically raised the application of section 107(b) 
of the PWFA to claims regarding retaliation and coercion. The 
Commission's application of section 107(b) in this context will be 
informed by its application of section 702(a) of the Civil Rights Act 
of 1964 in analogous circumstances.
    The Commission notes that the operative language in the PWFA's 
retaliation provision is the same as the language in Title VII's 
retaliation provision, and the Commission will interpret it 
accordingly.\247\
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    \247\ 42 U.S.C. 2000gg-2(f)(1) (PWFA); 42 U.S.C. 2000e-3(a) 
(Title VII).
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    The coercion provision in the PWFA, 42 U.S.C. 2000gg-2(f)(2), is 
not in Title VII, but similar language is in the ADA's interference 
provision, and the Commission will interpret it accordingly.\248\ As 
set out in the Interpretive Guidance in section 1636.5(f)(2) under 
Prohibition Against Coercion, the purpose of this provision is to 
ensure that employees are free to avail themselves of the protections 
of the statute. Thus, consistent with the ADA regulation for the 
essentially identical provision, the rule adds ``harass'' to the list 
of prohibitions; the inclusion of the term ``harass'' in the regulation 
is intended to characterize the type of adverse treatment that may in 
some circumstances violate the interference provision.\249\ As with the 
ADA, the provision does not apply to any and all conduct or statements 
that an individual finds intimidating; it prohibits only conduct that 
is reasonably likely to interfere with the exercise or enjoyment of 
PWFA rights.\250\ As the Commission stated in the preamble in section 
1636.5(f) regarding the coercion provision, the Commission received a 
few comments expressing concern that mission statements, statements 
regarding religious beliefs of an employer, or statements in employee 
handbooks would be seen as violating Sec.  1636.5(f)(2). Whether a 
statement violates 42 U.S.C. 2000gg-2 (Sec.  1636.5(f)(2)) will depend 
on the language of the statement, but, as the examples provided in the 
NPRM and in the Interpretive Guidance in section 1636.5(f)(2) 
Prohibition Against Coercion show, the making of general statements 
regarding an employer's mission or religious beliefs is not the type of 
conduct that the Commission previously has determined would be 
prohibited by this provision.
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    \248\ 42 U.S.C. 2000gg-2(f)(2) (PWFA); 42 U.S.C. 12203(b) (ADA).
    \249\ See 29 CFR 1630.12(b); Enforcement Guidance on Retaliation 
and Related Issues, at (III) (stating, with regard to the ADA, that 
``[t]he statute, regulations, and court decisions have not 
separately defined the terms `coerce,' `intimidate,' `threaten,' and 
`interfere.' Rather, as a group, these terms have been interpreted 
to include at least certain types of actions which, whether or not 
they rise to the level of unlawful retaliation, are nevertheless 
actionable as interference.'') (2016) [hereinafter Enforcement 
Guidance on Retaliation], https://www.eeoc.gov/laws/guidance/enforcement-guidance-retaliation-and-related-issues.
    \250\ See Enforcement Guidance on Retaliation, supra note 249, 
at (III).
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    If a claim is raised regarding retaliation or coercion against a 
religious employer, the Commission will apply the same type of case-by-
case analysis it applies to other PWFA and Title VII claims.

Additional Potential Defenses to the PWFA for Covered Entities

Religious Freedom Restoration Act
    The Religious Freedom Restoration Act (RFRA) provides that the 
``[g]overnment shall not substantially burden a person's exercise of 
religion even if the burden results from a rule of general 
applicability,'' except when application of the burden to the person 
``is in furtherance of a compelling governmental interest'' and ``is 
the least restrictive means of furthering that compelling governmental 
interest.'' \251\ Nondiscrimination laws and policies have been found 
to serve a compelling governmental interest, including where the 
Commission has sought to enforce Title VII.\252\ As stated in the NPRM, 
the Commission will carefully consider these matters, analyzing RFRA 
defenses to claims of discrimination on a case-by-case basis.\253\
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    \251\ 42 U.S.C. 2000bb-1(a), (b). If an employer raises RFRA as 
a defense to the Government's enforcement of a law and meets its 
burden of showing that the law substantially burdens its religious 
exercise, the burden then shifts to the Government to show that the 
challenged law furthers a compelling governmental interest and is 
the least restrictive means of furthering that compelling 
governmental interest, as applied to ``the particular claimant whose 
sincere exercise of religion is being substantially burdened.'' See 
Holt v. Hobbs, 574 U.S. 352, 362-63 (2015) (quoting Burwell v. Hobby 
Lobby Stores, Inc., 573 U.S. 682, 726 (2014)) (internal citations 
and quotation marks omitted).
    \252\ See, e.g., Harris Funeral Homes, 884 F.3d at 581 (``EEOC 
has established that it has a compelling interest in ensuring the 
Funeral Home complies with Title VII; and enforcement of Title VII 
is necessarily the least restrictive way to achieve that compelling 
interest.''); Hsu v. Roslyn Union Free Sch. Dist. No. 3, 876 F. 
Supp. 445, 463 (E.D.N.Y. 1995) (concluding that a school district's 
policy was justified by its ``compelling interest in eliminating and 
preventing discrimination''), aff'd in part, rev'd in part on other 
grounds, 85 F.3d 839 (2d Cir. 1996). But cf. Braidwood Mgmt., Inc. 
v. EEOC, 70 F.4th 914, 939-40 (5th Cir. 2023) (``Even if there is a 
compelling interest as a categorical matter, there may not be a 
compelling interest in prohibiting all instances of discrimination. 
. . . [EEOC] does not show a compelling interest in denying 
Braidwood, individually, an exemption.'').
    \253\ Compliance Manual on Religious Discrimination, supra note 
215, at (12-I)(C)(3) (counseling EEOC investigators to ``take great 
care'' in situations involving the First Amendment and RFRA); see 
also Little Sisters of the Poor Saints Peter & Paul Home v. 
Pennsylvania, 591 U.S. __, 140 S. Ct. 2367, 2383 (2020) (``[T]he 
[government] must accept the sincerely held complicity-based 
objections of religious entities.'').

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[[Page 29149]]

Comments Related to RFRA
    Some comments agreed with the Commission that RFRA may be a defense 
to PWFA claims brought by the Commission. Some comments asserted that 
being required to provide accommodations, absent undue hardship, for 
certain health care services to which employers may object for 
religious reasons--such as abortion, IVF, surrogacy, contraception, and 
sterilization--violates RFRA. These comments argued that being required 
to provide a workplace accommodation to receive these services would 
substantially burden some employers' ability to exercise their 
religious beliefs.
    The Commission received several comments stating that the PWFA 
proposed regulation would impose a substantial burden on employers' 
religious exercise and that the Commission lacks a compelling 
governmental interest in enforcing the statute, as implemented by the 
regulation. In support, comments asserted that: in the Title VII 
context, the Federal Government must demonstrate a very specific 
compelling interest when requiring a religious organization to act 
contrary to its understanding of sex; strict scrutiny applies when 
there is a threat to religious freedom by the Federal Government; the 
Commission should acknowledge that the PWFA regulation would 
substantially burden employers' religious exercise; the Commission 
should offer its analysis of existing case law and state whether it 
believes it could ever have a compelling interest in requiring an 
objecting religious employer to violate its religious convictions 
regarding abortion; the Commission's case-by-case view does not comport 
with Title VII's definition of religion, which includes all aspects of 
religious observance and practice as well as belief; and the Commission 
does not have a compelling interest in denying an exception under the 
PWFA to a religious employer because that would force religious parties 
to violate their sincerely held religious beliefs.
    Many comments addressed the application of RFRA in lawsuits that do 
not involve the Government. These comments asserted that: because the 
Commission says RFRA may not be an applicable defense in some cases and 
is no defense at all to private suits,\254\ the Commission needs to 
clarify how its RFRA process will operate; RFRA should be available in 
all cases, including all cases where the Government substantially 
burdens religious exercise through the implementation of Federal law, 
regardless of whether the Government is a party to the lawsuit; if RFRA 
is not available in cases in which the Government is not a party, then 
the Commission could decline to bring a lawsuit where a religious 
employer could have brought a successful RFRA defense, and the employer 
would lose its rights to religious exercise; and if a RFRA defense only 
is available if the Government is a party to the lawsuit, the 
Commission should describe the steps it will take to ensure it does not 
intentionally avoid involving itself in litigation with the intent of 
preventing the employer from raising RFRA as a defense.
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    \254\ See, e.g., Listecki v. Off. Comm. of Unsecured Creditors, 
780 F.3d 731, 736-37 (7th Cir. 2015); Gen. Conf. Corp. of Seventh-
Day Adventists v. McGill, 617 F.3d 402, 409-12 (6th Cir. 2010). The 
Second Circuit has held otherwise in the ADEA context, Hankins v. 
Lyght, 441 F.3d 96, 103-04 (2d Cir. 2006) (holding that an employer 
could raise RFRA as a defense to an employee's Age Discrimination in 
Employment Act (ADEA) claim because the ADEA is enforceable both by 
the EEOC and private litigants), but the Second Circuit has 
questioned the correctness of Hankins given the text of RFRA, 
Rweyemamu v. Cote, 520 F.3d 198, 203 & n.2 (2d Cir. 2008).
---------------------------------------------------------------------------

    The Commission also received comments stating that the Commission 
must conduct an individualized review of any defense raised under RFRA 
and ensure that there is a sufficiently strong nexus between the 
asserted burden and a religious exercise, the religious exercise is 
based on sincerely held religious beliefs, the burden is substantial, 
and the requested religious exception is tailored to address the 
burden. Further, comments asserted that the Commission must conduct an 
Establishment Clause analysis of any proposed exception.
Response to Comments Related to RFRA
    As the Supreme Court has recognized, RFRA requires a fact-
sensitive, case-by-case analysis of burdens and interests.\255\ The 
Commission takes the protections of RFRA seriously and has instructed 
its staff to use ``great care in situations involving both (a) the 
statutory rights of employees to be free from discrimination at work, 
and (b) the rights of employers under the First Amendment and RFRA.'' 
\256\ Consistent with RFRA, as part of that analysis, the Commission 
will ensure when considering the application of any RFRA defense raised 
that it assesses whether any religious burden imposed on the employer 
is substantial and whether enforcement is the least restrictive means 
of furthering a compelling governmental interest, as applied to that 
employer. It will further analyze any defense to ensure that any 
limitation on enforcement is constitutionally permissible under the 
Establishment Clause.\257\
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    \255\ See, e.g., Gonzales v. O Centro Esp[iacute]rita 
Beneficente Uni[atilde]o do Vegetal, 546 U.S. 418, 430-31 (2006) 
(observing that, when applying RFRA, courts look ``beyond broadly 
formulated interests justifying the general applicability of 
government mandates and scrutinize[] the asserted harm of granting 
specific exemptions to particular religious claimants''); cf. 
Ramirez v. Collier, 595 U.S. 411, 433 (2022) (holding that the 
Religious Land Use and Institutionalized Persons Act, which applies 
RFRA's test for religious defenses in the prison context, ``requires 
that courts take cases one at a time, considering only `the 
particular claimant whose sincere exercise of religion is being 
substantially burdened' '' (quoting Holt, 574 U.S. at 363)).
    \256\ Compliance Manual on Religious Discrimination, supra note 
215, at (12-I)(C)(3).
    \257\ See infra in the preamble in section 1636.7 under Response 
to Comments Related to First Amendment Establishment Clause 
Considerations.
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    Here, the Commission generally explains its understanding of the 
requirements of RFRA and provides some information regarding how RFRA 
may apply in the context of the PWFA. As stated above, RFRA requires a 
fact-specific analysis. Thus, in a specific situation, the information 
provided here may or may not apply.\258\
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    \258\ Initially, the Commission notes that for a RFRA defense to 
arise in litigation brought by the Commission under the PWFA, there 
would first have to be a charge of discrimination filed where the 
employer refused to provide an accommodation based on its religious 
exercise. Then, prior to filing an enforcement action in court, the 
Commission would have to investigate the charge, find reasonable 
cause, and decide to bring litigation. At any point during that 
administrative process, the employer could assert a RFRA defense.
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    Although RFRA applies to enforcement by the Government, in order to 
inform the Commission of possible RFRA defenses and reasons the 
Government should not bring an enforcement action, an employer may 
raise a RFRA defense at any point during the Commission's 
administrative process. Assuming the employer asserted a RFRA defense 
based on a sincerely held religious belief, the Commission would first 
assess whether, were the Government to bring a lawsuit to enforce the 
PWFA against the employer, that enforcement would impose a substantial 
burden on the employer's religious exercise.\259\ The Commission would 
consider a variety of factors in making that assessment.\260\
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    \259\ See Harris Funeral Homes, 884 F.3d at 587 (``Under Holt v. 
Hobbs . . . a government action that puts a religious practitioner 
to the choice of engaging in conduct that seriously violates his 
religious beliefs or facing serious consequences constitutes a 
substantial burden for the purposes of RFRA.'') (internal citations, 
quotation marks, and alterations omitted).
    \260\ See, e.g., Hobby Lobby, 573 U.S. at 720-26 (finding that a 
contraceptive mandate imposed a substantial burden on religious 
beliefs by forcing employers to choose between providing coverage or 
paying ``an enormous sum of money--as much as $475 million per 
year'' if they did not); Harris Funeral Homes, 884 F.3d at 586-90 
(holding that the employer's religious exercise would not be 
substantially burdened by continuing to employ a transgender 
worker); Braidwood Mgmt., 70 F.4th at 938 (finding a substantial 
burden by being forced to employ individuals whose conduct violates 
``the company's convictions'').

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[[Page 29150]]

    The Commission also would consider whether, as applied in the 
specific case, filing a PWFA enforcement lawsuit would further the 
Government's compelling interest,\261\ including as expressed by 
Congress.\262\
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    \261\ See, e.g., Hobby Lobby, 573 U.S. at 733 (``The Government 
has a compelling interest in providing an equal opportunity to 
participate in the workforce without regard to race, and 
prohibitions on racial discrimination are precisely tailored to 
achieve that critical goal.''); Harris Funeral Homes, 884 F.3d at 
591-92; Hosanna-Tabor Evangelical Lutheran Church & Sch. v. EEOC, 
565 U.S. 171, 196 (2012) (``The interest of society in the 
enforcement of employment discrimination statutes is undoubtedly 
important.''); Fremont Christian Sch., 781 F.2d at 1368-69 (``By 
enacting Title VII, Congress clearly targeted the elimination of all 
forms of discrimination as a `highest priority' . . . . Congress' 
purpose to end discrimination is equally if not more compelling than 
other interests that have been held to justify legislation that 
burdened the exercise of religious convictions.'' (quoting EEOC v. 
Pacific Press Publ'g Ass'n, 676 F.2d 1272, 1280 (9th Cir. 1982), 
abrogated on other grounds by Emp. Div., Dep't of Hum. Res. of 
Oregon v. Smith, 494 U.S. 872 (1990)); Miss. Coll., 626 F.2d 477, 
488 (5th Cir. 1980) (stating, in a Title VII subpoena enforcement 
action related to a race and sex discrimination charge, that ``the 
government has a compelling interest in eradicating discrimination 
in all forms''); Redhead v. Conf. of Seventh-Day Adventists, 440 F. 
Supp. 2d 211, 220 (E.D.N.Y. 2006) (rejecting a RFRA defense in a 
Title VII sex discrimination case and stating, ``generally, Title 
VII's purpose of eradicating employment discrimination is a 
`compelling government interest' ''); see also H.R. Rep. No. 117-27, 
pt. 1, at 32 (``Although religious employers may claim that a 
required accommodation is a substantial burden on their free 
exercise of religion under RFRA, it is the position of the Committee 
that nondiscrimination provisions are a compelling government 
interest and the least restrictive means to achieve the policy of 
equal employment opportunity.''); cf. Bd. of Dirs. of Rotary Int'l 
v. Rotary Club of Duarte, 481 U.S. 537, 549 (1987) (observing that 
the State has a compelling interest in eliminating sex-based 
discrimination) (citing Roberts v. U.S. Jaycees, 468 U.S. 609, 624 
(1984) (explaining that the goal of ``eliminating discrimination and 
assuring [citizens] equal access to publicly available goods and 
services . . . plainly serves compelling state interests of the 
highest order'') (internal citation omitted))).
    \262\ See H.R. Rep. No. 117-27, pt. 1, at 5 (stating under the 
report's purpose and summary, ``When pregnant workers do not have 
access to reasonable workplace accommodations, they are often forced 
to choose between their financial security and a healthy pregnancy. 
Ensuring that pregnant workers have access to reasonable 
accommodations will promote the economic well-being of working 
mothers and their families and promote healthy pregnancies.''); see 
also Little Sisters, 140 S. Ct. at 2392 (Alito, J., concurring) 
(observing that courts ``answer the compelling interest question 
simply by asking whether Congress has treated the [interest] as a 
compelling interest'') (emphasis in original).
---------------------------------------------------------------------------

    Finally, the Commission disagrees with comments stating that the 
Commission must file suit against those employers the Commission 
believes have a valid RFRA defense so that the covered entities may 
avoid liability by successfully proving their RFRA defense in court. 
Imposing such a requirement would infringe on the executive branch's 
Article II authority to determine which enforcement actions to bring, 
and the Commission will not interpret the PWFA to impose any 
unconstitutional requirements.\263\ The Commission concludes that the 
better approach to situations in which it agrees with employers 
regarding their RFRA defenses raised during the administrative process 
is to refrain from bringing an enforcement action.\264\
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    \263\ See, e.g., United States v. Texas, 599 U.S. 670, 678 
(2023) (``Under Article II, the Executive Branch possesses authority 
to decide `how to prioritize and how aggressively to pursue legal 
actions against defendants who violate the law.''' (citations 
omitted)); id. at 679 (``[T]he Executive Branch has exclusive 
authority and absolute discretion to decide whether to prosecute a 
case'') (quoting United States v. Nixon, 418 U.S. 683, 693 (1974)) 
(internal quotation marks omitted).
    \264\ Additionally, under section 706(f)(1) of Title VII, which 
is incorporated into the PWFA in 42 U.S.C. 2000gg-2(a)(1), an 
employee may, as a matter of right, intervene in a case brought by 
the Commission on behalf of that employee. Thus, even if the 
Commission were required to bring such an action, the employer could 
still face a claim from the employee.
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Constitutional Considerations
The Ministerial Exception
    As set out in the NPRM, the Supreme Court has recognized a 
ministerial exception, derived from the religion clauses of the First 
Amendment, which may provide an affirmative defense to an otherwise 
cognizable claim of a certain category of employees under certain anti-
discrimination laws, including the PWFA. Under the ministerial 
exception, a religious organization may select those who will 
``personify its beliefs,'' ``shape its own faith and mission,'' or 
``minister to the faithful.'' \265\ The exception applies to 
discrimination claims involving the selection, supervision, and removal 
by a religious institution of employees who perform vital religious 
duties at the core of the mission of the religious institution.\266\
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    \265\ Hosanna-Tabor, 565 U.S. at 188-89.
    \266\ Compliance Manual on Religious Discrimination, supra note 
215, at (12-I)(C)(2) (citing Our Lady of Guadalupe Sch. v. 
Morrissey-Berru, 591 U.S. __, 140 S. Ct. 2049, 2055, 2066 (2020)). 
There is some disagreement among courts as to the applicability of 
the ministerial exception to hostile work environment claims. 
Compare Demkovich v. St. Andrew the Apostle Par., Calumet City, 3 
F.4th 968, 979 (7th Cir. 2021) (applying the ministerial exception 
to a hostile work environment claim involving allegations of 
minister-on-minister harassment), with Elvig v. Calvin Presbyterian 
Church, 375 F.3d 951, 962 (9th Cir. 2004) (finding that a hostile 
work environment claim was not barred by the ministerial exception, 
because sexual harassment is not a protected employment decision).
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Comments Regarding the Ministerial Exception
    A few comments requested that the Commission state or clarify the 
scope of the First Amendment ``ministerial exception'' in the final 
rule, including by: adding language from Our Lady of Guadalupe School 
v. Morrissey-Berru to the rule; \267\ stating that the exception bars 
all PWFA claims for qualifying ministerial employees; or stating that 
the PWFA covers a religious entity's non-ministerial employees.
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    \267\ See generally 140 S. Ct. at 2049.
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Response to Comments Regarding the Ministerial Exception
    The Commission declines to make changes regarding its 
interpretation of the ministerial exception, as the Commission's 
position is consistent with the relevant Supreme Court case law and 
reflects the policies set forth in this preamble. The Commission will 
apply the exception on a case-by-case basis in light of the facts,\268\ 
and in determining whether the exception applies to a claim, the 
Commission follows the Supreme Court's reasoning in Hosanna-Tabor 
Evangelical Lutheran Church & School v. EEOC,\269\ Our Lady of 
Guadalupe School v. Morrissey-Berru,\270\ and other applicable 
decisions, reviewing the factors set out by the Court. For example, if 
a religious school instructor employed by the Catholic Church as a 
Catechist (typically the type of teacher who performs vital religious 
duties) \271\ asks her employer for time to attend prenatal 
appointments and the employer refuses to provide the leave because the 
teacher is pregnant but not married, and raises the ministerial 
exception as a defense to the employee's charge of discrimination, the 
Commission (after gathering relevant facts about the applicability of 
that defense) will likely apply the ministerial exception and find that 
the employee is not entitled to the requested accommodation. In making 
such a determination, the Commission will ``take all relevant 
circumstances into account'' and determine whether the ``particular 
position implicate[s] the fundamental purpose of the exception.'' \272\
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    \268\ See id. at 2063 (``In determining whether a particular 
position falls within the Hosanna-Tabor exception, a variety of 
factors may be important.'').
    \269\ See 565 U.S. at 190-94.
    \270\ See 140 S. Ct. at 2063-69.
    \271\ See id. at 2057, 2066.
    \272\ See 140 S. Ct. at 2067.

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[[Page 29151]]

First Amendment Establishment and Free Exercise Clause Considerations
    The First Amendment provides that ``Congress shall make no law 
respecting an establishment of religion, or prohibiting the free 
exercise thereof.'' \273\ Under the Establishment Clause of the First 
Amendment, the Government's actions cannot establish religion; in other 
words, ``government may not, consistent with a historically sensitive 
understanding of the Establishment Clause, make a religious observance 
compulsory.'' \274\
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    \273\ U.S. Const. amend. I.
    \274\ Kennedy v. Bremerton Sch. Dist., 597 U.S. 507, 536-37 
(2022) (citation and internal quotation marks omitted).
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    Under the Free Exercise Clause, the ``Government fails to act 
neutrally when it proceeds in a manner intolerant of religious beliefs 
or restricts practices because of their religious nature.'' \275\ Where 
a law burdens religious exercise and is not neutral or generally 
applicable, it is subject to strict scrutiny, meaning that it must 
advance a compelling governmental interest and be narrowly tailored to 
achieve that interest.\276\ By contrast, laws that merely incidentally 
burden religion are ordinarily not subject to strict scrutiny, and thus 
do not need to be justified by a compelling governmental interest, to 
defeat a Free Exercise claim, as long as they are neutral and generally 
applicable.\277\ Laws are not neutral and generally applicable 
``whenever they treat any comparable secular activity more favorably 
than religious exercise.'' \278\ In addition, ``[a] law is not 
generally applicable if it invite[s] the government to consider the 
particular reasons for a person's conduct by providing a mechanism for 
individualized exemptions'' that are entirely discretionary.\279\
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    \275\ Fulton v. City of Philadelphia, 593 U.S. 522, 533 (2021) 
(citations omitted).
    \276\ See, e.g., id. at 541 (citation omitted); Church of Lukumi 
Babalu Aye, Inc. v. City of Hialeah, 508 U.S. 520, 531-32 (1993).
    \277\ Fulton, 593 U.S. at 533 (citing Emp't Div., Dep't of Hum. 
Res. of Ore. v. Smith, 494 U.S. 872, 878-82 (1990)).
    \278\ Tandon v. Newsom, 593 U.S. 61, 62 (2021) (per curiam) 
(providing that whether two activities are comparable must be judged 
against the governmental interest that justifies the law at issue 
and concerns the risks various activities pose); see also Fulton, 
593 U.S. at 534 (``A law . . . lacks general applicability if it 
prohibits religious conduct while permitting secular conduct that 
undermines the government's asserted interests in a similar way.'').
    \279\ Fulton, 593 U.S. at 533, 535 (citing Smith, 494 U.S. at 
884 (1990)) (internal quotation marks omitted).
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Comments Related to First Amendment Establishment Clause Considerations
    As noted above, the Commission received comments stating that the 
Commission must conduct an individualized review of any defense 
asserted under RFRA and ensure that there is a sufficiently strong 
nexus between the asserted burden and a religious exercise, the 
religious exercise is based on sincerely held religious beliefs, the 
burden is substantial, and the action taken by the government is 
tailored to address the burden. Further, comments asserted that the 
Commission must conduct an Establishment Clause analysis of any 
asserted RFRA defense.
Response to Comments Related to First Amendment Establishment Clause 
Considerations
    The Commission agrees that when evaluating a religious employer's 
RFRA defense or any other religious defense, the Commission will 
consider the Establishment Clause implications as part of its case-by-
case analysis.\280\
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    \280\ As the Supreme Court has observed, ``The First Amendment 
provides, in part, that Congress shall make no law respecting an 
establishment of religion, or prohibiting the free exercise thereof. 
We have said that these two Clauses often exert conflicting 
pressures, and that there can be internal tension between the 
Establishment Clause and the Free Exercise Clause.'' Hosanna-Tabor, 
565 U.S. at 181 (internal citations and quotation marks omitted).
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Comments Related to First Amendment Free Exercise Clause Considerations
    Several comments stated that the rule could violate a covered 
entity's First Amendment right to the free exercise of religion. Some 
comments disputed whether the final rule is a rule of general 
applicability, asserting that the PWFA is not generally applicable, 
e.g., because it contains religious exemptions and excludes small 
employers with fewer than 15 employees.
Response to Comments Related to First Amendment Free Exercise Clause 
Considerations
    The PWFA, like Title VII, is a neutral law of general 
applicability.\281\ Thus, it does not need to be justified by a 
compelling governmental interest and narrowly tailored to achieve that 
interest under the First Amendment Free Exercise Clause.\282\ The PWFA 
does not provide any system of discretionary, individualized exemptions 
for any secular employers, and it does not treat religious exercise any 
less favorably than comparable secular activities.\283\ Congress, in 
enacting the PWFA, as it did with Title VII, exempted employers (both 
secular and religious) with fewer than 15 employees.\284\ It also 
provided an exception for religious employers under the rule of 
construction, which requires the Commission to assess whether an entity 
is a qualifying religious employer under an established set of factors 
based in case law.\285\ Thus, the PWFA does not provide the Commission 
with discretion to grant individualized exemptions, for either secular 
or religious purposes.\286\
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    \281\ See, e.g., Hosanna-Tabor, 565 U.S. at 190 (stating in 
dicta that the ADA's anti-retaliation provision, which (like Title 
VII) exempts certain employers for secular reasons, ``is a valid and 
neutral law of general applicability''); EEOC v. Cath. Univ. of Am., 
83 F.3d 455, 467 (D.C. Cir. 1996) (stating that Title VII is ``a 
neutral law of general application'').
    \282\ See Fulton, 593 U.S. at 533 (citing Smith, 494 U.S. at 
878-82); see also Smith, 494 U.S. at 894 (O'Connor, J., concurring).
    \283\ See, e.g., Fulton, 593 U.S. at 533-34 (citing Lukumi 
Babalu Aye, 508 U.S. at 542-46; Smith, 494 U.S. at 884).
    \284\ See 42 U.S.C. 2000gg(2)(B)(i), 2000e(b). The Commission 
rejects the assertion that simply because the PWFA only applies to 
businesses with 15 or more employees, the Commission can never make 
out a compelling interest. See, e.g., Harris Funeral Homes, 884 F.3d 
at 600 (``EEOC has shown that enforcing Title VII here is the least 
restrictive means of furthering its compelling interest in combating 
and eradicating sex discrimination.''). As the Supreme Court has 
noted, Congress decided to limit Title VII's coverage to firms with 
15 or more employees for the purpose of ``easing entry into the 
market and preserving the competitive position of smaller firms.'' 
Clackamas Gastroenterology Assocs., P.C. v. Wells, 538 U.S. 440, 447 
(2003) (quoting the lower court's dissent, that ``Congress decided 
to spare very small firms from the potentially crushing expense of 
mastering the intricacies of the antidiscrimination laws, 
establishing procedures to assure compliance, and defending against 
suits when efforts at compliance fail'') (citation and internal 
quotation marks omitted). The legislative history of Title VII 
supports this proposition. See Tomka v. Seiler Corp., 66 F.3d 1295, 
1314 (2d Cir. 1995) (outlining Title VII's legislative history 
around the factors Congress considered in enacting 42 U.S.C. 
2000e(b), including the costs associated with defending against 
discrimination claims), abrogated on other grounds as recognized by 
Eisenhauer v. Culinary Inst. of Am., 84 F.4th 507, 524, n.83 (2d 
Cir. 2023). Federal statutes often include exemptions for small 
employers, and such exemptions do not undermine the larger interests 
served by those statutes. See, e.g., FMLA, 29 U.S.C. 2611(4)(A)(i) 
(applicable to employers with 50 or more employees); ADEA, 29 U.S.C. 
630(b) (originally exempting employers with fewer than 50 employees, 
81 Stat. 605, the statute now governs employers with 20 or more 
employees); ADA, 42 U.S.C. 12111(5)(A) (applicable to employers with 
15 or more employees). The government's generally applicable goal of 
protecting small businesses from the burdens of regulatory 
compliance is not comparable to the type of discretionary, 
individualized exemption that the Supreme Court rejected in Fulton. 
See 593 U.S. at 533-34.
    \285\ See supra in the preamble in section 1636.7(b) Rule of 
Construction.
    \286\ Cf. Fulton, 593 U.S. at 536-41 (providing that the 
inclusion of ``a formal system of entirely discretionary 
exceptions'' in the contractual nondiscrimination requirement at 
issue rendered the requirement not generally applicable and thus 
subject to strict scrutiny).

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[[Page 29152]]

First Amendment Free Speech and Expressive Association Considerations
    The First Amendment provides that ``Congress shall make no law . . 
. abridging the freedom of speech.'' \287\ To determine whether 
``particular conduct possesses sufficient communicative elements to 
bring the First Amendment into play,'' courts consider whether ``[a]n 
intent to convey a particularized message was present, and [whether] 
the likelihood was great that the message would be understood by those 
who viewed it.'' \288\
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    \287\ U.S. Const. amend. I.
    \288\ Texas v. Johnson, 491 U.S. 397, 404 (1989) (quoting Spence 
v. Washington, 418 U.S 405, 410-11 (1974)).
---------------------------------------------------------------------------

    The Supreme Court also has recognized a ``right to associate for 
the purpose of engaging in those activities protected by the First 
Amendment.'' \289\ The freedom of expressive association includes a 
freedom not to associate.\290\ In order for Government action to 
unconstitutionally burden the right of expressive association, a group 
must engage in expressive association.\291\ If a group does so, then 
the proper inquiry is whether the Government action at issue, often the 
forced inclusion of a member, would significantly affect the group's 
ability to advocate public or private viewpoints.\292\ Finally, to 
determine whether the Government's interest justifies the burden, the 
Government's interest implicated in its action is weighed against the 
burden imposed on the associational expression.\293\
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    \289\ Jaycees, 468 U.S. at 618.
    \290\ Id. at 622-23.
    \291\ Boy Scouts of America v. Dale, 530 U.S. 640, 648 (2000).
    \292\ Id. at 650.
    \293\ Id. at 658-59.
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Comments Related to First Amendment Free Speech Considerations
    Several comments asserted that including infertility treatments, 
contraception, abortion, sterilization, and surrogacy in the definition 
of ``pregnancy, childbirth, or related medical conditions'' would 
require covered entities to provide accommodations for employees that 
would violate the entities' freedom of speech. For example, some 
comments stated that providing an accommodation related to an 
employee's abortion would chill the speech of covered entities by 
requiring them to convey a message to employees and the public that 
abortion is a legitimate medical procedure, contrary to their anti-
abortion beliefs or identity, or because maintaining their policies 
would put them in the position of violating the PWFA's anti-retaliation 
and anti-coercion provisions.
Response to Comments Related to First Amendment Free Speech 
Considerations
    The Commission does not agree that the PWFA or the final rule 
infringes on any covered entity's freedom of speech. The act of making 
a personnel decision, such as employing or continuing to employ an 
individual who has engaged in personal conduct with which an employer 
disagrees, is not protected speech or expressive conduct that 
communicates the employer's agreement with the individual's personal 
decisions.\294\ In this business context, providing an employee a 
reasonable accommodation under the PWFA during their employment does 
not constitute speech or expressive conduct on the part of the 
employer.\295\
---------------------------------------------------------------------------

    \294\ See Harris Funeral Homes, 884 F.3d at 589-90 (providing 
that ``bare compliance'' with antidiscrimination laws does not 
amount to an endorsement of a certain viewpoint).
    \295\ See also Rumsfeld v. Forum for Academic & Institutional 
Rights, Inc., 547 U.S. 47, 65-67 (2006) (concluding that a law 
requiring that institutions of higher education allow military 
recruiters access equal to that provided to other recruiters, or 
lose certain Federal funds, regulated conduct, not speech, and the 
regulated conduct was not inherently expressive such that it was 
protected under the First Amendment).
---------------------------------------------------------------------------

    As discussed in relation to the PWFA's rule of construction, 
whether an employer's policies or actions could implicate the PWFA's 
anti-retaliation or anti-coercion provision is a highly fact-specific 
inquiry. For over four decades, the Commission has interpreted Title 
VII, which contains an anti-retaliation provision, to protect employees 
from being fired for having an abortion or contemplating an abortion, 
and courts have affirmed this interpretation.\296\ The Commission is 
not aware of any cases during these past four decades in which an 
employer has challenged this interpretation on First Amendment free 
speech grounds. Likewise, the ADA has language similar to the PWFA's 
anti-coercion provision in its interference provision, and the 
Commission is similarly unaware of any cases where an employer 
challenged the interference provision on First Amendment free speech 
grounds. In addition, the Commission has explained in the preamble and 
the Interpretive Guidance in section 1636.5(f) Prohibition Against 
Retaliation the type of actions that could be violations under the 
anti-coercion and anti-retaliation provisions; they do not involve 
protected speech.\297\ Nevertheless, should the Commission receive a 
charge alleging coercion or retaliation, and should the responding 
employer raise constitutional concerns as a defense to the charge 
during the administrative charge process, the Commission will evaluate 
each claim on a case-by-case basis under the process it has outlined 
above.\298\
---------------------------------------------------------------------------

    \296\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A)(4)(c) & n.58; Doe, 527 F.3d at 364 (holding that 
Title VII, as amended by the PDA, prohibits an employer from 
discriminating against a female employee because she has exercised 
her right to have an abortion); Turic, 85 F.3d at 1214 (finding the 
termination of a pregnant employee because she contemplated having 
an abortion violated the PDA).
    \297\ See Sec.  1636.5(f).
    \298\ See supra note 242.
---------------------------------------------------------------------------

Comments Related to First Amendment Expressive Association 
Considerations
    Some comments asserted that including certain pregnancy-related 
health care services as medical conditions related to pregnancy or 
childbirth would require covered entities to provide accommodations for 
employees that would violate the entities' First Amendment right to 
expressive association. In particular, some comments stated that 
employers, particularly those whose express mission is to oppose 
abortion, might be required under the rule to hire, or continue to 
employ, or promote, employees who have abortions in violation of an 
employer's policies.
Response to Comments Related to First Amendment Expressive Association 
Considerations
    The Commission does not agree that the PWFA or the final rule 
infringes on any covered entity's freedom of expressive association. 
First, the Commission is unaware of any case holding that enforcing 
Title VII violates the First Amendment's right of free association, 
and, indeed, the Supreme Court has expressly held to the contrary.\299\ 
Second, assuming that a covered entity can show that it engages in 
expressive activity, with the possible exception of certain mission-
driven organizations, it is unlikely that a covered entity also could 
show that simply allowing an employee to access an accommodation would 
significantly affect its ability to advocate public or private 
viewpoints.\300\ The Commission

[[Page 29153]]

believes its position strikes the correct balance between, on one hand, 
the Government's interest in ensuring employees affected by pregnancy, 
childbirth, or related medical conditions are able to remain healthy 
and in their jobs and, on the other, the employer's ability to express 
its message to the public, its employees, and other stakeholders such 
that its advocacy is not significantly affected by providing an 
accommodation.\301\ Nevertheless, should the Commission receive a 
charge relating to an accommodation for pregnancy, childbirth, or 
related medical conditions, and should the responding employer raise 
constitutional expressive association concerns as a defense to the 
charge during the charge process, the Commission will evaluate each 
claim on a case-by-case basis under the framework outlined above.\302\
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    \299\ Hishon v. King & Spalding, 467 U.S. 69, 78 (1984) (holding 
that, as applied to a law firm partnership, Title VII did not 
infringe employer's ``constitutional rights of expression or 
association''); see also id. (observing that ``[i]nvidious private 
discrimination may be characterized as a form of exercising freedom 
of association protected by the First Amendment, but it has never 
been accorded affirmative constitutional protections'') (citation 
and internal quotation marks omitted).
    \300\ Compare Boy Scouts, 530 U.S. at 655-59 (determining that 
retaining a gay scoutmaster would significantly affect the 
organization's expression), and Slattery v. Hochul, 61 F.4th 278, 
288 (2d Cir. 2023) (holding that rape crisis pregnancy center stated 
plausible claim that application of New York law prohibiting 
discrimination in employment based on reproductive health decisions 
would severely burden its right to freedom of expressive association 
given that the statute, if applied, would ``forc[e] [the center] to 
employ individuals who act or have acted against the very mission of 
its organization''), with Rumsfeld, 547 U.S. at 68-69 (explaining 
that a law that allows military recruiters equal access to law 
schools does not force the school ``to accept members it does not 
desire'').
    \301\ See Rumsfeld, 547 U.S. at 69-70.
    \302\ See supra note 242.
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Comments Related to Constitutional Avoidance
    A few comments stated that including abortion in the definition of 
medical conditions related to pregnancy and childbirth creates First 
Amendment free speech and religion conflicts, and statutes should be 
interpreted to avoid constitutional concerns; therefore, the Commission 
should exclude the possibility of an employee receiving an 
accommodation related to an abortion from the regulation.
Response to Comments Related to Constitutional Avoidance
    As explained supra, the Commission disagrees that the rule 
categorically conflicts with the First Amendment, and thus does not 
agree that the canon of constitutional avoidance applies. The 
Commission's interpretation of ``pregnancy, childbirth, or related 
medical conditions'' is consistent with its interpretation of this 
phrase for more than four decades in Title VII, as amended by the PDA, 
a similar statute. In those decades, the Commission's interpretation 
under Title VII has never been successfully challenged on First 
Amendment grounds. The comments that raised this issue did not 
demonstrate that abortion must be excluded to avoid an unconstitutional 
interpretation. Moreover, the Commission cannot anticipate whether 
constitutional issues will arise in future litigation on facts that 
have not yet occurred.
Comments Regarding Requests for an Exemption for a Covered Entity's 
Moral Objections
    Several comments stated that the final rule should provide an 
exemption for covered entities that object to abortion and other 
medical conditions related to pregnancy and childbirth based on 
conscience, moral, ethical, scientific, health, or medical grounds, or 
for any other reason that is not associated with a religious belief. A 
few comments further asserted that, because the PWFA rule of 
construction provides an exception for certain religious entities, the 
Commission must provide an exception for similarly situated covered 
entities that object to accommodations on non-religious grounds.
Response to Comments Regarding Requests for an Exemption for a Covered 
Entity's Moral Objections
    To create a new, stand-alone exemption for secular entities would 
exceed the Commission's congressionally-provided authority. In enacting 
the PWFA, Congress restricted coverage for only two categories of 
employers: (1) certain qualifying religious entities under the rule of 
construction at section 107(b), ``subject to the applicability to 
religious employment'' set forth in section 702(a) of the Civil Rights 
Act of 1964; and (2) certain entities, regardless of religious 
affiliation, that have fewer than 15 employees. The Commission notes 
that an individual's religious beliefs may include moral and ethical 
beliefs,\303\ and thus in individual cases, the Commission will assess 
asserted accommodation requests and objections based on that 
longstanding interpretation and applicable law. However, the Commission 
will not create through rulemaking a new exemption for secular 
organizations with certain moral or ethical beliefs, beyond the PWFA's 
existing exceptions.
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    \303\ In the context of Title VII's prohibition of 
discrimination against employees based on religion, the Commission 
has said that ``[c]ourts have looked for certain features to 
determine if an individual's beliefs can be considered religious.'' 
To this end, ``[s]ocial, political, or economic philosophies, as 
well as mere personal preferences, are not religious beliefs 
protected by Title VII,'' but overlap between a religious and 
political view may be protected under Title VII ``as long as that 
view is part of a comprehensive religious belief system.'' 
Compliance Manual on Religious Discrimination, supra note 215, at 
(12-I)(A)(1); see also 29 CFR 1605.1.
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Comments Regarding Requests for a Per Se Undue Hardship Exemption
    In the alternative, several comments asserted that covered entities 
that do not qualify for an exemption under the rule of construction, 
but that nevertheless object to abortion or other medical conditions 
related to pregnancy or childbirth for religious reasons, reasons 
related to their mission, or other secular reasons, should receive a 
per se undue hardship exemption.
Response to Comments Regarding Requests for a Per Se Undue Hardship 
Exemption
    The Commission declines to create a per se undue hardship 
exemption, for several reasons. First, the PWFA incorporates the ADA's 
``undue hardship'' definition, and under the ADA, employers may assert 
undue hardship as a defense but must conduct an individualized 
assessment when determining whether a reasonable accommodation will 
impose an undue hardship.\304\ Creating a per se rule that an 
employer's beliefs automatically and always create an undue hardship 
would be fundamentally inconsistent with this requirement that undue 
hardship be assessed as a defense on a case-by-case basis, and would 
therefore be inconsistent with the PWFA.\305\ This is especially so 
where, as here, even the religious beliefs of employers that share the 
same religion are not monolithic, and the specific facts and 
circumstances in a given situation may affect whether the employer 
objects to an employee's actions on religious grounds.
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    \304\ 88 FR 54734.
    \305\ 42 U.S.C. 2000gg(7). The final rule creates a small 
category of modifications that will, ``in virtually all cases,'' be 
reasonable accommodations that do not impose an undue hardship. 
Importantly, in creating this category, the Commission did not alter 
the definition of ``undue hardship'' or deprive a covered entity of 
the opportunity to bring forward facts to demonstrate that a 
proposed accommodation imposes an undue hardship for its business 
under its own particular circumstances, even when one of the four 
simple modifications in Sec.  1636.3(j)(4) is involved. Given the 
differences in religious beliefs and the impact of an accommodation 
that may violate those beliefs, it would not be possible for the 
Commission to determine that these beliefs would ``in virtually all 
cases'' cause an undue hardship.
---------------------------------------------------------------------------

    Second, nothing in the PWFA provides for an exemption that directly 
links the undue hardship standard to an entity's religious beliefs, 
status, or secular beliefs. On the contrary, the statute expressly 
directs that the term ``undue hardship'' should ``have the meaning[ ] 
given such term[ ] in [the ADA] and shall be construed as such

[[Page 29154]]

[term is] construed under such Act and as set forth in the regulations 
required by this division.'' \306\
---------------------------------------------------------------------------

    \306\ 42 U.S.C. 2000gg(7).
---------------------------------------------------------------------------

    Third, the factors used to assess an undue hardship defense 
typically focus on measurable impacts on business operations. Under the 
PWFA rule, ``undue hardship'' means an action requiring significant 
difficulty or expense, when considered in light of several factors: (i) 
the nature and net cost of the accommodation needed under the PWFA; 
(ii) the overall financial resources of the facility or facilities 
involved in the provision of the reasonable accommodation, the number 
of persons employed at such facility, and the effect on expenses and 
resources; (iii) the overall financial resources of the covered entity, 
the overall size of the business of the covered entity with respect to 
the number of its employees, and the number, type and location of its 
facilities; (iv) the type of operation or operations of the covered 
entity, including the composition, structure, and functions of the 
workforce of such entity, and the geographic separateness and 
administrative or fiscal relationship of the facility or facilities in 
question to the covered entity; and (v) the impact of the accommodation 
upon the operation of the facility, including the impact on the ability 
of other employees to perform their duties and the impact on the 
facility's ability to conduct business.\307\ As explained by Congress, 
``Like the ADA, the PWFA seeks to balance the interests of the employer 
and employee and, although there may be some costs associated with 
making a reasonable accommodation, the `undue hardship' standard limits 
the employer's exposure both to overly burdensome accommodation 
requests and lawsuits that would attempt to hold the employer liable 
for failing to provide a prohibitively expensive accommodation.'' \308\
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    \307\ 88 FR 54769; Sec.  1636.3(j).
    \308\ H.R. Rep. No. 117-27, pt. 1, at 29.
---------------------------------------------------------------------------

    The Commission has stated that under the ADA, ``the `undue 
hardship' provision takes into account the financial realities of the 
particular employer or other covered entity. However, the concept of 
undue hardship is not limited to financial difficulty. `Undue hardship' 
refers to any accommodation that would be unduly costly, extensive, 
substantial, or disruptive, or that would fundamentally alter the 
nature or operation of the business.'' \309\ Of note, cases 
interpreting the impact of a reasonable accommodation on other 
employees or the facility's ability to conduct business have generally 
been about distribution of workloads, business operational needs, and 
elemental changes to the day-to-day operations of a business, not the 
moral views of coworkers or employers.\310\ That said, the Commission 
will, as it currently does, consider all assertions of the undue 
hardship defense on a case-by-case basis, including whether granting a 
particular reasonable accommodation would ``fundamentally alter the 
nature of the business.''
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    \309\ 29 CFR part 1630, appendix, 1630.2(p) (citing S. Rep. No. 
101-116, at 35 (1989); H.R. Rep. 101-485, pt. 2, at 67 (1990)).
    \310\ See, e.g., Milton v. Scrivner, Inc., 53 F.3d 1118, 1125 
(10th Cir. 1995) (providing that an accommodation that would result 
in other employees having to work harder or longer hours is not 
required; slowing the production schedule or assigning the 
plaintiffs lighter loads would fundamentally alter the nature of the 
defendant's warehouse operation, a change not required by law) 
(citing 29 CFR 1630.2(p)(2)(v) and 29 CFR part 1630, appendix, 
1630.2(p)); Turco v. Hoechst Celanese Corp., 101 F.3d 1090, 1094 
(5th Cir. 1996) (determining that, where the employer had no 
straight day-shift chemical operator positions, moving the plaintiff 
to such a shift would place a heavier burden on the rest of the 
operators in the plant and was not required under the ADA); Mears v. 
Gulfstream Aerospace Corp., 905 F. Supp. 1075, 1081 (S.D. Ga. 1995) 
(concluding that an accommodation that would require employees from 
six different departments to deliver invoices to the plaintiff 
adversely impacted other employees' ability to do their jobs and was 
an undue burden), aff'd, 87 F.3d 1331 (11th Cir. 1996); Bryant v. 
Caritas Norwood Hosp., 345 F. Supp. 2d 155, 171 (D. Mass. 2004) 
(shifting responsibility for an essential function, all heavy 
lifting, to coworkers would have a deleterious impact on the ability 
of coworkers to do their own jobs); Fralick v. Ford, No. 2:12-CV-
1210, 2014 WL 1875705, at *7 (D. Utah May 9, 2014) (permitting the 
plaintiff to work fewer than 60 hours per week was found to 
``fundamentally alter the nature of'' the finance manager position 
and therefore was not a reasonable accommodation); cf. Morrill v. 
Acadia Healthcare, No. 2:17-CV-01332, 2020 WL 1249478, at *8 (D. 
Utah Mar. 16, 2020) (determining that the defendant failed to 
establish that prior equitable distribution of a mopping task 
amongst all employees, as a reasonable accommodation, impeded 
functioning of the business or harmed coworkers).
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    Additionally, in determining whether there is disruption to the 
covered entity's business under the ADA, the Commission has stated with 
regard to disabilities that an employer will be unable to ``show undue 
hardship if the disruption to its employees [is] the result of those 
employees' fears or prejudices toward the individual's disability and 
not the result of the provision of the accommodation. Nor [will] the 
employer be able to demonstrate undue hardship by showing that the 
provision of the accommodation has a negative impact on the morale of 
its other employees but not on the ability of these employees to 
perform their jobs.'' \311\ As the definition of ``undue hardship'' 
under the PWFA follows the ADA, the same rules will apply. An employer 
will not be able to demonstrate undue hardship under the PWFA if the 
disruption to its employees was the result of those employees' fears or 
prejudices. Nor would the employer be able to demonstrate undue 
hardship by showing that the provision of the accommodation has a 
negative impact on the morale of its other employees but not on the 
ability of these employees to perform their jobs.
---------------------------------------------------------------------------

    \311\ See 29 CFR part 1630, appendix, 1630.15(d).
---------------------------------------------------------------------------

    Ultimately, an employer may assert an undue hardship defense to any 
PWFA claim. An employer may be able to show undue hardship if the 
provision of a particular accommodation results in an impact that is 
unduly costly, extensive, substantial, or disruptive, or that would 
fundamentally alter the nature or operation of the business.\312\ As 
with all undue hardship assessments, an employer would need to show 
individualized evidence of undue hardship.
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    \312\ See 29 CFR part 1630, appendix, 1630.2(p).
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Other Comments and Response to Comments Regarding Religious and 
Conscience Considerations
    Several comments stated that the inclusion of abortion as a related 
medical condition revealed that the Commission harbored anti-Catholic 
bias, and others claimed that the Commission would target Catholic 
employers for enforcement.
    As explained above, the Commission interprets the PWFA's provision 
regarding pregnancy, childbirth, or related medical conditions 
consistent with the PWFA's text and the Commission's interpretation of 
identical language in Title VII, an interpretation adopted more than 40 
years ago. The Commission disagrees that interpreting the PWFA in a 
manner consistent with the statutory text and the agency's decades-long 
interpretation of Title VII is suggestive of any anti-Catholic bias or 
that the Commission otherwise harbors any bias. The Commission's 
enforcement decisions are based on whether the facts of the charge show 
reasonable cause to believe discrimination occurred. Further, the 
Commission's history under Title VII reflects that the Commission 
brings cases that protect employees who are being harassed about their 
decision not to have an abortion and that protect the

[[Page 29155]]

religious views of employees who oppose abortion.\313\
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    \313\ See, e.g., EEOC v. Big Lots Stores, Inc., No. 9:08-CV-177, 
2009 WL 10677352, at *6 (E.D. Tex. Oct. 6, 2009) (alleging, as part 
of the plaintiff's harassment claim, that the harasser urged the 
plaintiff to have an abortion). Other suits brought by the EEOC 
regarding abortion pertained to the EEOC protecting the religious 
views of employees. See, e.g., EEOC v. Univ. of Detroit, 904 F.2d 
331, 335 (6th Cir. 1990) (suit brought by EEOC on behalf of an 
employee who did not want to pay union dues because the dues were 
used to support political action in favor of abortion, which the 
employee disagreed with on religious grounds); EEOC v. Am. Fed'n of 
State, Cnty. & Mun. Emps., AFL-CIO, 937 F. Supp. 166, 167 (N.D.N.Y. 
1996) (addressing a lawsuit brought by EEOC on behalf of an employee 
who did not want to pay union dues because the dues were used to 
support political action in favor of abortion and the death penalty, 
which the employee disagreed with on religious grounds).
---------------------------------------------------------------------------

    Second, some comments asserted that an employer's potential 
obligation under the PWFA to provide an accommodation for abortion 
could violate the religious rights of other employees, such as human 
resources employees, who would have to explain to an employee that a 
reasonable accommodation is available in these circumstances and 
process the paperwork. The Commission has addressed steps employers may 
take to respond to conflicts with religious beliefs in these 
circumstances in its Compliance Manual on Religious 
Discrimination.\314\
---------------------------------------------------------------------------

    \314\ Compliance Manual on Religious Discrimination, supra note 
215, at Examples #44 & #45.
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    Third, some comments stated that if employees decide to work for a 
religious employer, then they must abide by the employer's beliefs or 
risk consequences. The Commission made no changes based on these 
comments. As explained above, the PWFA provides for defenses for 
religious organizations and is subject to certain other constitutional 
and statutory exceptions. But none of those defenses or exceptions 
remove all rights from employees who are employed by religious 
employers.

1636.8 Severability

    In the final rule, the Commission has added that the severability 
provisions express the Commission's intent as to severability. Further, 
the Commission clarified that its intent regarding severability applies 
to the Interpretive Guidance as well and has included this language in 
the Interpretive Guidance in section 1636.8 Severability.
    As stated in the Interpretive Guidance in section 1636.8 
Severability, pursuant to 42 U.S.C. 2000gg-6, in places where the 
regulation uses the same language as the statute, if any of those 
identical regulatory provisions, or the application of those provisions 
to particular persons or circumstances, is held invalid or found to be 
unconstitutional, the remainder of the regulation and the application 
of that provision of the regulation to other persons or circumstances 
shall not be affected. For example, if Sec.  1636.4(d) (which uses the 
same language as 42 U.S.C. 2000gg-1(4) and prohibits a covered entity 
from requiring a qualified employee to take leave as a reasonable 
accommodation if there is another reasonable accommodation that can be 
provided) were to be found invalid or unconstitutional, it is the 
intent of the Commission that the remainder of the regulation shall not 
be affected. The Commission would continue to enforce the statute but, 
in this hypothetical example, would not consider it a violation if an 
employer required an employee to take leave as a reasonable 
accommodation when there was another reasonable accommodation 
available.
    Where the regulation or the Interpretive Guidance provides 
additional guidance to carry out the PWFA, including examples of 
reasonable accommodations, it is the Commission's intent that if any of 
those provisions or the application of those provisions to particular 
persons or circumstances were to be held invalid or found to be 
unconstitutional, the remainder of the regulation or the Interpretive 
Guidance and the application of that provision of the regulation or the 
Interpretive Guidance to other persons or circumstances shall not be 
affected. For example, if a court were to determine that a certain 
medical condition such as a pelvic prolapse is not found to be a 
``related medical condition'' in a specific case, the Commission 
intends other conditions could still be determined to be ``related 
medical conditions,'' including pelvic prolapse in another case, 
depending on the facts.

Preamble to the Final Economic Analysis

Executive Orders 12866 (Regulatory Planning and Review), 13563 
(Improving Regulation and Regulatory Review), and 14094 (Modernizing 
Regulatory Review)

Summary of the Commission's Preliminary Economic Analysis of Impacts: 
Costs

    According to the Commission's preliminary economic analysis, the 
proposed rule would impose two quantifiable costs on employers: the 
annual cost of providing pregnancy-related reasonable accommodations as 
a result of the statute and the rule, and the one-time cost of becoming 
familiar with the rule. In all cases, the Commission relied on publicly 
available data for its estimates.\315\
---------------------------------------------------------------------------

    \315\ For the Commission's preliminary economic analysis, see 88 
FR 54754-65.
---------------------------------------------------------------------------

    To estimate the annual cost of providing pregnancy-related 
reasonable accommodations as a result of the statute and the rule, the 
Commission first estimated the total number of employees who were not 
independently entitled to PWFA-type accommodations under an analogous 
State law, which the Commission calculated is 65.11 million employees.
    The Commission then estimated the number of such individuals who 
will be entitled to a reasonable accommodation under the PWFA. To do 
so, the Commission first assumed that the number of such individuals 
will be approximately the same as the number of individuals who 
actually become pregnant during that year. Again, based on publicly 
available data, the Commission estimated that 33 percent of the 65.11 
million employees who are not independently entitled to PWFA-type 
accommodations under an analogous State law are capable of becoming 
pregnant, and that of these, 4.7 percent will actually become pregnant 
in a given year. Applying these percentages yielded a total estimate of 
one million individuals who (a) were not independently entitled to 
PWFA-type accommodations under an analogous State law, and (b) will 
actually become pregnant during a given year. Finally, the Commission 
estimated that between 23 percent (``lower bound estimate'') and 71 
percent (``upper bound estimate'') of these one million individuals 
(between 230,000 and 710,000 individuals) will require a pregnancy-
related reasonable accommodation.
    To calculate the associated costs, the Commission first estimated 
that the accommodations needed by 49.4 percent of the individuals above 
will have zero cost, leaving between 116,000 and 360,000 individuals 
needing accommodations with non-zero cost. It then estimated that each 
of the accommodations needed by these individuals would cost an average 
of $300 distributed over 5 years, or $60 annually. Multiplying these 
numbers together yielded final estimated annual costs of between $6 
million and $18 million for private employers; between $800,000 and 
$2.4 million for State and local government employers; and between 
$300,000 and $800,000 for Federal employers.

[[Page 29156]]

Comments and Response to Comments Regarding the Estimated Percentage of 
Individuals Capable of Becoming Pregnant Who Will Actually Become 
Pregnant in a Given Year
    As explained above, in the NPRM, the Commission estimated that 4.7 
percent of individuals who are capable of becoming pregnant will 
actually become pregnant in a given year.\316\ Some comments stated 
that this estimate is too low because the Commission based its estimate 
on research that tracked the percentage of women participants who gave 
birth in a given year. As such, the 4.7 percent estimate did not 
include individuals who became pregnant in a given year but did not 
give birth, including individuals who had miscarriages, stillbirths, or 
abortions. Because this figure was used to calculate the number of 
reasonable accommodations needed, the comments further reasoned, the 
cost estimates did not take into account any reasonable accommodations 
needed by individuals who had miscarriages, stillbirths, or abortions.
---------------------------------------------------------------------------

    \316\ Id. at 54757.
---------------------------------------------------------------------------

    The Commission agrees that the research it relied upon did not take 
account of individuals who became pregnant during a given year but who 
did not give birth, and therefore that its previous estimate of 4.7 
percent was too low. To correct the shortcoming, the Commission has 
relied upon Centers for Disease Control (CDC) research showing that, 
between 2015 and 2019, live births in the United States accounted for 
67% of all pregnancies among women aged 15-44 years on average.\317\ 
Assuming that the ratio of live births to total pregnancies among women 
of reproductive age in the labor force is the same as among all 15-44 
years old women, the Commission thus estimates that the percentage of 
individuals capable of becoming pregnant who will actually become 
pregnant in given year is 0.047 / 0.67 = 0.071 (rounded up), or 7.1 
percent. This revised estimate is used in the revised economic analysis 
below.
---------------------------------------------------------------------------

    \317\ Lauren M. Rossen et al., U.S. Dep't of Health & Hum. 
Servs., Ctrs. for Disease Control & Prevention, Nat'l Ctr. for 
Health Stat., Updated Methodology to Estimate Overall and Unintended 
Pregnancy Rates in the United States 15 (2023), https://stacks.cdc.gov/view/cdc/124395.
---------------------------------------------------------------------------

Comments and Response to Comments Regarding the Percentage of Pregnant 
Employees Needing a Reasonable Accommodation Under the PWFA
    As explained above, in the NPRM, the Commission estimated that 
between 23 percent (lower bound estimate) and 71 percent (upper bound 
estimate) of individuals who are actually pregnant in a given year will 
need a reasonable accommodation under the PWFA.\318\ The report that 
the Commission used to arrive at these estimates stated that 71 percent 
of pregnant individuals surveyed needed more frequent breaks, such as 
extra bathroom breaks; 61 percent needed a change in schedule or more 
time off; 53 percent needed a change in duties; and 40 percent needed 
some other type of workplace adjustment.\319\ The Commission chose the 
highest of these numbers (71 percent) as its upper bound estimate of 
the percentage of pregnant employees needing accommodations.
---------------------------------------------------------------------------

    \318\ 88 FR 54758.
    \319\ Eugene R. Declercq et al., Listening to Mothers III: New 
Mothers Speak Out 36 (2013), https://www.nationalpartnership.org/our-work/resources/health-care/maternity/listening-to-mothers-iii-new-mothers-speak-out-2013.pdf.
---------------------------------------------------------------------------

    The Commission received a comment stating that the report cited by 
the Commission does not support the use of 71 percent as an upper bound 
estimate of the percentage of pregnant individuals needing an 
accommodation because the report established that 71 percent of the 
pregnant individuals surveyed needed additional breaks, but did not 
state whether any of the other 29 percent of pregnant individuals 
surveyed needed a different type of accommodation (such as a change in 
schedule or a change in duties). If so, then more than 71 percent of 
pregnant individuals surveyed needed at least one accommodation.
    The report the Commission relied upon to set its upper and lower 
bound estimates did not state whether any of the 29 percent of 
individuals who did not need additional breaks needed a different sort 
of accommodation. It was therefore not possible for the Commission to 
determine, on the basis of this report, the percentage of employees 
surveyed who needed at least one accommodation. The comment objecting 
to the Commission's use of the 71 percent estimate did not provide 
additional data for the Commission to consider, and the Commission 
could not independently locate any more precise information. The 
Commission therefore must rely on reasonable assumptions to set its 
upper bound estimate of the percentage of pregnant employees needing 
accommodation.
    Although it is possible that some of the 29 percent of pregnant 
individuals who did not need additional breaks needed a different type 
of accommodation, the Commission continues to assume for purposes of 
the economic analysis that the individuals who needed a different type 
of pregnancy-related accommodation are a subset of those who needed 
additional breaks. In the Commission's opinion, it is unlikely that a 
pregnant individual who does not need additional breaks would need a 
less common type of accommodation such as a change in schedule or a 
change in duties. Additionally, many of the 71 percent of pregnant 
individuals surveyed who needed additional breaks may be entitled to 
them under the ADA, Title VII, or employer policies, and therefore the 
71 percent figure likely overstates the number of individuals who will 
receive those breaks specifically as a consequence of the PWFA. The 
Commission is therefore confident that 71 percent is a reasonable 
estimate of the proportion of pregnant individuals needing 
accommodation under the PWFA given the paucity of data available at the 
time of this rulemaking.
    The same comment objected to the Commission's use of 23 percent as 
a lower bound estimate of the percentage of pregnant employees who will 
need an accommodation under the rule. The Commission relied on the same 
report discussed immediately above to arrive at this estimate. Based on 
data in this report, the Commission calculated that 32 percent of 
pregnant individuals surveyed needed, but did not receive, more 
frequent breaks, such as extra bathroom breaks; 20 percent needed, but 
did not receive, a change in schedule or more time off; 23 percent 
needed, but did not receive, a change in duties; and 18 percent needed, 
but did not receive, some other type of workplace adjustment.\320\ The 
Commission averaged these numbers to arrive at a lower bound estimate 
of 23 percent.\321\
---------------------------------------------------------------------------

    \320\ Id.
    \321\ 88 FR 54758.
---------------------------------------------------------------------------

    According to the comment, the Commission's calculations established 
that at least 32 percent of pregnant employees surveyed needed, but did 
not receive, at least one pregnancy-related accommodation 
(specifically, additional breaks). The comment further argued that the 
Commission failed to offer any justification for the decision to 
average the four figures.
    The Commission agrees with the comment that using the highest of 
the four figures (32 percent) is the better approach. As explained 
above, the report establishes that 32 percent of pregnant employees 
surveyed needed, but did not receive, at least one type of pregnancy-
related accommodation. The Commission therefore has raised its lower 
bound estimate from 23 percent to 32 percent in the analysis below.

[[Page 29157]]

Comments and Response to Comments Regarding the Estimated Average Cost 
of an Accommodation
    As stated above, in its previous analysis, the Commission estimated 
that 49.4 percent of needed pregnancy-related accommodations will have 
no cost, and that the average cost of the remaining 50.6 percent will 
be $300 distributed over 5 years, or $60 annually.\322\
---------------------------------------------------------------------------

    \322\ Id. at 54759.
---------------------------------------------------------------------------

    One comment stated that this estimate was too low because it did 
not include costs associated with having a vacant position and with 
looking for new hires, both of which may be necessary when a pregnant 
employee takes leave. The comment emphasized that these costs affect 
both customers and other staff members.
    The Commission declines to raise the estimated average cost of an 
accommodation in response to this comment. To estimate costs 
responsibly, the Commission must rely on existing data. According to 
the best available data, the average cost of a non-zero-cost reasonable 
accommodation provided pursuant to the ADA is $300.\323\ Leave is an 
accommodation that is available under the ADA. The costs associated 
with leave, including the kinds of costs identified by the comment, 
were therefore presumably included in the data used to generate the 
$300 average. Additionally, if an employer did not provide leave to the 
employee and simply terminated the employee, the employer would still 
face the costs of having a vacant position and looking for new hires. 
To the extent that an accommodation allows the pregnant employee to 
stay with the employer, the employer could realize cost savings because 
it will not have to hire and train new employees.\324\
---------------------------------------------------------------------------

    \323\ Id.
    \324\ Id. at 54754.
---------------------------------------------------------------------------

Comments and Response to Comments Regarding Alleged Additional Costs: 
Abortion
    Many comments stated that the economic analysis should be revised 
to incorporate not only costs arising from the provision of abortion-
related reasonable accommodations, but also the costs of abortions 
themselves together with some of their alleged downstream consequences.
    Some comments suggested adding the costs of abortions to the 
analysis because they mistakenly understood the proposed rule as 
requiring employers to bear those costs. For example, some comments 
stated that the proposed rule required employers to pay for abortion 
services or to pay for associated travel and lodging expenses as 
reasonable accommodations. Because the proposed rule did not, and the 
final rule does not, require covered employers to bear these costs, the 
Commission declines to amend the economic analysis to incorporate these 
costs to employers.
    In most cases, however, comments suggesting inclusion of abortion-
related costs identified costs that do not apply directly to employers. 
For example, some of these comments stated that the estimated cost of 
the rule should be increased by the value of the years of life lost by 
the individuals who were never born due to abortion. Others stated that 
the estimated cost of the rule should be revised to include health care 
costs that the comments alleged would be incurred by individuals who 
undergo abortion care. Other comments stated that the estimate should 
include certain large-scale societal costs that they linked to 
abortion. Several of these comments cited a 2022 report by Joint 
Economic Committee Republicans.\325\
---------------------------------------------------------------------------

    \325\ Joint Economic Committee Republicans, The Economic Cost of 
Abortion (2022), https://www.jec.senate.gov/public/_cache/files/b8807501-210c-4554-9d72-31de4e939578/the-economic-cost-of-abortion.pdf.
---------------------------------------------------------------------------

    The Commission declines to change its analysis in response to these 
comments. The alleged cost of abortion and its downstream consequences 
cannot properly be attributed to the final rule and statute simply 
because abortion-related accommodations are available under the 
PWFA.\326\ Neither the statute nor the final rule has an impact on the 
costs that commenters allege are associated with abortion. Indeed, the 
comments themselves appear to acknowledge that the purported costs 
imposed by abortion are independent of the rule.\327\
---------------------------------------------------------------------------

    \326\ Many of the comments stating that the Commission should 
account for the cost of abortion and its downstream consequences 
described the rule as containing an ``abortion mandate'' or as 
``encouraging'' abortion. This is a mischaracterization of the rule. 
Rather than requiring or encouraging abortion, this rule simply 
requires employers to provide reasonable accommodations to the known 
limitations of employees under some circumstances.
    \327\ The $6.9 trillion in annual abortion-related costs 
identified by Joint Economic Committee Republicans in their 2022 
report, for example, were said to have occurred in 2019--well before 
the effective date of the statute or final rule. These costs should 
therefore be considered part of the pre-statutory baseline, rather 
than new costs attributable specifically to the statute and final 
rule.
---------------------------------------------------------------------------

    The Commission recognizes that, under the statute and final rule, 
some individuals will obtain reasonable accommodations that they may 
not have otherwise obtained, possibly including leave as a reasonable 
accommodation related to an abortion.\328\ But it does not follow that 
any of these individuals will have abortions because they were able to 
obtain an accommodation. It therefore does not follow that the costs 
associated with the abortions themselves should be included in the 
economic analysis.
---------------------------------------------------------------------------

    \328\ The Commission notes that it is possible that the 
availability of abortion-related reasonable accommodations--such as 
leave--may have additional effects on the circumstances of an 
abortion, for example by enabling the individual to have the 
abortion at an earlier time; to elect a different method of 
abortion; to have the abortion at a nearby clinic instead of 
traveling to a more distant clinic; or to have the abortion 
performed by a reputable provider. The Commission was unable to 
incorporate these cost savings into the quantitative analysis, 
however, due to lack of data.
---------------------------------------------------------------------------

    A small number of comments argued that the proposed rule will 
increase the number of abortions performed, and that the economic 
analysis should include costs associated specifically with this 
increase. According to these comments, to calculate the cost of the 
final rule, the Commission must first determine the proportional 
economic impact of a single abortion and then multiply that figure by 
the number of additional abortions performed as a result of the rule.
    The Commission declines to take this approach because the comments 
did not provide any evidence, and the Commission is not aware of such 
evidence, to support the conclusion that the number of abortions will 
increase as a consequence of the statute and the final rule.
    A few comments asserted that the number of abortions will increase 
because the rule, by making abortion-related accommodations available, 
will make pregnant employees ``uncomfortable'' about bringing their 
pregnancies to term. These commenters did not provide support for this 
proposition, however. Other comments stated that the rule will increase 
the number of abortions because some employers may prefer that their 
employees terminate their pregnancies rather than bring their 
pregnancies to term, and, therefore, these employers may pressure their 
employees into having abortions by refusing to provide any pregnancy-
related accommodations other than leave to obtain an abortion. This 
argument is unpersuasive because such refusal would be unlawful under 
the PWFA. An employer could not satisfy its PWFA obligations by 
providing leave to have an abortion to an individual who requests 
additional bathroom breaks due to pregnancy, for example, because such 
leave would not be an effective accommodation under those 
circumstances. In addition, Title VII prohibits employers from coercing

[[Page 29158]]

employees into having abortions because it prohibits them from taking 
an adverse action against an individual because of the individual's 
decision to have--or not to have--an abortion.\329\
---------------------------------------------------------------------------

    \329\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (I)(A)(4)(c).
---------------------------------------------------------------------------

    Again, the Commission recognizes that, under the statute and the 
final rule, an employee who has decided to have an abortion may request 
and receive an abortion-related accommodation, absent undue hardship. 
But it does not follow from this fact alone that the individual has 
decided to have the abortion because of the rule. The assumption 
implicit in comments--that some employees will decide to have abortions 
because the final rule and statute make abortion-related accommodations 
available--is speculative.\330\ Research shows that individuals who are 
unable to access abortion care typically are unable to do so for 
multiple reasons, none of which are determinative.\331\ Because the 
Commission is unaware of any data showing specifically that access to 
PWFA-type accommodations will increase the number of abortions 
performed, it declines to add the associated costs to its 
analysis.\332\
---------------------------------------------------------------------------

    \330\ To support the assertion that the costs of an abortion are 
attributable to the final rule and statute, research would need to 
show that the abortion-related accommodation provided under the 
rule--in most cases leave--is a but-for cause of the abortion, and 
that the individual does not have independent access to the leave 
under a different law or policy.
    \331\ See, e.g., Jenna Jerman et al., Barriers to Abortion Care 
and Their Consequences for Patients Traveling for Services: 
Qualitative Findings From Two States, 49 Persps. on Sexual & Reprod. 
Health 95, 98-99 (2017).
    \332\ The Commission notes that, even if data could be found 
showing that the final rule and statute will increase the number of 
abortions that are performed, the Commission would still need to 
engage in considerable speculation in order to estimate the 
associated costs. Although some comments cited research purporting 
to measure costs imposed by abortion on individuals who undergo 
abortion care and on society as a whole, the research did not 
establish a consensus on this issue. See generally Ushma D. Upadhyay 
et al., Intended Pregnancy After Receiving Vs. Being Denied a Wanted 
Abortion, 99 Contraception 42 (2019).
---------------------------------------------------------------------------

Comments and Response to Comments Regarding Alleged Additional Costs: 
Litigation
    Some comments stated that the rule would increase costs for 
employers by increasing litigation. Some of these provided only a very 
brief justification for the claim. Some comments, for example, claimed 
that the rule would increase litigation because it is ``expansive'' or 
because the range of accommodations required is broad. One comment 
stated that the rule is likely to invite litigation because it is 
likely that a different Presidential administration will change this 
policy. These comments did not include data or cite any supporting 
research.
    One comment, signed by several Attorneys General from States that 
have PWFA-type statutes, supports the opposite conclusion:

    Nor have the PWFA-analogue States experienced a marked increase 
in litigation following enactment of their PWFA/Break Time law 
analogues. In Washington State, all but 2 of the 650 pregnancy 
accommodation intakes received by the Attorney General's Office 
resolved without the need to file a lawsuit. In New York State, 
which enacted its PWFA analogue in 2016, the vast majority of 
discrimination complaints filed with the New York Division of Human 
Rights involve allegations of employment discrimination, yet 
complaints relating to reasonable accommodations for pregnancy-
related conditions account for at most .03% of all employment 
discrimination filings. Moreover, 86% of the employment 
discrimination cases that involve reasonable accommodations for a 
pregnancy-related condition resolve prior to an agency hearing. The 
pre-hearing resolution numbers are similar in Connecticut. In 
Oregon, only about 1.5% of cases filed with the Civil Rights 
Division of the state's Bureau of Labor and Industries involve 
pregnancy or post-partum accommodation issues, a good portion of 
which are voluntarily resolved. . . . And in Illinois, only 1% of 
charges filed with the Department of Human Rights involved 
pregnancy-related charges seeking an accommodation. A study in 
California, which enacted its state PWFA in 2000, showed the total 
number of pregnancy discrimination charges filed with the state 
human rights agency actually decreased after the law was 
enacted.\333\
---------------------------------------------------------------------------

    \333\ Comment EEOC-2023-0004-98337, New York State Attorney 
General, at 5 (Oct. 10, 2023).

    The Commission also disagrees with the claim that its definition of 
``pregnancy, childbirth, or related medical conditions'' is expansive 
and will increase litigation, or the characterization of its definition 
as an example of something that will lead to litigation because another 
Presidential administration will change it. As explained in the 
preamble to the final rule, ``pregnancy, childbirth, or related medical 
conditions'' is language from Title VII, and the Commission's 
interpretation of that phrase in the PWFA is consistent with how courts 
and the Commission have interpreted that phrase in Title VII. Moreover, 
the interpretation of ``pregnancy, childbirth, or related medical 
conditions'' in the PWFA is consistent with the interpretation the 
Commission has had in many different Presidential administrations. 
Finally, given the long-standing definition of ``pregnancy, childbirth, 
or related medical conditions'' in Title VII, changing it for the PWFA 
also would have the potential to create litigation.
    Some comments stated more specifically that interpreting the term 
``related medical conditions'' to include abortion will cause 
litigation because employers that comply by providing abortion-related 
leave as a reasonable accommodation may be found liable for pregnancy 
discrimination. For example, one comment stated that if an employer 
provided an employee sufficient leave to travel out of the State to 
have an abortion but denied a request by a pregnant employee who did 
not want an abortion for the same amount of leave to see an out-of-
State obstetrician, instead only providing an amount of leave 
sufficient to visit an in-State obstetrician, the employer could face a 
claim that it is discriminating against women who do not get abortions.
    The Commission disagrees that provision of abortion-related leave 
as a reasonable accommodation could give rise to liability for 
pregnancy discrimination under the circumstances described. First, if 
the employer is providing the leave as a reasonable accommodation, then 
it is not providing either employee with ``benefits.'' Rather, it is 
providing them with reasonable accommodations to which they are 
entitled under the law.
    Second, the two kinds of leave are not ``unequal.'' With respect to 
both individuals, the employer is providing the amount of leave 
necessary to address the individual's known pregnancy-related 
limitation. It is often the case that the cash value of one reasonable 
accommodation is less than that of another. For example, if an employer 
provides one pregnant individual a reasonable accommodation of drinking 
water because that is what the individual needs, and provides a second 
pregnant individual with a chair to sit on because that is what the 
second pregnant individual needs, the employer is not discriminating 
against the first individual just because a chair costs more than 
permission to drink water--both individuals have been given reasonable 
accommodations appropriate to their known pregnancy-related 
limitations.
    Because the comments discussed above did not provide evidence to 
support the conclusion that promulgation of the rule will invite 
increased litigation, the Commission declines to incorporate 
litigation-related costs into the final economic analysis.

[[Page 29159]]

Comments and Response to Comments Regarding Additional Costs: Male 
Employees
    Some comments stated that it was unclear whether the rule entitled 
men to pregnancy-related accommodations (including, for example, male 
infertility treatment), but that, if the rule entitled men to such 
accommodations, these costs should be reflected in the analysis. The 
Commission declines to incorporate these costs into the analysis 
because, as explained in the preamble to the final rule, the definition 
of ``pregnancy, childbirth, or related medical conditions'' in the 
final rule only encompasses medical conditions which relate to 
pregnancy or childbirth, ``as applied to the specific employee or 
applicant in question.''
Comments and Response to Comments Regarding Alleged Additional Costs: 
Other Costs
    One comment stated that the Commission's economic analysis should 
account for costs arising from the loss of free speech and free 
exercise rights. The Commission does not agree that the regulation 
creates such a loss and has explained in the preamble to the final rule 
why free speech and religious exercise are not negatively affected by 
and are, instead, protected by the rule.
    A few comments stated that the Commission should account for the 
reduction in hiring of women based on the ``expansive'' accommodation 
requirements. The Commission does not agree that this is a cost it 
should take into account for the economic analysis. First, 
discrimination against women because they need an accommodation, or may 
need an accommodation, under the PWFA violates the PWFA and potentially 
Title VII. Second, these comments did not provide evidence supporting 
the conclusion that employers will hire fewer women as a result of the 
rule and underlying law.
    One comment stated that the Commission's economic analysis, which 
did not consider accommodation costs for States with their own PWFA-
type statutes, did not account for the fact that these State statutes 
do not permit accommodations for abortions. This comment did not 
support this statement with data or case law, and the Commission was 
unable to find any independent evidence of any such restriction.\334\ 
Additionally, as noted in the preamble to the final rule, an employee 
may need an abortion for a variety of reasons, which could affect the 
ability of the employee to use the State statute for an accommodation.
---------------------------------------------------------------------------

    \334\ Some comments stated more generally that the impact 
analysis should account for the fact that some State PWFA-type laws 
may not be identical to the PWFA, and therefore that such States may 
face slightly additional costs for reasonable accommodations 
required by the PWFA but not by the pre-existing State law. These 
comments failed to identify whether or how the interpretations of 
the State law differ from the PWFA and to cite or provide data that 
would support any changes.
---------------------------------------------------------------------------

    One comment stated that the economic analysis should include costs 
related to severance, retirement, and labor shortages, and, 
additionally, that it should include costs arising from the decline in 
private firms' participation in the national economy. The Commission 
declines to include these costs because the comment provided no data 
supporting a connection between provision of pregnancy-related 
reasonable accommodations, on the one hand, and an employee's decision 
to leave the workforce or to decline to participate in market 
activities, on the other hand. The Commission further notes that it 
received countervailing comments on this issue, suggesting that the 
rule will enable covered entities to prevent individuals from leaving 
the workforce by making pregnancy-related accommodations available to 
those who need them.
    One comment stated that the Commission should consider the 
alternative of defining ``related medical conditions'' to exclude 
abortion. As explained in the final rule, the Commission's 
interpretation is consistent with the PWFA's text, and for over 40 
years, the Commission and courts have interpreted the phrase 
``pregnancy, childbirth, or related medical conditions'' in Title VII 
to include abortion. The Commission concludes that it is unnecessary to 
consider this alternative for the economic analysis.
    One comment stated that, in States that have laws like the PWFA, 
employees are more likely to ask for and receive accommodations, and in 
States where there are no PWFA-like laws, employees are less likely to 
ask for or receive accommodations; thus, those who have not received 
accommodations prior to the PWFA should be overrepresented among those 
who now have rights. The Commission based its calculations on the data 
that is available, and this comment did not provide data to support 
this point or dispute the Commission's calculations.
Comments and Response to Comments Regarding the Time To Read the 
Regulation
    Several comments stated that the Commission underestimated the time 
to read and understand the regulation, including stating that small 
businesses without a legal staff would take a long time to read and 
understand the rule; that the amount of time for compliance should be 
increased to account for time to read and review the regulation, obtain 
legal advice, develop a compliance policy, train employees, and 
implement the rule, including creating systems to collect, retain, and 
secure protected information; that a specific individual took 2 days to 
read the regulation and several of the comments; that the cost should 
account for the hiring of outside counsel; that the Commission should 
include the cost of processing each request for an accommodation; and 
that the Commission should account for costs to train new employees and 
for new businesses in future years. Most of these comments on this 
topic did not provide either data or evidence to support a revision by 
the Commission. Those that did so provided estimates that varied 
greatly, and none were grounded in research.
    The Commission has slightly increased its estimate of the amount of 
time allotted for compliance activities, in part to account for the 
fact that the final rule and Interpretive Guidance are slightly longer, 
and therefore would take slightly longer to read, than the proposed 
rule and Interpretive Guidance contained in the NPRM, and in part in 
response to comments indicating additional time is needed for covered 
entities to become familiar with the rule. The Commission estimates 
that compliance activities for a covered entity will take an average of 
135 minutes, or 2.25 hours, in States that do not already have laws 
substantially similar to the PWFA and an average of 45 minutes in 
States with existing laws similar to the PWFA. This estimate is 
consistent with the amount of time the Commission allotted for 
compliance activities under other recent regulations that it has 
published in connection with civil rights laws. For example, in 
publishing a regulation implementing Title II of the Genetic 
Information Nondiscrimination Act (GINA), the Commission estimated 3 
hours for rule familiarization, which was appropriate because GINA 
involved a new protection against discrimination based on genetic 
information.\335\ Conversely, the Commission did not include a 
calculation of the cost for rule familiarization in its rule amending 
its Age Discrimination in Employment Act (ADEA) regulations concerning 
disparate-impact claims and the reasonable factors other than age

[[Page 29160]]

defense (RFOA) \336\ or its rule implementing the ADA Amendments Act 
(ADAAA).\337\
---------------------------------------------------------------------------

    \335\ 75 FR 68912, 68931 (Nov. 9, 2010).
    \336\ 77 FR 19080, 19090-94 (Mar. 30, 2012).
    \337\ 76 FR 16978, 16994-95, 16999 (Mar. 25, 2011).
---------------------------------------------------------------------------

    Here, the Commission has calculated compliance activities under the 
PWFA regulation in light of the fact that the PWFA is a new civil 
rights statute, but employers covered by the PWFA already are covered 
by Title VII and the ADA. Presumably, these employers already have 
standard procedures to inform their employees and supervisors about 
their rights and responsibilities under Title VII, the ADA, and other 
workplace laws. Given the similarities between the PWFA and the ADA and 
Title VII, employers will be able to use many of their existing 
procedures and include the PWFA in their training regarding the ADA and 
Title VII.\338\ Further, the Commission offers training and assistance 
specifically tailored to small businesses.\339\ The Commission does not 
anticipate that covered entities will need legal advice; the PWFA and 
the regulation draw on well-established concepts and procedures from 
Title VII and the ADA. For example, as under the ADA, an employer does 
not have to require supporting documentation to provide a PWFA 
accommodation; if it does, the documentation under the PWFA, like under 
the ADA, must be kept separate from the employee's personnel file. 
Thus, employers will be able to use a compliance mechanism they have 
already developed for the ADA for the PWFA. Similarly, employers can 
use the same human resources staff they use to process requests for 
accommodations under the ADA or Title VII for such requests under the 
PWFA. Accordingly, the Commission does not anticipate that covered 
employers will need time in addition to the time provided in the final 
rule.
---------------------------------------------------------------------------

    \338\ H.R. Rep. No. 117-27, pt. 1, at 26-31 (discussing the 
similarities between the PWFA and the ADA and the PWFA and Title 
VII).
    \339\ EEOC, Small Business Resource Center, https://www.eeoc.gov/employers/small-business (last visited Mar. 25, 2024)
---------------------------------------------------------------------------

    Additionally, the Commission received comments that stated that the 
regulation would provide appropriate guidance and would assist 
employers in compliance, which would reduce employer costs.

Summary of the Commission's Preliminary Economic Analysis of Impacts: 
Nonquantifiable Benefits

    In the NPRM, the Commission identified five primary benefits of the 
proposed rule and underlying statute that are difficult to quantify: 
(1) improvements in maternal and infant health outcomes; (2) 
improvements in pregnant employees' economic security; (3) non-
discrimination and other intrinsic benefits, such as the enhancement of 
human dignity; (4) clarity in enforcement and efficiencies in 
litigation; and (5) benefits for covered entities.\340\
---------------------------------------------------------------------------

    \340\ 88 FR 54751-54.
---------------------------------------------------------------------------

Comments and Response to Comments Regarding Non-Quantifiable Benefits
    A number of comments agreed with the identified benefits and 
provided additional research or anecdotal evidence to support the 
benefits.
    Regarding improvements in maternal and infant health outcomes, one 
comment asserted that the rule will have positive effects on pregnant 
employees' mental health, stating that even perceived pregnancy 
discrimination at work has been linked to increased stress and symptoms 
of postpartum depression.\341\ This comment linked stress resulting 
from workplace discrimination and workplace conditions to increased 
risk of preterm birth or low birth weight, potentially resulting in 
serious health problems at birth that may cause long-term health and 
developmental consequences in children.\342\ Such health challenges may 
result in additional health care costs; accordingly, reducing stress 
during pregnancy also may reduce health care costs.\343\ Other comments 
observed that, because research shows that certain workplace 
conditions, such as lengthy periods of standing or walking, or high 
risk of chemical exposure or noise, can result in complications for a 
pregnant employee and their baby, accommodations to alleviate those 
conditions improve health outcomes for pregnant employees and their 
children.\344\ Additionally, one comment cited a source that drew from 
a study that found that, overall, employment during pregnancy is 
associated with a reduction in the risk of preterm birth, which 
supports the need to keep pregnant employees in the workforce.\345\ 
Other comments provided anecdotal evidence that employees who received 
accommodations under the PWFA felt secure in their employment and thus 
better able to focus on their new babies' needs.
---------------------------------------------------------------------------

    \341\ See Kaylee J. Hackney et al., Examining the Effects of 
Perceived Pregnancy Discrimination on Mother and Baby Health, 106 J. 
Applied Psych. 774, 777, 781 (2021).
    \342\ Id. at 778, 781; March of Dimes, Stress and Pregnancy, 
https://www.marchofdimes.org/find-support/topics/pregnancy/stress-and-pregnancy (last visited Mar. 25, 2024); March of Dimes, Long-
Term Health Effects of Preterm Birth (Oct. 2019), https://www.marchofdimes.org/find-support/topics/birth/long-term-health-effects-premature-birth.
    \343\ March of Dimes, Premature Birth: The Financial Impact on 
Business (2013), https://onprem.marchofdimes.org/materials/premature-birth-the-financial-impact-on-business.pdf.
    \344\ See generally Frincy Francis et al., Ergonomic Stressors 
Among Pregnant Healthcare Workers, 21 Sultan Qaboos Univ. Med. J. 
172 (2021), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219330 
(describing ergonomic stressors and pregnancy outcomes); see also 
Louisville Dep't of Pub. Health & Wellness, Pregnant Workers Health 
Impact Assessment 17-19, 23 (2019) [hereinafter Pregnant Workers 
Health Impact Assessment], https://louisvilleky.gov/center-health-equity/document/pregnant-workers-hia-final-02182019pdf (identifying 
workplace conditions that may impact the health of a pregnant worker 
and their child and basic accommodations to alleviate those 
conditions to improve health outcomes).
    \345\ Pregnant Workers Health Impact Assessment, supra note 344, 
at 16-17 (citing a study finding that, overall, employment during 
pregnancy is associated with a reduction in risk of preterm birth, 
although certain types of jobs or environments may increase the risk 
of preterm birth).
---------------------------------------------------------------------------

    Regarding improvements in pregnant employees' economic security, 
several comments underscored that many American workers lack a 
financial cushion and that the proposed rule and underlying law will 
mitigate short- and long-term negative financial consequences 
associated with losing a job at a critical time, given increased costs 
due to childbirth, child rearing, and childcare.\346\ At least one 
comment observed that women of color and Native women are 
overrepresented in low-paid jobs with few benefits, and that providing 
accommodations that can help employees stay in the workforce is 
critical to promoting economic security.\347\
---------------------------------------------------------------------------

    \346\ See, e.g., Lane Gillespie, Bankrate, Bankrate's 2023 
Annual Emergency Savings Report (June 22, 2023), https://www.bankrate.com/banking/savings/emergency-savings-report/ (finding 
that 48 percent of Americans have enough emergency savings to cover 
3 months of expenses); Matthew Rae et al., KFF, Health Costs 
Associated with Pregnancy, Childbirth, and Postpartum Care (July 13, 
2022), https://www.kff.org/health-costs/issue-brief/health-costs-associated-with-pregnancy-childbirth-and-postpartum-care/ (noting 
that the average health care costs associated with ``pregnancy, 
childbirth, and post-partum care'' total $18,865, and the average 
out-of-pocket cost is $2,854).
    \347\ See Jasmine Tucker & Julie Vogtman, Nat'l Women's Law 
Ctr., Hard Work Is Not Enough: Women in Low-Paid Jobs 15 (2023), 
https://nwlc.org/wp-content/uploads/2020/04/%C6%92.NWLC_Reports_HardWorkNotEnough_LowPaid_2023.pdf.
---------------------------------------------------------------------------

    Regarding non-discrimination and other intrinsic benefits, several 
comments confirmed that non-discrimination and other intrinsic benefits 
result from the proposed rule and underlying law. For example, one 
comment stated that the underlying law gives pregnant employees ``a 
strong sense of dignity and belonging in the workforce,'' reduces 
stigma and stereotyping regarding pregnancy, and

[[Page 29161]]

reestablishes pregnancy as an ordinary part of employment. One comment 
cited a source that stated, ``The reasonable accommodation framework 
relieves individual employees of the burden of proving animus: of 
showing that an employer's inflexible imposition of workplace standards 
reflects sex stereotyping that flows from the invidious assumption that 
pregnant workers are not competent or committed workers.'' \348\ 
Several comments provided anecdotal accounts of the sense of dignity 
that receiving pregnancy-related accommodations under the PWFA has 
given individual employees. Another comment noted that the proposed 
rule and underlying law will reduce incidents in which pregnant 
employees experienced humiliation at the hands of supervisors who 
denied accommodations and singled out pregnant employees for negative 
treatment.
---------------------------------------------------------------------------

    \348\ Reva B. Siegel, The Pregnant Citizen, from Suffrage to the 
Present, 108 Georgetown L.J. 167, 220-26 (2020).
---------------------------------------------------------------------------

    Regarding clarity in enforcement and efficiencies in litigation, 
multiple comments confirmed that the proposed rule would provide 
clarity regarding employees' rights and employers' obligations under 
the PWFA. One comment stated that the NPRM explains the PWFA in an 
understandable and accessible way. One comment from a nonprofit 
observed that ``dozens and dozens'' of low-wage employees had informed 
them of the ``transformative'' effect of the law in their lives; some 
employees reported that their employers had previously denied or 
ignored their requests for accommodation but granted them after the 
PWFA became effective.\349\ At the same time, this nonprofit noted that 
many employees, particularly low-wage women of color, are still denied 
their rights under the PWFA, demonstrating the need for a clear and 
comprehensive rule. Finally, as previously noted, the comment from 
several State Attorneys General observed that States that had enacted 
laws protecting pregnant employees in the workplace did not experience 
a marked increase in litigation following the law's enactment, and the 
vast majority of complaints resolve prior to administrative proceedings 
or litigation.\350\
---------------------------------------------------------------------------

    \349\ Comment EEOC-2023-0004-98298, A Better Balance, at 7 (Oct. 
10, 2023).
    \350\ See supra note 333.
---------------------------------------------------------------------------

    Regarding benefits for covered entities, some comments stated that 
employers benefit from retaining pregnant employees because searching 
for and training new employees results in costs and stress on an 
organization, which can, in turn, negatively affect customers and other 
employees. Several comments highlighted that laws like the PWFA enable 
businesses to retain valuable employees, improve productivity and 
morale, reduce workers' compensation costs and absenteeism, and improve 
company diversity, and stated that the proposed rule would have the 
same effects. One comment observed that, for small businesses 
struggling with worker shortages and seeking to incentivize employee 
retention, the proposed rule could facilitate incentivizing worker 
retention.
    One comment asserted that the rule would benefit employees in 
industries that are traditionally male dominated, such as manufacturing 
and the trades, and are physically demanding. The comment stated that 
providing pregnancy-related accommodations will reduce occupational 
segregation by gender, which in turn may affect the pay gap. Although 
this logically may be a possible benefit, the sources cited did not 
directly support this proposition. The Commission thus declines to 
include this as a benefit of the final rule.
    The Commission received a few comments asserting that certain 
factors offset the non-quantifiable benefits identified by the 
Commission. One comment stated that in its discussion of the benefits 
to civil rights, the Commission must account for the harm done to the 
civil rights of religious employers that may have to provide 
accommodations that conflict with their religious beliefs. The 
Commission does not agree with this comment; as discussed in the 
preamble to the final rule, several defenses are available to religious 
employers.
    The Commission also received several comments stating that the 
proposed rule would create harm to women and families because of its 
inclusion of abortion in the definition of ``pregnancy, childbirth, or 
related medical conditions.'' As set out in the economic analysis and 
the preamble to the final rule, the rule does not require anyone to 
have an abortion or force employers to pay for abortions. Further, as 
set out in the response to comments on the quantitative analysis above, 
there is no evidence that the rule will increase the number of 
abortions. The Commission does not agree that the considerations raised 
in these comments should be included here.
    The Commission concludes that the benefits articulated in the NPRM 
are attributable to the rule and the Commission incorporates 
supplemental evidence of each benefit, as described above, into the 
final rule.

Regulatory Flexibility Act and Executive Order 13272 (Proper 
Consideration of Small Entities in Agency Rulemaking)

Summary of the Commission's Certification That the Rule Will Not Have a 
Significant Economic Impact on a Substantial Number of Small Entities

    In the NPRM, the Commission certified that the rule will not have a 
significant economic impact on a substantial number of small 
entities.\351\ The Commission reasoned that, although the rule would 
apply to all small entities with 15 or more employees, and therefore 
would affect a ``substantial'' number of small entities, it would not 
have a ``significant economic impact'' on a substantial number of small 
entities.
---------------------------------------------------------------------------

    \351\ 88 FR 54764. The Commission's analysis under the 
Regulatory Flexibility Act, summarized here, is available at 88 FR 
54764-65.
---------------------------------------------------------------------------

    To justify its decision to certify in the final rule, the 
Commission again began its analysis by assuming that the rule will 
impose two quantifiable costs on small entities: the annual cost of 
providing pregnancy-related reasonable accommodations as a result of 
the statute and the rule, and the one-time cost of becoming familiar 
with the rule.
    To estimate the one-time cost of becoming familiar with the rule, 
based on the analysis detailed in the Initial Regulatory Impact 
Analysis (IRIA), the Commission estimated that small entities in States 
and localities that have laws substantially similar to the PWFA will be 
limited to a one-time administrative cost of approximately $56.76, and 
that small entities that are not already subject to State or local laws 
substantially similar to the PWFA will face a one-time administrative 
cost of approximately $170.27.
    To estimate the annual cost of accommodation required by the rule, 
consistent with the IRIA, in the NPRM the Commission assumed that the 
number of individuals seeking accommodations will be approximately 
equal to the number of individuals who actually become pregnant during 
that year; that 33 percent of the employees within each small entity 
are capable of becoming pregnant, and that, of these, 4.7 percent will 
actually become pregnant in a given year; that between 23 and 71 
percent of pregnant individuals within each small entity will need an 
accommodation; that 49.4 percent of such accommodations will have no 
cost; and that the average cost of the remaining 50.6 percent of needed 
accommodations will be $300 distributed over 5 years, or $60

[[Page 29162]]

annually. Using these figures, it generated the following cost 
estimates for small entities of various sizes: \352\
---------------------------------------------------------------------------

    \352\ Id. at 54764-65.
    [GRAPHIC] [TIFF OMITTED] TR19AP24.086
    
    Because entities that are already subject to laws substantially 
similar to the PWFA are already required to provide accommodations 
consistent with the PWFA, their total costs were estimated to be the 
one-time cost of $56.75.
    Total costs for entities that are not already subject to laws 
substantially similar to the PWFA were estimated to be the annual cost 
of providing reasonable accommodations as detailed in Table 13 in the 
NPRM (between $60 for businesses with 15 employees and $540 for 
businesses with 1,500 employees), plus $170.27 (the cost of becoming 
familiar with the rule) in the first year.

Revisions in Response to Comments That Addressed Both the IRIA and the 
Commission's Justification for Certifying Under the Regulatory 
Flexibility Act (RFA)

    As detailed in the discussion of the Regulatory Impact Analysis 
(RIA) above, in response to comments the Commission made adjustments to 
its estimate of the percentage of individuals capable of becoming 
pregnant who actually become pregnant during a given year (revised 
upward from 4.7 percent to 7.1 percent), and to its lower bound 
estimate of the percentage of pregnant individuals who will need a 
reasonable accommodation (revised upward from 23 percent to 32 
percent). The Commission also increased the amount of time it estimated 
employers would need to familiarize themselves with the rule. Because 
the Commission's analysis under the Regulatory Flexibility Act (RFA) 
relied on these same estimates, the Commission has made conforming 
changes below.
Comments and Response to Comments Pertaining Specifically to Small 
Entities
    In addition to the comments that apply both to the RIA and the 
analysis under the RFA, the Commission received some comments 
specifically addressing the rule's effect on small entities.
    Many comments made general statements about the rule's effect on 
small businesses, without addressing specific aspects of the reasoning 
offered by the Commission in support of its decision to certify.
    Some comments stated generally that small entities will have 
difficulty complying with the rule. A few of these emphasized that 
small entities may have especial difficulty reading and understanding 
the rule or hiring personnel to cover for pregnant employees who take 
leave as a reasonable accommodation. Some asserted that small entities 
will hire fewer women in anticipation of added costs arising from the 
need to provide accommodations.
    Other comments stated broadly that the rule will be beneficial to 
small entities. One such comment noted that many States have laws 
similar to the PWFA with thresholds even lower than 15 employees; that, 
in those States, even smaller employers must provide reasonable 
accommodations absent undue hardship; that providing for accommodations 
may allow employers to keep employees and thus reduce costs for 
replacement and retraining; that the PWFA will encourage pregnant 
employees to stay in the workforce, thereby supporting small 
businesses; and that in States with PWFA-type statutes, increased costs 
or adverse economic outcomes either have not been reported or have been 
so insignificant that they are not easily measurable, likely because 
the required accommodations tend to be low-cost or no-cost.
    On balance, the Commission concludes that the comments discussed 
above do not provide it with sufficient

[[Page 29163]]

reason to withdraw its earlier decision to certify that the rule will 
not have a significant economic effect on a substantial number of small 
entities. As detailed above, these comments were not uniformly in favor 
of withdrawal. Further, the comments stating generally that small 
entities will have difficulty complying with the rule did not provide 
data in support of those claims. The Commission also observes that 
these comments generally appear to overlook the fact that, if a 
particular reasonable accommodation would impose undue hardship on the 
employer, neither the PWFA nor the rule require the employer to provide 
it. To the extent that the above comments predict that the rule will 
cause small employers to hire fewer women, the Commission notes that 
such action is independently unlawful pursuant to Title VII's 
prohibition against refusal to hire women because they may become 
pregnant.\353\
---------------------------------------------------------------------------

    \353\ 42 U.S.C. 2000e(k).
---------------------------------------------------------------------------

    Some comments addressed the Commission's reasoning more directly. 
One comment stated that the Commission should retract its certification 
because over 10 percent of the 33 million small businesses in the 
United States will be required to comply with the rule. This comment 
misrepresents the Commission's reason for certifying. As explained 
above, in the NPRM the Commission agreed that the rule will affect a 
``substantial'' number of small entities but concluded that the 
economic impact on such entities would, in almost all cases, fail to be 
``significant.'' \354\ The Commission thus declines to retract its 
certification in response to this comment.
---------------------------------------------------------------------------

    \354\ 88 FR 54764.
---------------------------------------------------------------------------

    One comment stated that, in estimating the cost of accommodations 
on small entities, the Commission should not have relied on the average 
cost for such accommodations, but rather should have focused on 
``budget-busting'' accommodations that would be especially difficult 
for small entities to handle. This comment did not cite data 
establishing how much an accommodation would need to cost in order to 
qualify as ``budget-busting'' for small entities of a given size, what 
sorts of pregnancy-related accommodations were likely to reach that 
threshold, or how often such an accommodation is likely to be needed. 
Further, the comment did not account for the fact that the PWFA does 
not require employers to provide reasonable accommodations that would 
impose undue hardship; presumably the ``budget-busting'' accommodations 
would be likely to meet this standard.
    One comment objected to the Commission's method of determining 
whether a given entity meets the 15-employee threshold for coverage 
under the PWFA. Specifically, the comment objected to the fact that the 
Commission counts temporary or seasonal employees toward this total 
under some circumstances. The Commission declines to change its method 
for determining whether an entity has 15 employees in response to this 
comment. The same method has been used consistently for decades under 
all of the statutes enforced by the EEOC and has been endorsed by the 
Supreme Court.\355\
---------------------------------------------------------------------------

    \355\ See generally Walters v. Metro. Educ. Enters., Inc., 519 
U.S. 202 (1997).
---------------------------------------------------------------------------

    One comment objected to the Commission's decision to distribute the 
average cost of a non-zero-cost accommodation ($300) over 5 years for 
purposes of the RFA analysis. The Commission distributed the costs over 
5 years under the assumption that most accommodations with a cost will 
involve purchase of durable goods with a life of 5 years.\356\ The 
Commission made this same assumption when it estimated the costs 
arising from the provision of additional reasonable accommodations as a 
result of the ADAAA.\357\ The comment stated that small employers 
generally will have no use for these durable goods after they are used 
by the original requester. The comment provided no data to support this 
assertion. Further, the comment did not identify a reason why the 
Commission's estimate of average accommodation costs under the PWFA 
should differ from its estimate of the same under the ADA. The 
Commission, therefore, declines to amend its analysis in response to 
the comment.
---------------------------------------------------------------------------

    \356\ 88 FR 54759.
    \357\ 76 FR 16977, 16994 (Mar. 25, 2011).
---------------------------------------------------------------------------

    Some comments objected to the Commission's method of estimating the 
percentage of employees within a given small entity who actually become 
pregnant in a given year. Although the Commission's estimate may be 
accurate for small entities in certain industries, these comments 
argued, they may not be accurate for small entities operating in 
industries that employ disproportionately high numbers of women. One 
comment identified ``education and health; leisure and hospitality; and 
retail and wholesale trade'' as industries that employ 
disproportionately high numbers of women. The comment offered the 
hypothetical situation of a preschool with 25 employees, 20 of whom are 
women of reproductive age. The comment concluded that the preschool 
likely will have continuous costs imposed by the proposed rule, even 
though it has just 25 employees.
    The Commission is unpersuaded that it should retract its 
certification that the rule will not have a significant economic impact 
on a substantial number of small entities in response to these 
comments. In the Commission's view, they overestimate the costs that 
will be experienced in industries with disproportionately high numbers 
of women employees. Consider the example discussed above in which a 
business employs 25 employees, 20 of whom are capable of becoming 
pregnant. To generate a lower bound estimate of the number of expected 
non-zero-cost accommodations per year in the example, the Commission 
calculates as follows: 20 x 0.071 x 0.32 x 0.506 = 0.22 individuals per 
year are likely to need a non-zero-cost pregnancy-related reasonable 
accommodation, roughly equivalent to one individual every 5 years.\358\ 
To generate an upper bound estimate: 20 x 0.071 x 0.71 x 0.506 = 0.52 
individuals per year are likely to need a non-zero-cost pregnancy-
related accommodation, roughly equivalent to one individual every 2 
years. As discussed above, these costs are not expected to be high--the 
expected annual cost per accommodation is estimated to be $60 per year. 
Thus, rather than imposing ``continuous'' high costs, businesses like 
the one in the example should only expect to provide one relatively 
low-cost accommodation every 2 to 5 years.\359\ Additionally, even

[[Page 29164]]

if a substantial number of small entities in a particular industry were 
to face ``continuous'' costs as a result of the rule--as demonstrated 
by the calculations above, a highly unlikely occurrence--it would not 
follow that such costs would be ``economically significant.''
---------------------------------------------------------------------------

    \358\ The estimate was calculated by multiplying the number of 
individuals in the business who are capable of becoming pregnant 
(20) by (a) 7.1 percent, to account for the fact that only some 
individuals who are capable of becoming pregnant will actually 
become pregnant in a given year; (b) 32 percent, to account for the 
fact that only some pregnant individuals will need accommodation; 
and (c) 50.6 percent, to account for the fact that only some needed 
accommodations will have a cost. For a detailed discussion of these 
calculations, see the Costs section in the Final Regulatory Impact 
Analysis below.
    \359\ Further, the Commission has been given no reason to 
believe that the example offered in the comment and discussed here 
is representative of any real industry. The percentage of employees 
capable of becoming pregnant in the example is 20 / 25 = 80 
percent--roughly 2.5 times as high as the 33 percent national 
average. Additionally, the business in the example had only 25 
employees. The comment failed to provide any data establishing the 
existence of any industry that has a ``substantial'' number of 
entities that have so few employees and that employs women at such a 
disproportionately high rate. The example is of an entity in the 
education industry. The Small Business Administration does not 
define the meaning of ``small entity'' for any of the education-
related industries in terms of a number of employees. See 13 CFR 
121.210. It defines ``small entity'' in the elementary and secondary 
school industry to be an entity that has $20 million or less in 
annual receipts, id., but the Commission was unable to determine the 
percentage of elementary or secondary schools with $20 million or 
less in annual receipts that have 25 or fewer employees.
---------------------------------------------------------------------------

    For the reasons discussed above, the Commission has determined that 
the comments it received regarding occupational segregation do not 
require it to retract its certification that the rule will not have a 
significant economic impact on a substantial number of small entities, 
or to revise its justification for certifying.

Final Economic Analysis

Executive Orders 12866 (Regulatory Planning and Review), 13563 
(Improving Regulation and Regulatory Review), and 14094 (Modernizing 
Regulatory Review)

Introduction

    The final rule has been drafted and reviewed in accordance with 
Executive Order (E.O.) 12866. The rule and the Interpretive Guidance 
are intended to add to the predictability and consistency of executive 
enforcement of the PWFA and to provide covered entities and employees 
with information regarding their rights and responsibilities. The rule 
is required pursuant to 42 U.S.C. 2000gg-5. The Final Regulatory Impact 
Analysis estimates the cost of the rule to be between $466.71 million 
and $484.71 million in the first year, and between $14.82 and $32.82 
million annually thereafter. It estimates that the benefits will be 
significant. While those benefits cannot be fully quantified and 
monetized, the Commission concludes that, consistent with E.O. 13563, 
the benefits (qualitative and quantitative) will justify the costs. The 
Commission notes that the rule and underlying statute create many 
important benefits that, in the words of E.O. 13563, stem from ``values 
that are difficult or impossible to quantify'' including ``equity, 
human dignity, fairness and distributive impacts.'' Additionally, 
because the rule provides employees who are affected by pregnancy, 
childbirth, or related medical conditions with reasonable 
accommodations that enable them to continue working, the benefits of 
the rule include increased productivity. These benefits cannot be 
quantified at this time, however.

Summary

    As detailed in the Final Regulatory Impact Analysis (FRIA) section 
below, the final rule and underlying statute are expected to provide 
numerous unquantifiable benefits to qualified employees and applicants 
with known limitations related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions, especially in 
States that currently do not have laws substantially similar to the 
PWFA. It will also benefit covered entities, the U.S. economy, and 
society as a whole. These unquantifiable benefits include improved 
maternal and infant health; improved economic security for pregnant 
employees; increased equity, human dignity, and fairness; improved 
clarity of enforcement standards and efficiencies in litigation; and 
decreased costs related to employee turnover for covered entities.
    The quantitative section in the FRIA below provides estimates of 
the two main expected costs associated with the rule and underlying 
statute: (a) annual costs associated with providing reasonable 
accommodations to qualified applicants and employees with known 
limitations related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions by employers in States that 
do not currently have such a requirement, and (b) one-time 
administrative costs for covered entities, which include becoming 
familiar with the rule, posting new equal employment opportunity (EEO) 
posters,\360\ and updating EEO policies and handbooks. The Commission 
expresses the quantifiable impacts in 2022 dollars and uses discount 
rates of 3 and 7 percent pursuant to OMB Circular A-4.
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    \360\ The Commission posted an updated poster on its website 
concurrent with the PWFA's effective date of June 27, 2023. See 
EEOC, ``Know Your Rights: Workplace Discrimination is Illegal'' 
Poster, https://www.eeoc.gov/poster (last visited Mar. 25, 2024).
---------------------------------------------------------------------------

    The analysis concludes that approximately 49.4 percent of the 
reasonable accommodations that will be required by the rule and 
underlying statute will have no cost to covered entities, and that the 
average annual cost for the remaining 50.6 percent of such 
accommodations is approximately $60 per year per accommodation. Taking 
into account that many entities covered by the PWFA are already 
required to provide such accommodations under State and local laws, the 
total impact on the U.S. economy to provide reasonable accommodations 
under the rule and underlying statute is estimated to be between $14.82 
million and $32.82 million per year.
    The estimated one-time costs associated with administrative tasks 
are quite low on a per-establishment basis--between $57.02 and $255.40, 
depending on the State and on the type of employer. Despite the low 
per-establishment cost, the proposed rule is a ``significant regulatory 
action'' under section 3(f)(1) of E.O. 12866, as amended by E.O. 14094, 
because the number of regulated entities--hence the number of entities 
expected to incur one-time administrative costs--is extremely large 
(including all public and private employers with 15 or more employees 
and the Federal Government). As a result, the Commission has concluded 
that the overall cost to the U.S. economy will be in excess of $200 
million.\361\
---------------------------------------------------------------------------

    \361\ The Congressional Budget Office (CBO) did not review the 
PWFA for intergovernmental or private-sector mandates because 
``[s]ection 4 of the Unfunded Mandates Reform Act excludes from the 
application of that act any legislative provision that would 
establish or enforce statutory rights prohibiting discrimination,'' 
and CBO ``determined that the bill falls within that exclusion 
because it would extend protections against discrimination in the 
workplace based on sex to employees requesting reasonable 
accommodations for pregnancy, childbirth, or related medical 
conditions.'' H.R. Rep. No. 117-27, pt. 1, at 41.
---------------------------------------------------------------------------

Final Regulatory Impact Analysis (FRIA)

The Need for Regulatory Action

    The PWFA and the final rule respond to the previously limited 
availability of accommodations for employees affected by pregnancy, 
childbirth, or related medical conditions under Federal law. Although 
Title VII (as amended by the Pregnancy Discrimination Act (PDA)) 
provided some protections for employees affected by pregnancy, 
childbirth or related medical conditions, court decisions regarding the 
ability of employees affected by pregnancy, childbirth, or related 
medical conditions to obtain workplace accommodations created 
``unworkable'' standards that did not adequately protect pregnant 
employees.\362\ Similarly, prior to the PWFA, some pregnant employees 
could obtain protections under the ADA, but these were limited.\363\ 
Pregnant employees who could not obtain accommodations risked their 
economic security, which had harmful effects for

[[Page 29165]]

themselves and their families.\364\ Furthermore, the loss of a job can 
affect a pregnant employee's economic security for decades, as they 
lose out on ``retirement contributions . . . short-term disability 
benefits, seniority, pensions, social security contributions, life 
insurance, and more.'' \365\ Additionally, the lack of workplace 
accommodations can harm the health of the employee and their 
pregnancy.\366\ While numerous States have laws that provide for 
accommodations for pregnant employees, the lack of a national standard 
prior to passage of the PWFA meant that employees' rights varied 
depending on the State in which they lived, some of which left 
employees completely unprotected.\367\
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    \362\ Id. at 14-16 (describing court rulings under Title VII and 
the Supreme Court's decision in Young, 575 U.S. 206); see 88 FR 
54714-16.
    \363\ H.R. Rep. No. 117-27, pt. 1, at 19-21 (describing court 
decisions under the ADA that failed to find coverage for employees 
with pregnancy-related disabilities).
    \364\ Id. at 22 (``When pregnant workers are not provided 
reasonable accommodations on the job, they are oftentimes forced to 
choose between economic security and their health or the health of 
their babies.''); id. at 24 (noting that ``families increasingly 
rely on pregnant workers' incomes.'').
    \365\ Id. at 25.
    \366\ Id. at 22 (``According to the American College of 
Obstetricians and Gynecologists (ACOG), providing reasonable 
accommodations to pregnant workers is critical for the health of 
women and their children.''); id. (describing how a lack of an 
accommodation led to a miscarriage for a worker).
    \367\ See infra Table 1 for a calculation of the number of 
employees who live in States without PWFA-analogue laws.
---------------------------------------------------------------------------

    The PWFA at 42 U.S.C. 2000gg-3(a) provides that ``[n]ot later than 
1 year after [the date of enactment of the Act], the Commission shall 
issue regulations in an accessible format in accordance with subchapter 
II of chapter 5 of title 5 [of the United States Code] to carry out 
this chapter. Such regulations shall provide examples of reasonable 
accommodations addressing known limitations related to pregnancy, 
childbirth, or related medical conditions.''
    Pursuant to 42 U.S.C. 2000gg-3(a), the EEOC is issuing this rule 
following the procedures codified at 5 U.S.C. 553(b).

Baseline

    The PWFA is a new law that requires covered entities to provide 
reasonable accommodations to the known limitations related to, affected 
by, or arising out of pregnancy, childbirth, or related medical 
conditions of qualified employees. As set out in the NPRM,\368\ the 
PWFA seeks to fill gaps in the Federal and State legal landscape 
regarding protections for employees affected by pregnancy, childbirth, 
or related medical conditions.
---------------------------------------------------------------------------

    \368\ 88 FR 54714-15.
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    Employees affected by pregnancy, childbirth, or related medical 
conditions have certain rights under existing civil rights laws, such 
as Title VII, the ADA, the Family and Medical Leave Act of 1993, 29 
U.S.C. 2601 et seq. (FMLA), the Providing Urgent Maternal Protections 
for Nursing Mothers Act (PUMP Act), and various State and local 
laws.\369\
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    \369\ For a list of State laws, see infra Table 1. In addition, 
Federal laws regarding Federal funding such as Title IX of the 
Education Amendments of 1972, 20 U.S.C. 1681 et seq., and the 
Workforce Innovation and Opportunity Act, 29 U.S.C. 3248(a)(2), 
provide protection from sex discrimination, including discrimination 
based on pregnancy, childbirth, or related medical conditions.
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    Under Title VII, an employee affected by pregnancy, childbirth, or 
related medical conditions may be able to obtain a workplace 
modification to allow them to continue to work.\370\ Typically courts 
have only found in favor of such claims if the employee can identify 
another individual similar in their ability or inability to work who 
received such an accommodation, or if there is some direct evidence of 
disparate treatment (such as a biased comment or a policy that, on its 
face, excludes pregnant employees). However, there may not always be 
similarly situated employees. For this reason, some pregnant employees 
have not received simple, common-sense accommodations, such as a stool 
for a cashier \371\ or bathroom breaks for a preschool teacher.\372\ 
And even when the pregnant employee can identify other employees who 
are similar in their ability or inability to work, some courts still 
have not found a Title VII violation.\373\
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    \370\ As relevant here, Title VII protects employees from 
discrimination based on pregnancy, childbirth, or related medical 
conditions ``with respect to . . . compensation, terms, conditions, 
or privileges of employment[ ] because of such individual's . . . 
sex.'' 42 U.S.C. 2000e-2(a)(1). Discrimination because of sex 
includes discrimination based on ``pregnancy, childbirth, or related 
medical conditions.'' 42 U.S.C. 2000e(k). Title VII also provides 
that ``women affected by pregnancy, childbirth, or related medical 
conditions shall be treated the same for all employment-related 
purposes, including receipt of benefits under fringe benefit 
programs, as other persons not so affected but similar in their 
ability or inability to work.'' Id.
    \371\ See, e.g., Portillo v. IL Creations Inc., No. 1:17-cv-
01083, 2019 WL 1440129, at *5 (D.D.C. Mar. 31, 2019).
    \372\ See, e.g., Wadley v. Kiddie Acad. Int'l, Inc., No. 2:17-
CV-05745, 2018 WL 3035785, at *4 (E.D. Pa. June 19, 2018).
    \373\ See, e.g., Wal-Mart Stores E., 46 F.4th at 597-99 
(concluding that the employer did not engage in discrimination when 
it failed to accommodate pregnant employees with light duty 
assignments, even though the employer provided light duty 
assignments for employees who were injured on the job); but see, 
e.g., Legg, 820 F.3d at 69, 75-77 (vacating judgment for the 
employer where officers injured on the job were entitled to light 
duty but pregnant employees were not).
---------------------------------------------------------------------------

    Under the ADA, certain employees affected by pregnancy, childbirth, 
or related medical conditions may have the right to accommodations if 
they have an ``actual'' or ``record of'' ADA disability; this standard 
does not include pregnancy itself but includes a pregnancy-related 
disability.\374\
---------------------------------------------------------------------------

    \374\ 42 U.S.C. 12102(2), (4); 29 CFR part 1630, appendix 
1630(h); Enforcement Guidance on Pregnancy Discrimination, supra 
note 31, at (II).
---------------------------------------------------------------------------

    Under the FMLA, covered employees can receive up to 12 weeks of 
job-protected unpaid leave for, among other things, a serious health 
condition, the birth of a child, and bonding with a newborn within 1 
year of birth.\375\ However, employees must work for an employer with 
50 or more employees within 75 miles of their worksite and meet certain 
tenure requirements in order to be entitled to FMLA leave.\376\ Survey 
data from 2018 show that only 56 percent of employees are eligible for 
FMLA leave.\377\ Further, the FMLA only provides unpaid leave--it does 
not require reasonable accommodations that would allow employees to 
stay on the job and continue to be paid.
---------------------------------------------------------------------------

    \375\ 29 U.S.C. 2612(a)(1); 29 CFR 825.120.
    \376\ 29 U.S.C. 2611(2)(A), (B).
    \377\ Scott Brown et al., Employee and Worksite Perspectives of 
the Family and Medical Leave Act: Executive Summary for Results from 
the 2018 Surveys 3 (2020), https://www.dol.gov/sites/dolgov/files/OASP/evaluation/pdf/WHD_FMLA2018SurveyResults_ExecutiveSummary_Aug2020.pdf.
---------------------------------------------------------------------------

    The PUMP Act requires employers who are covered by the Fair Labor 
Standards Act, 29 U.S.C. 201 et seq. (FLSA), to provide reasonable 
break time for an employee to express breast milk for their nursing 
child each time such employee has need to express milk for 1 year after 
the child's birth. The PUMP Act also requires employers to provide a 
place to pump at work, other than a bathroom, that is shielded from 
view and free from intrusion from coworkers and the public.\378\
---------------------------------------------------------------------------

    \378\ U.S. Dep't of Lab., FLSA Protections to Pump at Work, 
https://www.dol.gov/agencies/whd/pump-at-work (last visited Mar. 25, 
2024).
---------------------------------------------------------------------------

    As set out in Table 1, 30 States currently have laws similar to the 
PWFA that provide for accommodations for pregnant employees. In most 
States, again as set out in Table 1, the State laws cover the same 
employers that are covered by the PWFA. Employees in the remaining 
States and Federal Government employees have the rights set out in the 
Federal laws described above and, until the passage of the PWFA, did 
not have the protections of a law like the PWFA.
    In addition to the protections provided by the above laws, the 
Federal Government provides 12 weeks of paid parental leave to eligible 
Federal employees upon the birth of a new child.\379\
---------------------------------------------------------------------------

    \379\ Federal Employee Paid Leave Act, Public Law 116-92, 133 
Stat. 1198, 2304-09 (2019).

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[[Page 29166]]

Nonquantifiable Benefits

    The final rule and the underlying statute create many important 
benefits that stem from ``values that are difficult or impossible to 
quantify,'' including ``equity, human dignity, [and] fairness.'' \380\ 
These benefits are the marginal increase in those values beyond the 
protections provided in the laws outlined above. The Commission has 
identified five primary benefits of the rule and underlying statute. 
The Commission did not quantify each of the following benefits that are 
expected to result from the PWFA and its implementing regulation, 
however, because it did not identify sufficient data to quantify these 
benefits.\381\
---------------------------------------------------------------------------

    \380\ 76 FR 3821 (Jan. 21, 2011).
    \381\ Where relevant, the Commission requested additional data 
in the NPRM. See 88 FR 54749.
---------------------------------------------------------------------------

Improvements in Health for Pregnant Employees and Their Babies
    Congress enacted the PWFA in large part to improve maternal and 
infant health outcomes. The legislative history emphasizes that the new 
law was needed because ``[n]o worker should have to choose between 
their health, the health of their pregnancy, and the ability to earn a 
living.'' \382\ Congress further concluded that ``providing reasonable 
accommodations to pregnant workers is critical to the health of women 
and their children.'' \383\ The need to improve health outcomes 
surrounding pregnancy is critical--as a recent report noted, ``women in 
our country are dying at a higher rate from pregnancy-related causes 
than in any other developed nation.'' \384\ Additionally, ``Black women 
are more than three times as likely as White women to die from 
pregnancy-related causes, while American Indian/Alaska Native [women] 
are more than twice as likely,'' \385\ and a recent study shows that 
negative health outcomes during pregnancy disproportionately affect 
Black women compared to White women regardless of wealth.\386\
---------------------------------------------------------------------------

    \382\ H.R. Rep. No. 117-27, pt. 1, at 11.
    \383\ Id. at 11, 22.
    \384\ The White House, White House Blueprint for Addressing the 
Maternal Health Crisis 1 (2022), https://www.whitehouse.gov/wp-content/uploads/2022/06/Maternal-Health-Blueprint.pdf.
    \385\ Id. at 15.
    \386\ Kate Kennedy-Moulton et al., Maternal and Infant Health 
Inequality: New Evidence from Linked Administrative Data 5 (Nat'l 
Bureau of Econ. Rsch., Working Paper No. 30,693, 2022), https://www.nber.org/system/files/working_papers/w30693/w30693.pdf (finding 
that maternal and infant health vary with income, but infant and 
maternal health in Black families at the top of the income 
distribution is similar to or worse than that of White families at 
the bottom of the income distribution).
---------------------------------------------------------------------------

    Some studies have shown increased risk of miscarriage,\387\ preterm 
birth,\388\ low birth weight, urinary tract infections, fainting, and 
other health problems for pregnant employees because of workplace 
conditions.\389\ Research also shows that certain workplace conditions, 
such as lengthy periods of standing or walking, or high risk of 
chemical exposure or noise, can result in complications for a pregnant 
employee and their baby; thus accommodations to alleviate those 
conditions improve health outcomes for pregnant employees and their 
children.\390\
---------------------------------------------------------------------------

    \387\ H.R. Rep. No. 117-27, pt. 1, at 22; Am. Coll. of 
Obstetricians & Gynecologists, Comm. Opinion No. 733, Employment 
Considerations During Pregnancy and the Postpartum Period e119 
(2018) [hereinafter ACOG Committee Opinion], https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2018/04/employment-considerations-during-pregnancy-and-the-postpartum-period.pdf (discussing studies that showed an increased 
risk of miscarriage or stillbirth associated with night work, 
working more than 40 hours a week, or extensive lifting, but noting 
that ``[i]t is difficult to draw definitive conclusions from these 
studies'').
    \388\ H.R. Rep. No. 117-27, pt. 1, at 22; ACOG Committee 
Opinion, supra note 387, at e119-20 (discussing studies that found a 
``slight to modest risked increase'' of preterm birth with some work 
conditions, but also noting that it is hard to know whether these 
results were due to ``bias and confounding or to an actual 
effect'').
    \389\ H.R. Rep. No. 117-27, pt. 1, at 22; see also Hackney et 
al., supra note 341, at 774, 781 (2021) (describing two studies that 
demonstrated that perceived pregnancy discrimination serves as a 
threat to women's resources which leads to increased postpartum 
depressive symptoms for mothers, decreased birth weight and 
gestational age, and increased doctors' visits for their babies, via 
mothers' stress); Renee Mehra et al., ```Oh Gosh, Why Go?' Cause 
They Are Going to Look At Me and Not Hire'': Intersectional 
Experiences of Black Women Navigating Employment During Pregnancy 
and Parenting, BMC Pregnancy & Childbirth 2 (2023), https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-05268-9 (describing studies that found that policies that 
protect women in the workplace during pregnancy and the postpartum 
period are important for maternal and infant health outcomes); H.M. 
Salihu et al., Pregnancy In the Workplace, 62 Occupational Med. 88, 
94 (2012), https://academic.oup.com/occmed/article/62/2/88/1480061?login=false (finding that while physically demanding jobs do 
not pose a substantial risk to fetal health, ``[a] moderate 
temporary reduction in job physicality may promote improved maternal 
and foetal health''); ACOG Committee Opinion, supra note 387, at 
e117 (discussing modifications for physical work and how they could 
help the health of pregnant workers).
    \390\ See generally Francis et al., supra note 344 (describing 
ergonomic stressors and pregnancy outcomes); see also Pregnant 
Workers Health Impact Assessment, supra note 344, at 17-19, 23 
(identifying workplace conditions that may impact the health of a 
pregnant worker and their child and basic accommodations to 
alleviate those conditions to improve health outcomes).
---------------------------------------------------------------------------

    Additionally, the provision of accommodations may improve pregnant 
employees' mental health, as even perceived pregnancy discrimination at 
work has been linked to increased stress and symptoms of postpartum 
depression.\391\ Stress resulting from workplace discrimination and 
workplace conditions can increase risk of preterm birth or low birth 
weight, potentially resulting in serious health problems at birth that 
may cause long-term health and developmental consequences in 
children.\392\ Such health challenges may result in additional health 
care costs; accordingly, reducing stress during pregnancy also may 
reduce health care costs.\393\
---------------------------------------------------------------------------

    \391\ Hackney et al., supra note 341, at 777, 781.
    \392\ Id. at 778, 781; March of Dimes, Stress and Pregnancy, 
https://www.marchofdimes.org/find-support/topics/pregnancy/stress-and-pregnancy (last visited Mar. 25, 2024); March of Dimes, Long-
Term Health Effects of Preterm Birth (Oct. 2019), https://www.marchofdimes.org/find-support/topics/birth/long-term-health-effects-premature-birth.
    \393\ March of Dimes, Premature Birth: The Financial Impact on 
Business (2013), https://onprem.marchofdimes.org/materials/premature-birth-the-financial-impact-on-business.pdf.
---------------------------------------------------------------------------

    Moreover, employees who do not receive needed accommodations, and 
who quit their jobs as a result in order to maintain a healthy 
pregnancy, often lose employer-sponsored health insurance in addition 
to losing their incomes.\394\ In a letter to Congress, a group of 
leading health care practitioner organizations explained that when a 
pregnant employee loses health insurance, ``the impact on both mother 
and baby may be long-lasting and severe. One of the main predictors of 
a healthy pregnancy is early and consistent prenatal care. Loss of 
employment and health benefits impact family resources, threatening the 
ability to access vital health care when a woman needs it the most.'' 
\395\
---------------------------------------------------------------------------

    \394\ Fighting for Fairness: Examining Legislation To Confront 
Workplace Discrimination, Joint Hearing Before the Subcomm. on Civ. 
Rts. & Hum. Servs. and the Subcomm. on Workforce Prots. of the H. 
Comm. on Educ. & Lab., 117th Cong. 153 (2021) [hereinafter Fighting 
for Fairness] (statement of Dina Bakst, Co-Founder & Co-President, A 
Better Balance) (describing employees who lose their income and, as 
a result, lose their health insurance, forcing them to delay or 
avoid critical prenatal or postnatal care).
    \395\ Long Over Due: Exploring the Pregnant Workers Fairness Act 
(H.R. 2694), Hearing Before the Subcomm. on Civ. Rts. & Hum. Servs. 
of the H. Comm. on Educ. & Lab., 116th Cong. 142 (2019) [hereinafter 
Long Over Due] (including a letter from professional medical 
associations, including the American Academy of Family Physicians, 
the American Academy of Pediatrics, the American Public Health 
Association, the American College of Nurse-Midwives, the American 
College of Obstetricians and Gynecologists, the Association of 
Women's Health, Obstetric and Neonatal Nurses, the National Alliance 
to Advance Adolescent Health, and Physicians for Reproductive 
Health); Fighting for Fairness, supra note 394, at 30-31 (statement 
of Dina Bakst, Co-Founder and Co-President, A Better Balance) 
(discussing Julia Barton, a pregnant corrections officer who quit 
her job because she did not receive an accommodation and therefore 
lost her health insurance).

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[[Page 29167]]

    Finally, by helping pregnant employees avoid health risks to 
themselves and their pregnancies, the PWFA will help contribute to 
improved maternal and child health and lower health care costs 
nationally.
Improvements in Pregnant Employees' Economic Security
    Access to reasonable accommodations at work will help employees 
with limitations related to pregnancy, childbirth, or related medical 
conditions to stay in the workforce, maintain their income, and provide 
for themselves and their families.\396\ Based on anecdotal evidence, 
unavailability of accommodations often forces employees to take unpaid 
leave, quit their jobs, or seek jobs that are potentially less 
lucrative, threatening their economic security.\397\ The lack of an 
accommodation may also have far-reaching economic effects. As the House 
Committee on Education and Labor Report for the PWFA stated, ``Pregnant 
workers who are pushed out of the workplace might feel the effects for 
decades, losing out on everything from 401(k) or other retirement 
contributions to short-term disability benefits, seniority, pensions, 
social security contributions, life insurance, and more.'' \398\ 
Provision of reasonable accommodations may also have economic benefits 
to society as a whole by keeping people attached to the labor force and 
lowering the likelihood of some employees being compelled to seek 
public assistance after they are forced to quit their jobs.\399\
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    \396\ The Commission is not able to monetize or quantify this 
benefit because, although anecdotal evidence establishes that lack 
of accommodation has led employees to quit their jobs, there are no 
data on how frequently this happens.
    \397\ Long Over Due, supra note 395, at 15 (statement of 
Kimberlie Michelle Durham) (describing losing her job because she 
needed an accommodation and explaining that her new job did not 
provide overtime or benefits); id. at 150-53 (letter from the ACLU) 
(describing the ACLU's legal representation of pregnant employees, 
many of whom were forced to take unpaid leave or lost their jobs).
    \398\ See H.R. Rep. No. 117-27, pt. 1, at 21-22, 25.
    \399\ See Long Over Due, supra note 395, at 15 (statement of 
Kimberlie Michelle Durham) (describing when she was forced to go on 
unpaid leave after she asked for an accommodation and, as a 
consequence, was unable to find new employment, moved back in with 
family, and was unable to find a job with benefits comparable to 
those offered by her EMT job, including health insurance; her child 
is on Medicaid); id. at 41 (statement of Dina Bakst, Co-Founder & 
Co-President, A Better Balance) (discussing a pregnant cashier who 
needed lifting restriction but was sent home and, without income, 
became homeless); id. at 46 (statement of Dina Bakst) (discussing an 
armored truck company employee who requested to avoid heavy lifting 
at the end of pregnancy but was instead sent home; as a result, she 
lost health insurance and needed to rely on public benefits such as 
food stamps); id. at 70 (statement of Dina Bakst) (presenting 
stories from State legislatures that describe savings to government 
assistance programs stemming from the passage of PWFA-like laws in 
their States).
---------------------------------------------------------------------------

    Providing needed workplace accommodations to qualified applicants 
and employees with limitations related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions is another step 
toward ensuring women's continued and increased participation in the 
labor force.\400\ Among other things, women's participation in the 
labor force is heavily impacted by pregnancy and the demands associated 
with raising young children.\401\ The passage of the PDA in 1978, which 
prohibits employment discrimination based on pregnancy, childbirth, or 
related medical conditions and requires that women affected by 
pregnancy, childbirth, or related medical conditions be treated the 
same as other individuals similar in their ability or inability to 
work, increased the participation rate of pregnant women in the labor 
market.\402\ As of 2021, over 66 percent of women in the United States 
who gave birth in the prior year were in the labor force,\403\ up from 
about 57 percent in 2006.\404\ Moreover, an increasing number of 
pregnant employees are working later into their pregnancies--over 65 
percent of first-time mothers who worked during their pregnancy worked 
into the last month before their child's birth.\405\ By requiring 
reasonable accommodations for employees with limitations related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions, the PWFA and this rule will further support and 
enhance women's labor force participation, and, in turn, grow the U.S. 
economy.\406\
---------------------------------------------------------------------------

    \400\ Id.; see also id. at 25 (statement of Iris Wilbur, Vice 
President of Government Affairs & Public Policy, Greater Louisville, 
Inc., The Metro Chamber of Commerce) (``[T]he Act will help boost 
our country's workforce participation rate among women. In States 
like Kentucky, which ranks 44th in the nation for female labor 
participation, we know one contributor to this abysmal statistic is 
a pregnant worker who is forced out or quits a job due to a lack of 
reasonable workplace accommodations.'').
    \401\ Catherine Doren, Is Two Too Many? Parity and Mothers' 
Labor Force Exit, 81 J. Marriage & Fam. 327, 341 (2019) (stating 
that ``transition to motherhood is the primary turning point in 
women's labor force participation'').
    \402\ Sankar Mukhopadhyay, The Effects of the 1978 Pregnancy 
Discrimination Act on Female Labor Supply, 53 Int'l Econ. Rev. 1133 
(2012).
    \403\ U.S. Dep't of Com., Census Bureau, Births in the Past Year 
and Labor Force Participation for Women Aged 16-50, by Education: 
2006 to 2019 (2023) [hereinafter Births in the Past Year and Labor 
Force Participation], https://www.census.gov/data/tables/time-series/demo/fertility/his-cps.html (select ``Historical Table 5''); 
see also Steven Ruggles et al., IPUMS USA: Version 12.0 (2022), 
https://doi.org/10.18128/D010.V12.0.
    \404\ Births in the Past Year and Labor Force Participation, 
supra note 403.
    \405\ Lynda Laughlin, U.S. Dep't of Com., Census Bureau, 
Maternity Leave and Employment Patterns of First-Time Mothers, 1961-
2008 6 (2011), https://www2.census.gov/library/publications/2011/demo/p70-128.pdf.
    \406\ H.R. Rep. No. 117-27, pt.1, at 24 (``Ensuring pregnant 
workers have reasonable accommodations helps ensure that pregnant 
workers remain healthy and earn an income when they need it the 
most.'').
---------------------------------------------------------------------------

Non-Discrimination and Other Intrinsic Benefits
    Providing accommodations to employees with limitations related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions also has important implications for equity, human 
dignity, and fairness.
    First, by allowing pregnant employees to care for their health and 
the health of their pregnancies, the PWFA enhances human dignity. 
Employees will be able to prioritize their health and the health of 
their future children, giving their children the best possible start in 
life while also protecting their economic security. As one comment 
explained, the PWFA gives pregnant employees a strong sense of dignity 
and belonging in the workforce, and ``the reasonable accommodation 
framework relieves individual employees of the burden of proving 
animus: of showing that an employer's inflexible imposition of 
workplace standards reflects sex stereotyping that flows from the 
invidious assumption that pregnant workers are not competent or 
committed workers.'' \407\
---------------------------------------------------------------------------

    \407\ Siegel, supra note 348, at 220-26.
---------------------------------------------------------------------------

    Second, the PWFA will diminish the incidence of sex discrimination 
against qualified employees, enable them to reach their full potential, 
reduce exclusion, and promote self-respect. The statute and the rule 
provide for reasonable accommodations to employees who would otherwise 
not receive them and thus could be forced to leave their jobs or the 
workforce because of their pregnancy, childbirth, or related medical 
conditions. Also, the statute and the rule require a covered entity to 
engage an employee in an interactive process, rather than simply 
assigning the employee an accommodation, which combats stereotypes 
about the capabilities of employees affected by pregnancy, childbirth, 
or related medical conditions. Finally, the statute and the rule 
protect employees against retaliation and coercion for using the 
protections of the statute. These protections against discrimination

[[Page 29168]]

promote human dignity and equity by enabling qualified employees to 
participate or continue to participate in the workforce.\408\
---------------------------------------------------------------------------

    \408\ See Salihu et al., supra note 389, at 94 (finding that 
``[w]omen who perceive employers and superiors as supportive are 
more likely to return to work after childbirth. This reduces the 
risk to employers regarding loss in skill and training. Similarly, 
businesses that plan for and proactively approach pregnancy in the 
workplace show lower rates of quitting and greater ease of shifting 
workloads in the event of a pregnancy, which increases productivity 
and decreases losses''); Long Over Due, supra note 395, at 15 
(testimony of Kimberlie Michelle Durham) (``I wanted to work. I 
loved my job.''). See also Salihu et al., supra note 389, at 93 
(describing steps pregnant women take to combat the perception that 
they are a liability in the workforce and reinforce their role as 
``professionals''); Long Over Due, supra note 395, at 41 (statement 
of Dina Bakst, Co-Founder & Co-President, A Better Balance) 
(describing an employee who was denied an accommodation but who 
``desperately wanted to continue working''); Hackney et al., supra 
note 341, at 780 (explaining that managers may make incorrect 
assumptions about what pregnant employees want, such as assuming a 
reduced workload is beneficial, whereas pregnant employees might 
find this accommodation demeaning or discriminatory, and noting the 
importance of managers ``hav[ing] an open dialogue with their 
employees about what types of support [are] needed and desired'').
---------------------------------------------------------------------------

    Third, because the PWFA applies to so many covered entities, it 
will improve equity in the workforce. Currently, employees affected by 
pregnancy, childbirth, or related medical conditions in higher paying 
jobs and non-physical jobs are much more likely to be able to control 
their schedules, take bathroom breaks, or eat, drink water, or telework 
when necessary.\409\ These employees may not have to request 
accommodations from their employers to meet many of their pregnancy-
related needs. Employees in low-wage jobs, however, are much less 
likely to be able to organize their schedules to allow them to take 
breaks that may be necessary due to pregnancy, childbirth, or related 
medical conditions.\410\ Nearly one-third of Black and Latina workers 
are in low-wage jobs,\411\ the types of jobs that are less likely to 
currently provide accommodations.\412\ Therefore, the PWFA and this 
rule will improve equity in the workforce by ensuring that low-paid 
employees, including Black and Latina employees who may have a more 
difficult time securing voluntary accommodations, will have a right to 
them.
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    \409\ Long Over Due, supra note 395, at 83 (statement of Rep. 
Barbara Lee) (describing her own pregnancy, which required bedrest, 
and contrasting her experience with the experience of employees in 
less flexible jobs).
    \410\ Fighting for Fairness, supra note 394, at 108 (statement 
of Fatima Goss Graves, President & CEO of the National Women's Law 
Center) (``[O]ver 40% of full-time workers in low-paid jobs report 
that their employers do not permit them to decide when to take 
breaks, and roughly half report having very little or no control 
over the scheduling of hours.''). NWLC defines low-wage occupations 
as jobs that pay $11.50 per hour or less (the annual equivalent of 
about $23,920 per year ($11.50 x 2080 hours), which assumes a 40-
hour workweek for 52 weeks). Morgan Harwood & Sarah David Heydemann, 
By the Numbers: Where Do Pregnant Women Work?, Nat'l Women's Law 
Ctr. 4 n.11 (Aug. 2019), https://nwlc.org/wp-content/uploads/2019/08/Pregnant-Workers-by-the-Numbers-v3-1.pdf.
    \411\ Fighting for Fairness, supra note 394, at 108.
    \412\ Id. at 204 (Letter from the National Partnership for Women 
& Families) (stating that women of color and immigrants are 
``disproportionately likely to work in jobs and industries where 
accommodations during pregnancy are not often provided (such as home 
health aides, food service workers, package handlers and 
cleaners)''); id. at 207-08 (Letter from Physicians for Reproductive 
Choice) (``The absence of legislation like the Pregnant Workers 
Fairness Act disproportionately impacts pregnant people with low-
incomes and migrant workers who are more likely to work in arduous 
settings. These are the same communities that are also most at risk 
of experiencing increased maternal mortality.'').
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    Fourth, providing reasonable accommodations to employees who would 
otherwise have been denied them yields third-party benefits that 
include diminishing stereotypes regarding employees who are 
experiencing pregnancy, childbirth, or related medical conditions; 
\413\ promoting design, availability, and awareness of accommodations 
that can have benefits for the general public, including non-pregnant 
employees, and attitudinal benefits; \414\ increasing understanding and 
fairness in the workplace; \415\ and creating less discriminatory work 
environments that benefit employees, employers, and society.\416\
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    \413\ See Salihu et al., supra note 389, at 93 (describing 
studies that have ``substantiated the pervasiveness of negative 
perceptions of pregnant women'' and the common belief that they 
serve as a liability in the workplace); id. at 94-95 (concluding 
that the issue of pregnancy in the workplace needs to be addressed 
proactively with an emphasis on combating stereotypes of pregnant 
women as incompetent or uncommitted).
    \414\ See Elizabeth F. Emens, Integrating Accommodation, 156 U. 
Pa. L. Rev. 839, 850-59 (2008) (describing a wide range of potential 
third-party benefits that may arise from workplace accommodations 
for individuals with disabilities, many of which are also relevant 
to accommodations for individuals protected by the PWFA).
    \415\ See id. at 883-96 (describing attitudinal third-party 
benefits that arise when co-workers work with individuals receiving 
accommodations in the workplace under the ADA, many of which are 
relevant to accommodations for individuals protected by the PWFA).
    \416\ See Long Over Due, supra note 395, at 3 (statement of Rep. 
Suzanne Bonamici) (describing the PWFA as ``an opportunity for 
Congress to finally fulfill the promise of the Pregnancy 
Discrimination Act and take an important step towards workplace 
gender equity,'' among other benefits).
---------------------------------------------------------------------------

Clarity in Enforcement and Efficiencies in Litigation
    Congress, in describing the goals of the PWFA, also focused on the 
clarity that the PWFA would bring to the question of when employers 
must provide accommodations for limitations related to pregnancy, 
childbirth, or related medical conditions: ``The PWFA eliminates a lack 
of clarity in the current legal framework that has frustrated pregnant 
workers' legal rights to reasonable accommodations while providing 
clear guidance to both workers and employers.'' \417\ By creating a 
national standard, the PWFA also may increase compliance with State 
laws requiring accommodations for pregnant employees,\418\ as coming 
into compliance with the PWFA may increase employers' knowledge about 
these laws in general. In the short time that the PWFA has been in 
effect, one comment noted that dozens of employees had informed them of 
the ``transformative effect'' of the law, with employees who had 
previously been denied reasonable accommodations having them 
provided.\419\ For example, an electrician's assistant reported that, 
following her request for a pregnancy-related accommodation, her 
employer attempted to place her on leave; but after advocating for 
herself under the PWFA, her employer exhibited increased flexibility 
and willingness to accommodate her.\420\ An employee in 
telecommunications stated that, after her employer took months to 
respond to her request for a postpartum accommodation, she informed her 
employer of her rights under the PWFA, and her employer granted the 
accommodation request.\421\ A tax specialist reported that she 
requested a pregnancy-related accommodation that her employer denied 
without explanation; after she educated her employer about the PWFA, 
her employer granted her request for an accommodation.\422\
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    \417\ H.R. Rep. No. 117-27, pt. 1, at 11, 31 (``By guaranteeing 
pregnant workers the right to reasonable accommodations in the 
workplace, the PWFA could also decrease employers' legal 
uncertainty.''); see also Long Over Due, supra note 395, at 24 
(statement of Iris Wilbur, Vice President of Government Affairs & 
Public Policy, Greater Louisville, Inc., The Metro Chamber of 
Commerce) (``For our members, uncertainty means dollars. A 
consistent and predictable legal landscape means a business-friendly 
environment. Before Kentucky's law was enacted this summer, our 
employers were forced to navigate a complex web of Federal laws and 
court decisions to figure out their obligations. And now this 
guidance is especially beneficial for the smaller companies we 
represent who cannot afford expensive legal advisors.'').
    \418\ For a list of these laws, see infra Table 1.
    \419\ Comment EEOC-2023-0004-98298, A Better Balance, at 7 (Oct. 
10, 2023).
    \420\ Id. at 88.
    \421\ Id. at 88-89.
    \422\ Id. at 89.
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    By clarifying the rules regarding accommodations for pregnant 
employees, the PWFA and the rule will decrease the need for litigation

[[Page 29169]]

regarding accommodations under the PWFA. To the extent that litigation 
remains unavoidable in certain circumstances, the PWFA and the rule are 
expected to eliminate the need to litigate whether the condition in 
question is a ``disability'' under the ADA, and to limit discovery and 
litigation costs that arise under Title VII regarding determining if 
there are valid comparators, thus streamlining the issues requiring 
judicial attention.\423\
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    \423\ See H.R. Report No. 117-27, pt. 1, at 14-17 (describing 
the need to find comparators under Title VII and the difficulties it 
has caused pregnant employees seeking accommodations); id. at 17-21 
(describing the protections available for pregnant employees under 
the ADA and the fact that frequently even pregnancies with severe 
complications are found by courts not to be ``disabilities'').
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Benefits for Covered Entities
    Providing accommodations needed due to pregnancy, childbirth, or 
related medical conditions is also likely to provide benefits to 
covered entities. By providing accommodations to employees affected by 
pregnancy, childbirth, or related medical conditions and retaining them 
as employees, employers will save money by not having to obtain and 
train new employees. The Commission is not aware of any data regarding 
the need to obtain and train employees arising specifically from 
provision of reasonable accommodations for pregnancy, childbirth, or 
related medical conditions. Studies examining the relationship between 
employee retention and provision of reasonable accommodations for 
disabilities generally suggest that the benefits to covered entities 
may be significant. According to one study, 85 percent of employers 
that provided accommodations to individuals with disabilities reported 
that doing so enabled them to retain a valued employee; 53 percent 
reported an increase in that employee's productivity; 46 percent 
reported elimination of costs associated with training a new employee; 
48 percent reported an increase in that employee's attendance; 33 
percent noted that providing the accommodation increased diversity in 
the company; and 23 percent reported a decrease in workers' 
compensation or other costs. Employers also noted several indirect 
benefits: 30 percent noted an increase in company morale, and 21 
percent noted an increase in overall company productivity.\424\
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    \424\ See Costs and Benefits of Accommodation, supra note 209.
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Costs

Covered Entities and the Existing Legal Landscape
    Entities covered by the PWFA and the regulation include all 
employers covered by Title VII and the Government Employee Rights Act 
of 1991, 42 U.S.C. 2000e-16a-16c (GERA), including private and public 
sector employers with 15 or more employees, Federal agencies, 
employment agencies, and labor organizations.\425\
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    \425\ See 42 U.S.C. 2000gg(2)(A). The PWFA also applies to 
employers covered by the Congressional Accountability Act of 1995 
(42 U.S.C. 2000gg(2)(B)(ii)). The proposed regulation does not apply 
to employers covered under the Congressional Accountability Act, as 
the Commission does not have the authority to enforce the PWFA with 
respect to employees covered by the Act.
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    In addition to the legal protections described earlier in the 
preamble pertaining to Title VII, the ADA, and the FMLA, there are 
three other important legal considerations that impact the costs of 
accommodations under the PWFA and this regulation.
    First, 30 States and 5 localities have laws substantially similar 
to the PWFA, requiring covered employers to provide reasonable 
accommodations to pregnant employees.\426\ As a result, this rule will 
impose minimal, if any, additional costs on the covered entities in 
these States and localities.\427\
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    \426\ See infra Table 1; see also U.S. Dep't of Lab., Employment 
Protections for Workers Who Are Pregnant or Nursing, https://www.dol.gov/agencies/wb/pregnant-nursing-employment-protections 
(last visited Mar. 25, 2024).
    \427\ The PWFA analogues in Alaska, North Carolina, and Texas 
only cover certain public employers. The laws in Louisiana and 
Minnesota apply to employers larger than the PWFA threshold of 15 or 
more employees (25 or more employees in Louisiana; 21 or more 
employees in Minnesota). As explained below, the analysis takes 
these differences into account.
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    Second, when it enacted the PWFA, Congress also enacted the PUMP 
Act, which requires employers who are covered by the FLSA to provide 
reasonable break time for an employee to pump breast milk each time 
such employee has the need to express milk for up to 1 year after the 
child's birth. The PUMP Act also requires employers to provide a place 
to pump at work, other than a bathroom, that is shielded from view and 
free from intrusion from coworkers and the public.\428\ As a result, 
the Commission anticipates that most employees will not need to seek 
reasonable accommodations regarding a time and place to pump at work 
under the PWFA because they will already be entitled to these under the 
PUMP Act.
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    \428\ U.S. Dep't of Lab., FLSA Protections to Pump at Work, 
https://www.dol.gov/agencies/whd/pump-at-work (last visited Mar. 25, 
2024).
---------------------------------------------------------------------------

    Third, the Federal Government provides 12 weeks of paid parental 
leave to eligible Federal employees upon the birth of a new child.\429\ 
As a result, these Federal employees may make fewer requests for leave 
as a reasonable accommodation under the PWFA as they are already 
guaranteed a certain amount of paid leave.
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    \429\ Federal Employee Paid Leave Act, 133 Stat. at 2304-05.
---------------------------------------------------------------------------

Estimate of the Number of Reasonable Accommodations That Will Be 
Provided as a Result of the Rule and Underlying Statute
    As set out in Tables 1 and 2 and explained in detail below, the 
rule and underlying statute cover approximately 116.7 million employees 
of private establishments with 15 or more employees, 18.8 million State 
and local government employees, and 2.3 million Federal employees. Only 
a small percentage of these employees are expected to seek and be 
entitled to accommodations as a result of the rule and underlying 
statute.
    Approximately 52 percent of private sector enterprises with 15 or 
more employees in the United States (1.4 million establishments), 
employing about 61.2 million employees (accounting for 52 percent of 
employment in those States), are currently subject to State or local 
laws that are substantially similar to the PWFA. The enactment of the 
PWFA and promulgation of the rule, therefore, should not result in 
additional accommodation-related costs for these employers. Subtracting 
61.2 million employees from the total number of covered employees 
employed by private sector enterprises (116.7 million) yields a total 
of approximately 55.5 million employees of private sector 
establishments who will be covered by the rule and underlying statute, 
and who are not also covered by State or local laws that are 
substantially similar to the PWFA. Tables 1 and 2 display

[[Page 29170]]

each State's share of the total national number of private sector 
establishments that have 15 or more employees and thus will be subject 
to the PWFA, and the percentage of employees in the State employed by 
such establishments. States with laws substantially similar to the PWFA 
are in Table 1; States without such a law are in Table 2.
---------------------------------------------------------------------------

    \430\ U.S. Dep't of Com., Census Bureau, The Number of Firms and 
Establishments, Employment, and Annual Payroll by State, Industry, 
and Enterprise Employment Size: 2020 (2020) [hereinafter Firms and 
Establishments Data by State], https://www.census.gov/data/tables/2020/econ/susb/2020-susb-annual.html (select ``U.S. & States, NAICS, 
Detailed Employment Sizes''). Percentages in the Table reflect 
filtering by size and summing by State.
    \431\ This number is limited to enterprises with 15 or more 
employees.
    \432\ This denotes the minimum number of employees that an 
employer must have to be covered by the State law.
    \433\ These numbers only account for enterprises with at least 
25 employees because Louisiana's pregnancy accommodation law applies 
to employers with 25 or more employees. See La. Rev. Stat. Ann. sec. 
23:341 (2021).
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BILLING CODE 6570-01-P
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[[Page 29171]]


[GRAPHIC] [TIFF OMITTED] TR19AP24.088

     
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    \434\ These numbers only account for enterprises with at least 
25 employees because Minnesota's pregnancy accommodation law applies 
to employers with 21 or more employees. Minn. Stat. sec. 181.940, 
181.9414, 181.9436 (2014). Data on enterprises with 21 to 24 
employees are not available.
    \435\ Pennsylvania does not have a State-wide pregnancy 
accommodation law, but Philadelphia does. See Phila. Code sec. 9-
1128 (2014). Philadelphia accounts for approximately 9 percent of 
Pennsylvania establishments and approximately 12 percent of 
individuals employed in Pennsylvania. See U.S. Dep't of Comm., 
Census Bureau, The Number of Firms and Establishments, Employment, 
and Annual Payroll by Congressional District, Industry, and 
Enterprise Employment Size: 2019 (2019), https://www.census.gov/data/tables/2019/econ/susb/2019-susb-annual.html (select ``State by 
Congressional District, NAICS Sectors''). The calculation is based 
on the total number of establishments and total employment in 
Pennsylvania and in Philadelphia County and the shares of employment 
in each.
    \436\ This total does not include Alaska, North Carolina, and 
Texas, where the pregnancy accommodation laws only apply to certain 
public employees.

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[[Page 29172]]

[GRAPHIC] [TIFF OMITTED] TR19AP24.089

[GRAPHIC] [TIFF OMITTED] TR19AP24.090

    Similarly, approximately 11.5 million State and local government 
employees are covered by laws that are substantially similar to the 
PWFA.\445\ Subtracting this number from the total number of covered 
State and local government employees (18.8 million) yields a total of 
7.3 million State and local government employees who will be covered by 
the rule and underlying statute and who are not already covered by 
State or local laws substantially similar to the PWFA.
---------------------------------------------------------------------------

    \437\ Firms and Establishments Data by State, supra note 430. 
Percentages in the table reflect filtering by size and summing by 
State.
    \438\ This number is limited to enterprises with 15 or more 
employees.
    \439\ Alaska's statute, codified at Alaska Stat. sec. 39.20.520 
(1992), covers public employers only.
    \440\ These numbers only include enterprises with 15-24 
employees because Louisiana's pregnancy accommodation law applies to 
employers with 25 or more employees. La. Rev. Stat. Ann. sec. 23:341 
(2021).
    \441\ These numbers only include enterprises with 15-24 
employees because Minnesota's pregnancy accommodation law applies to 
employers with 21 or more employees. Minn. Stat. sec. 181.940, 
181.9414, 181.9436 (2014). Data on enterprises with 15-20 employees 
are not available.
    \442\ North Carolina Executive Order No. 82 (2018) covers public 
employers only.
    \443\ See supra note 435.
    \444\ The Texas statute, codified at Tex. Loc. Gov't Code sec. 
180.004 (2001), covers local public employers only.
    \445\ U.S. Dep't of Com., Census Bureau, 2021 ASPEP Datasets & 
Tables (2021) [hereinafter ASPEP Datasets], https://www.census.gov/data/datasets/2021/econ/apes/annual-apes.html. The calculation is 
based on data from the ``State Government Employment & Payroll 
Data'' and the ``Local Government Employment & Payroll'' files, in 
the ``Government Function'' column.

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[[Page 29173]]

    Finally, there are 2.3 million Federal employees. The Federal 
Government does not currently require accommodations for pregnant 
employees; thus, the PWFA provides a new right for these 
employees.\446\
---------------------------------------------------------------------------

    \446\ As noted above, however, most Federal employees are 
entitled to 12 weeks of paid parental leave during the 12-month 
period following birth of a child (or other qualifying event) under 
the FEPLA. See Federal Employee Paid Leave Act, 133 Stat. at 2304-
05. Individuals eligible for such leave may be less likely to need 
leave as a reasonable accommodation under the PWFA.
---------------------------------------------------------------------------

    Again, however, not all employees who are now covered by the PWFA 
will seek and be entitled to accommodations as a result of the rule and 
underlying statute; only a small percentage will become pregnant and 
need accommodations in a given year.
    To estimate the number of individuals who will be entitled to a 
pregnancy-related accommodation, and who will receive one as a result 
of the PWFA and its implementing regulations, the Commission first 
estimates the proportion of newly covered employees who are capable of 
becoming pregnant. In 2021, women of reproductive age (aged 16-50 
years) comprised approximately 33 percent of U.S. employees.\447\ On 
the basis of this finding, the Commission adopts 33 percent as its 
estimate of the percentage of employees who are capable of becoming 
pregnant.
---------------------------------------------------------------------------

    \447\ See Ruggles et al., supra note 403.
---------------------------------------------------------------------------

    The Commission next estimates the proportion of individuals capable 
of becoming pregnant who will actually become pregnant in a given year. 
Research shows that approximately 4.7 percent of individuals who are 
capable of becoming pregnant gave birth to at least one child during 
the previous year.\448\ This figure must be adjusted upward to account 
for the fact that not all individuals who become pregnant give birth--
some pregnant individuals have miscarriages, stillbirths, or abortions. 
Research shows that, between 2015 and 2019, live births in the United 
States accounted for 67 percent of all pregnancies among women aged 15-
44 years on average.\449\ Assuming that the ratio of live births to 
total pregnancies among women of reproductive age in the labor force is 
the same as among all 15-44 years old women, the Commission estimates 
that the percentage of individuals capable of becoming pregnant who 
will actually become pregnant in given year is 0.047 / 0.67 = 0.071 
(rounded up), or 7.1 percent. The Commission thus adopts 7.1 percent as 
its estimate of the percentage of individuals capable of becoming 
pregnant within a population who will actually become pregnant in a 
given year.
---------------------------------------------------------------------------

    \448\ Id.
    \449\ Rossen et al., supra note 317, at 9 tbl. A.
---------------------------------------------------------------------------

    Applying these percentages to the numbers above yields totals 
(rounded to the nearest 1,000) of, in a given year, 1.3 million private 
sector employees (55,500,000 x 0.33 x 0.071), 171,000 State and local 
government employees (7,300,000 x 0.33 x 0.071), and 54,000 Federal 
employees (2,300,000 x 0.33 x 0.071) who are both newly eligible for 
reasonable accommodations under the rule and underlying statute, and 
who may be expected to become pregnant in a given year. Tables 3, 4, 
and 5 display these calculations.
[GRAPHIC] [TIFF OMITTED] TR19AP24.091


[[Page 29174]]


[GRAPHIC] [TIFF OMITTED] TR19AP24.092

[GRAPHIC] [TIFF OMITTED] TR19AP24.093

BILLING CODE 6570-01-C
    The sum of the expected number of pregnant women eligible for PWFA 
accommodations in the private sector (1.3 million), State and local 
government (171,000), and Federal Government (54,000) is 1.525 million.
---------------------------------------------------------------------------

    \450\ The calculation is based on data as described in ASPEP 
Datasets, supra note 445.
    \451\ This number includes 12 percent of State and local 
government employment in Pennsylvania to account for Philadelphia's 
PWFA-type law, excludes local government employment in North 
Carolina because the existing law only applies to State employees, 
and excludes State government employment in Texas because the 
existing law only applies to local governments.
    \452\ This number includes State and local government employment 
in Pennsylvania not accounted for by Philadelphia, includes local 
government employment in North Carolina because the existing law 
only applies to State employees, and includes State government 
employment in Texas because the existing law only applies to local 
governments.
    \453\ U.S. Dep't of Com., Bureau of Econ. Analysis, Full-Time 
and Part-Time Employees by Industry, https://apps.bea.gov/iTable/?reqid=19&step=2&isuri=1&1921=survey#eyJhcHBpZCI6MTksInN0ZXBzIjpbMSwyLDNdLCJkYXRhIjpbWyJDYXRlZ29yaWVzIiwiU3VydmV5Il0sWyJOSVBBX1RhYmxlX0xpc3QiLCIxOTMiXV19 (last updated Sept. 29, 2023).
---------------------------------------------------------------------------

    The Commission next estimates the proportion of pregnant 
individuals in the workplace who may need a pregnancy-related 
reasonable accommodation and who will receive such accommodation as a 
result of the rule and the underlying statute. Data regarding the 
number of pregnant employees needing some type of accommodation are 
limited. One survey indicated that 71 percent of pregnant employees 
experience a pregnancy-related limitation that requires extra breaks, 
such as bathroom breaks; 61 percent experience a limitation that 
requires a change in schedule or more time off, for example, to see 
prenatal care providers; 53 percent experience a limitation that 
requires a change in duties, such as less lifting or more sitting; and 
40 percent experience a limitation that requires some other type of 
workplace adjustment.\454\
---------------------------------------------------------------------------

    \454\ Declercq et al., supra note 319, at 36. As explained in 
the preamble, the Commission is maintaining this as the high bound 
of employees who may need an accommodation because this is the 
percentage of employees who needed the simplest accommodation (e.g., 
breaks to use the bathroom).
---------------------------------------------------------------------------

    The research establishes that 71 percent of pregnant individuals 
surveyed needed the most common type of pregnancy-related reasonable 
accommodation: additional breaks. The Commission assumes for purposes 
of the final economic impact analysis that the pregnant individuals in 
the study who needed one of the more unusual accommodations are a 
subset of the 71 percent who need additional breaks. The Commission 
thus adopts 71 percent as its upper bound estimate of the percentage of 
pregnant employees who will need a pregnancy-related accommodation 
under the rule.\455\ Applying the 71 percent estimate yields upper 
bound estimates (rounded to the nearest 1,000) of 923,000 private 
sector employees (71 percent of 1,300,000), 121,000 State and local 
government employees (71 percent of 171,000), and 38,000 Federal sector 
employees (71 percent of 54,000), for a total 1,082,000 employees, who 
will need a reasonable accommodation and who will receive one as a 
result of the PWFA and the rule in a given year.
---------------------------------------------------------------------------

    \455\ The Commission asserts that this estimate is almost 
certainly too high because, although 71 percent of the pregnant 
individuals participating in the research needed a reasonable 
accommodation, not all such individuals needed the PWFA to obtain 
such accommodation. As explained above, many individuals who need 
pregnancy-related accommodations may already be entitled to them 
under the ADA, Title VII, or formal or informal employer policies.
---------------------------------------------------------------------------

    In setting its lower bound estimate, the Commission observes that 
not every individual who is newly entitled to a pregnancy-related 
accommodation under the PWFA and the rule, and who receives such an 
accommodation, will receive it as a result of the rule. Some of these 
individuals will already be entitled to receive pregnancy-related 
accommodations under other authorities, independently of the PWFA and 
its implementing regulations--some will already be entitled to them 
under the ADA, others will be entitled to them under Title VII, and yet 
others will be

[[Page 29175]]

entitled to them under formal or informal employer policies.\456\ 
Therefore, costs arising from pregnancy-related accommodations cannot 
always be attributed to the rule and the underlying statute, even where 
the employee in question was not previously covered under a State law 
analogous to the PWFA.
---------------------------------------------------------------------------

    \456\ Additionally, some workplace modifications, such as 
providing personal protective equipment, and protecting employees 
from exposures to hazardous chemicals, may already be required by 
Federal or State workplace health and safety laws, regardless of 
whether the employee is pregnant.
---------------------------------------------------------------------------

    To generate its lower bound estimate, the Commission reduces its 
upper bound estimate of 71 percent to reflect the fact that some of 
those individuals would receive their requested accommodation 
independently of the rule. According to the study cited above,\457\ 42 
percent of the individuals who needed additional breaks due to a 
pregnancy-related limitation did not receive them because they were 
never requested, and 3 percent did not receive them because the 
employer denied their request. Thus, 0.71 x 0.45 = 0.32, or 32 percent, 
of pregnant individuals surveyed needed, but did not receive the 
requested accommodation. On the basis of this research, the Commission 
adopts 32 percent as its lower bound estimate of the percentage of 
pregnant employees who will need a reasonable accommodation under the 
PWFA and its implementing regulations. Applying this percentage yields 
lower bound estimates (rounded to the nearest 1,000) of approximately 
416,000 private sector employees (32 percent of 1,300,000); 55,000 
State and local government employees (32 percent of 171,000); and 
17,000 Federal sector employees (32 percent of 54,000), for a total of 
488,000 employees who will need, and be newly entitled to, reasonable 
accommodations under the rule and underlying statute in a given year.
---------------------------------------------------------------------------

    \457\ See Declercq et al., supra note 319, at 36. We note that 
this study was conducted prior to many PWFA-type laws being enacted. 
Because the data are being used to estimate the number of requests 
that will occur in States and localities that do not already have 
PWFA-type laws, EEOC believes it is appropriate to rely on this 
survey.
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Cost of Accommodation
    Accommodations that allow pregnant employees to continue to perform 
their job duties, thereby allowing them to receive continued pay and 
benefits, include additional rest or bathroom breaks, use of a stool or 
chair, a change in duties to avoid strenuous physical activities, and 
schedule changes to attend prenatal appointments.\458\ Some of these 
accommodations, especially additional rest or bathroom breaks and 
provision of a stool or chair, are expected to impose minimal or no 
additional costs on the employer. Certain other types of 
accommodations, such as allowing the employee to avoid heavy lifting or 
exposure to certain types of chemicals, may be easy to provide in some 
jobs but more difficult to provide in others, necessitating temporary 
restructuring of responsibilities or transferring to a different 
position.
---------------------------------------------------------------------------

    \458\ Id.; see also Long Over Due, supra note 395, at 79 
(statement of Dina Bakst, Co-Founder & Co-President, A Better 
Balance) (describing potential accommodations).
---------------------------------------------------------------------------

    The Commission was unable to find any data on the average cost of 
reasonable accommodations related specifically to pregnancy, 
childbirth, or related medical conditions. The Commission has therefore 
relied on the available data on the cost of accommodations for 
individuals with disabilities for purposes of this analysis.
    A survey conducted by the Job Accommodation Network (JAN) indicates 
that most workplace accommodations for individuals with disabilities 
are low-cost.\459\ Of the employers participating in this survey 
between 2019 and 2022, 49.4 percent reported that they provided an 
accommodation needed because of a disability that did not cost anything 
to implement. The Commission believes that the percentage of no-cost 
accommodations is likely to be higher for accommodations related 
specifically to pregnancy, childbirth, or related medical conditions, 
because many will be simple and no-cost like access to water, stools, 
or more frequent bathroom breaks, and because the vast majority will be 
temporary. Nevertheless, because the Commission is unable to locate any 
data on the percentage of accommodations needed because of pregnancy-
related conditions that have no cost, the Commission conservatively 
assumes for purposes of this analysis that the percentages are the 
same.
---------------------------------------------------------------------------

    \459\ Costs and Benefits of Accommodation, supra note 209.
---------------------------------------------------------------------------

    The same research showed that the median one-time cost of providing 
a non-zero-cost accommodation was $300. Only 7.2 percent of employers 
reported that they provided an accommodation that resulted in ongoing 
annual costs. Because pregnancy is a temporary condition, the ongoing 
costs incurred by 7.2 percent of employers are unlikely to be 
applicable to pregnancy-related accommodations, and the Commission 
adopts $300 as the median one-time cost for employers that incurred a 
cost (50.6 percent of employers). Again, although the Commission 
believes that the average cost is likely lower for accommodations 
needed specifically for pregnancy, childbirth, or related medical 
conditions, it will use the data for the purposes of this analysis.
    Because non-zero-cost accommodations generally involve durable 
goods such as additional stools, infrastructure for telework, and 
machines to help with lifting, and because these goods generally have a 
useful life of 5 years, the Commission will assume that the annual cost 
of providing these accommodations is approximately $60 per year per 
accommodation.\460\
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    \460\ The Commission made a similar assumption of a 5-year life 
for accommodations in its cost analysis of the amendments to the 
ADA. 76 FR 16977, 16994 (Mar. 25, 2011).
---------------------------------------------------------------------------

    Using these cost estimates, and applying them to the upper and 
lower bound estimates for the number of additional accommodations that 
will likely be required by the rule and underlying statute, the 
estimated annual costs (rounded to the nearest 1,000) for private 
employers is between $12.60 million and $28.02 million; the estimated 
annual costs for State and local governments is between $1.68 million 
and $3.66 million, and the estimated annual costs for the Federal 
Government is between $540,000 and $1.14 million. See Tables 6, 7, and 
8.
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    Thus, the overall economic cost on the U.S. economy of providing 
reasonable accommodations pursuant to the rule and underlying statute 
is estimated to be between $14.82 million and $32.82 million annually.
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    \461\ This is based on the distinct number of States and local 
government filers of the 2021 EEO-4 survey where available, and the 
2021 Annual Survey of Public Employment & Payroll (ASPEP) when not 
available.
    \462\ Id.
    \463\ See EEOC, Department of Agency List with Second Level 
Reporting Components, https://www.eeoc.gov/federal-sector/management-directive/department-or-agency-list-second-level-reporting-components (last visited Mar. 25, 2024).
    \464\ As described above, a GS-14, Step 5 salary is $63.21 per 
hour. See U.S. Off. of Pers. Mgmt., Salary Table 2023-RUS (Jan. 
2023), https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2023/RUS_h.pdf. This is then adjusted for 
average hourly benefits for Federal employees. See Cong. Budget 
Off., Comparing the Compensation of Federal and Private-Sector 
Employees, 2011 to 2015, at 14 (Apr. 25, 2017), https://www.cbo.gov/system/files/115th-congress-2017-2018/reports/52637-federalprivatepay.pdf (reporting that the average benefits for 
Federal employees range from $21.30 per hour to $29.80 per hour). 
This analysis uses the high estimate of $29.80 to compute the total 
hourly compensation at $93.01 ($63.21 + $29.80). The Commission was 
unable to find data on overhead costs for the Federal Government. 
The Commission assumed the rate to be the same as in the private 
sector (17 percent), see supra note 467, totaling $10.75 ($63.21 x 
0.17) per hour. This resulted in a fully-loaded hourly compensation 
rate of $103.76 (%63.21 + 29.80 + 10.75).

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[[Page 29177]]

    The costs in Tables 6, 7, and 8 likely overestimate the costs to 
covered entities in at least six respects:
     The estimated one-time cost of $300 per non-zero-cost 
accommodation is based on costs of accommodations for individuals with 
disabilities generally, not only those related to pregnancy, among the 
JAN survey respondents. The Commission believes that the average cost 
of accommodations related to pregnancy, childbirth, or related medical 
conditions is less than the average cost of disability-related 
accommodations because many of the reasonable accommodations requested 
under the PWFA will be simple and inexpensive to provide, and the vast 
majority will be temporary.
     The sample obtained in the JAN study may not be 
representative of all employers, because employers who consult with JAN 
are likely to be facing more difficult and costly accommodation issues 
than employers overall.\465\
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    \465\ JAN provides free assistance regarding workplace 
accommodation issues. See generally Job Accommodation Network, 
https://askjan.org/ (last visited Mar. 25, 2024).
---------------------------------------------------------------------------

     The estimate does not account for the fact that some 
employees who will be entitled to reasonable accommodations under the 
PWFA and the rule are independently entitled to accommodations under 
the ADA or Title VII, to break time and a private place to pump at work 
under the PUMP Act, and, in some cases, leave under the FMLA or the 
Federal Employees Paid Leave Act.\466\
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    \466\ Brown et al., supra note 377, at 6 (finding that about 56 
percent of U.S. employees were eligible for FMLA in 2018, and 25 
percent of the FMLA leave taken in the prior 12 months accounted for 
the arrival of a new child).
---------------------------------------------------------------------------

     The estimate does not account for the fact that some 
employers voluntarily provide accommodations to employees affected by 
pregnancy, childbirth, or related medical conditions and may not incur 
new costs.
     This analysis does not account for the fact that not all 
employees who seek accommodations will meet the definition of 
``qualified,'' and an employer may decline to provide a reasonable 
accommodation if doing so creates an undue hardship.
    The Commission did not include costs related to processing requests 
for accommodation in its estimate because it expects these costs to be 
extremely low. Employers that are covered by State or local laws 
substantially similar to the PWFA already have these procedures in 
place. The Commission assumes that employers not covered by such State 
or local laws, and the Federal Government, will adapt existing 
procedures for providing accommodations under Title VII and the ADA and 
for providing leave under the FMLA.
One-Time Administrative Costs for Covered Entities
    Administrative costs, which include rule familiarization, posting 
new EEO posters, and updating EEO policies and handbooks, represent 
additional, one-time direct costs to covered entities.
    It is estimated that in States that do not already have laws 
substantially similar to the PWFA, compliance activities for a covered 
entity would take an average of 135 minutes, or 2.25 hours, by an Equal 
Opportunity Officer who is paid a fully-loaded wage of $113.51 per hour 
\467\ ($76.03 for a State or local government employee).\468\ In States 
with already existing laws similar to the PWFA, an Equal Opportunity 
Officer will take an average of 45 minutes for compliance activities. 
For the Federal Government, which does not have an existing PWFA, it is 
estimated that compliance activities would take an average of 135 
minutes by an Equal Opportunity Officer at a GS 14-5 salary.\469\ These 
calculations are displayed in Table 9.
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    \467\ The Commission anticipates that the bulk of the workload 
under this rule would be performed by employees in occupations 
similar to those associated with the Standard Occupational 
Classification (SOC) code of SOC 11-3121 (Human Resources Managers). 
According to the U.S. Bureau of Labor Statistics, the mean hourly 
wage rate for Human Resources Managers in May 2022 was $70.07. See 
U.S. Dep't of Lab., Bureau of Lab. Stat., Employment of Human 
Resources Managers, by State, May 2022 (2022), https://www.bls.gov/oes/current/oes113121.htm#st. For this analysis, the Commission used 
a fringe benefits rate of 45 percent and an overhead rate of 17 
percent, resulting in a fully-loaded hourly compensation rate for 
Human Resources Managers of $113.51 ($70.07 + ($70.07 x 0.45) + 
($70.07 x 0.17)).
    \468\ U.S. Dep't of Lab., Bureau of Lab. Stat., Employer Costs 
for Employee Compensation for State and Local Government Workers by 
Occupational and Industry Group (Mar. 17, 2023), https://www.bls.gov/news.release/archives/ecec_03172023.pdf. Total employer 
compensation costs for State and local government averaged $57.60 
per hour worked (see Table 3 row 1, column 1 of the cited document). 
Average compensation ranged from $68.57 in management, professional, 
and related occupations (row 3) to $40.05 in sales and office 
occupation (row 7). This analysis uses the high estimate of $68.57 
per hour worked, which includes average wage and salary cost of 
$43.87 per hour (row 3, column 3) and average benefit costs of 
$24.70 per hour (row 3, column 5). The Commission was not able to 
find data on overhead costs for State and local governments. The 
Commission assumed the rate to be the same as in the private sector 
(17 percent), see supra note 467, totaling $7.46 ($43.87 x 0.17) per 
hour. This resulted in a fully-loaded hourly compensation rate of 
$76.03 ($43.87 + $24.70 + $7.46).
    \469\ In 2023, a GS-14, Step 5 salary is $63.21 per hour. See 
U.S. Off. of Pers. Mgmt., Salary Table 2023-RUS (Jan. 2023), https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2023/RUS_h.pdf.
---------------------------------------------------------------------------

Totals and Discount Rates
    Total costs for providing reasonable accommodations in each year 
are estimated by multiplying the number of non-zero accommodations in 
Tables 6-8 above by the upfront cost of $300. Because these are assumed 
to be durable accommodations, we assume that an employer that acquires 
an accommodation in a given year will reuse the accommodation 
throughout its useful life. Throughout the document, we assume a useful 
life of 5 years, which amounts to an average annual cost of $60. To 
more accurately reflect the present value of these upfront expenses, 
EEOC annualizes the total costs.
    Adding the annualized cost of providing reasonable accommodations, 
assuming a useful life of 5 years (between $14.82 million and $32.82 
million), to the estimated administrative costs in year 1 ($451.89 
million) yields estimated total costs of between $466.71 million and 
$484.71 million in the first year, and between $14.82 million and 
$32.82 million annually thereafter.
    Table 10 provides the analysis of discount rates at 3% and 7%, as 
required by OMB Circular A-4, for the lower and upper bound costs of 
providing accommodations. Table 11 provides that information for the 
one-time administrative costs.
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Time Horizon of Analysis
---------------------------------------------------------------------------

    \470\ Exec. Off. of the President, Off. of Mgmt. & Budget, 
Circular A-4 (Sept. 17, 2003), https://obamawhitehouse.archives.gov/omb/circulars_a004_a-4/ (addressing discount rates).
---------------------------------------------------------------------------

    Neither the PWFA nor the rule contains a sunset provision.
    The cost analysis assumes a one-time administrative cost for 
employers, and the amount of time varies depending on whether the 
employer is in a State with or without its own version of the PWFA.
    The cost and benefit analysis calculates the annual cost of 
accommodations per pregnant employee who may need them. Because 
different employees enter the labor market every year and may become 
pregnant, or an employee who was pregnant may become pregnant again, 
the Commission does not believe that the need for accommodations or the 
costs or benefits will substantially change over time.

Range of Regulatory Alternatives

    The range of alternatives available to the Commission consistent 
with the Executive Order is narrow:
     Because 42 U.S.C. 2000gg-3(a) requires the Commission to 
issue regulations, the Commission could not consider non-regulatory 
alternatives.
     Because 42 U.S.C. 2000gg determines coverage, the 
Commission could not consider exemptions based on firm size or 
geography.
     Because 42 U.S.C. 2000gg-2 provides how the statute will 
be enforced, the Commission could not consider alternative methods of 
enforcement, such as market-oriented approaches, performance standards, 
default rules, monitoring by other agencies, or reporting.
     Because section 109 of the PWFA states when the law will 
go into effect, the Commission could not consider alternative 
compliance dates.\471\
---------------------------------------------------------------------------

    \471\ 136 Stat. 6089.
---------------------------------------------------------------------------

    Further, because the PWFA is a Federal law that intentionally sets 
a national standard, the Commission could not consider deferring to 
State or local regulations. The one exception to this is that 42 U.S.C 
2000gg-5(a)(1) provides that nothing in the PWFA invalidates or limits 
rights under Federal, State, or local laws that provide equal or 
greater protection for individuals affected by pregnancy, childbirth, 
or related medical conditions. The rule includes this language. Thus, 
the rule does not preempt State or local regulations that provide equal 
or greater protection relative to the PWFA.
    The Commission considered two regulatory alternatives, discussed 
below. The Commission does not believe that either alternative would 
decrease the costs for covered entities.
Definition of ``In the Near Future''
    The statute at 42 U.S.C. 2000gg(6) defines a ``qualified'' employee 
to include employees whose inability to perform one or more essential 
functions of the job is temporary, who will be able to perform the 
essential functions ``in the near future,'' and whose inability to 
perform essential function(s) can be reasonably accommodated without 
undue hardship.
    The final rule defines ``in the near future'' to mean ``generally 
within 40 weeks'' for pregnancy only. The Commission considered, but 
rejected, shorter periods such as 6 months or less \472\ for several 
reasons. First, pregnancy generally lasts 40 weeks; a rule that an 
employee is only ``qualified'' if they are able to perform all the 
essential functions of the job within 6 months of the function(s) being 
temporarily suspended could classify many employees who need a 
temporary suspension of an essential function(s) for a longer period as 
``unqualified'' and therefore ineligible for reasonable accommodations. 
The Commission believes that this outcome would frustrate the purpose 
of the statute, which is to enable employees who need temporary 
accommodations related to pregnancy, childbirth, or related medical 
conditions to continue working.
---------------------------------------------------------------------------

    \472\ H.R. Rep. No. 117-27, pt. 1, at 28 (citing Robert, 691 
F.3d at 1218). Although it does not define ``in the near future,'' 
Robert cites to Epps, 353 F.3d at 593, which found that under the 
ADA, a request for leave that would last 6 months was too long to be 
``in the near future'' to qualify as a possible reasonable 
accommodation.
---------------------------------------------------------------------------

    Second, defining ``in the near future'' to mean ``generally 40 
weeks'' for pregnancy does not mean that the employer will be required 
to actually provide a reasonable accommodation for that length of time. 
The definition of ``in the near future'' is one step in the definition 
of ``qualified''; even if an employee can meet this part of the 
definition, an employer still may refuse to provide an accommodation if 
the employer cannot reasonably accommodate the temporary suspension of 
the essential function or if doing so would impose ``undue hardship'' 
(defined as significant difficulty or expense, relative to the 
employer's overall resources). Additionally, not all employees who need 
an essential function(s) suspended will need it suspended for 40 weeks. 
It is the Commission's hope that setting a single standard for the 
meaning of ``in the near future'' for pregnancy will benefit both 
employers and employees by reducing litigation over the meaning of the 
term and placing the focus on the central issue of whether the 
accommodation would impose an undue hardship.
    If the definition of ``qualified'' is ``generally 40 weeks'' rather 
than ``less than 6 months,'' more pregnant employees will be able to 
meet the definition of qualified. It is not possible to estimate how 
many. The Commission anticipates that there will be little or no 
additional cost to covered entities because it is the act of providing 
an accommodation--not classifying an individual as meeting part of the 
definition of qualified--that imposes actual costs on the employer. A 
covered entity can still argue that the accommodation would impose an 
undue hardship. Further, even if it provides the accommodation, the 
covered entity is likely to experience cost savings from not having to 
recruit, hire, or train a new employee.
    The Commission also considered not defining the term ``in the near 
future,'' but determined that doing so would harm employers by 
increasing uncertainty and harm employees by failing to ensure equal 
treatment.
Predictable Assessments
    In the section defining ``undue hardship,'' the rule lists four job 
modifications often sought by pregnant employees that, in virtually all 
cases, will be found to be reasonable accommodations that do not impose 
undue hardship: (1) carrying or keeping water near and drinking, as 
needed; (2) allowing additional restroom breaks, as needed; (3) 
allowing sitting for those whose work requires standing and standing 
for those whose work requires sitting, as needed; and (4) allowing 
breaks to eat and drink, as needed.
    As explained in the NPRM, these accommodations are repeatedly 
discussed in the PWFA's legislative history as common sense, low-cost 
accommodations that most pregnant employees will need.\473\ To increase

[[Page 29180]]

efficiency and to decrease the time that it takes for employees to 
receive these accommodations, the Commission has determined that these 
modifications will in virtually all cases be determined to be 
reasonable accommodations that do not impose an undue hardship.
---------------------------------------------------------------------------

    \473\ See H.R. Rep.117-27, pt. 1, at 11, 22, 29, 113; Fighting 
for Fairness, supra note 394, at 4 (statement of Rep. Suzanne 
Bonamici); Long Over Due, supra note 395, at 7 (statement of Rep. 
Jerrold Nadler), 25 (statement of Iris Wilbur, Vice President of 
Government Affairs & Public Policy, Greater Louisville, Inc., The 
Metro Chamber of Commerce), 83 (statement of Rep. Barbara Lee). See 
also 168 Cong. Rec. H10,527 (daily ed. Dec. 23, 2022) (statement of 
Rep. Jerrold Nadler); 168 Cong. Rec. S10,081 (daily ed. Dec. 22, 
2022) (statement of Sen. Robert P. Casey, Jr.); 168 Cong. Rec. 
S7,079 (daily ed. Dec. 8, 2022) (statement of Sen. Robert P. Casey, 
Jr.); 168 Cong. Rec. H2,324 (daily ed. May 14, 2021) (statement of 
Rep. Suzanne Bonamici).
---------------------------------------------------------------------------

    As an alternative to providing that these simple, common-sense 
modifications will virtually always be determined to be reasonable 
accommodations that do not impose undue hardship, the Commission 
considered taking the position that such modifications would always be 
reasonable accommodations and never impose undue hardship. The 
Commission decided against this approach because some employers may 
encounter circumstances that would lead to a determination that these 
modifications are not reasonable accommodations and/or would impose an 
undue hardship.
    The Commission also considered the option of not including 
information regarding ``predictable assessments'' in the rule. The 
Commission determined that providing this information will be helpful 
to the public because doing so explains to covered entities and 
employees how the Commission intends to enforce the PWFA, potentially 
increases voluntary compliance, and increases certainty for covered 
entities, which will decrease costs.
    The Commission does not anticipate that the rule's ``predictable 
assessments'' section would increase costs for covered entities. The 
examples given are low- to no-cost accommodations, and under the rule, 
the employer may still claim that these modifications would impose an 
undue hardship.

Uncertainty in Benefits, Costs, and Net Benefits

    The Commission has based its estimates of the costs and benefits of 
the rule on the best data available to it at the current time. 
Nevertheless, the Commission recognizes these estimates are somewhat 
uncertain in several respects.
    The data used to estimate the cost of providing accommodations as 
required by the PWFA come entirely from research on the cost of 
accommodations for individuals with disabilities; the Commission is not 
aware of any data concerning the cost of accommodations that relate 
specifically to pregnancy, childbirth, or related medical conditions. 
The reliance on ADA data has likely resulted in an inflated cost 
estimate. As discussed above, the Commission believes that the 
percentage of accommodations that do not cost anything to implement is 
likely to be higher for accommodations related specifically to 
pregnancy, childbirth, or related medical conditions than for 
accommodations needed because of a disability. Additionally, in some 
cases, an individual who is entitled to an accommodation under the PWFA 
may be entitled to it under another law or policy. For example, 
although leave often may be needed for recovery from childbirth, Bureau 
of Labor Statistics data show that 88 percent of employees already have 
access to some unpaid family leave independent of the PWFA, either 
through the FMLA or otherwise.\474\ Therefore, with respect to these 
individuals, any costs attributable to or benefits accruing from the 
PWFA for leave related to childbirth would be limited to the short 
period of time during which such leave is required due to childbirth 
but unavailable from those other sources.
---------------------------------------------------------------------------

    \474\ U.S. Dep't of Labor, Bureau of Lab. Stat., Access to Paid 
and Unpaid Family Leave in 2018 (Feb. 27, 2019), https://www.bls.gov/opub/ted/2019/access-to-paid-and-unpaid-family-leave-in-2018.htm.
---------------------------------------------------------------------------

Conclusion

    As detailed above, the estimated annual cost of providing 
accommodations required by the rule and underlying statute--but not 
independently required by a State or local law substantially similar to 
the PWFA--is estimated to be up to $28.02 million for private 
employers, up to $3.66 million for State and local governments, and up 
to $1.14 million for the Federal Government. In addition, employers are 
expected to face one-time costs associated with complying with the rule 
and underlying statute. These are estimated to be $451.22 million for 
private employers ($119.19 million for private employers in States with 
existing PWFA-type laws + $332.03 million for private employers in 
States without existing PWFA-type laws), $619,000 for State and local 
governments ($186,000 for public employers in States with existing 
PWFA-type laws + $433,000 for public employers in States without 
existing PWFA-type laws), and $49,000 for the Federal Government.
    These figures are almost certainly overestimates of the costs 
imposed by the rule, in part because some of the accommodations 
required by the rule and underlying statute are already required under 
the ADA and Title VII and some employers voluntarily provide 
accommodations. Due to a lack of data, however, the Commission was 
unable to account for this overlap in the above analysis.
    The Commission has nevertheless determined that the benefits of the 
rule and underlying statute justify its costs.\475\ The annual costs 
associated with the main requirement of the rule--to give reasonable 
accommodations to individuals who need them because of pregnancy, 
childbirth, or related medical conditions--are not significant under 
section 3(f)(1) of E.O. 12866. And although the aggregate one-time 
compliance costs are in excess of $200 million, and therefore 
significant, the estimated cost on a per-establishment basis is low--
between $57.02 and $255.40, depending on whether or not the State in 
which the entity is located has a law substantially similar to the PWFA 
and on the type of employer.
---------------------------------------------------------------------------

    \475\ 76 FR 3821 (Jan. 21, 2011).
---------------------------------------------------------------------------

    The benefits of the rule and underlying statute to employees 
affected by pregnancy, childbirth, or related medical conditions, 
however, are significant, including improved health, improved economic 
security, and increased equity, human dignity, and fairness. The number 
of individuals who may experience such benefits is relatively large--
the number of employees who will be newly entitled to reasonable 
accommodations for pregnancy and may need them is estimated to be 
between approximately 488,000 and 1.082 million per year. This number 
does not include the children, family members, and members of society 
at large who also will potentially enjoy some of the benefits listed 
above.
    The Commission further concludes that the rule is tailored to 
impose the least burden on society consistent with achieving the 
regulatory objectives, and that the agency has selected the approach 
that maximizes net benefits. The range of alternatives available to the 
Commission was extremely limited. The alternatives that were consistent 
with the PWFA's statutory language would not, in the Commission's 
opinion, reduce costs to employers.

Regulatory Flexibility Act and Executive Order 13272 (Proper 
Consideration of Small Entities in Agency Rulemaking)

    The Regulatory Flexibility Act (RFA), 5 U.S.C. 601-612, requires 
the Commission to evaluate the economic impact of this rule on small 
entities. The RFA defines small entities to include small businesses, 
small organizations, including not-for-profit organizations, and small 
governmental jurisdictions. The Commission must determine whether the 
rule would impose a significant economic impact on a

[[Page 29181]]

substantial number of such small entities.
    When an agency issues a rulemaking proposal, the RFA requires the 
agency to ``prepare and make available for public comment an initial 
regulatory flexibility analysis'' which will ``describe the impact of 
the rule on small entities.'' \476\ Section 605 of the RFA allows an 
agency to certify a rule, in lieu of preparing an analysis, if the 
rulemaking is not expected to have a significant economic impact on a 
substantial number of small entities. For the reasons outlined below, 
the Chair of the Commission hereby certifies that this rule will not 
have a significant economic impact on a substantial number of small 
entities.
---------------------------------------------------------------------------

    \476\ 5 U.S.C. 603(a).
---------------------------------------------------------------------------

    Small businesses range in size, based on the industry, between 1 to 
1,500 employees; \477\ the PWFA and the rule apply to all employers in 
the United States with 15 or more employees. Thus, for purposes of the 
RFA, the Commission has determined that the regulation will have an 
economic impact on a substantial number of small entities.\478\
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    \477\ U.S. Small Bus. Admin., Table of Size Standards (Mar. 17, 
2023), https://www.sba.gov/document/support-table-size-standards.
    \478\ For example, there are over 1 million businesses with 
between 20 and 500 employees. See U.S. Dep't of Com., Census Bureau, 
Small Business Week: April 30-May 6, 2023 (Apr. 30, 2023), https://www.census.gov/newsroom/stories/small-business-week.html.
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    However, the Commission has determined that the economic impact on 
entities affected by the PWFA and the rule will not be ``significant.''
    As detailed in the FRIA above, the impact on small entities in 
States and localities that have laws substantially similar to the PWFA 
will be limited to a one-time administrative cost of approximately 
$85.13 in the first year for small private employers (0.75 hours x 
$113.51 hourly wage), and $57.02 for small State or local government 
employers (0.75 hours x $76.03 hourly wage). Since these entities are 
already required to provide accommodations consistent with the PWFA, 
they will face no additional costs for accommodations.
    Small entities that are not already subject to State or local laws 
substantially similar to the PWFA will face a one-time administrative 
cost of approximately $255.40 for private employers (2.25 hours x 
$113.51 hourly wage) and $171.07 for State or local government 
employers (2.25 hours x $76.03 hourly wage), plus annual costs 
associated with providing reasonable accommodations consistent with the 
rule and underlying statute. To calculate the cost of providing such 
accommodations, the Commission has constructed cost estimates for a 
range of small business sizes.
[GRAPHIC] [TIFF OMITTED] TR19AP24.100

    Using the amounts for a small entity with 500 employees as an 
example, the calculation was conducted as follows:
     Based on data outlined in the FRIA above, the Commission 
estimates that approximately 33 percent, or 165, of these employees are 
women of reproductive age (aged 16-50 years),\479\ and that 
approximately 7.1 percent of these, or 11.715 employees, will give 
birth to at least one child during a given year.
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    \479\ The Commission acknowledges that there may be industries 
in which the representation rate for individuals capable of giving 
birth is higher than 33 percent. The Commission has determined, 
however, that these differences are not large enough to affect the 
decision to certify that the final rule will not have a significant 
economic impact on a substantial number of small entities. For a 
discussion in the response to comments received, see supra, Summary 
of the Commission's Certification That the Rule Will Not Have a 
Significant Economic Impact on a Substantial Number of Small 
Entities in the preamble.
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     The Commission again adopts 71 percent as its upper bound 
estimate and 32 percent as its lower bound estimate of the percentage 
of pregnant employees who will need a reasonable accommodation related 
to pregnancy.
     Thus, the Commission estimates that between 3.749 (32 
percent of 11.715) and 8.318 (71 percent of 11.715) employees of a 
small entity with 500 employees will require annually a reasonable 
accommodation under the PWFA.
     The Commission further assumes, based on data regarding 
the average cost of reasonable accommodations for individuals with 
disabilities presented in the FRIA above, that 50.6 percent of the 
required accommodations will have a non-zero cost.
     This yields lower and upper bound estimates of the number 
of non-zero-cost accommodations of 1.9 (50.6 percent of 3.749) and 4.21 
(50.6 percent of 8.318), respectively. Rounding up these numbers, the 
Commission estimates that

[[Page 29182]]

a small entity with 500 employees will be required to provide between 2 
and 5 additional non-zero-cost accommodations per year as a result of 
the rule and underlying statute. Multiplying by an average cost of $60 
per year for each accommodation, the estimated total cost for 
accommodations required under the PWFA per small entity with 500 
employees is between $120 and $300.
    Thus, the annual cost of providing reasonable accommodations for 
entities not already subject to State or local laws substantially 
similar to the PWFA is estimated to be between $60 (lower bound 
estimate, for entities with 15 employees) and $780 (upper bound 
estimate, for entities with 1,500 employees).
    The costs detailed above are not likely to constitute a 
``significant'' economic impact for many small entities, if any. 
Further, the Commission notes that all businesses in the United States 
with 15 or more employees already must comply with Title VII and the 
ADA, both of which could, in certain circumstances, require 
accommodations for employees affected by pregnancy, childbirth, or 
related medical conditions. Further, Title VII, the ADA, and State laws 
requiring accommodations for pregnancy apply to all industries; given 
that, the Commission does not believe that the PWFA will have a greater 
effect in any industry.
    Accordingly, the Chair of the Commission hereby certifies that this 
rule will not have a significant economic impact on a substantial 
number of small entities.

Paperwork Reduction Act

    The Paperwork Reduction Act of 1995, 44 U.S.C. 3501 et seq. (PRA), 
requires the EEOC to consider the impact of information collection 
burdens imposed on the public. The PRA typically requires an agency to 
provide notice and seek public comments on any ``collection of 
information'' contained in a rule.\480\
---------------------------------------------------------------------------

    \480\ See 44 U.S.C. 3506(c)(2)(B); 5 CFR 1320.8.
---------------------------------------------------------------------------

    The Commission has determined that there is no new requirement for 
information collection associated with this rule.
    Consequently, this rule does not require review by the Office of 
Management and Budget under the authority of the PRA.

Executive Order 13132 (Federalism)

    The Commission has reviewed this rule in accordance with Executive 
Order 13132 regarding federalism and has determined that it does not 
have ``federalism implications.'' The statute at 42 U.S.C. 2000gg(2) 
provides that the PWFA applies to employers as that term is defined in 
Title VII. States and local governments are subject to Title VII, 
including its prohibition on sex discrimination, which includes 
discrimination based on pregnancy, childbirth, or related medical 
conditions. The statute at 42 U.S.C. 2000gg-4 provides that a State 
will not be immune under the 11th Amendment to actions brought under 
the PWFA in a court of competent jurisdiction and that in any action 
against a State for a violation of the PWFA, remedies, including 
remedies both at law and in equity, are available for such violation to 
the same extent that they are available against any other public or 
private entity. The rule does not limit or expand these statutory 
definitions. Additionally, the regulation will not have substantial 
direct effects ``on the relationship between the national government 
and the States, or on the distribution of power and responsibilities 
among the various levels of government.''

Unfunded Mandates Reform Act of 1995

    Section 202(a) of the Unfunded Mandates Reform Act of 1995 (UMRA) 
requires that the Commission determine whether a regulation proposes a 
Federal mandate that may result in the expenditure by State, local, or 
tribal governments, in the aggregate, or by the private sector, of $100 
million or more in a single year (adjusted annually for inflation). 
However, 2 U.S.C. 1503 excludes from UMRA's ambit any provision in a 
final regulation that, among other things, enforces constitutional 
rights of individuals or establishes or enforces any statutory rights 
that prohibit discrimination on the basis of race, color, religion, 
sex, national origin, age, handicap, or disability; thus, UMRA does not 
apply to the PWFA.\481\
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    \481\ H.R. Report No. 117-27, pt. 1, at 41 (containing a report 
by the Congressional Budget Office stating that the PWFA was not 
reviewed ``for intergovernmental or private-sector mandates'' 
because it falls within the exception to the Unfunded Mandates 
Reform Act as it ``would extend protections against discrimination 
in the workplace based on sex to employees requesting reasonable 
accommodation for pregnancy, childbirth, or related medical 
conditions'').
---------------------------------------------------------------------------

Plain Language

    The Commission has attempted to draft this final rule in plain 
language.

Assessment of Federal Regulations and Policies on Families

    The undersigned hereby certifies that the rule will not adversely 
affect the well-being of families, as discussed under section 654 of 
the Treasury and General Government Appropriations Act of 1999. To the 
contrary, by providing reasonable accommodation to employees with known 
limitations related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions, absent undue hardship, the 
rule will have a positive effect on the economic well-being and 
security of families.

Executive Order 13175 (Indian Tribal Governments)

    This rule does not have tribal implications under Executive Order 
13175 that require a tribal summary impact statement. The rule will not 
have substantial direct effects on one or more Indian tribes, on the 
relationship between the Federal Government and Indian tribes, or on 
the distribution of power and responsibilities between the Federal 
Government and Indian tribes. The definition of ``covered entity'' in 
the PWFA follows that of Title VII; Title VII exempts ``a corporation 
wholly owned by an Indian tribe.'' \482\
---------------------------------------------------------------------------

    \482\ 42 U.S.C. 2000e(b).
---------------------------------------------------------------------------

Executive Order 12988 (Civil Justice Reform)

    This rule was drafted and reviewed in accordance with Executive 
Order 12988 and will not unduly burden the Federal court system. The 
rule was: (1) reviewed to eliminate drafting errors and ambiguities; 
(2) written to minimize litigation; and (3) written to provide a clear 
legal standard for affected conduct and to promote burden reduction.

List of Subjects in 29 CFR Part 1636

    Administrative practice and procedure, Equal employment 
opportunity, Reasonable accommodation, Pregnancy.

    For the Commission.
Charlotte A. Burrows,
Chair.

0
For the reasons set forth in the preamble, the EEOC amends 29 CFR 
chapter XIV by adding part 1636 to read as follows:

PART 1636--PREGNANT WORKERS FAIRNESS ACT

Sec.
1636.1 Purpose.
1636.2 Definitions--general.
1636.3 Definitions--specific to the PWFA.

[[Page 29183]]

1636.4 Nondiscrimination with regard to reasonable accommodations 
related to pregnancy.
1636.5 Remedies and enforcement.
1636.6 Waiver of State immunity.
1636.7 Relationship to other laws.
1636.8 Severability.
Appendix A to Part 1636--Interpretive Guidance on the Pregnant 
Workers Fairness Act

    Authority:  42 U.S.C. 2000gg et seq.


Sec.  1636.1  Purpose.

    (a) The purpose of this part is to implement the Pregnant Workers 
Fairness Act, 42 U.S.C. 2000gg et seq. (PWFA).
    (b) The PWFA:
    (1) Requires a covered entity to make reasonable accommodation to 
the known limitations of a qualified employee related to pregnancy, 
childbirth, or related medical conditions, absent undue hardship;
    (2) Prohibits a covered entity from requiring a qualified employee 
to accept an accommodation, other than a reasonable accommodation 
arrived at through the interactive process;
    (3) Prohibits the denial of employment opportunities based on the 
need of the covered entity to make reasonable accommodation to the 
known limitations related to the pregnancy, childbirth, or related 
medical conditions of a qualified employee;
    (4) Prohibits a covered entity from requiring a qualified employee 
to take leave if another reasonable accommodation can be provided to 
the known limitations related to the pregnancy, childbirth, or related 
medical conditions of the employee;
    (5) Prohibits a covered entity from taking adverse actions in 
terms, conditions, or privileges of employment against a qualified 
employee on account of the employee requesting or using a reasonable 
accommodation for known limitations related to pregnancy, childbirth, 
or related medical conditions;
    (6) Prohibits discrimination against an employee for opposing 
unlawful discrimination under the PWFA or participating in a proceeding 
under the PWFA;
    (7) Prohibits coercion of individuals in the exercise of their 
rights under the PWFA; and
    (8) Provides remedies for individuals whose rights under the PWFA 
are violated.


Sec.  1636.2  Definitions--general.

    (a) Commission means the Equal Employment Opportunity Commission 
established by section 705 of the Civil Rights Act of 1964, 42 U.S.C. 
2000e-4.
    (b) Covered entity means respondent as defined in section 701(n) of 
the Civil Rights Act of 1964, 42 U.S.C. 2000e(n), and includes:
    (1) Employer, which is a person engaged in an industry affecting 
commerce who has 15 or more employees, as defined in section 701(b) of 
the Civil Rights Act of 1964, 42 U.S.C. 2000e(b);
    (2) Employing office, as defined in section 101 of the 
Congressional Accountability Act of 1995, 2 U.S.C. 1301, and 3 U.S.C. 
411(c);
    (3) An entity employing a State employee (or the employee of a 
political subdivision of a State) described in section 304(a) of the 
Government Employee Rights Act of 1991, 42 U.S.C. 2000e-16c(a); and
    (4) An entity to which section 717(a) of the Civil Rights Act of 
1964, 42 U.S.C. 2000e-16(a), applies.
    (c) Employee means:
    (1) An employee (including an applicant), as defined in section 
701(f) of the Civil Rights Act of 1964, 42 U.S.C. 2000e(f);
    (2) [Reserved]
    (3) A covered employee (including an applicant), as defined in 3 
U.S.C. 411(c);
    (4) A State employee (including an applicant) (or the employee or 
applicant of a political subdivision of a State) described in section 
304(a) of the Government Employee Rights Act of 1991, 42 U.S.C. 2000e-
16c(a); and
    (5) An employee (including an applicant) to which section 717(a) of 
the Civil Rights Act of 1964, 42 U.S.C. 2000e-16(a), applies.
    (d) Person means person as defined by section 701(a) of the Civil 
Rights Act of 1964, 42 U.S.C. 2000e(a).


Sec.  1636.3  Definitions--specific to the PWFA.

    (a) Known limitation. Known limitation means a physical or mental 
condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions that the employee or the 
employee's representative has communicated to the covered entity, 
whether or not such condition meets the definition of disability 
specified in section 3 of the Americans with Disabilities Act of 1990, 
42 U.S.C. 12102.
    (1) Known, in terms of limitation, means the employee or the 
employee's representative has communicated the limitation to the 
employer.
    (2) Limitation means a physical or mental condition related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions, of the specific employee in question. ``Physical or 
mental condition'' is an impediment or problem that may be modest, 
minor, and/or episodic. The physical or mental condition may be that an 
employee affected by pregnancy, childbirth, or related medical 
conditions has a need or a problem related to maintaining their health 
or the health of the pregnancy. The definition also includes when an 
employee is seeking health care related to pregnancy, childbirth, or a 
related medical condition itself. The physical or mental condition can 
be a limitation whether or not such condition meets the definition of 
disability specified in section 3 of the Americans with Disabilities 
Act of 1990, 42 U.S.C. 12102.
    (b) Pregnancy, childbirth, or related medical conditions. 
``Pregnancy'' and ``childbirth'' refer to the pregnancy or childbirth 
of the specific employee in question and include, but are not limited 
to, current pregnancy; past pregnancy; potential or intended pregnancy 
(which can include infertility, fertility treatment, and the use of 
contraception); labor; and childbirth (including vaginal and cesarean 
delivery). ``Related medical conditions'' are medical conditions 
relating to the pregnancy or childbirth of the specific employee in 
question. The following are examples of conditions that are, or may be, 
``related medical conditions'': termination of pregnancy, including via 
miscarriage, stillbirth, or abortion; ectopic pregnancy; preterm labor; 
pelvic prolapse; nerve injuries; cesarean or perineal wound infection; 
maternal cardiometabolic disease; gestational diabetes; preeclampsia; 
HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome; 
hyperemesis gravidarum; anemia; endometriosis; sciatica; lumbar 
lordosis; carpal tunnel syndrome; chronic migraines; dehydration; 
hemorrhoids; nausea or vomiting; edema of the legs, ankles, feet, or 
fingers; high blood pressure; infection; antenatal (during pregnancy) 
anxiety, depression, or psychosis; postpartum depression, anxiety, or 
psychosis; frequent urination; incontinence; loss of balance; vision 
changes; varicose veins; changes in hormone levels; vaginal bleeding; 
menstruation; and lactation and conditions related to lactation, such 
as low milk supply, engorgement, plugged ducts, mastitis, or fungal 
infections. This list is non-exhaustive.
    (c) Employee's representative. Employee's representative means a 
family member, friend, union representative, health care provider, or 
other representative of the employee.
    (d) Communicated to the employer. Communicated to the employer, 
with

[[Page 29184]]

respect to a known limitation, means an employee or the employee's 
representative has made the employer aware of the limitation by 
communicating with a supervisor, a manager, someone who has supervisory 
authority for the employee or who regularly directs the employee's 
tasks (or the equivalent for an applicant), human resources personnel, 
or another appropriate official, or by following the steps in the 
covered entity's policy to request an accommodation.
    (1) The communication may be made orally, in writing, or by another 
effective means.
    (2) The communication need not be in writing, be in a specific 
format, use specific words, or be on a specific form in order for it to 
be considered ``communicated to the employer.''
    (e) Consideration of mitigating measures. (1) The determination of 
whether an employee has a limitation shall be made without regard to 
the ameliorative effects of mitigating measures.
    (2) The non-ameliorative effects of mitigating measures, such as 
negative side effects of medication or burdens associated with 
following a particular treatment regimen, may be considered when 
determining whether an employee has a limitation.
    (f) Qualified employee. Qualified employee with respect to an 
employee with a known limitation under the PWFA means:
    (1) An employee who, with or without reasonable accommodation, can 
perform the essential functions of the employment position. With 
respect to leave as an accommodation, the relevant inquiry is whether 
the employee is reasonably expected to be able to perform the essential 
functions, with or without a reasonable accommodation, at the end of 
the leave, if time off is granted, or if the employee is qualified as 
set out in paragraph (f)(2) of this section after returning from leave.
    (2) Additionally, an employee shall be considered qualified if they 
cannot perform one or more essential functions if:
    (i) Any inability to perform an essential function(s) is for a 
temporary period, where ``temporary'' means lasting for a limited time, 
not permanent, and may extend beyond ``in the near future'';
    (ii) The essential function(s) could be performed in the near 
future. This determination is made on a case-by-case basis. If the 
employee is pregnant, it is presumed that the employee could perform 
the essential function(s) in the near future because they could perform 
the essential function(s) within generally 40 weeks of its suspension; 
and
    (iii) The inability to perform the essential function(s) can be 
reasonably accommodated. This may be accomplished by temporary 
suspension of the essential function(s) and the employee performing the 
remaining functions of their position or, depending on the position, 
other arrangements, including, but not limited to: the employee 
performing the remaining functions of their position and other 
functions assigned by the covered entity; the employee performing the 
functions of a different job to which the covered entity temporarily 
transfers or assigns the employee; or the employee being assigned to 
light duty or modified duty or participating in the covered entity's 
light or modified duty program.
    (g) Essential functions. Essential functions mean the fundamental 
job duties of the employment position the employee with a known 
limitation under the PWFA holds or desires. The term ``essential 
functions'' does not include the marginal functions of the position.
    (1) A job function may be considered essential for any of several 
reasons, including but not limited to the following:
    (i) The function may be essential because the reason the position 
exists is to perform that function;
    (ii) The function may be essential because of the limited number of 
employees available among whom the performance of that job function can 
be distributed; and/or
    (iii) The function may be highly specialized so that the incumbent 
in the position is hired for their expertise or ability to perform the 
particular function.
    (2) Evidence of whether a particular function is essential 
includes, but is not limited to:
    (i) The employer's judgment as to which functions are essential;
    (ii) Written job descriptions prepared before advertising or 
interviewing applicants for the job;
    (iii) The amount of time that would be spent on the job performing 
the function during the time the requested accommodation will be in 
effect;
    (iv) The consequences of not requiring the incumbent to perform the 
function;
    (v) The terms of a collective bargaining agreement;
    (vi) The work experience of past incumbents in the job; and/or
    (vii) The current work experience of incumbents in similar jobs.
    (h) Reasonable accommodation--generally. (1) With respect to an 
employee or applicant with a known limitation under the PWFA, 
reasonable accommodation includes:
    (i) Modifications or adjustments to a job application process that 
enable a qualified applicant with a known limitation under the PWFA to 
be considered for the position such qualified applicant desires;
    (ii) Modifications or adjustments to the work environment, or to 
the manner or circumstances under which the position held or desired is 
customarily performed, that enable a qualified employee with a known 
limitation under the PWFA to perform the essential functions of that 
position;
    (iii) Modifications or adjustments that enable a covered entity's 
employee with a known limitation under the PWFA to enjoy equal benefits 
and privileges of employment as are enjoyed by its other similarly 
situated employees without known limitations; or
    (iv) Temporary suspension of essential function(s) and/or 
modifications or adjustments that permit the temporary suspension of 
essential function(s).
    (2) To request a reasonable accommodation, the employee or the 
employee's representative need only communicate to the covered entity 
that the employee needs an adjustment or change at work due to their 
limitation (a physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions).
    (i) The communication may be made to any of the individuals in 
paragraph (d) of this section. The provisions of paragraphs (d)(1) and 
(2) of this section, which define what it means to communicate a 
limitation to a covered entity, apply to communications under this 
paragraph (h)(2).
    (ii) An employee's request does not have to identify a medical 
condition, whether from paragraph (b) of this section or otherwise, or 
use medical terms.
    (3) To determine the appropriate reasonable accommodation, it may 
be necessary for the covered entity to initiate an informal, 
interactive process as explained in paragraph (k) of this section.
    (i) Reasonable accommodation--examples. Reasonable accommodation 
may include, but is not limited to:
    (1) Making existing facilities used by employees readily accessible 
to and usable by employees with known limitations under the PWFA;
    (2) Job restructuring; part-time or modified work schedules; 
reassignment to a vacant position; breaks for use of the restroom, 
drinking, eating, and/or resting; acquisition or modification of

[[Page 29185]]

equipment, uniforms, or devices, including devices that assist with 
lifting or carrying for jobs that involve lifting or carrying; 
modifying the work environment; providing seating for jobs that require 
standing, or allowing standing for jobs that require sitting; 
appropriate adjustment or modifications of examinations or policies; 
permitting the use of paid leave (whether accrued, as part of a short-
term disability program, or any other employer benefit) or providing 
unpaid leave for reasons including, but not limited to, recovery from 
childbirth, miscarriage, stillbirth, or medical conditions related to 
pregnancy or childbirth, or to attend health care appointments or 
receive health care treatment related to pregnancy, childbirth, or 
related medical conditions; placement in the covered entity's light or 
modified duty program or assignment to light duty or modified work; 
telework, remote work, or change of work site; adjustments to allow an 
employee to work without increased pain or increased risk to the 
employee's health or the health of the pregnancy; temporarily 
suspending one or more essential functions of the position; providing a 
reserved parking space if the employee is otherwise entitled to use 
employer-provided parking; and other similar accommodations for 
employees with known limitations under the PWFA.
    (3) The reasonable accommodation of leave includes, but is not 
limited to, the examples in paragraphs (i)(3)(i) through (iii) of this 
section.
    (i) The ability to use paid leave (whether accrued, short-term 
disability, or another employer benefit) or unpaid leave, including, 
but not limited to, leave during pregnancy; to recover from childbirth, 
miscarriage, stillbirth, or other related medical conditions; and to 
attend health care appointments or receive health care treatments 
related to pregnancy, childbirth, or related medical conditions;
    (ii) The ability to use paid leave (whether accrued, short-term 
disability, or another employer benefit) or unpaid leave for a known 
limitation under the PWFA; and
    (iii) The ability to choose whether to use paid leave (whether 
accrued, short-term disability or another employer benefit) or unpaid 
leave to the extent that the covered entity allows employees using 
leave for reasons not related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions to choose between 
the use of paid leave and unpaid leave.
    (4) Reasonable accommodation related to lactation includes, but is 
not limited to:
    (i) Breaks, a space for lactation, and other related modifications 
as required under the Providing Urgent Maternal Protections for Nursing 
Mothers Act (PUMP Act) (Pub. L. 117-328, Div. KK, 136 Stat. 4459, 6093 
(2022)), if not otherwise provided under the PUMP Act;
    (ii) Accommodations related to pumping, such as, but not limited 
to, ensuring that the area for lactation is in reasonable proximity to 
the employee's usual work area; that it is a place other than a 
bathroom; that it is shielded from view and free from intrusion; that 
it is regularly cleaned; that it has electricity, appropriate seating, 
and a surface sufficient to place a breast pump; and that it is in 
reasonable proximity to a sink, running water, and a refrigerator for 
storing milk;
    (iii) Accommodations related to nursing during work hours (where 
the regular location of the employee's workplace makes nursing during 
work hours a possibility because the child is in close proximity); and
    (iv) Other reasonable accommodations, including those listed in 
paragraphs (i)(1) through (3) of this section.
    (5) The temporary suspension of one or more essential functions of 
the position in question, as defined in paragraph (g) of this section, 
is a reasonable accommodation if an employee with a known limitation 
under the PWFA is unable to perform one or more essential functions 
with or without a reasonable accommodation and the conditions set forth 
in paragraph (f)(2) of this section are met.
    (j) Undue hardship--(1) In general. Undue hardship means, with 
respect to the provision of an accommodation, significant difficulty or 
expense incurred by a covered entity, when considered in light of the 
factors set forth in paragraph (j)(2) of this section.
    (2) Factors to be considered. In determining whether an 
accommodation would impose an undue hardship on a covered entity, 
factors to be considered, with no one factor to be dispositive, 
include:
    (i) The nature and net cost of the accommodation needed under the 
PWFA;
    (ii) The overall financial resources of the facility or facilities 
involved in the provision of the reasonable accommodation, the number 
of persons employed at such facility, and the effect on expenses and 
resources;
    (iii) The overall financial resources of the covered entity, the 
overall size of the business of the covered entity with respect to the 
number of its employees, and the number, type, and location of its 
facilities;
    (iv) The type of operation or operations of the covered entity, 
including the composition, structure, and functions of the workforce of 
such entity, and the geographic separateness and administrative or 
fiscal relationship of the facility or facilities in question to the 
covered entity; and
    (v) The impact of the accommodation upon the operation of the 
facility, including the impact on the ability of other employees to 
perform their duties and the impact on the facility's ability to 
conduct business.
    (3) Temporary suspension of an essential function(s). If an 
employee with a known limitation under the PWFA meets the definition of 
``qualified employee'' under paragraph (f)(2) of this section and needs 
one or more essential functions of the relevant position to be 
temporarily suspended, the covered entity must provide the 
accommodation unless doing so would impose an undue hardship on the 
covered entity when considered in light of the factors provided in 
paragraphs (j)(2)(i) through (v) of this section as well as the 
following additional factors where they are relevant and with no one 
factor to be dispositive:
    (i) The length of time that the employee will be unable to perform 
the essential function(s);
    (ii) Whether, through the factors listed in paragraph (f)(2)(iii) 
of this section or otherwise, there is work for the employee to 
accomplish;
    (iii) The nature of the essential function(s), including its 
frequency;
    (iv) Whether the covered entity has provided other employees in 
similar positions who are unable to perform the essential function(s) 
of their position with temporary suspensions of the essential 
function(s);
    (v) If necessary, whether there are other employees, temporary 
employees, or third parties who can perform or be hired to perform the 
essential function(s); and
    (vi) Whether the essential function(s) can be postponed or remain 
unperformed for any length of time and, if so, for how long.
    (4) Predictable assessments. The individualized assessment of 
whether a modification listed in paragraphs (j)(4)(i) through (iv) of 
this section is a reasonable accommodation that would cause undue 
hardship will, in virtually all cases, result in a determination that 
the four modifications are reasonable accommodations that will not 
impose an undue hardship under the PWFA when they are requested as 
workplace accommodations by an employee who is

[[Page 29186]]

pregnant. Therefore, with respect to these modifications, the 
individualized assessment should be particularly simple and 
straightforward:
    (i) Allowing an employee to carry or keep water near and drink, as 
needed;
    (ii) Allowing an employee to take additional restroom breaks, as 
needed;
    (iii) Allowing an employee whose work requires standing to sit and 
whose work requires sitting to stand, as needed; and
    (iv) Allowing an employee to take breaks to eat and drink, as 
needed.
    (k) Interactive process. Interactive process means an informal, 
interactive process between the covered entity and the employee seeking 
an accommodation under the PWFA. This process should identify the known 
limitation under the PWFA and the adjustment or change at work that is 
needed due to the limitation, if either of these is not clear from the 
request, and potential reasonable accommodations. There are no rigid 
steps that must be followed.
    (l) Limits on supporting documentation. (1) A covered entity is not 
required to seek supporting documentation. A covered entity may seek 
supporting documentation from an employee who requests an accommodation 
under the PWFA only when it is reasonable under the circumstances for 
the covered entity to determine whether the employee has a physical or 
mental condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions (a limitation) and needs an 
adjustment or change at work due to the limitation. The following 
situations are examples of when it is not reasonable under the 
circumstances to seek supporting documentation:
    (i) When the physical or mental condition related to, affected by, 
or arising out of pregnancy, childbirth, or related medical conditions 
(a limitation), and the adjustment or change at work needed due to the 
limitation are obvious and the employee provides self-confirmation as 
defined in paragraph (l)(4) of this section;
    (ii) When the employer already has sufficient information to 
determine whether the employee has a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions (a limitation) and needs an adjustment or 
change at work due to the limitation;
    (iii) When the employee is pregnant and seeks one of the 
modifications listed in paragraphs (j)(4)(i) through (iv) of this 
section due to a physical or mental condition related to, affected by, 
or arising out of pregnancy (a limitation) and the employee provides 
self-confirmation as defined in paragraph (l)(4) of this section;
    (iv) When the reasonable accommodation is related to a time and/or 
place to pump at work, other modifications related to pumping at work, 
or a time to nurse during work hours (where the regular location of the 
employee's workplace makes nursing during work hours a possibility 
because the child is in close proximity), and the employee provides 
self-confirmation, as defined in paragraph (l)(4) of this section; or
    (v) When the requested accommodation is available to employees 
without known limitations under the PWFA pursuant to a covered entity's 
policies or practices without submitting supporting documentation.
    (2) When it is reasonable under the circumstances, based on 
paragraph (l)(1) of this section, to seek supporting documentation, the 
covered entity is limited to seeking reasonable documentation.
    (i) Reasonable documentation means the minimum that is sufficient 
to:
    (A) Confirm the physical or mental condition (i.e., an impediment 
or problem that may be modest, minor, and/or episodic; a need or a 
problem related to maintaining the employee's health or the health of 
the pregnancy; or an employee seeking health care related to pregnancy, 
childbirth, or a related medical condition itself) whether or not such 
condition meets the definition of disability specified in section 3 of 
the Americans with Disabilities Act of 1990, 42 U.S.C. 12102;
    (B) Confirm that the physical or mental condition is related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions (together with paragraph (l)(2)(i)(A) of this 
section, ``a limitation''); and
    (C) Describe the adjustment or change at work that is needed due to 
the limitation.
    (ii) Covered entities may not require that supporting documentation 
be submitted on a specific form.
    (3) When it is reasonable under the circumstances, based on 
paragraph (l)(1) of this section, to seek supporting documentation, a 
covered entity may require that the reasonable documentation comes from 
a health care provider, which may include, but is not limited to: 
doctors, midwives, nurses, nurse practitioners, physical therapists, 
lactation consultants, doulas, occupational therapists, vocational 
rehabilitation specialists, therapists, industrial hygienists, licensed 
mental health professionals, psychologists, or psychiatrists. The 
health care provider may be a telehealth provider. The covered entity 
may not require that the health care provider submitting documentation 
be the provider treating the condition at issue. The covered entity may 
not require that the employee seeking the accommodation be examined by 
a health care provider selected by the covered entity.
    (4) Self-confirmation means a simple statement where the employee 
confirms, for purposes of paragraph (l)(1)(i), (iii), or (iv) of this 
section, the physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions (a 
limitation), and the adjustment or change at work needed due to the 
limitation. The statement can be made in any manner and can be made as 
part of the request for reasonable accommodation under paragraph (h)(2) 
of this section. A covered entity may not require that the statement be 
in a specific format, use specific words, or be on a specific form.


Sec.  1636.4  Nondiscrimination with regard to reasonable 
accommodations related to pregnancy.

    (a) It is an unlawful employment practice for a covered entity not 
to make reasonable accommodations to the known limitations related to 
the pregnancy, childbirth, or related medical conditions of a qualified 
employee, unless such covered entity can demonstrate that the 
accommodation would impose an undue hardship on the operation of the 
business of such covered entity.
    (1) An unnecessary delay in providing a reasonable accommodation to 
the known limitations related to the pregnancy, childbirth, or related 
medical conditions of a qualified employee may result in a violation of 
the PWFA, 42 U.S.C. 2000gg-1(1), even if the covered entity eventually 
provides the reasonable accommodation. In determining whether there has 
been an unnecessary delay, factors to be considered, with no one factor 
to be dispositive, include:
    (i) The reason for the delay;
    (ii) The length of the delay;
    (iii) The length of time that the accommodation is needed. If the 
accommodation is needed for a short time, unnecessary delay in 
providing it may effectively mean failure to provide the accommodation;
    (iv) How much the employee and the covered entity each contributed 
to the delay;
    (v) Whether the covered entity was engaged in actions related to 
the reasonable accommodation request during the delay;

[[Page 29187]]

    (vi) Whether the accommodation was or would be simple or complex to 
provide. There are certain accommodations, set forth in Sec.  
1636.3(j)(4), that are common and easy to provide. Delay in providing 
these accommodations will virtually always result in a finding of 
unnecessary delay; and
    (vii) Whether the covered entity offered the employee an interim 
reasonable accommodation during the interactive process or while 
waiting for the covered entity's response. For the purposes of this 
factor, the interim reasonable accommodation should be one that allows 
the employee to continue working. Leave will not be considered an 
interim reasonable accommodation supporting this factor, unless the 
employee selects or requests leave as an interim reasonable 
accommodation.
    (2) An employee with known limitations related to pregnancy, 
childbirth, or related medical conditions is not required to accept an 
accommodation. However, if such employee rejects a reasonable 
accommodation that is necessary to enable the employee to perform an 
essential function(s) of the position held or desired or to apply for 
the position, or rejects the temporary suspension of an essential 
function(s) if the employee is qualified under Sec.  1636.3(f)(2), and, 
as a result of that rejection, cannot perform an essential function(s) 
of the position, or cannot apply, the employee will not be considered 
``qualified.''
    (3) A covered entity cannot justify failing to provide a reasonable 
accommodation or the unnecessary delay in providing a reasonable 
accommodation to a qualified employee with known limitations related to 
pregnancy, childbirth, or related medical conditions based on the 
employee failing to provide supporting documentation, unless:
    (i) The covered entity seeks the supporting documentation;
    (ii) Seeking the supporting documentation is reasonable under the 
circumstances as set out in Sec.  1636.3(l)(1);
    (iii) The supporting documentation is ``reasonable documentation'' 
as defined in Sec.  1636.3(l)(2); and
    (iv) The covered entity provides the employee sufficient time to 
obtain and provide the supporting documentation.
    (4) When choosing among effective accommodations, the covered 
entity must choose an accommodation that provides the qualified 
employee with known limitations related to pregnancy, childbirth, or 
related medical conditions equal employment opportunity to attain the 
same level of performance, or to enjoy the same level of benefits and 
privileges as are available to the average employee without a known 
limitation who is similarly situated. The similarly situated average 
employee without a known limitation may include the employee requesting 
an accommodation at a time prior to communicating the limitation.
    (b) It is an unlawful employment practice for a covered entity to 
require a qualified employee affected by pregnancy, childbirth, or 
related medical conditions to accept an accommodation other than any 
reasonable accommodation arrived at through the interactive process 
referred to in 42 U.S.C. 2000gg(7) and described in Sec.  1636.3(k).
    (c) It is an unlawful employment practice for a covered entity to 
deny employment opportunities to a qualified employee if such denial is 
based on the need, or potential need, of the covered entity to make 
reasonable accommodations to the known limitations related to the 
pregnancy, childbirth, or related medical conditions of the qualified 
employee.
    (d) It is an unlawful employment practice for a covered entity:
    (1) To require a qualified employee to take leave, whether paid or 
unpaid, if another reasonable accommodation can be provided to the 
known limitations related to the pregnancy, childbirth, or related 
medical conditions of the qualified employee that does not result in an 
undue hardship for the covered entity; but
    (2) Nothing in paragraph (d)(1) of this section prohibits leave as 
a reasonable accommodation if that is the reasonable accommodation 
requested or selected by the employee, or if it is the only reasonable 
accommodation that does not cause an undue hardship.
    (e) It is an unlawful employment practice for a covered entity:
    (1) To take adverse action in terms, conditions, or privileges of 
employment against a qualified employee on account of the employee 
requesting or using a reasonable accommodation to the known limitations 
related to the pregnancy, childbirth, or related medical conditions of 
the employee.
    (2) Nothing in paragraph (e)(1) of this section limits the rights 
available under 42 U.S.C. 2000gg-2(f).


Sec.  1636.5  Remedies and enforcement.

    (a) Employees covered by Title VII of the Civil Rights Act of 
1964--(1) In general. The powers, remedies, and procedures provided in 
sections 705, 706, 707, 709, 710, and 711 of the Civil Rights Act of 
1964, 42 U.S.C. 2000e-4 et seq., to the Commission, the Attorney 
General, or any person alleging a violation of Title VII of such Act, 
42 U.S.C. 2000e et seq., shall be the powers, remedies, and procedures 
the PWFA provides to the Commission, the Attorney General, or any 
person, respectively, alleging an unlawful employment practice in 
violation of the PWFA against an employee described in 42 U.S.C. 
2000gg(3)(A), except as provided in paragraphs (a)(2) and (3) of this 
section.
    (2) Costs and fees. The powers, remedies, and procedures provided 
in subsections (b) and (c) of section 722 of the Revised Statutes, 42 
U.S.C. 1988, shall be the powers, remedies, and procedures the PWFA 
provides to the Commission, the Attorney General, or any person 
alleging such practice.
    (3) Damages. The powers, remedies, and procedures provided in 
section 1977A of the Revised Statutes, 42 U.S.C. 1981a, including the 
limitations contained in subsection (b)(3) of such section 1977A, shall 
be the powers, remedies, and procedures the PWFA provides to the 
Commission, the Attorney General, or any person alleging such practice 
(not an employment practice specifically excluded from coverage under 
section 1977A(a)(1) of the Revised Statutes, 42 U.S.C. 1981a(a)(1)).
    (b) [Reserved]
    (c) Employees covered by Chapter 5 of Title 3, United States Code--
(1) In general. The powers, remedies, and procedures provided in 
chapter 5 of title 3, United States Code, to the President, the 
Commission, the Merit Systems Protection Board, or any person alleging 
a violation of section 411(a)(1) of such title shall be the powers, 
remedies, and procedures this section provides to the President, the 
Commission, the Board, or any person, respectively, alleging an 
unlawful employment practice in violation of this section against an 
employee described in 42 U.S.C. 2000gg(3)(C), except as provided in 
paragraphs (c)(2) and (3) of this section.
    (2) Costs and fees. The powers, remedies, and procedures provided 
in subsections (b) and (c) of section 722 of the Revised Statutes, 42 
U.S.C. 1988, shall be the powers, remedies, and procedures this section 
provides to the President, the Commission, the Board, or any person 
alleging such practice.
    (3) Damages. The powers, remedies, and procedures provided in 
section 1977A of the Revised Statutes, 42 U.S.C. 1981a, including the 
limitations contained in subsection (b)(3) of such section 1977A, shall 
be the powers, remedies, and procedures this section provides to the 
President, the

[[Page 29188]]

Commission, the Board, or any person alleging such practice (not an 
employment practice specifically excluded from coverage under section 
1977A(a)(1) of the Revised Statutes, 42 U.S.C. 1981a(a)(1)).
    (d) Employees covered by Government Employee Rights Act of 1991--
(1) In general. The powers, remedies, and procedures provided in 
sections 302 and 304 of the Government Employee Rights Act of 1991, 42 
U.S.C. 2000e-16b and 2000e-16c, to the Commission or any person 
alleging a violation of section 302(a)(1) of such Act, 42 U.S.C. 2000e-
16b(a)(1), shall be the powers, remedies, and procedures the PWFA 
provides to the Commission or any person, respectively, alleging an 
unlawful employment practice in violation of the PWFA against an 
employee described in 42 U.S.C. 2000gg(3)(D), except as provided in 
paragraphs (d)(2) and (3) of this section.
    (2) Costs and fees. The powers, remedies, and procedures provided 
in subsections (b) and (c) of section 722 of the Revised Statutes, 42 
U.S.C. 1988, shall be the powers, remedies, and procedures the PWFA 
provides to the Commission or any person alleging such practice.
    (3) Damages. The powers, remedies, and procedures provided in 
section 1977A of the Revised Statutes, 42 U.S.C. 1981a, including the 
limitations contained in subsection (b)(3) of such section 1977A, shall 
be the powers, remedies, and procedures the PWFA provides to the 
Commission or any person alleging such practice (not an employment 
practice specifically excluded from coverage under section 1977A(a)(1) 
of the Revised Statutes, 42 U.S.C. 1981a(a)(1)).
    (e) Employees covered by Section 717 of the Civil Rights Act of 
1964--(1) In general. The powers, remedies, and procedures provided in 
section 717 of the Civil Rights Act of 1964, 42 U.S.C. 2000e-16, to the 
Commission, the Attorney General, the Librarian of Congress, or any 
person alleging a violation of that section shall be the powers, 
remedies, and procedures the PWFA provides to the Commission, the 
Attorney General, the Librarian of Congress, or any person, 
respectively, alleging an unlawful employment practice in violation of 
the PWFA against an employee described in 42 U.S.C. 2000gg(3)(E), 
except as provided in paragraphs (e)(2) and (3) of this section.
    (2) Costs and fees. The powers, remedies, and procedures provided 
in subsections (b) and (c) of section 722 of the Revised Statutes, 42 
U.S.C. 1988, shall be the powers, remedies, and procedures the PWFA 
provides to the Commission, the Attorney General, the Librarian of 
Congress, or any person alleging such practice.
    (3) Damages. The powers, remedies, and procedures provided in 
section 1977A of the Revised Statutes, 42 U.S.C. 1981a, including the 
limitations contained in subsection (b)(3) of such section 1977A, shall 
be the powers, remedies, and procedures the PWFA provides to the 
Commission, the Attorney General, the Librarian of Congress, or any 
person alleging such practice (not an employment practice specifically 
excluded from coverage under section 1977A(a)(1) of the Revised 
Statutes, 42 U.S.C. 1981a(a)(1)).
    (f) Prohibition against retaliation--(1) Prohibition against 
retaliation. No person shall discriminate against any employee because 
such employee has opposed any act or practice made unlawful by the PWFA 
or because such employee made a charge, testified, assisted, or 
participated in any manner in an investigation, proceeding, or hearing 
under the PWFA.
    (i) An employee need not be a qualified employee with a known 
limitation under the PWFA to bring an action under this paragraph 
(f)(1).
    (ii) A request for reasonable accommodation for a known limitation 
under the PWFA constitutes protected activity under this paragraph 
(f)(1).
    (iii) An employee does not actually have to be deterred from 
exercising or enjoying rights under the PWFA in order for the 
retaliation to be actionable.
    (2) Prohibition against coercion. It shall be unlawful to coerce, 
intimidate, threaten, harass, or interfere with any individual in the 
exercise or enjoyment of, or on account of such individual having 
exercised or enjoyed, or on account of such individual having aided or 
encouraged any other individual in the exercise or enjoyment of, any 
right granted or protected by the PWFA.
    (i) An individual need not be a qualified employee with a known 
limitation under the PWFA to bring an action under this paragraph 
(f)(2).
    (ii) An individual does not actually have to be deterred from 
exercising or enjoying rights under the PWFA for the coercion, 
intimidation, threats, harassment, or interference to be actionable.
    (3) Remedy. The remedies and procedures otherwise provided for 
under this section shall be available to aggrieved individuals with 
respect to violations of this section regarding retaliation or 
coercion.
    (g) Limitation on monetary damages. Notwithstanding paragraphs 
(a)(3), (c)(3), (d)(3), and (e)(3) of this section, if an unlawful 
employment practice involves the provision of a reasonable 
accommodation pursuant to the PWFA or this part, damages may not be 
awarded under section 1977A of the Revised Statutes, 42 U.S.C. 1981a, 
if the covered entity demonstrates good faith efforts, in consultation 
with the qualified employee with known limitations related to, affected 
by, or arising out of pregnancy, childbirth, or related medical 
conditions who has informed the covered entity that accommodation is 
needed, to identify and make a reasonable accommodation that would 
provide such employee with an equally effective opportunity and would 
not cause an undue hardship on the operation of the business of the 
covered entity.


Sec.  1636.6  Waiver of State immunity.

    A State shall not be immune under the 11th Amendment to the 
Constitution from an action in a Federal or State court of competent 
jurisdiction for a violation of the PWFA. In any action against a State 
for a violation of the PWFA, remedies (including remedies both at law 
and in equity) are available for such a violation to the same extent 
such remedies are available for such a violation in an action against 
any public or private entity other than a State.


Sec.  1636.7  Relationship to other laws.

    (a) In general. (1) The PWFA and this part do not invalidate or 
limit the powers, remedies, and procedures under any Federal law, State 
law, or the law of any political subdivision of any State or 
jurisdiction that provides greater or equal protection for individuals 
affected by pregnancy, childbirth, or related medical conditions.
    (2) The PWFA and this part do not require an employer-sponsored 
health plan to pay for or cover any particular item, procedure, or 
treatment, or affect any right or remedy available under any other 
Federal, State, or local law with respect to any such payment or 
coverage requirement.
    (b) Rule of construction. The PWFA and this part are subject to the 
applicability to religious employment set forth in section 702(a) of 
the Civil Rights Act of 1964, 42 U.S.C. 2000e-1(a).
    (1) Nothing in 42 U.S.C. 2000gg-5(b) or this part should be 
interpreted to limit a covered entity's rights under the U.S. 
Constitution.
    (2) Nothing in 42 U.S.C. 2000gg-5(b) or this part should be 
interpreted to limit an employee's rights under other civil rights 
statutes.

[[Page 29189]]

Sec.  1636.8  Severability.

    (a) The Commission intends that, if any provision of the PWFA or 
the application of that provision to particular persons or 
circumstances is held invalid or found to be unconstitutional, the 
remainder of the statute and the application of that provision to other 
persons or circumstances shall not be affected.
    (b) The Commission intends that, if any provision of this part that 
uses the same language as the statute, or the application of that 
provision to particular persons or circumstances, is held invalid or 
found to be unconstitutional, the remainder of this part and the 
application of that provision to other persons or circumstances shall 
not be affected.
    (c) The Commission intends that, if any provision of this part or 
the interpretive guidance in appendix A to this part that provides 
additional guidance to implement the PWFA, including examples of 
reasonable accommodations, or the application of that provision to 
particular persons or circumstances, is held invalid or found to be 
unconstitutional, the remainder of this part or the interpretive 
guidance and the application of that provision to other persons or 
circumstances shall not be affected.

Appendix A to Part 1636--Interpretive Guidance on the Pregnant Workers 
Fairness Act

I. Introduction

    1. The Pregnant Workers Fairness Act (PWFA) requires a covered 
entity to provide reasonable accommodations to a qualified 
employee's known limitation related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions, absent 
undue hardship on the operation of the business of the covered 
entity. Although employees affected by pregnancy, childbirth, or 
related medical conditions have certain rights under existing civil 
rights laws, including Title VII of the Civil Rights Act of 1964 
(Title VII), as amended by the Pregnancy Discrimination Act of 1978 
(PDA), 42 U.S.C. 2000e et seq., and the Americans with Disabilities 
Act of 1990 (ADA), as amended by the ADA Amendments Act of 2008 
(ADAAA or Amendments Act), 42 U.S.C. 12111 et seq.,\1\ Congress 
determined that the legal protections offered by these two statutes, 
particularly as interpreted by the courts, were ``insufficient to 
ensure that pregnant workers receive the accommodations they need.'' 
\2\
---------------------------------------------------------------------------

    \1\ References to the ADA throughout this part and the 
Interpretive Guidance in this appendix are intended to apply equally 
to the Rehabilitation Act of 1973, as all nondiscrimination 
standards under title I of the ADA also apply to Federal agencies 
under section 501 of the Rehabilitation Act. See 29 U.S.C. 791(f).
    \2\ H.R. Rep. No. 117-27, pt. 1, at 12 (2021).
---------------------------------------------------------------------------

    2. The PWFA, at 42 U.S.C. 2000gg-3, directs the U.S. Equal 
Employment Opportunity Commission (EEOC or Commission) to promulgate 
regulations to implement the PWFA.
    3. This Interpretive Guidance addresses the major provisions of 
the PWFA and its regulation and explains the major concepts 
pertaining to nondiscrimination with respect to reasonable 
accommodations for known limitations (physical or mental conditions 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions) under the statute. The Interpretive 
Guidance represents the Commission's interpretation of the issues 
addressed within it, and the Commission will be guided by the 
regulation and the Interpretive Guidance when enforcing the PWFA.

II. General Information and Terms Used in the Regulation and 
Interpretive Guidance

    1. The PWFA at 42 U.S.C. 2000gg(3) uses the term ``employee 
(including an applicant)'' in its definition of ``employee.'' \3\ 
Thus, throughout the statute, the final regulation, and this 
Interpretive Guidance, the term ``employee'' should be understood to 
include ``applicant'' where relevant. Because the PWFA relies on 
Title VII for its definition of ``employee,'' that term also 
includes ``former employee,'' where relevant.\4\ The PWFA defines 
``covered entity'' using the definition of ``employer'' from 
different statutes, including Title VII.\5\ Thus ``covered 
entities'' under the PWFA include public or private employers with 
15 or more employees, unions, employment agencies, and the Federal 
Government.\6\ In the regulation and this Interpretive Guidance, the 
Commission uses the terms ``covered entity'' and ``employer'' 
interchangeably.
---------------------------------------------------------------------------

    \3\ 42 U.S.C. 2000gg(3).
    \4\ Robinson v. Shell Oil Co., 519 U.S. 337, 346 (1997).
    \5\ 42 U.S.C. 2000gg(2)(A), (B)(i), (B)(iii), (B)(iv). The other 
statutes are the Congressional Accountability Act of 1995 and 3 
U.S.C. 411(c).
    \6\ The statute at 42 U.S.C. 2000gg(2) provides that the term 
``covered entity'' has the meaning given the term ``respondent'' 
under 42 U.S.C. 2000e(n) and includes employers as defined in 42 
U.S.C. 2000e(b), 2000e-16c(a), and 2000e-16(a). The statute at 42 
U.S.C. 2000gg-5(b) provides as a rule of construction that the 
chapter is subject to the applicability to religious employment set 
forth in 42 U.S.C. 2000e-1(a) [section 702(a) of the Civil Rights 
Act of 1964].
---------------------------------------------------------------------------

    2. This Interpretive Guidance contains many examples to 
illustrate situations under the PWFA. The examples do not, and are 
not intended to, cover every limitation or possible accommodation 
under the PWFA. Depending on the facts in the examples, the same 
facts could lead to claims also being brought under other statutes 
that the Commission enforces, such as Title VII and the ADA. 
Moreover, the situations in specific examples could implicate other 
Federal laws, including, but not limited to, the Family and Medical 
Leave Act of 1993, 29 U.S.C. 2601 et seq. (FMLA); the Occupational 
Safety and Health Act, 29 U.S.C. 651 et seq. (OSH Act); and the 
Providing Urgent Maternal Protections for Nursing Mothers Act (PUMP 
Act) (Pub. L. 117-328, Div. KK, 136 Stat. 4459, 6093 (2022)).\7\ 
Finally, although some examples state that the described actions 
``would violate'' the PWFA, additional facts not described in the 
examples could change that determination.\8\
---------------------------------------------------------------------------

    \7\ To the extent that an accommodation in an example is 
required under another law, like the OSH Act, the example should not 
be read to suggest that such a requirement is not applicable.
    \8\ In this part and the Interpretive Guidance, the Commission 
uses the terms ``leave'' and ``time off'' and intends those terms to 
cover leave however it is identified by the specific employer. 
Additionally, in this part and the Interpretive Guidance, the 
Commission uses the term ``light duty.'' The Commission recognizes 
that ``light duty'' programs, or other programs providing modified 
duties, can vary depending on the covered entity. See EEOC, 
Enforcement Guidance: Workers' Compensation and the ADA, text 
preceding Question 27 (1996) [hereinafter Enforcement Guidance: 
Workers' Compensation], https://www.eeoc.gov/laws/guidance/enforcement-guidance-workers-compensation-and-ada. The Commission 
intends ``light duty'' to include the types of programs included in 
Questions 27 and 28 of the Enforcement Guidance: Workers' 
Compensation and any other policy, practice, or system that a 
covered entity has for accommodating employees, including when one 
or more essential functions of a position are temporarily excused.
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III. 1636. Definitions--Specific to the PWFA

1636.3(a) Known Limitation

    1. Section 1636.3(a) reiterates the definition of ``known 
limitation'' from 42 U.S.C. 2000gg(4) of the PWFA and then provides 
definitions for the operative terms.

1636.3(a)(1) Known

    2. Paragraph (a)(1) adopts the definition of ``known'' from the 
PWFA and thus defines it to mean that the employee, or the 
employee's representative, has communicated the limitation to the 
covered entity.\9\
---------------------------------------------------------------------------

    \9\ 42 U.S.C. 2000gg(4).
---------------------------------------------------------------------------

1636.3(a)(2) Limitation

    3. Paragraph (a)(2) adopts the definition of ``limitation'' from 
the PWFA and thus defines it to mean a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions.\10\ The limitation must be of the 
specific employee in question. The ``physical or mental condition'' 
that is the limitation may be a modest, minor, and/or episodic 
impediment or problem. The definition encompasses when an employee 
affected by pregnancy, childbirth, or related medical conditions has 
a need or a problem related to maintaining their health or the 
health of the pregnancy.\11\
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    \10\ Id.
    \11\ In Sec.  1636.3(a)(2) and the Interpretive Guidance, the 
Commission uses the phrase ``maintaining their health or the health 
of the pregnancy.'' This includes avoiding risk to the employee's 
health or to the health of the pregnancy.
---------------------------------------------------------------------------

    4. The definition of ``limitation'' also includes when an 
employee is seeking health care related to the pregnancy, 
childbirth, or a related medical condition itself. Under the ADA, 
when an individual has an actual or a record of a disability, 
employers often may be required to provide the reasonable 
accommodation of leave so that an employee

[[Page 29190]]

can obtain medical treatment.\12\ Similarly, under the PWFA, an 
employee may require a reasonable accommodation of leave to attend 
health care appointments or receive treatment for or recover from 
their pregnancy, childbirth, or related medical conditions.\13\ In 
passing the PWFA, Congress sought, in part, to help pregnant 
employees maintain their health.\14\ Thus, the PWFA covers 
situations when an employee requests an accommodation in order to 
maintain their health or the health of their pregnancy and avoid 
negative consequences, and when an employee seeks health care for 
their pregnancy, childbirth, or related medical conditions. 
Practically, allowing for accommodations to maintain health and 
attend medical appointments may decrease the need for a more 
extensive accommodation because the employee may be able to avoid 
more serious complications.
---------------------------------------------------------------------------

    \12\ EEOC, Enforcement Guidance on Reasonable Accommodation and 
Undue Hardship under the ADA, at text after n.49 (2002) [hereinafter 
Enforcement Guidance on Reasonable Accommodation], http://www.eeoc.gov/laws/guidance/enforcement-guidance-reasonable-accommodation-and-undue-hardship-under-ada.
    \13\ See, e.g., U.S. Dep't of Health & Hum. Servs., Off. of 
Women's Health, Prenatal Care, https://www.womenshealth.gov/a-z-topics/prenatal-care (last updated Feb. 22, 2021) (stating that 
during pregnancy usually visits are once a month until week 28, 
twice a month from weeks 28-36 and once a week from week 36 to 
birth); Am. Coll. of Obstetricians & Gynecologists, Comm. Opinion 
No. 736, Optimizing Postpartum Care (reaff'd 2021), https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care (stating the importance of 
regular postpartum care); and Opinion No. 826, Protecting and 
Expanding Medicaid to Improve Women's Health (2021), https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/06/protecting-and-expanding-medicaid-to-improve-womens-health 
(encouraging the expansion of Medicaid to improve postpartum care).
    \14\ See Markup of the Paycheck Fairness Act; Pregnant Workers 
Fairness Act; Workplace Violence Prevention for Health Care and 
Social Service Workers Act, YouTube (2021), at 54:46 (statement of 
Rep. Kathy E. Manning) (stating that a goal of the PWFA is to help 
pregnant workers ``deliver healthy babies while maintaining their 
jobs''); at 21:50 (statement of Rep. Robert C. Scott) (``[W]ithout 
[these] basic protections, too many workers are forced to choose 
between a healthy pregnancy and their paychecks.''); at 1:35:01 
(statement of Rep. Lucy McBath) (``[N]o mother should ever have to 
choose between the health of herself/themselves and their child or a 
paycheck.''); and at 1:37:38 (statement of Rep. Suzanne Bonamici) 
(``[P]regnant workers should not have to choose between a healthy 
pregnancy and a paycheck.''), https://www.youtube.com/watch?v=p6Ie2S9sTxs; see also H.R. Rep. No. 117-27, pt. 1, at 12 
(workers whose pregnancy-related impairments substantially limit a 
major life activity are covered by the ADA; ``this standard leaves 
women with less serious pregnancy-related impairments, and who need 
accommodations, without legal recourse''); id. at 22-23 
(accommodations are frequently needed by, and should be provided to, 
people with healthy pregnancies); id. at 23 (example of an 
``uneventful pregnancy'' in which a woman needed more bathroom 
breaks); id. at 14-21 (outlining the gaps created by court 
interpretations of Title VII and the ADA that the PWFA is intended 
to fill so that pregnant workers can receive reasonable 
accommodations); id. at 56 (noting that a ``minor limitation'' can 
be covered because it presumably requires only minor 
accommodations).
---------------------------------------------------------------------------

    5. The physical or mental condition (the limitation) required to 
trigger the obligation to provide a reasonable accommodation under 
the PWFA does not need to meet the definition of a ``disability'' 
under the ADA.\15\ In other words, an employee need not have an 
impairment that substantially limits a major life activity to be 
entitled to a reasonable accommodation under the PWFA, nor does an 
employee need to have an ``impairment'' as defined in the regulation 
implementing the ADA.\16\ The PWFA can cover physical or mental 
conditions that also are covered under the ADA. In these situations, 
an individual may be entitled to an accommodation under the ADA as 
well as the PWFA.
---------------------------------------------------------------------------

    \15\ 42 U.S.C. 2000gg(4).
    \16\ See 29 CFR 1630.2(h).
---------------------------------------------------------------------------

    6. The PWFA does not create a right to reasonable accommodation 
based on an individual's association with someone else who may have 
a PWFA-covered limitation. Nor is a qualified employee entitled to 
accommodation because they have a physical or mental condition 
related to, affected by, or arising out of someone else's pregnancy, 
childbirth, or related medical conditions. For example, a spouse 
experiencing anxiety due to a partner's pregnancy is not covered by 
the PWFA. Time for bonding or time for childcare also is not covered 
by the PWFA.
    7. Whether an employee has a ``physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions'' shall be construed broadly to the 
maximum extent permitted by the PWFA.

Related to, Affected by, or Arising Out of

    8. The PWFA's use of the inclusive terms ``related to, affected 
by, or arising out of'' \17\ means that pregnancy, childbirth, or 
related medical conditions do not need to be the sole, the original, 
or a substantial cause of the physical or mental condition at issue 
for the physical or mental condition to be ``related to, affected 
by, or arising out of'' pregnancy, childbirth, or related medical 
conditions.
---------------------------------------------------------------------------

    \17\ The statute at 42 U.S.C. 2000gg(4) defines the term ``known 
limitation'' as a physical or mental condition related to, affected 
by, or arising out of pregnancy, childbirth, or related medical 
conditions. Most of the prohibited acts in the statute, however, use 
the phrase ``known limitations related to the pregnancy, childbirth, 
or related medical conditions.'' See 42 U.S.C. 2000gg-1(1), (3)-(5). 
Thus, the Commission will define ``related to, affected by, or 
arising out of'' as one phrase and will not attempt to define each 
of the parts of it separately.
---------------------------------------------------------------------------

    9. Whether a physical or mental condition is related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions will be apparent in the majority of cases. 
Pregnancy and childbirth cause systemic changes that not only create 
new physical and mental conditions but also can exacerbate 
preexisting conditions and can cause additional pain or risk.\18\ 
Thus, a connection between an employee's physical or mental 
condition and their pregnancy, childbirth, or related medical 
conditions will be readily ascertained when an employee is currently 
pregnant or the employee is experiencing or has just experienced 
childbirth.
---------------------------------------------------------------------------

    \18\ See, e.g., Danforth's Obstetrics & Gynecology 286 (Ronald 
S. Gibbs et al. eds., 10th ed. 2008) (``Normal pregnancy entails 
many physiologic changes . . . .''); Clinical Anesthesia 1138 (Paul 
G. Barash et al. eds., 6th ed. 2009) (``During pregnancy, there are 
major alterations in nearly every maternal organ system.'')
---------------------------------------------------------------------------

    10. For example, if an employee is pregnant and as a result has 
pain when standing for long periods of time, the employee's physical 
or mental condition (pain when standing for a protracted period) is 
related to, affected by, or arising out of the employee's pregnancy. 
An employee who is pregnant and because of the pregnancy cannot lift 
more than 20 pounds has a physical condition related to, affected 
by, or arising out of pregnancy, because lifting is associated with 
low back pain and musculoskeletal disorders that may be exacerbated 
by physical changes associated with pregnancy.\19\ An employee who 
is pregnant and seeks time off for prenatal health care appointments 
is attending medical appointments related to, affected by, or 
arising out of pregnancy. An employee who requests an accommodation 
to attend therapy appointments for postpartum depression has a 
medical condition related to pregnancy or childbirth (postpartum 
depression) and is obtaining health care related to, affected by, or 
arising out of a related medical condition. A pregnant employee who 
is seeking an accommodation to limit exposure to secondhand smoke to 
protect the health of their pregnancy has a physical or mental 
condition (trying to maintain the employee's health or the health of 
their pregnancy, or to address increased sensitivity to secondhand 
smoke) related to, affected by, or arising out of pregnancy. A 
lactating employee who seeks an accommodation to take breaks to eat 
has a related medical condition (lactation) and a physical condition 
related to, affected by, or arising out of it (increased nutritional 
needs). A pregnant employee seeking time off in order to have an 
amniocentesis procedure is attending a medical appointment related 
to, affected by, or arising out of pregnancy. An employee who 
requests leave for in vitro fertilization (IVF) treatment for the 
employee to get pregnant has a limitation, either related to 
potential or intended pregnancy or a medical condition related to 
pregnancy (difficulty in becoming pregnant or infertility), and is 
seeking health care related to, affected by, or arising out of it. 
An employee whose pregnancy is causing fatigue has a physical 
condition (fatigue) related to, affected by, or arising out of 
pregnancy. An employee whose pregnancy is causing back pain has a 
physical condition (back pain) related to, affected by, or arising 
out of pregnancy. This is not by any means a complete list of 
physical or mental

[[Page 29191]]

conditions related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions, but rather a discussion 
of examples to illustrate application of the legal rule.
---------------------------------------------------------------------------

    \19\ Am. Coll. of Obstetricians & Gynecologists, Comm. Opinion 
No. 733, Employment Considerations During Pregnancy and the 
Postpartum Period (reaff'd 2023), https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/04/employment-considerations-during-pregnancy-and-the-postpartum-period.
---------------------------------------------------------------------------

    11. The Commission recognizes that some physical or mental 
conditions (which can be ``limitations'' as defined by the PWFA 
\20\), including some of those in the examples in paragraph 10 of 
this section, may occur even if they are not related to, affected 
by, or arising out of pregnancy, childbirth, or related medical 
conditions (e.g., attending medical appointments, increased 
nutritional needs, constraints on lifting). The Commission 
anticipates that confirming whether a physical or mental condition 
is related to, affected by, or arising out of pregnancy, childbirth, 
or related medical conditions usually will be straightforward and 
can be accomplished through the interactive process. If a physical 
or mental condition is not covered by the PWFA, it may be that the 
physical or mental condition constitutes a disability that is 
covered by the ADA.
---------------------------------------------------------------------------

    \20\ 42 U.S.C. 2000gg(4) (providing that a ``known limitation'' 
is a physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions 
that the employee or employee's representative has communicated to 
the employer).
---------------------------------------------------------------------------

    12. There may be situations where a physical or mental condition 
begins as something that is related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions, and, once 
the pregnancy, childbirth, or related medical conditions resolve, 
the physical or mental condition remains, evolves, or worsens. To 
confirm whether the employee's physical or mental condition is still 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions, the employer and the employee can engage 
in the interactive process.
    13. There will be situations where an individual with a physical 
or mental condition that is no longer related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions 
has an ``actual'' or ``record of'' disability under the ADA. In 
those situations, an individual may seek an accommodation under the 
ADA and the reasonable accommodation process would follow the 
ADA.\21\
---------------------------------------------------------------------------

    \21\ See, e.g., 29 CFR 1630.2(o)(3); 29 CFR part 1630, appendix, 
1630.2(o)(3) and 1630.9.
---------------------------------------------------------------------------

    14. Finally, there may be situations where the pregnancy, 
childbirth, or related medical conditions exacerbate existing 
conditions that may be disabilities under the ADA. In those 
situations, an employee can seek an accommodation under the PWFA or 
the ADA, or both statutes.

1636.3(b) Pregnancy, Childbirth, or Related Medical Conditions

    15. The PWFA uses the term ``pregnancy, childbirth, or related 
medical conditions,'' which appears in Title VII's definition of 
``sex.'' \22\ Because Congress chose to write the PWFA using the 
same language as Title VII, Sec.  1636.3(b) gives the term 
``pregnancy, childbirth, or related medical conditions'' the same 
meaning as under Title VII.\23\
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    \22\ See 42 U.S.C. 2000e(k).
    \23\ See, e.g., Tex. Dep't of Hous. & Cmty. Affs. v. Inclusive 
Cmtys. Project, Inc., 576 U.S. 519, 536 (2015) (``If a word or 
phrase has been . . . given a uniform interpretation by inferior 
courts . . . , a later version of that act perpetuating the wording 
is presumed to carry forward that interpretation.'') (omissions in 
original) (quoting Antonin Scalia & Bryan A. Garner, Reading Law: 
The Interpretation of Legal Texts 322 (2012)); Bragdon v. Abbott, 
524 U.S. 624, 645 (1998) (``When administrative and judicial 
interpretations have settled the meaning of an existing statutory 
provision, repetition of the same language in a new statute 
indicates, as a general matter, the intent to incorporate its 
administrative and judicial interpretations as well.''); Lorillard 
v. Pons, 434 U.S. 575, 581 (1978) (``[W]here, as here, Congress 
adopts a new law incorporating sections of a prior law, Congress 
normally can be presumed to have had knowledge of the interpretation 
given to the incorporated law, at least insofar as it affects the 
new statute.''); Hall v. U.S. Dep't of Agric., 984 F.3d 825, 840 
(9th Cir. 2020) (``Congress is presumed to be aware of an agency's 
interpretation of a statute. We most commonly apply that presumption 
when an agency's interpretation of a statute has been officially 
published and consistently followed. If Congress thereafter reenacts 
the same language, we conclude that it has adopted the agency's 
interpretation.'') (internal citations and quotation marks omitted); 
Antonin Scalia & Bryan A. Garner, Reading Law: The Interpretation of 
Legal Texts 323 (2012) (``[W]hen a statute uses the very same 
terminology as an earlier statute--especially in the very same 
field, such as securities law or civil-rights law--it is reasonable 
to believe that the terminology bears a consistent meaning.''); H.R. 
Rep. No. 117-27, pt. 1, at 11-17 (discussing the history of the 
passage of the PDA; explaining that, due to court decisions, the PDA 
did not fulfill its promise to protect pregnant employees; and that 
the PWFA was intended to rectify this problem and protect the same 
employees covered by the PDA).
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    16. The non-exhaustive list of examples in Sec.  1636.3(b) for 
the definition of ``pregnancy'' and ``childbirth'' includes current 
pregnancy, past pregnancy, potential or intended pregnancy (which 
can include infertility, fertility treatments, and the use of 
contraception), and labor and childbirth (including vaginal delivery 
and cesarean section).\24\
---------------------------------------------------------------------------

    \24\ EEOC, Enforcement Guidance on Pregnancy Discrimination and 
Related Issues, (I)(A) (2015) [hereinafter Enforcement Guidance on 
Pregnancy Discrimination], https://www.eeoc.gov/laws/guidance/enforcement-guidance-pregnancy-discrimination-and-related-issues 
(providing that the phrase ``pregnancy, childbirth, or related 
medical conditions'' includes current pregnancy, past pregnancy, 
potential or intended pregnancy, infertility treatment, use of 
contraception, lactation, breastfeeding, and the decision to have or 
not have an abortion, among other conditions); see, e.g., Kocak v. 
Cmty. Health Partners of Ohio, Inc., 400 F.3d 466, 470 (6th Cir. 
2005) (reasoning that the plaintiff ``cannot be refused employment 
on the basis of her potential pregnancy''); Piraino v. Int'l 
Orientation Res., Inc., 84 F.3d 270, 274 (7th Cir. 1996) (rejecting 
``surprising claim'' by the defendant that no pregnancy 
discrimination can be shown where the challenged action occurred 
after the birth of the plaintiff's baby); Pacourek v. Inland Steel 
Co., 858 F. Supp. 1393, 1397, 1402-04 (N.D. Ill. 1994) (observing 
that the PDA gives a woman ``the right . . . to be financially and 
legally protected before, during, and after her pregnancy'' and 
stating ``[a]s a general matter, a woman's medical condition 
rendering her unable to become pregnant naturally is a medical 
condition related to pregnancy and childbirth for purposes of the 
Pregnancy Discrimination Act'') (internal citations and quotation 
marks omitted); Donaldson v. Am. Banco Corp., Inc., 945 F. Supp. 
1456, 1464 (D. Colo. 1996) (``It would make little sense to prohibit 
an employer from firing a woman during her pregnancy but permit the 
employer to terminate her the day after delivery if the reason for 
termination was that the woman became pregnant in the first place. 
The plain language of the statute does not require it, and common 
sense precludes it.''); Neessen v. Arona Corp., 708 F. Supp. 2d 841, 
851 (N.D. Iowa 2010) (finding the plaintiff covered by the PDA where 
the defendant allegedly refused to hire her because she had recently 
been pregnant and given birth); EEOC, Commission Decision on 
Coverage of Contraception, at (I)(A) (Dec. 14, 2000), https://www.eeoc.gov/commission-decision-coverage-contraception (``The PDA's 
prohibition on discrimination against women based on their ability 
to become pregnant thus necessarily includes a prohibition on 
discrimination related to a woman's use of contraceptives.''); 
Cooley v. DaimlerChrysler Corp., 281 F. Supp. 2d 979, 984-85 (E.D. 
Mo. 2003) (determining that, although the defendant employer's 
policy was facially neutral, denying a prescription medication that 
allows an employee to control their potential to become pregnant is 
``necessarily a sex-based exclusion'' that violates Title VII, as 
amended by the PDA, because only people who have the capacity to 
become pregnant use prescription contraceptives, and the exclusion 
of prescription contraceptives may treat medication needed for a 
sex-specific condition less favorably than medication necessary for 
other medical conditions); Erickson v. Bartell Drug Co., 141 F. 
Supp. 2d 1266, 1271-72 (W.D. Wash. 2001) (determining that the 
selective exclusion of prescription contraceptives from an 
employer's generally comprehensive prescription drug plan violated 
the PDA because only people who have the capacity to become pregnant 
use prescription contraceptives).
---------------------------------------------------------------------------

    17. ``Related medical conditions'' are medical conditions that 
relate to pregnancy or childbirth.\25\ To be a related medical 
condition, the medical condition need not be caused solely, 
originally, or substantially by pregnancy or childbirth.
---------------------------------------------------------------------------

    \25\ Enforcement Guidance on Pregnancy Discrimination, supra 
note 24, at (I)(A)(4).
---------------------------------------------------------------------------

    18. There are some medical conditions where the relation to 
pregnancy will be readily apparent. They can include, but are not 
limited to, lactation (including breastfeeding and pumping), 
miscarriage, stillbirth, having or choosing not to have an abortion, 
preeclampsia, gestational diabetes, and HELLP (hemolysis, elevated 
liver enzymes and low platelets) syndrome.\26\

[[Page 29192]]

Pregnancy causes systemic changes that can create new medical 
conditions and risks and can exacerbate preexisting conditions and 
the risks posed by such conditions.\27\ Thus, the fact that a 
medical condition is related to pregnancy will usually be evident 
when the medical condition develops, is exacerbated, or poses a new 
risk during an employee's current pregnancy. Additionally, the 
relation will be apparent in many cases where the medical condition 
develops, is exacerbated, or poses a new risk during an employee's 
childbirth or during the employee's postpartum period.
---------------------------------------------------------------------------

    \26\ Id.; see also Hicks v. City of Tuscaloosa, 870 F.3d 1253, 
1259-60 (11th Cir. 2017) (finding lactation and breastfeeding 
covered under the PDA, and asserting that ``[t]he PDA would be 
rendered a nullity if women were protected during a pregnancy but 
then could be readily terminated for breastfeeding--an important 
pregnancy-related `physiological process' '') (internal citation 
omitted); EEOC v. Houston Funding II, Ltd., 717 F.3d 425, 428 (5th 
Cir. 2013) (holding that ``lactation is a related medical condition 
of pregnancy for purposes of the PDA''); Doe v. C.A.R.S. Prot. Plus, 
Inc., 527 F.3d 358, 364 (3d Cir. 2008) (holding that the PDA 
prohibits an employer from discriminating against a female employee 
because she has exercised her right to have an abortion); Turic v. 
Holland Hosp., Inc., 85 F.3d 1211, 1214 (6th Cir. 1996) (finding the 
termination of the employment of a pregnant employee because she 
contemplated having an abortion violated the PDA); Carney v. Martin 
Luther Home, Inc., 824 F.2d 643, 648 (8th Cir. 1987) (referencing 
the PDA's legislative history and noting commentator agreement that 
``[b]y broadly defining pregnancy discrimination, Congress clearly 
intended to extend protection beyond the simple fact of an 
employee's pregnancy to include `related medical conditions' such as 
nausea or potential miscarriage'') (internal citations and quotation 
marks omitted); Ducharme v. Crescent City D[eacute]j[agrave] Vu, 
LLC, 406 F. Supp. 3d 548, 556 (E.D. La. 2019) (finding that 
``abortion is encompassed within the statutory text prohibiting 
adverse employment actions `because of or on the basis of pregnancy, 
childbirth, or related medical conditions' ''); 29 CFR part 1604, 
appendix, Questions 34-37 (1979) (addressing coverage of abortion 
under the PDA); H.R. Rep. No. 95-1786, at 4 (1978), as reprinted in 
1978 U.S.C.C.A.N. 4749, 4766 (``Because the bill applies to all 
situations in which women are `affected by pregnancy, childbirth, 
and related medical conditions,' its basic language covers decisions 
by women who chose to terminate their pregnancies. Thus, no employer 
may, for example, fire or refuse to hire a woman simply because she 
has exercised her right to have an abortion.'').
    \27\ See supra note 18.
---------------------------------------------------------------------------

    19. However, simply because a condition is listed as one that 
may be a related medical condition does not mean it necessarily 
meets the definition of ``related medical conditions'' for the 
purposes of the PWFA. To be a related medical condition for the 
PWFA, the employee's medical condition must relate to pregnancy or 
childbirth. If an employee has a condition but, in their situation, 
it does not relate to pregnancy or childbirth, the condition is not 
covered under the PWFA. For example, if an employee who gave birth 2 
weeks ago is vomiting because of food poisoning, that medical 
condition is not related to pregnancy or childbirth and the employee 
is not eligible on that basis for a PWFA reasonable accommodation.
    20. Related medical conditions may include conditions that 
existed before pregnancy or childbirth and for which an individual 
may already receive an ADA reasonable accommodation. Pregnancy or 
childbirth may exacerbate the condition, such that additional or 
different accommodations are needed. For example, an employee who 
received extra breaks to eat or drink due to Type 2 diabetes before 
pregnancy (an ADA reasonable accommodation) may need additional 
accommodations during pregnancy to monitor and manage the diabetes 
more closely to avoid or minimize adverse health consequences to the 
employee or the pregnancy. As another example, an employee may have 
had high blood pressure that could be managed with medication prior 
to pregnancy, but once the employee is pregnant, the high blood 
pressure may pose a risk to the employee or their pregnancy such 
that the employee needs bed rest. In these situations, an employee 
could request a continued or an additional accommodation under the 
ADA and/or an accommodation under the PWFA.
    21. The Commission emphasizes that the list of ``pregnancy, 
childbirth or related medical conditions'' in Sec.  1636.3(b) is 
non-exhaustive; to receive an accommodation a qualified employee 
does not have to specify a condition on this list or use medical 
terms to describe a condition.
    22. When an employer has received a request for an accommodation 
under the PWFA, the employer and employee can engage in the 
interactive process, if necessary, in order to confirm whether a 
medical condition is related to pregnancy or childbirth.

1636.3(c) Employee's Representative

    23. The limitation may be communicated to the covered entity by 
the employee or the employee's representative. The term ``employee's 
representative'' encompasses any representative of the employee, 
including a family member, friend, union representative, health care 
provider, or other representative. In most instances, the Commission 
expects that the representative will have the employee's permission 
before communicating the limitation to the covered entity, but there 
may be some situations, for example if the employee is 
incapacitated, where that is not the case. Once the covered entity 
is made aware of the limitation, the representative's participation 
in any aspect of the reasonable accommodation process is at the 
discretion of the employee, and the employee may decide not to have 
the representative participate at any time. In most instances, the 
Commission expects that the covered entity will engage directly with 
the employee, even where the employee's representative began the 
process, but acknowledges that in some situations, for example, when 
the employee is incapacitated or the representative is the 
employee's attorney, the covered entity will need to continue to 
engage with the representative rather than the employee.

1636.3(d) Communicated to the Employer and 1636.3(h)(2) How To 
Request a Reasonable Accommodation

    24. Section 1636.3(d) and (h)(2) sets out how an employee 
informs a covered entity of their limitation in order to make it 
``known'' and how an employee requests a reasonable accommodation. 
In practice, the Commission expects that these actions--
communicating the limitation to the employer and requesting a 
reasonable accommodation--will take place at the same time.
    25. Informing the employer of the limitation and requesting a 
reasonable accommodation should not be complicated or difficult. The 
covered entity must permit an employee to do both through various 
avenues and means, as set forth in Sec.  1636.3(d). Given that many 
accommodations requested under the PWFA will be straightforward--
like additional bathroom breaks or access to water--the Commission 
emphasizes the importance of employees being able to obtain 
accommodations by communicating with the employer representative(s) 
with whom they would normally consult if they had questions or 
concerns about work matters. Employees should not be made to wait 
for a reasonable accommodation, especially one that is simple and 
imposes negligible cost or is temporary, because they spoke to the 
``wrong'' supervisor. The individuals to whom an employee can 
communicate to seek accommodation include persons with supervisory 
authority for or who regularly direct the employee's work (or the 
equivalent for the applicant) and human resources personnel. 
Depending on the situation, employees also may communicate with 
other appropriate officials such as an agent of the employer (e.g., 
a search firm, staffing agency, or third-party benefits 
administrator).
    26. Section 1636.3(d)(1) and (2) explains that the communication 
informing the covered entity of the limitation does not need to be 
in writing, be in a specific format, use specific words, or be on a 
specific form in order for it to be considered ``communicated to the 
employer.''
    27. Just as the communication informing the covered entity of 
the limitation does not need to be in writing or use specific 
phrases, the same is true for the request for a reasonable 
accommodation. Employees may inform the employer of the limitation 
and request an accommodation in a conversation or may use another 
mode of communication to inform the employer.\28\ A covered entity 
may choose to confirm a request in writing or may ask the employee 
to fill out a form or otherwise confirm the request in writing. 
However, the covered entity cannot ignore or close an initial 
request that satisfies Sec.  1636.3(h)(2) if the employee does not 
complete such confirmation procedures, because that initial request 
is sufficient to place the employer on notice.\29\ If a form is 
used, the form should be a simple one that does not deter the 
employee from pursuing the request and does not delay the provision 
of an accommodation. Additionally, although employees are not 
required to communicate limitations or request reasonable 
accommodations in writing, an employee may choose email or other 
written means to submit a request for an accommodation, which can 
promote clarity and create a record of their request. Finally, the 
request for accommodation does not need to be in the form of a 
``request,'' i.e., an employee does not need to ``ask'' but may 
provide a statement of their need for an accommodation.
---------------------------------------------------------------------------

    \28\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at Questions 1-3 (addressing requests for accommodation 
under the ADA).
    \29\ See id.
---------------------------------------------------------------------------

    28. The requirement that no specific words or phrases are 
necessary to communicate a limitation or request a reasonable 
accommodation includes not needing to specifically identify whether 
a condition is ``pregnancy, childbirth, or related medical 
conditions'' or whether it is a ``physical or mental condition.'' 
The statutory definition of ``limitation'' uses the words 
``condition''

[[Page 29193]]

and ``related'' twice (``known limitation'' means a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions.).\30\ Under 
Sec.  1636.3(d), ``physical or mental conditions'' are impediments 
or problems affecting an employee that may be modest or minor.\31\ A 
``physical or mental condition'' includes when an employee affected 
by pregnancy, childbirth, or related medical conditions has a need 
or a problem related to maintaining their health or the health of 
the pregnancy; or is seeking health care related to pregnancy, 
childbirth, or a related medical condition itself.\32\ ``Related 
medical conditions'' are conditions related to the pregnancy or 
childbirth of the specific employee in question.
---------------------------------------------------------------------------

    \30\ 42 U.S.C. 2000gg(4); 29 CFR 1636.3(a)(2).
    \31\ 29 CFR 1636.3(a)(2).
    \32\ Id.
---------------------------------------------------------------------------

    29. Many, but not all, conditions related to pregnancy and 
childbirth can be both a ``limitation'' and a ``related medical 
condition.'' For example, hyperemesis gravidarum experienced during 
pregnancy is a ``condition'' that could be classified as either a 
``limitation'' (nausea and vomiting that arises out of pregnancy), 
or a ``related medical condition'' (a condition that is related to 
pregnancy); similarly, incontinence could be a ``limitation'' (for 
example, when someone who is pregnant becomes less able to 
comfortably hold urine and thus requires more frequent bathroom 
breaks), or a ``related medical condition'' (for example, when the 
medical condition of incontinence arises out of or is exacerbated as 
a result of pregnancy or childbirth).\33\ Either way, such needs can 
be a reason for a reasonable accommodation under the PWFA.
---------------------------------------------------------------------------

    \33\ By contrast, normal weight gain during pregnancy that 
necessitates a larger uniform would be a ``limitation'' but not a 
``related medical condition.''
---------------------------------------------------------------------------

    30. Because the statute uses the same term (``condition'') to 
define both ``limitation'' and ``related medical conditions'' and 
because some ``conditions'' can be both a ``limitation'' and a 
``related medical condition,'' an employee does not have to identify 
whether a particular condition is a ``limitation'' or a ``related 
medical condition'' when requesting a reasonable accommodation. For 
example, where an employee is experiencing nausea and vomiting in 
connection with a pregnancy, the employee need not determine whether 
this is a ``limitation'' or a ``related medical condition'' in order 
to request an accommodation under the PWFA. Similarly, there is no 
need for the employer to make such a determination before granting 
an accommodation under the PWFA.
    31. Finally, PWFA limitations also may be ADA disabilities.\34\ 
Therefore, an employee is not required to identify the statute under 
which they are requesting a reasonable accommodation. Doing so would 
require that employees seeking accommodations use specific words or 
phrases, which Sec.  1636.3(d) prohibits.
---------------------------------------------------------------------------

    \34\ 42 U.S.C. 2000gg(4); see also infra in the Interpretive 
Guidance in section 1636.7(a)(1) under The PWFA and the ADA.
---------------------------------------------------------------------------

1636.3(e) Consideration of Mitigating Measures

    32. There may be steps that an employee can take to mitigate, or 
lessen, the effects of a known limitation such as taking medication, 
getting extra rest, or using a reasonable accommodation. Paragraph 
(e) of Sec.  1636.3 explains that the ameliorative, or positive, 
effects of ``mitigating measures,'' as that term is defined in the 
ADA,\35\ shall not be considered when determining whether the 
employee has a limitation under the PWFA. By contrast, the 
detrimental or non-ameliorative effects of mitigating measures, such 
as negative side effects of medication, the burden of following a 
particular treatment regimen, and complications that arise from 
surgery, may be considered when determining whether an employee has 
a limitation under the PWFA.\36\ Both the positive and negative 
effects of mitigating measures may be considered when determining 
what accommodation an employee may need.
---------------------------------------------------------------------------

    \35\ See 42 U.S.C. 12102(4)(E).
    \36\ See 29 CFR 1630.2(j)(1)(vi) and (j)(4)(ii); see also 29 CFR 
part 1630, appendix, 1630.2(j)(1)(vi).
---------------------------------------------------------------------------

1636.3(f) Qualified Employee

    33. An employee must meet the definition of ``qualified'' in the 
PWFA in one of two ways.\37\ Paragraph (f) of Sec.  1636.3 
reiterates the statutory language that ``qualified employee'' means 
an employee who, with or without reasonable accommodation, can 
perform the essential functions of the position.\38\ Additionally, 
following the statute, Sec.  1636.3(f) also states that an employee 
shall be considered qualified if: (1) any inability to perform an 
essential function(s) is for a temporary period; (2) the essential 
function(s) could be performed in the near future; and (3) the 
inability to perform the essential function(s) can be reasonably 
accommodated.\39\
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    \37\ The PWFA does not address prerequisites for a position. 
Whether an employee is qualified for the position in question is 
determined based on whether the employee can perform the essential 
functions of the position, with or without a reasonable 
accommodation, or based on the second part of the PWFA's definition 
of ``qualified.'' 42 U.S.C. 2000gg(6).
    \38\ 42 U.S.C. 2000gg(6).
    \39\ 42 U.S.C. 2000gg(6)(A)-(C).
---------------------------------------------------------------------------

    34. For both definitions of qualified, the determination of 
whether an employee with a known limitation is qualified should be 
based on the capabilities of the employee at the time of the 
relevant employment decision.\40\ The determination of qualified 
should not be based on speculation that the employee may become 
unable in the future to perform certain tasks, may cause increased 
health insurance premiums or workers' compensation costs, or may 
require leave.\41\
---------------------------------------------------------------------------

    \40\ See 29 CFR part 1630, appendix, 1630.2(m).
    \41\ See 29 CFR part 1630, appendix, 1630.2(m).
---------------------------------------------------------------------------

1636.3(f)(1) Qualified Employee--With or Without Reasonable 
Accommodation

    35. The first way that an employee can be ``qualified'' under 42 
U.S.C. 2000gg(6) is if they can perform the essential functions of 
their job with or without reasonable accommodation, which is the 
same language as in the ADA and is interpreted accordingly. 
``Reasonable'' has the same meaning as under the ADA on this topic--
an accommodation that ``seems reasonable on its face, i.e., 
ordinarily or in the run of cases,'' ``feasible,'' or ``plausible.'' 
\42\ Many employees will meet this part of the PWFA definition of 
qualified. For example, a pregnant cashier who needs a stool to 
perform the job will be qualified with the reasonable accommodation 
of a stool. A teacher recovering from childbirth who needs 
additional bathroom breaks will be qualified with a reasonable 
accommodation that allows such breaks.
---------------------------------------------------------------------------

    \42\ US Airways, Inc. v. Barnett, 535 U.S. 391, 401-02 (2002); 
see, e.g., Shapiro v. Twp. of Lakewood, 292 F.3d 356, 360 (3d Cir. 
2002) (citing the definition from Barnett); Osborne v. Baxter 
Healthcare Corp., 798 F.3d 1260, 1267 (10th Cir. 2015) (citing the 
definition from Barnett); EEOC v. United Airlines, Inc., 693 F.3d 
760, 762 (7th Cir. 2012) (citing the definition from Barnett); see 
also Enforcement Guidance on Reasonable Accommodation, supra note 
12, at text accompanying nn.8-9 (citing the definition from 
Barnett).
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``Qualified'' for the Reasonable Accommodation of Leave

    36. When determining whether an employee who needs leave as a 
reasonable accommodation meets the definition of ``qualified,'' the 
relevant inquiry is whether the employee would be able to perform 
the essential functions of the position, with or without reasonable 
accommodation (or, if not, if the inability to perform the essential 
function(s) is for a temporary period, the essential function(s) 
could be performed in the near future, and the inability to perform 
the essential function(s) can be reasonably accommodated), with the 
benefit of a period of leave (e.g., intermittent leave, part-time 
work, or a period of leave or time off). Thus, an employee who needs 
some form of leave to recover from a known limitation related to 
pregnancy, childbirth, or related medical conditions can readily 
meet the definition of ``qualified'' under the first part of the 
PWFA definition because it is reasonable to conclude that once they 
return from the period of leave (or during the time they are working 
if it is intermittent leave), they will be able to perform the 
essential functions of the job, with or without additional 
reasonable accommodations, or will be ``qualified'' under the second 
part of the PWFA definition.\43\
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    \43\ If the employee will not be able to perform all of the 
essential functions at the end of the leave period, with or without 
accommodation, the employee may still be qualified under the second 
part of the PWFA's definition of qualified employee. 42 U.S.C. 
2000gg(6).
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1636.3(f)(2) Qualified Employee--Temporary Suspension of an 
Essential Function(s)

    37. The PWFA provides that an employee can meet the definition 
of ``qualified'' even if they cannot perform one or more essential 
functions of the position in question with or without a reasonable 
accommodation, provided three conditions are met: (1) the inability 
to perform an essential function(s) is for a temporary period; (2) 
the essential function(s) could be performed in the near future; and 
(3) the inability to perform the

[[Page 29194]]

essential function(s) can be reasonably accommodated.\44\
---------------------------------------------------------------------------

    \44\ 42 U.S.C. 2000gg(6); see H.R. Rep. No. 117-27, pt. 1, at 27 
(``[T]he temporary inability to perform essential functions due to 
pregnancy, childbirth, or related medical conditions does not render 
a worker `unqualified.' . . . [T]here may be a need for a pregnant 
worker to temporarily perform other tasks or otherwise be excused 
from performing essential functions before fully returning to her 
position once she is able.'').
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    38. Based on the overall structure and wording of the statute, 
the second part of the definition of ``qualified'' is relevant only 
when an employee cannot perform one or more essential functions of 
the job in question, even with a reasonable accommodation, due to a 
known limitation under the PWFA. It is not relevant in any other 
circumstance. If the employee can perform the essential functions of 
the position with or without a reasonable accommodation, the first 
definition of ``qualified'' applies (i.e., able to do the job with 
or without a reasonable accommodation). For example, if a pregnant 
employee requests additional restroom breaks, they are qualified if 
they can perform the essential functions of the job with the 
reasonable accommodation of additional restroom breaks, and, if so, 
there is no need to reach the second part of the definition of 
``qualified,'' i.e., to apply definitions of ``temporary'' or ``in 
the near future,'' or to determine whether the inability to perform 
an essential function(s) can be reasonably accommodated (as no such 
inability exists).
    39. By contrast, some examples of situations where the second 
part of the definition of ``qualified'' may be relevant include: (1) 
a pregnant construction worker is told by their health care provider 
to avoid lifting more than 20 pounds during the second through ninth 
months of pregnancy, an essential function of the worker's job 
requires lifting more than 20 pounds, and there is not a reasonable 
accommodation that will allow the employee to perform that function 
without lifting more than 20 pounds; and (2) a pregnant police 
officer is unable because of their pregnancy to perform patrol 
duties during the third through ninth months of pregnancy, patrol 
duties are an essential function of the job, and there is not a 
reasonable accommodation that will allow the employee to perform the 
patrol duties.
    40. This definition is solely concerned with determining whether 
an individual is ``qualified.'' An employer may still defend the 
failure to provide the reasonable accommodation based on undue 
hardship.

1636.3(f)(2)(i) Temporary

    41. ``Temporary'' means that the need to suspend one or more 
essential functions is ``lasting for a limited time,\45\ not 
permanent, and may extend beyond `in the near future.' '' How long 
it may take before the essential function(s) can be performed is 
further limited by the definition of ``in the near future.''
---------------------------------------------------------------------------

    \45\ Temporary, Merriam-Webster.com, https://www.merriam-webster.com/dictionary/temporary (last visited Mar. 13, 2024) 
(defining ``temporary'' as ``lasting for a limited time''). This 
definition is consistent with logic in the House Report, which 
states that ``the temporary inability to perform essential functions 
due to pregnancy, childbirth, or related medical conditions does not 
render a worker `unqualified' '' and cites to Robert v. Board of 
County Commissioners of Brown County, 691 F.3d 1211, 1218 (10th Cir. 
2012). See H.R. Rep. No. 117-27, pt. 1, at 27, n.109.
---------------------------------------------------------------------------

1636.3(f)(2)(ii) In the Near Future

    42. An employee can be qualified under the exception in 42 
U.S.C. 2000gg(6)(A)-(C) if they could perform the essential 
function(s) ``in the near future.'' In explaining the inclusion of 
this additional definition of ``qualified,'' the House Report 
analogized the suspension of an essential function under the PWFA to 
cases under the ADA regarding leave; ``in the near future'' is a 
term some courts have used in the context of determining whether an 
employee can perform the essential functions of the job with a 
reasonable accommodation of leave and, therefore, is qualified under 
the ADA.\46\ These ADA leave cases provide some helpful guideposts 
to interpret this term in the PWFA. Under the ADA, courts have 
concluded that an employee who needs indefinite leave (that is, 
leave for a period of time that they cannot reasonably estimate 
under the circumstances) cannot perform essential job functions ``in 
the near future.'' \47\ Similarly, the Commission concludes that a 
need under the PWFA to indefinitely suspend an essential function(s) 
cannot reasonably be considered to meet the standard of an employee 
who could perform the essential function(s) ``in the near future.'' 
\48\
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    \46\ H.R. Rep. No. 117-27, pt. 1, at 27-28. As explained infra, 
this definition of ``qualified'' at 42 U.S.C. 2000gg(6)(A)-(C) is 
not used to determine ``qualified'' for the purposes of leave under 
the PWFA.
    \47\ See, e.g., Herrmann v. Salt Lake City Corp., 21 F.4th 666, 
676-77 (10th Cir. 2021); Cisneros v. Wilson, 226 F.3d 1113, 1129 
(10th Cir. 2000), overruled on other grounds by Bd. of Trs. of Univ. 
of Ala. v. Garrett, 531 U.S. 356 (2001). The Commission cites these 
ADA cases because they use the term ``in the near future'' in a 
related context (employees are ``qualified'' for leave under the ADA 
because the leave will allow them to return to work and perform 
essential functions ``in the near future''). The Commission 
emphasizes its position, as discussed below, that under both the 
PWFA and the ADA, leave provided as an accommodation does not 
constitute a suspension of an essential function. Thus, under the 
PWFA, in determining whether an essential function could be 
performed ``in the near future,'' the period of time during which an 
employee may be on leave is not included in the assessment. 
Likewise, in determining whether an individual is qualified for 
leave as a reasonable accommodation under the PWFA, the statutory 
term ``in the near future'' is not relevant.
    \48\ However, the Commission notes that the employee's inability 
to pinpoint the exact date when they expect to be able to perform 
the essential functions of the position, or their ability to provide 
only an estimated range of dates, does not make the temporary 
suspension of the essential function(s) ``indefinite'' or mean that 
they cannot perform the job's essential functions ``in the near 
future.'' The fact that an exact date is not necessary is supported 
by the language in the statute, which requires that the essential 
function(s) ``could'' be performed in the near future. 42 U.S.C. 
2000gg(6)(B).
---------------------------------------------------------------------------

    43. Pregnancy is a temporary condition with an ascertainable end 
date; the request to temporarily suspend an essential function(s) 
due to a current pregnancy will never be indefinite and will not be 
more than generally 40 weeks. Thus, for a current pregnancy, Sec.  
1636.3(f) defines ``in the near future'' to mean generally 40 weeks 
from the start of the temporary suspension of an essential 
function(s). To define ``in the near future'' as less than generally 
40 weeks--i.e., the duration of a full-term pregnancy--would run 
counter to a central purpose of the PWFA of keeping pregnant 
employees in the workforce even when pregnancy, childbirth, or 
related medical conditions necessitate the reasonable accommodation 
of temporarily suspending the performance of one or more essential 
functions of a job.\49\
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    \49\ See H.R. Rep. No. 117-27, pt. 1, at 5 (``When pregnant 
workers do not have access to reasonable workplace accommodations, 
they are often forced to choose between their financial security and 
a healthy pregnancy. Ensuring that pregnant workers have access to 
reasonable accommodations will promote the economic well-being of 
working mothers and their families and promote healthy 
pregnancies.''); id. at 22 (``When pregnant workers are not provided 
reasonable accommodations on the job, they are oftentimes forced to 
choose between economic security and their health or the health of 
their babies.''); id. at 24 (``Ensuring pregnant workers have 
reasonable accommodations helps ensure that pregnant workers remain 
healthy and earn an income when they need it the most.''); id. at 33 
(``The PWFA is about ensuring that pregnant workers can stay safe 
and healthy on the job by being provided reasonable accommodations 
for pregnancy, childbirth, or related medical conditions . . . . The 
PWFA is one crucial step needed to reduce the disparities pregnant 
workers face by ensuring that pregnant women, and especially 
pregnant women of color, can remain safe and healthy at work.'').
---------------------------------------------------------------------------

    44. The Commission emphasizes that the definition in Sec.  
1636.3(f)(2)(ii) does not mean that the essential function(s) always 
must be suspended for 40 weeks, or that if an employee seeks the 
temporary suspension of an essential function(s) for 40 weeks the 
employer must automatically grant it. The actual length of the 
temporary suspension of the essential function(s) will depend upon 
what the employee requires, and the covered entity always has 
available the defense that it would create an undue hardship. 
However, the mere fact that the temporary suspension of one or more 
essential functions is needed for any time period up to and 
including generally 40 weeks for a pregnant employee will not, on 
its own, render an employee unqualified under the PWFA.
    45. For conditions other than a current pregnancy, the 
Commission is not setting a specific length of time for ``in the 
near future'' because, unlike a current pregnancy, there is not a 
consistent measure of how long these diverse conditions can 
generally last, and thus, what ``in the near future'' might mean in 
different instances.
    46. The Commission notes that beyond an agreement that an 
indefinite amount of time does not meet the standard of ``in the 
near future,'' how long a period of leave may be under the ADA and 
still be a reasonable accommodation (thus, allowing the individual 
to remain qualified) varies.\50\ The

[[Page 29195]]

Commission believes, however, that depending on the facts of a case, 
leave cases that allow for a longer period are more relevant to the 
determination of ``in the near future'' under the PWFA for three 
reasons. First, what constitutes ``in the near future'' may differ 
depending on factors, including but not limited to, the known 
limitation and the employee's position. For example, an employee 
whose essential job functions require lifting only during the summer 
months would remain qualified even if unable to lift during a 7-
month period over the fall, winter, and spring months because the 
employee could perform the essential function ``in the near future'' 
(in this case, as soon as the employee was required to perform that 
function). Second, the determination of whether the employee could 
resume the essential functions of their position in the near future 
is only one step in the definition of qualified; standing alone, it 
does not require the employer to provide an accommodation. If the 
temporary suspension cannot be reasonably accommodated, or if the 
temporary suspension causes an undue hardship, the employer is not 
required to provide it.\51\ Third, as detailed in the notice of 
proposed rulemaking (NPRM), especially in the first year after 
giving birth, employees may experience serious health issues related 
to their pregnancy that may prevent them from performing the 
essential functions of their positions.\52\ Accommodating these 
situations and allowing employees to stay employed are among the key 
purposes of the PWFA.
---------------------------------------------------------------------------

    \50\ See, e.g., Robert, 691 F.3d at 1218 (citing a case in which 
a 6-month leave request was too long to be a reasonable 
accommodation but declining to address whether, in the instant case, 
a further exemption following the 6-month temporary accommodation at 
issue would exceed ``reasonable durational bounds'') (citing Epps v. 
City of Pine Lawn, 353 F.3d 588, 593 (8th Cir. 2003)); see also 
Blanchet v. Charter Commc'ns, LLC, 27 F.4th 1221, 1225-26, 1230-31 
(6th Cir. 2022) (determining that a pregnant employee who developed 
postpartum depression and requested a 5-month leave after her 
initial return date, and was fired after requesting an additional 60 
days of leave could still be ``qualified,'' as additional leave 
could have been a reasonable accommodation); Cleveland v. Fed. 
Express Corp., 83 F. App'x 74, 76-81 (6th Cir. 2003) (declining ``to 
adopt a bright-line rule defining a maximum duration of leave that 
can constitute a reasonable accommodation'' and determining that a 
6-month medical leave for a pregnant employee with systemic lupus 
could be a reasonable accommodation); Garcia-Ayala v. Lederle 
Parenterals, Inc., 212 F.3d 638, 641-42, 646-49 (1st Cir. 2000) 
(reversing the district court's finding that a secretary was not a 
``qualified individual'' under the ADA because additional months of 
unpaid leave could be a reasonable accommodation, even though she 
had already taken over year of medical leave for breast cancer 
treatment, and rejecting per se rules as to when additional medical 
leave is unreasonable); Nunes v. Wal-Mart Stores, Inc., 164 F.3d 
1243, 1245-1247 (9th Cir. 1999) (opining that, because extending 
leave to 9 months to treat a fainting disorder could be a reasonable 
accommodation, an employee's inability to work during that period of 
leave did not automatically render her unqualified); Cayetano v. 
Fed. Express Corp., No. 1:19-CV-10619, 2022 WL 2467735, at *1-*2, 
*4-*7 (S.D.N.Y. July 6, 2022) (determining that an employee who 
underwent shoulder surgery could be ``qualified'' because 6 months 
of leave is not per se unreasonable as a matter of law); Durrant v. 
Chemical/Chase Bank/Manhattan Bank, N.A., 81 F. Supp. 2d 518, 519, 
521-22 (S.D.N.Y. 2000) (concluding that an employee who was on leave 
for nearly 1 year due to a leg injury and extended her leave to 
treat a psychiatric condition could be ``qualified'' under the ADA 
with the accommodation of additional leave of reasonable duration).
    \51\ The Commission is aware of and disagrees with ADA cases 
that held, for example, that 2 to 3 months of leave following a 12-
week FMLA period was presumptively unreasonable as an accommodation. 
See, e.g., Severson v. Heartland Woodcraft, Inc., 872 F.3d 476, 481 
(7th Cir. 2017). In any event, such cases have no bearing on the 
determination of ``in the near future'' under the definition of 
``qualified'' for the PWFA because this definition expressly 
contemplates temporarily suspending one or more essential functions.
    \52\ 88 FR 54724-25; see, e.g., Susanna Trost et al., U.S. Dep't 
of Health & Hum. Servs., Ctrs. for Disease Control & Prevention, 
Pregnancy-Related Deaths: Data from Maternal Mortality Review 
Committees in 36 U.S. States, 2017-2019 (2022), https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html 
(stating that 53% of pregnancy-related deaths occurred from one week 
to one year after delivery, and 30% occurred one- and one-half 
months to one year postpartum).
---------------------------------------------------------------------------

    47. Further, the Commission recognizes that employees may need 
an essential function(s) temporarily suspended because of a current 
pregnancy; take leave to recover from childbirth; and, upon 
returning to work, need the same essential function(s) or a 
different one temporarily suspended due to the same or a different 
physical or mental condition related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions. In keeping 
with the requirement that the determination of whether an individual 
is qualified under the PWFA should be made at the time of the 
employment decision,\53\ the determination of ``in the near future'' 
should be made when the employee asks for each accommodation that 
requires the suspension of one or more essential functions. Thus, an 
employee who is 3 months pregnant and who is seeking an 
accommodation of the temporary suspension of an essential 
function(s) due to a limitation related to pregnancy will meet the 
definition of ``in the near future'' because the inability to 
perform the essential function(s) will end in less than 40 weeks. 
When the employee returns to work from leave after childbirth, if 
the employee needs an essential function temporarily suspended for a 
reason related to pregnancy, childbirth, or related medical 
conditions, there should be a new determination made as to whether 
the employee is qualified under Sec.  1636.3(f)(2). In other words, 
there is a new calculation of ``in the near future'' with the new 
employment decision that involves the temporary suspension of an 
essential function(s).\54\
---------------------------------------------------------------------------

    \53\ See 29 CFR part 1630, appendix, 1630.2(m).
    \54\ There is a new calculation regardless of whether the 
employee seeks to temporarily suspend the same essential function 
that was suspended during pregnancy or a different one.
---------------------------------------------------------------------------

    48. Determining ``in the near future'' in the definition of 
``qualified'' when the employment decision is made is necessary 
because it would often be difficult, if not impossible, for a 
pregnant employee to predict what their limitations (if any) will be 
when returning to work after pregnancy. While pregnant, they may not 
know whether and, if so, for how long, they will have a known 
limitation or need an accommodation. They also may not know whether 
an accommodation after returning to work will require the temporary 
suspension of an essential function(s), and, if so, for how long. 
All of these questions may be relevant under the PWFA's second 
definition of ``qualified.''
    49. Leave as a reasonable accommodation (e.g., for recovery from 
pregnancy, childbirth, or related medical conditions or any other 
purpose) does not count as time when an essential function(s) is 
suspended and, thus, is not relevant for the second part of the 
definition of ``qualified'' (Sec.  1636.3(f)(2)). If an individual 
needs leave as a reasonable accommodation under the PWFA or, indeed, 
any reasonable accommodation other than the temporary suspension of 
an essential function(s), only the first part of the definition of 
``qualified'' is relevant (Sec.  1636.3(f)(1)). In the case of 
leave, the question would be whether the employee, after returning 
from the requested period of leave, would be able to perform the 
essential functions of the position with or without reasonable 
accommodation (or, if not, if the inability to perform the essential 
function(s) is for a temporary period, the essential function(s) 
could be performed in the near future, and the inability to perform 
the essential function(s) can be reasonably accommodated). 
Furthermore, for some employees, leave to recover from childbirth 
will not require a reasonable accommodation because they have a 
right to leave under Federal, State, or local law or under an 
employer's policy.\55\
---------------------------------------------------------------------------

    \55\ For additional information on how leave should be addressed 
under the PWFA, see infra in the Interpretive Guidance in section 
1636.3(h) under Particular Matters Regarding Leave as a Reasonable 
Accommodation.
---------------------------------------------------------------------------

1636.3(f)(2)(iii) Can Be Reasonably Accommodated

    50. The second part of the PWFA's definition of ``qualified'' 
further requires that the suspension ``can be reasonably 
accommodated.'' \56\ For some positions, this may mean that one or 
more essential functions are temporarily suspended, with or without 
assigning the essential function(s) to someone else, and the 
employee continues to perform the remaining functions of the job. 
For other positions, some of the essential function(s) may be 
temporarily suspended, with or without assigning the essential 
function(s) to someone else, and the employee may be given other 
tasks to replace them. In other situations, one or more essential 
functions may be temporarily suspended, with or without giving the 
essential function(s) to someone else, and the employee may perform 
the functions of a different job to which the employer temporarily 
transfers or moves them, or the employee may participate in the 
employer's light or modified duty program.\57\
---------------------------------------------------------------------------

    \56\ 42 U.S.C. 2000gg(6)(C).
    \57\ See H.R. Rep. No. 117-27, pt. 1, at 27 (``[T]he temporary 
inability to perform essential functions due to pregnancy, 
childbirth, or related medical conditions does not render a worker 
`unqualified.' . . . [T]here may be a need for a pregnant worker to 
temporarily perform other tasks or otherwise be excused from 
performing essential functions before fully returning to her 
position once she is able.'').
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    51. Examples Regarding Sec.  1636.3(f)(2):
    Example #1/Definition of ``Qualified'': One month into 
pregnancy, Akira, an employee in

[[Page 29196]]

a paint manufacturing plant, is told by her health care provider 
that she should avoid certain chemicals for the remainder of the 
pregnancy. One of several essential functions of the job involves 
regular exposure to these chemicals. Akira talks to her supervisor, 
explains her limitation, and asks that she be allowed to continue to 
perform her other tasks that do not require exposure to the 
chemicals.
    1. Known limitation and request for accommodation: Akira's need 
to avoid exposure to chemicals is a physical or mental condition 
related to, affected by, or arising out pregnancy, childbirth, or 
related medical conditions; Akira needs an adjustment or change at 
work due to the limitation; and Akira has communicated this 
information to her employer.
    2. Qualified: If modifications that would allow Akira to 
continue to perform the essential functions of her position (such as 
enclosing the chemicals, providing a local exhaust vent, or 
providing additional personal protective gear) are not effective or 
cause an undue hardship, Akira can still be qualified under the 
definition that allows for a temporary suspension of an essential 
function(s).
    a. Akira's inability to perform the essential function(s) is 
temporary.
    b. Akira can perform the essential function(s) of her job in the 
near future because she is pregnant and needs an essential 
function(s) suspended for less than 40 weeks.
    c. Akira's inability to perform the essential function(s) may be 
reasonably accommodated. The employer can suspend the essential 
function(s) that requires her to work with the chemicals, while 
allowing her to do the remainder of her job.
    Example #2/Definition of ``Qualified'': Two months into a 
pregnancy, Lydia, a delivery driver, is told by her health care 
provider that she should adhere to clinical guidelines for lifting 
during pregnancy, which means she should not continue to lift 30-40 
pounds, which she routinely did at work when moving packages as part 
of the job. She discusses the limitation with her employer. The 
employer is unable to provide Lydia with assistance in lifting 
packages, and Lydia requests placement in the employer's light duty 
program, which is used for drivers who have on-the-job injuries.
    1. Known limitation and request for accommodation: Lydia's 
lifting restriction is a physical or mental condition related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions; she needs an adjustment or change at work due to 
the limitation; and she has communicated this information to the 
employer.
    2. Qualified: Lydia needs the temporary suspension of an 
essential function(s).
    a. Lydia's inability to perform the essential function(s) is 
temporary.
    b. Lydia can perform the essential function(s) of her job in the 
near future because Lydia is pregnant and needs an essential 
function(s) suspended for less than 40 weeks.
    c. Lydia's need to temporarily suspend an essential function(s) 
of her job may be reasonably accommodated through the existing light 
duty program.
    Example #3/Definition of ``Qualified'': Olga's position as a 
carpenter involves lifting heavy wood that weighs more than 20 
pounds. Upon returning to work after giving birth, Olga tells her 
supervisor that she has a lifting restriction of 10 pounds due to 
her cesarean delivery. The restriction is for 8 weeks. The employer 
does not have an established light duty program but does have other 
design or administrative duties that Olga can perform.
    1. Known limitation and request for accommodation: Olga's 
lifting restriction is a physical or mental condition related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions; she needs an adjustment or change at work due to 
the limitation; and she has communicated this information to the 
employer.
    2. Qualified: Olga needs the temporary suspension of an 
essential function(s).
    a. Olga's inability to perform the essential function(s) is 
temporary.
    b. Olga can perform the essential function(s) of her job in the 
near future because she needs the essential function(s) suspended 
for 8 weeks.\58\
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    \58\ See Cehrs v. Ne. Ohio Alzheimer's Rsch. Ctr., 155 F.3d 775, 
781-783 (6th Cir. 1998) (determining that an employee suffering from 
severe psoriasis who was on an 8-week leave of absence and requested 
an additional 1-month leave could be ``otherwise qualified'' under 
the ADA).
---------------------------------------------------------------------------

    c. Olga's need to temporarily suspend an essential function(s) 
of her job may be reasonably accommodated by temporarily suspending 
the essential function(s) and temporarily assigning Olga to design 
or administrative duties.
    Example #4/Definition of ``Qualified'': One of the essential 
functions of Elena's position as a park ranger involves patrolling 
the park. Park rangers also answer questions for guests, sell 
merchandise, and explain artifacts and maps. Due to her postpartum 
depression, Elena is experiencing an inability to sleep, severe 
anxiety, and fatigue. Her anti-depressant medication also is causing 
dizziness and blurred vision, which make it difficult to drive. 
Elena seeks the temporary suspension of the essential function of 
patrolling the park for 12 weeks.
    1. Known limitation and request for accommodation: Elena's 
inability to sleep, anxiety, fatigue, dizziness, and blurred vision 
are physical or mental conditions related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions; 
she needs an adjustment or change at work due to the limitation; and 
she has communicated this information to the employer.
    2. Qualified: Elena needs the temporary suspension of an 
essential function(s).
    a. Elena's inability to perform the essential function(s) is 
temporary.
    b. Elena can perform the essential function(s) of her job in the 
near future because she needs an essential function(s) suspended for 
12 weeks.\59\
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    \59\ See Criado v. IBM Corp., 145 F.3d 437, 443-43 (1st Cir. 
1998) (concluding that an employee with severe anxiety and 
depression who was on leave for approximately 6 weeks and requested 
an extension of temporary leave was ``qualified'' under the ADA); 
Durrant, 81 F. Supp. 2d at 519, 521-22 (concluding that an employee 
who was on leave for nearly 11 months due to a leg injury and 
extended her leave to treat a psychiatric condition could be 
``qualified'' under the ADA); Powers v. Polygram Holding, 40 F. 
Supp. 2d 195, 199 (S.D.N.Y. 1999) (determining that an employee 
experiencing bipolar disorder who requested a total of 17 weeks of 
leave could be ``qualified'' under the ADA).
---------------------------------------------------------------------------

    c. Elena's need to temporarily suspend an essential function(s) 
of her job may be reasonably accommodated by temporarily suspending 
the essential function(s) and temporarily assigning Elena to duties 
such as answering questions and selling merchandise at the visitor's 
center.
    Example #5/Definition of ``Qualified'': Tamara's position at a 
retail establishment involves working as a cashier and folding and 
putting away clothing. In her final trimester of pregnancy, Tamara 
develops carpal tunnel syndrome that makes gripping objects and 
buttoning clothing difficult. Tamara seeks the temporary suspension 
of the essential functions of folding and putting away clothing. The 
employer provides the accommodation and temporarily assigns Tamara 
to greeting and assisting customers, tasks that cashiers are 
normally assigned to on a rotating basis. When she returns to work 
after she gives birth, Tamara continues to experience carpal tunnel 
symptoms, which her doctor believes will cease in approximately 16 
weeks.
    1. Known limitation and request for accommodation: Tamara's 
inability to grip objects and button clothing are physical or mental 
conditions related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions; she needs an adjustment 
or change at work due to the limitation; and she has communicated 
this information to the employer.
    2. Qualified: Tamara needs the temporary suspension of an 
essential function(s).
    a. Tamara's inability to perform the essential function(s) is 
temporary.
    b. Tamara can perform the essential functions of her job in the 
near future because she needs an essential function(s) suspended for 
16 weeks.\60\
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    \60\ See Rascon v. U.S. W. Commc'ns, Inc., 143 F.3d 1324, 1333 
(10th Cir. 1998) (agreeing that an employee diagnosed with post-
traumatic stress disorder who requested a 4-month leave for a 
treatment program was a ``qualified'' individual under the ADA), 
abrogated on other grounds by New Hampshire v. Maine, 532 U.S. 742 
(2001).
---------------------------------------------------------------------------

    c. Tamara's need to temporarily suspend an essential function(s) 
of her job may be reasonably accommodated by temporarily suspending 
the essential function(s) and temporarily assigning Tamara to duties 
such as greeting and assisting customers.

1636.3(g) Essential Functions

    52. Section 1636.3(g) adopts the Commission's definition of 
``essential functions'' contained in the regulation implementing the 
ADA.\61\ Thus, in determining whether something is an essential 
function, the first consideration is whether employees in the 
position actually are required to perform the function. This 
consideration will generally include one or more of the factors 
listed in Sec.  1636.3(g)(1), although this list is non-exhaustive. 
Relevant evidence as to whether a particular function

[[Page 29197]]

is essential includes, but is not limited to, information from the 
employer (such as the position description) and information from 
incumbents (including the employee requesting the accommodation) 
about what they actually do on the job.\62\ This includes whether 
employees in the position actually will be required to perform the 
function during the time for which an accommodation is expected to 
be needed. The list of factors in Sec.  1636.3(g)(2) is not 
exhaustive, and other relevant evidence also may be presented. No 
single factor is dispositive, and greater weight will not be granted 
to the types of evidence included on the list than to the types of 
evidence not listed.\63\
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    \61\ See 29 CFR 1630.2(n).
    \62\ See 29 CFR 1630.2(n); 29 CFR part 1630, appendix, 
1630.2(n).
    \63\ See 29 CFR part 1630, appendix, 1630.2(n).
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1636.3(h) Reasonable Accommodation--Generally

1636.3(h)(1) Definition of Reasonable Accommodation

    53. The statute at 42 U.S.C. 2000gg(7) states that the term 
``reasonable accommodation'' has the meaning given to it in section 
101 of the ADA \64\ and shall be construed as it is construed under 
the ADA and the Commission's regulation implementing the PWFA. Thus, 
under the PWFA, as under the ADA, the obligation to make reasonable 
accommodation is a form of non-discrimination and is therefore best 
understood as a means by which barriers to the equal employment 
opportunity are removed or alleviated.\65\ A modification or 
adjustment is reasonable if it ``seems reasonable on its face, i.e., 
ordinarily or in the run of cases''; this means it is ``reasonable'' 
if it appears to be ``feasible'' or ``plausible.'' \66\ An 
accommodation also must be effective in meeting the qualified 
employee's needs, meaning it removes a work-related barrier and 
provides the employee with equal employment opportunity.\67\
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    \64\ See 42 U.S.C. 12111(9).
    \65\ See 29 CFR part 1630, appendix 1630.9.
    \66\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at General Principles (quoting Barnett, 535 U.S. at 403-
06).
    \67\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at General Principles & Question 9; 29 CFR part 1630, 
appendix, 1630.9.
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    54. Under the PWFA, ``reasonable accommodation'' has the same 
definition as under the ADA, with the exceptions noted in items (1) 
through (3) of this paragraph.\68\ Therefore, like the ADA, 
reasonable accommodation under the PWFA includes: (1) modifications 
or adjustments to the job application process that enable a 
qualified applicant with a known limitation to be considered for the 
position; (2) modifications or adjustments to the work environment, 
or to the manner or circumstances under which the position is 
preformed to allow a qualified employee with a known limitation to 
perform the essential functions of the job; and (3) modifications or 
adjustments that enable an employee with a known limitation to enjoy 
equal benefits and privileges of employment as are enjoyed by its 
other similarly situated employees without known limitations.\69\
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    \68\ See 42 U.S.C. 2000gg(7).
    \69\ See 29 CFR 1630.2(o)(1)(i) through (iii). The requirement 
for employers to provide reasonable accommodations when requested 
that provide for equal benefits and privileges encompasses the 
requirement that an accommodation should provide the individual with 
an equal employment opportunity. 29 CFR part 1630, appendix, 1630.9. 
This requirement stems from the ADA's prohibition on discrimination 
in ``terms, conditions, and privileges of employment.'' 42 U.S.C. 
12112(a). The PWFA prohibits adverse action in the terms, 
conditions, or privileges of employment against a qualified employee 
for using or requesting an accommodation and Title VII--which 
applies to employees affected by pregnancy, childbirth, or related 
medical conditions--prohibits discrimination in the terms, 
conditions, or privileges of employment. See 42 U.S.C. 2000e-
2(a)(1). Based on the text of the PWFA, Title VII, and the 
requirement under the PWFA that reasonable accommodation has the 
same definition as in the ADA, the same requirement applies. Thus, a 
reasonable accommodation under the PWFA includes a change to allow 
employees affected by pregnancy, childbirth, or related medical 
conditions nondiscrimination in the terms, conditions, or privileges 
of employment or, in shorthand, to enjoy equal benefits and 
privileges. See also EEOC, Compliance Manual Section 613 Terms, 
Conditions, and Privileges of Employment, 613.1(a) (1982) 
[hereinafter Compliance Manual on Terms, Conditions, and Privileges 
of Employment], https://www.eeoc.gov/laws/guidance/cm-613-terms-conditions-and-privileges-employment (providing that ``terms, 
conditions, and privileges of employment'' are ``to be read in the 
broadest possible terms'' and ``a distinction is rarely made between 
terms of employment, conditions of employment, or privileges of 
employment'').
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    55. Because the PWFA also provides for reasonable accommodations 
when a qualified employee temporarily cannot perform one or more 
essential functions of a position but can meet the requirements of 
42 U.S.C. 2000gg(6)(A)-(C), reasonable accommodations under the PWFA 
also include modifications or adjustments that allow a qualified 
employee with a known limitation to temporarily suspend one or more 
essential functions of the position. This can be either through the 
essential function(s) being suspended or through the essential 
function(s) being suspended and the employee doing other work as set 
out in Sec.  1636.3(f)(2)(iii).

1636.3(h)(2) How To Request a Reasonable Accommodation

    56. To request a reasonable accommodation, the employee (or the 
employee's representative) must communicate to the employer that 
they need an adjustment or change at work due to their known 
limitation (a physical or mental condition related to, affected by, 
or arising out of pregnancy, childbirth, or related medical 
conditions). Section 1636.3(d) applies to communications to request 
a reasonable accommodation. An employee may use plain language and 
need not mention the PWFA. An employee does not have to use the 
phrases ``reasonable accommodation,'' ``limitation,'' ``known 
limitation,'' ``qualified,'' or ``essential function''; use any 
medical terminology; provide a specific medical condition; use any 
other specific words or phrases; or put the explanation of the need 
for accommodation in the form of a request.
    57. In these examples, the employee is communicating both their 
limitation and that they need an adjustment or change at work due to 
the limitation. The Commission expects that in the vast majority of 
cases these two communications will happen at the same time. All of 
these are examples of requests for reasonable accommodations under 
the PWFA.
    Example #6: A pregnant employee tells her supervisor, ``I'm 
having trouble getting to work at my scheduled starting time because 
of morning sickness.''
    Example #7: An employee who gave birth 3 months ago tells the 
person who assigns her work at the employment agency, ``I need an 
hour off once a week for treatments to help with my back problem 
that started during my pregnancy.''
    Example #8: An employee tells a human resources specialist that 
they are worried about continuing to lift heavy boxes because they 
are concerned that it will harm their pregnancy.
    Example #9: At the employee's request, an employee's spouse 
requests light duty for the employee because the employee has a 
lifting restriction related to pregnancy; the employee's spouse uses 
the employer's established process for requesting a reasonable 
accommodation.
    Example #10: An employee tells a manager of her need for more 
frequent bathroom breaks, explains that the breaks are needed 
because the employee is pregnant, but does not complete the 
employer's online form for requesting an accommodation.
    Example #11: An employee tells a supervisor that she needs time 
off to recover from childbirth.

Alleviating Increased Pain or Risk to Health Due to the Known 
Limitation

    58. One reason an employee may seek a reasonable accommodation 
is to alleviate increased pain or risk to health that is 
attributable to the physical or mental condition related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions that has been communicated to the employer (the 
known limitation).\70\ When dealing with requests for accommodation 
concerning the alleviation of increased pain or risk to health 
associated with a known limitation, the goal is to provide an 
accommodation that allows the qualified employee to alleviate the 
identified pain or risk to health.
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    \70\ Depending on the facts of the case, the accommodation 
sought will allow an applicant to apply for the position, or an 
employee to perform the essential functions of the job, to enjoy 
equal benefits and privileges of employment, or to temporarily 
suspend an essential function(s) of the job.
---------------------------------------------------------------------------

    59. Examples Regarding Alleviating Pain or Risk to Health Due to 
the Known Limitation:
    Example #12/Alleviating Pain or Risk to Health: Celia is a 
factory worker whose job requires her to regularly move boxes that 
weigh 50 pounds. Prior to her pregnancy, Celia occasionally felt 
pain in her knee when she walked for extended periods of time. When 
Celia returns to work after giving birth,

[[Page 29198]]

which was by cesarean section, Celia requests that she limit tasks 
to those that do not require moving boxes of more than 30 pounds for 
3 months because heavier lifting could increase the risk to her 
health and her continued recovery from childbirth. Under the PWFA, 
the employer is required to provide the requested accommodation (or 
another reasonable accommodation) absent undue hardship. However, 
under the PWFA, the employer would not be required to provide an 
accommodation for Celia's knee pain unless it was related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions. The employer also may have accommodation 
responsibilities regarding Celia's knee pain and lifting 
restrictions under the ADA.
    Example #13/Alleviating Pain or Risk to Health: Emily is a 
candidate for a police officer position. The application process 
takes place over several months and has multiple steps, one of which 
is a physical agility test. By the time it is Emily's turn to take 
the test, she is 7 months pregnant. To avoid risk to her health and 
the health of her pregnancy, Emily asks that the test be postponed 
and that her application be kept active so that once she has 
recovered from childbirth, she can resume the application process 
and not have to re-apply. Under the PWFA, the employer is required 
to provide the requested accommodation (or another reasonable 
accommodation) absent undue hardship.
    Example #14/Alleviating Pain or Risk to Health: Jackie's 
position at a fabrication plant involves working with certain 
chemicals, which Jackie thinks is the reason she has a nagging cough 
and chapped skin on her hands. For the one year when she is nursing, 
Jackie seeks the accommodation of a temporary suspension of an 
essential function--working with the chemicals--because of the risk 
that the chemicals will contaminate the milk she produces. The 
employer provides the accommodation. After Jackie stops nursing, she 
no longer has any known limitations. Thus, under the PWFA, she can 
be assigned to work with the chemicals again even if she would 
prefer not to do that work, because the PWFA requires an employer to 
provide an accommodation only if it is needed due to a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions. Jackie's 
employer may have accommodation responsibilities under the ADA.
    Example #15/Alleviating Pain or Risk to Health: Margaret is a 
retail worker who is pregnant. Because of her pregnancy, Margaret 
feels pain in her back and legs when she has to move stacks of 
clothing from one area to the other, one of the essential functions 
of her position. She can still manage to move the clothes, but, 
because of the pain, she requests a cart to use when she is moving 
the garments. Under the PWFA, the employer is required to provide 
the requested accommodation (or another reasonable accommodation) 
absent undue hardship.
    Example #16/Alleviating Pain or Risk to Health: Lourdes is 
pregnant and works outdoors as a farmworker. The conditions where 
she works expose her to certain chemicals and the conditions can be 
slippery. Because of her pregnancy, Lourdes has a problem with her 
balance and is more likely to slip and fall, and she needs to avoid 
exposure to the chemicals that she is normally exposed to at work. 
She seeks the accommodation of working indoors, which will allow her 
to avoid the conditions that could lead her to slip and fall and 
will allow her to avoid exposure to the chemicals. There is indoor 
work, which Lourdes is occasionally assigned to perform, available 
at the farm, as well as work that does not involve chemicals. Under 
the PWFA, the employer is required to provide the requested 
accommodation (or another reasonable accommodation) absent undue 
hardship.
    Example #17/Alleviating Pain or Risk to Health: Avery works as 
an administrative assistant and is pregnant. Avery normally works in 
the office and commutes by driving and public transportation. Due to 
pregnancy, Avery is experiencing sciatica; commuting is painful 
because it requires Avery to sit and stand in one position for an 
extended period of time. Avery seeks the accommodation of 
teleworking or changing the start and end time of the workday in 
order to commute during less crowded times and reduce the commute 
time and thereby reduce the pain. Under the PWFA, the employer is 
required to provide the requested accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #18/Alleviating Pain or Risk to Health: Arya is pregnant 
and works in a warehouse. When it is hot outside, the temperature in 
the warehouse increases to a level that creates a risk to Arya and 
her pregnancy.\71\ Arya seeks an accommodation of a portable cooling 
device to reduce the risk to her health and the health of her 
pregnancy because of the heat in her workplace. Under the PWFA, the 
employer is required to provide the requested accommodation (or 
another reasonable accommodation) absent undue hardship.
---------------------------------------------------------------------------

    \71\ U.S. Dep't of Health & Hum. Servs., Ctrs. for Disease 
Control & Prevention, Heat and Pregnant Women (Aug. 25, 2022), 
https://www.cdc.gov/disasters/extremeheat/heat_and_pregnant_women.html.
---------------------------------------------------------------------------

    Example #19/Alleviating Pain or Risk to Health: Talia is a nurse 
and is pregnant. The community where she lives is experiencing a 
surge in cases of a contagious respiratory viral disease that has 
been shown to increase the risk of negative outcomes for pregnancy. 
To reduce her risk and the risk to her pregnancy, Talia requests 
additional protective gear and to not be assigned to patients 
exhibiting symptoms of this virus. Under the PWFA, the employer is 
required to provide the requested accommodation (or another 
reasonable accommodation) absent undue hardship.

Particular Matters Regarding Leave as a Reasonable Accommodation

    60. Under the PWFA, leave may be a reasonable accommodation.\72\ 
If an employee requests leave as an accommodation or if there is no 
other reasonable accommodation that does not cause an undue 
hardship, the covered entity should evaluate whether to offer leave 
as a reasonable accommodation under the PWFA. This is the case even 
if the covered entity does not offer leave as an employee 
benefit,\73\ the employee is not eligible for leave under the 
employer's leave policy, or the employee has exhausted the leave the 
covered entity provides as a benefit (including leave exhausted 
under a workers' compensation program, the FMLA, or similar State or 
local laws).\74\
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    \72\ H.R. Rep. No. 117-27, pt. 1, at 29 (noting that ``leave is 
one possible accommodation under the PWFA, including time off to 
recover from delivery'').
    \73\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at text preceding Question 17 (explaining that if an 
employee with a disability needs 15 days of leave and an employer 
only provides 10 days of paid leave, the employer should allow the 
employee to use 10 days of paid leave and 5 days of unpaid leave). 
The Commission has stated in a technical assistance document 
regarding leave and the ADA that an employer should consider 
providing unpaid leave to an employee with a disability as a 
reasonable accommodation even when the employer does not offer leave 
as an employee benefit. See EEOC, Employer-Provided Leave and the 
Americans with Disabilities Act, at text above Example 4 (2016) 
[hereinafter Technical Assistance on Employer-Provided Leave], 
https://www.eeoc.gov/laws/guidance/employer-provided-leave-and-americans-disabilities-act.
    \74\ See supra note 73. If an employee has a right to leave 
under the FMLA, an employer policy, or a State or local law, the 
employee is entitled to leave regardless of whether they request 
leave as a reasonable accommodation. An employee who needs leave 
beyond what they are entitled to under those laws or policies may 
request a reasonable accommodation.
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    61. The Commission recognizes that there may be situations where 
an employer provides a reasonable accommodation to a qualified 
pregnant employee (e.g., a stool, additional breaks, or temporary 
suspension of one or more essential functions) under the PWFA, and 
then the employee requests leave as a reasonable accommodation 
(e.g., to recover from childbirth). In these situations, the covered 
entity should consider the request for the reasonable accommodation 
of leave to recover from childbirth in the same manner that it would 
any other request for leave as a reasonable accommodation. This 
requires first considering whether the employee will be able to 
perform the essential functions of the position with or without a 
reasonable accommodation after the period of leave, or, if not, 
whether, after the period of leave, the employee will meet the 
definition of ``qualified'' under Sec.  1636.3(f)(2).\75\
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    \75\ These considerations are relevant only if the leave is 
needed as a reasonable accommodation. The covered entity should 
first consider if there is a leave program that covers the need for 
leave to recover from childbirth and for which the employee is 
eligible. If there is a leave program that covers the request, the 
covered entity may not need to assess the employee's ability to 
perform essential functions upon return from leave under the PWFA.
---------------------------------------------------------------------------

    62. A qualified employee with a known limitation who is granted 
leave as a reasonable accommodation under the PWFA is entitled to 
return to their same position unless the employer demonstrates that 
holding open the position would impose an undue hardship.\76\ When 
the employee is

[[Page 29199]]

ready to return to work, the employer must allow the individual to 
return to the same position (assuming that there was no undue 
hardship in holding it open) if the employee is still qualified 
(i.e., the employee can perform the essential functions of the 
position with or without reasonable accommodation under Sec.  
1636.3(f)(1) or if the employee meets the definition of 
``qualified'' under Sec.  1636.3(f)(2)).\77\
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    \76\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at Question 18. As under the ADA, if an employer cannot 
hold a position open during the entire leave period without 
incurring undue hardship, the employer should consider whether it 
has a vacant, equivalent position for which the employee is 
qualified and to which the employee can be reassigned to continue 
their leave for a specific period of time and then, at the 
conclusion of the leave, can be returned to this new position.
    \77\ See id.
---------------------------------------------------------------------------

    63. Under the PWFA, an employer does not have to provide a 
reasonable accommodation if it causes an undue hardship--a 
significant difficulty or expense. Thus, if an employer can 
demonstrate that the impact of the leave requested as a reasonable 
accommodation poses an undue hardship under the factors set out in 
Sec.  1636.3(j)(2)--for example, because of the impact of its 
length, frequency, or unpredictable nature, or because of another 
factor that causes significant difficulty or expense--it does not 
have to provide the requested leave under the PWFA.
    64. Employees must be permitted to choose whether to use paid 
leave (whether accrued, as part of a short-term disability program, 
or as part of any other employee benefit) or unpaid leave to the 
same extent that the covered entity allows employees to choose 
between these types of leave when they are using leave for reasons 
unrelated to pregnancy, childbirth, or related medical 
conditions.\78\ Similarly, an employer must continue an employee's 
health insurance benefits during their leave period to the extent 
that it does so for other employees in a similar leave status, such 
as paid or unpaid leave. An employer is not required to provide 
additional paid leave under the PWFA beyond the amount provided to 
similarly situated employees.\79\
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    \78\ A failure to allow an employee affected by pregnancy, 
childbirth, or related medical conditions to use paid or unpaid 
leave to the same extent that the covered entity allows employees 
using leave for reasons unrelated to pregnancy, childbirth, or 
related medical conditions to do so or a failure to continue health 
care insurance for an employee affected by pregnancy, childbirth, or 
related medical conditions to the same extent that a covered entity 
does for other employees may be a violation of Title VII as well.
    \79\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at text after n.48.
---------------------------------------------------------------------------

Ensuring That Employees Are Not Penalized for Using Reasonable 
Accommodations

    65. Generally, covered entities are not required to lower 
production standards for qualified employees receiving 
accommodations under the PWFA.\80\ However, for example, when the 
reasonable accommodation is leave, the employee may not be able to 
meet a production standard during the period of leave or, depending 
on the length of the leave, meet that standard for a defined period 
of time (e.g., the production standard measures production in 1 year 
and the employee was on leave for 4 months). Thus, if the reasonable 
accommodation is leave, the production standard may need to be 
prorated to account for the reduced amount of time the qualified 
employee worked.\81\
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    \80\ See id. at text accompanying n.14.
    \81\ See id. at Question 19.
---------------------------------------------------------------------------

    66. In addition, covered entities making reasonable 
accommodations must ensure that their ordinary workplace policies or 
practices--including, but not limited to, attendance policies, 
productivity quotas, and requirements for mandatory overtime--do not 
operate to penalize qualified employees for utilizing PWFA 
accommodations.\82\ When a reasonable accommodation involves a pause 
in work--such as a break, a part-time or other reduced work 
schedule, or leave--a qualified employee cannot be penalized, or 
threatened with a penalty, for failing to perform work during that 
non-work period, including through actions like the assessment of 
penalty points for time off or discipline for failing to meet a 
production quota. For example, if a call center employee with a 
known limitation requests and is granted 2 hours of unpaid leave in 
the afternoon for rest, the employee's required number of calls may 
need to be reduced proportionately. Alternatively, the accommodation 
could allow for the qualified employee to make up the time at a 
different time during the day so that the employee's production 
standards and pay would not be reduced, as long as this would not 
make the accommodation ineffective.
---------------------------------------------------------------------------

    \82\ See id.
---------------------------------------------------------------------------

    67. Similarly, policies that monitor employees for time on task 
(whether through automated means or otherwise) and penalize them for 
being off task may need to be modified to avoid imposing penalties 
for non-work periods that the qualified employee was granted as a 
reasonable accommodation. This includes situations in which hours 
worked or time on task are used to measure traits like 
``productivity,'' ``focus,'' ``availability,'' or ``contributions.'' 
For example, if, as a reasonable accommodation, a qualified employee 
is excused from working overtime, and ``availability'' or 
``contribution'' is measured by an employee's overtime hours, a 
qualified employee should not be penalized in those categories.
    68. If an accommodation under the PWFA involves the temporary 
suspension of an essential function(s) of the position, a covered 
entity may not penalize a qualified employee for not performing the 
essential function(s) that has been temporarily suspended. So, for 
example, a covered entity must not penalize a qualified employee for 
not meeting a production standard related to the performance of the 
essential function(s) that has been temporarily suspended.
    69. Penalizing an employee in these situations could render the 
accommodation ineffective, thus making the covered entity liable for 
failing to make reasonable accommodation.\83\ It also may be an 
adverse action in the terms, conditions, or privileges of employment 
or retaliation.\84\
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    \83\ See Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at Question 19; see also 42 U.S.C. 2000gg-1(1) and the 
regulations in this part.
    \84\ 42 U.S.C. 2000gg-1(5); 42 U.S.C. 2000gg-2(f).
---------------------------------------------------------------------------

    70. The following examples illustrate situations where 
penalizing an employee may violate 42 U.S.C. 2000gg-1(1) (failing to 
make reasonable accommodation absent undue hardship), (5) 
(prohibiting employers from taking adverse action against an 
employee on account of the employee using a reasonable 
accommodation), and/or section 2000gg-2(f) (prohibiting 
retaliation).
    Example #20/Not Penalizing Employees: Arisa works in a 
fulfillment center that tracks employee productivity using personal 
tracking devices that monitor an employee's time on task and how 
long it takes an employee to complete a task. If the technology 
determines that an employee is spending insufficient time on task or 
taking too long to complete a task, the employee receives a warning, 
which can escalate to a reprimand and further discipline. Arisa is 
pregnant and, as a reasonable accommodation, is permitted to take 
bathroom breaks as necessary. Because the wearable technology 
determines that due to the approved additional bathroom breaks Arisa 
is spending insufficient time on task, Arisa receives a warning.
    Example #21/Not Penalizing Employees: Hanh works in a call 
center that has a ``no-fault'' attendance policy where employees 
accrue penalty points for all absences and late arrivals, regardless 
of the reason for the lateness or absence. The policy allows for 
discipline or termination when an employee accrues enough points 
within a certain time period. Hanh gave birth and has had some 
complications that involve heavy vaginal bleeding for which she 
occasionally needs time off, and she also needs to attend related 
medical appointments. She sought, and her employer provided, the 
reasonable accommodations of being able to arrive up to 1 hour late 
on certain days with time to attend medical appointments. Despite 
the reasonable accommodations, because of the no-fault policy, Hanh 
accrues penalty points under the policy, subjecting her to possible 
discipline or termination.
    Example #22/Not Penalizing Employees: Afefa, a customer service 
agent who is pregnant, requests two additional 10-minute rest breaks 
and additional bathroom breaks, as needed, during the workday. The 
employer determines that these breaks would not pose an undue 
hardship and grants the request. Because of the additional breaks, 
Afefa responds to three fewer calls during a shift. Afefa's 
supervisor gives her a lower performance rating because of her 
decrease in productivity.

Personal Use

    71. The obligation to provide reasonable accommodation under the 
PWFA, like that under the ADA, does not extend to the provision of 
adjustments or modifications that are primarily for the personal 
benefit of the qualified employee with a known limitation. However, 
adjustments or modifications that might otherwise be considered 
personal may be required as

[[Page 29200]]

reasonable accommodations ``where such items are specifically 
designed or required to meet job-related rather than personal 
needs.'' \85\
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    \85\ See 29 CFR part 1630, appendix, 1630.9.
---------------------------------------------------------------------------

    72. For example, if a warehouse employee is pregnant and is 
having difficulty sleeping, the PWFA would not require as a 
reasonable accommodation for the employer to provide a pregnancy 
pillow to help with sleeping because that is strictly for an 
employee's personal use. However, allowing the employee some 
flexibility in start times for the workday may be a reasonable 
accommodation because it modifies an employment-related policy. In a 
different context, if the employee who is having trouble sleeping 
works at a job that involves sleeping between shifts on-site, such 
as a job as a firefighter, sailor, emergency responder, health care 
worker, or truck driver, a pregnancy pillow may be a reasonable 
accommodation because the employee is having difficulty sleeping 
because of the pregnancy, the employer is providing pillows for all 
employees required to sleep on-site, and the employee needs a 
modification of the pillows provided.

All Services and Programs

    73. Under the PWFA, as under the ADA, the obligation to make 
reasonable accommodations applies to all services and programs 
provided in connection with employment and to all non-work 
facilities provided or maintained by an employer for use by its 
employees, so that employees with known limitations can enjoy equal 
benefits and privileges of employment.\86\ Accordingly, the 
obligation to provide reasonable accommodations, barring undue 
hardship, includes providing access to employer-sponsored placement 
or counseling services, such as employee assistance programs, to 
employer-provided cafeterias, lounges, gymnasiums, auditoriums, 
transportation, and to similar facilities, services, or 
programs.\87\ This includes situations where an employee is 
traveling for work and may need, for example, accommodations at a 
different work site or during travel.
---------------------------------------------------------------------------

    \86\ See id.
    \87\ See id.
---------------------------------------------------------------------------

Interim Reasonable Accommodations

    74. An interim reasonable accommodation can be used when there 
is a delay in providing the reasonable accommodation. For example, 
an interim reasonable accommodation may be sought when: there is a 
sudden onset of a known limitation under the PWFA, sometimes as an 
emergency, including one that makes it unsafe, risky, or dangerous 
to continue performing the normal tasks of the job; while the 
interactive process is ongoing, such as when an employer is waiting 
for the arrival of ordered equipment; or when the employee is 
waiting for the employer's decision on the accommodation request.
    75. Providing an interim reasonable accommodation is a best 
practice under the PWFA and may help limit a covered entity's 
exposure to liability under 42 U.S.C. 2000gg-1(1) (Sec.  
1636.4(a)(1)), or 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)).
    76. For example, consider a situation where an employee lets 
their supervisor know that they are pregnant and need to avoid 
working with certain chemicals in the workplace. Given the chemicals 
and the fact that the employee is pregnant, the employee needs the 
change immediately. In this situation, the best practice is to 
provide the employee with an interim reasonable accommodation that 
meets the employee's needs or limitations and allows the employee to 
perform tasks for the benefit of the employer while the employer 
determines its response. This is the best possible situation for 
both the employer and the employee, and the one that the Commission 
strongly encourages. In addition, this type of interim reasonable 
accommodation could help mitigate a claim of delay by the 
employee.\88\ The shortcomings and risks of two other approaches an 
employer might take are addressed in the following scenarios.
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    \88\ Section 1636.4(a)(1)(vii).
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     Require the employee to continue to work with the 
chemicals while the employer determines its response. In this 
situation, the employee would be forced to work outside of their 
restrictions. In addition to placing the employee in a situation 
that the PWFA was enacted to prevent--choosing between their health 
and the health of their pregnancy on one hand and a paycheck on the 
other--the covered entity may be risking liability under 42 U.S.C. 
2000gg-1(1) (if there is an unnecessary delay in providing the 
accommodation), and/or State and Federal workplace health and safety 
laws.
     Require the employee to take leave while the employer 
determines its response. In this situation, the employee is not 
exposed to the chemicals, so the risk is mitigated. However, 
depending on the facts, this option can have a severely detrimental 
effect on the employee--either because the leave is unpaid or 
because the employee is forced to use their paid leave. Meanwhile, 
the employee is unable to perform tasks for the employer.
    77. Moreover, depending on the facts, requiring an employee to 
take unpaid leave or use their leave after they ask for an 
accommodation and are awaiting a response could lead to a violation 
of 42 U.S.C. 2000gg-2(f). For example, if the employee is put on 
unpaid leave, even though there is paid work that the employer 
reasonably could have given the employee, the employer's decision 
could be retaliatory because it might well dissuade a reasonable 
person from engaging in protected activity, such as asking for an 
accommodation under the PWFA. If the employer's actions were 
challenged, the employer would have to produce a legitimate, non-
discriminatory reason for its actions. The employee could then show 
that the real reason for the action was retaliation.\89\ Because the 
claim would arise under 42 U.S.C. 2000gg-2(f), the employee would 
not have to show that they are qualified under 42 U.S.C. 2000gg(6), 
and the employer would not have recourse to an undue hardship 
defense.
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    \89\ See EEOC, Enforcement Guidance on Retaliation and Related 
Issues, (II)(C)(1)-(3) (discussing causation standard and evidence 
of causation), (4) (discussing facts that would defeat a claim of 
retaliation), and (III) (discussing ADA interference claims) (2016) 
[hereinafter Enforcement Guidance on Retaliation], https://www.eeoc.gov/laws/guidance/enforcement-guidance-retaliation-and-related-issues.
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    78. The possible connection between requiring leave as an 
interim reasonable accommodation and a potential violation of 42 
U.S.C. 2000gg-2(f) is in keeping with the purposes of the PWFA. The 
PWFA recognizes that historically employees with limitations related 
to pregnancy, childbirth, or related medical conditions have been 
required to take leave to their detriment. Thus, 42 U.S.C. 2000gg-
1(4) limits the use of leave as a reasonable accommodation, 
prohibiting employers from requiring qualified employees with known 
limitations to take leave as a reasonable accommodation where there 
is another reasonable accommodation that will allow them to remain 
at work that does not result in an undue hardship.
    79. Examples Regarding Interim Reasonable Accommodations:
    Example #23/Interim Reasonable Accommodation: Alicia is pregnant 
and works in a fulfillment center. Her job involves regularly moving 
boxes that weigh 15 to 20 pounds. On her Saturday shift, she informs 
her supervisor, Michelle, that she is pregnant and that she is 
worried about lifting these packages while she is pregnant. Michelle 
recognizes that Alicia is requesting a reasonable accommodation 
under the PWFA. While Michelle tells Alicia that she needs to wait 
until Monday to consult with human resources on the next steps, 
Michelle also immediately offers Alicia a cart to help move the 
boxes and assigns her to a line that has lighter packages. On 
Monday, Michelle tells Alicia that she will be provided with a hoist 
to help Alicia lift packages, but it will take a few days before it 
is installed. In the meantime, Alicia can continue to use the cart 
and work the lighter line. Once the hoist arrives, Alicia is able to 
use it while working on her usual line. If there were an unnecessary 
delay in providing the reasonable accommodation, and if Alicia were 
to challenge the delay as constituting a failure to make an 
accommodation, the employer could argue that the interim reasonable 
accommodation mitigates its liability.
    Example #24/Interim Reasonable Accommodation: Nour is pregnant, 
and she drives a delivery van. Her employer uses vans that do not 
have air conditioning. It is summer and the temperature is over 100 
degrees. Nour tells her supervisor she is pregnant and needs a 
change at work because of the risk to her health and the health of 
her pregnancy because of the excessive heat. Her supervisor orders 
equipment that will help Nour, such as a personal cooling vest or 
neck fan. While waiting for the equipment to be delivered, the 
employer does not have other possible work that Nour can do. In this 
situation, the employer could tell Nour that she may take leave 
while waiting for the equipment to arrive.
    Example #25/Interim Reasonable Accommodation: The scenario is 
the same as described in Example #24, but there is office work that 
Nour could perform while waiting for the equipment. Further, there 
is evidence

[[Page 29201]]

that the supervisor and others at the covered entity discussed the 
idea of giving Nour office work but decided against it because then 
``every woman is going to come in here and demand it.'' In this 
situation, failing to provide Nour the opportunity to work in the 
office could be a violation of 42 U.S.C. 2000gg-2(f).
    80. Covered entities that do not provide interim reasonable 
accommodations are reminded that an unnecessary delay in making a 
reasonable accommodation, including in responding to the initial 
request, in the interactive process, or in providing the 
accommodation may result in a violation of the PWFA if the delay 
constitutes an unlawful failure to make reasonable accommodation, as 
set forth in 42 U.S.C. 2000gg-1(1) (Sec.  1636.4(a)(1)).

1636.3(i) Reasonable Accommodation--Examples

    81. The definition of ``reasonable accommodation'' in Sec.  
1636.3(h)(1) tracks the meaning of the term from the ADA statute, 
regulation, and EEOC guidance documents.\90\ The PWFA, at 42 U.S.C. 
2000gg-3, directs the Commission to issue regulations providing 
examples of reasonable accommodations addressing known limitations 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions. The Commission notes that a qualified 
employee may need more than one of these accommodations at the same 
time, as a pregnancy progresses, or before, during, or after 
pregnancy. This list of possible reasonable accommodations is non-
exhaustive.\91\
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    \90\ See 42 U.S.C. 12111(9); 29 CFR 1630.2(o); Enforcement 
Guidance on Reasonable Accommodation, supra note 12.
    \91\ See, e.g., H.R. Rep. No. 117-27, pt. 1, at 29 (stating that 
``[t]he Job Accommodation Network (JAN), an ADA technical assistance 
center . . . lists numerous potential accommodations . . . including 
more than 20 suggested accommodations just for lifting restrictions 
related to pregnancy'').
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     Frequent breaks. The Commission has long construed the 
ADA to require additional breaks as a reasonable accommodation, 
absent undue hardship.\92\ Under the PWFA, for example, a pregnant 
employee might need more frequent breaks due to shortness of breath; 
an employee recovering from childbirth might need more frequent 
restroom breaks or breaks due to fatigue; an employee who is nursing 
during work hours, where the regular location of the employee's 
workplace makes nursing during work hours a possibility because the 
child is in close proximity (for example, if the employee normally 
works from home and the child is there or the child is at a nearby 
or onsite day care center), may need additional breaks to nurse 
during the workday; \93\ or an employee who is lactating might need 
more frequent breaks for water, for food, or to pump.\94\
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    \92\ Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at Question 22; see also H.R. Rep. 117-27, pt. 1, at 22; 
168 Cong. Rec. S7,048 (daily ed. Dec. 8, 2022) (statement of Sen. 
Robert P. Casey, Jr.); 168 Cong. Rec. S10,081 (daily ed. Dec. 22, 
2022) (statement of Sen. Robert P. Casey, Jr.).
    \93\ The Commission cautions that this provision is intended to 
address situations where the employee and child are in close 
proximity in the normal course of business. It is not intended to 
state that there is a right to create proximity to nurse because of 
an employee's preference. Of course, there may be limitations that 
would allow an employee to request as a reasonable accommodation the 
creation of proximity (e.g., a limitation that made pumping 
difficult or unworkable).
    \94\ Breaks may be paid or unpaid depending on the employer's 
normal policies and other applicable laws. Breaks may exceed the 
number that an employer normally provides because reasonable 
accommodations may require an employer to alter its policies, 
barring undue hardship.
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     Sitting/Standing. The Commission has recognized the 
provision of seating for jobs that require standing and standing for 
those that require sitting as potential reasonable accommodations 
under the ADA.\95\ Under the PWFA, reasonable accommodation of these 
needs might include, but is not limited to, policy modifications and 
the provision of equipment, such as seating, a sit/stand desk, or 
anti-fatigue floor matting, among other possibilities.
---------------------------------------------------------------------------

    \95\ Enforcement Guidance on Reasonable Accommodation, supra 
note 12, at General Principles, Example B; see also H.R. Rep. No. 
117-27, pt. 1, at 11, 22, 29.
---------------------------------------------------------------------------

     Schedule changes, part-time work, and paid and unpaid 
leave. Permitting the use of paid leave (whether accrued, as part of 
a short-term disability program, or as part of any other employee 
benefit) or providing unpaid leave is a potential reasonable 
accommodation under the ADA.\96\ Additionally, leave for medical 
treatment can be a reasonable accommodation.\97\ By way of example, 
under the PWFA an employee could need a schedule change to attend a 
round of IVF appointments to get pregnant; a part-time schedule to 
address fatigue during pregnancy; or unpaid leave for recovery from 
childbirth, medical treatment, postpartum treatment or recuperation 
related to a cesarean section, episiotomy, infection, depression, 
thyroiditis, or preeclampsia.
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    \96\ 29 CFR part 1630, appendix, 1630.2(o); see also Technical 
Assistance on Employer-Provided Leave, supra note 73. Additionally, 
an employer prohibiting an employee from using accrued leave for 
pregnancy, childbirth, or related medical conditions while allowing 
other employees to use leave for similar reasons also may violate 
Title VII.
    \97\ See 29 CFR part 1630, appendix, 1630.2(o).
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     Telework. Telework (or ``remote work'' or ``work from 
home'') has been recognized by the Commission as a potential 
reasonable accommodation under the ADA.\98\ Under the PWFA, telework 
could be used to accommodate, for example, a period of bed rest, a 
mobility impairment, or a need to avoid heightened health risk, such 
as from a communicable disease.
---------------------------------------------------------------------------

    \98\ See, e.g., Enforcement Guidance on Reasonable 
Accommodation, supra note 12, at Question 34.
---------------------------------------------------------------------------

     Parking. Providing a reserved parking space if the 
employee is otherwise entitled to use employer-provided parking may 
be a reasonable accommodation to assist an employee who is 
experiencing fatigue or limited mobility related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions.
     Light duty. Assignment to light duty or placement in a 
light duty program has been recognized by the Commission as a 
potential reasonable accommodation, even if the employer's light 
duty positions are normally reserved for those injured on-the-job 
and the person seeking a light duty position as an accommodation 
does not have an on-the-job injury.\99\
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    \99\ See Enforcement Guidance: Workers' Compensation, supra note 
8, at Question 28; see also 168 Cong. Rec. S7,048 (daily ed. Dec. 8, 
2022) (statement of Sen. Robert P. Casey, Jr.) (``What are other 
types of reasonable accommodations that pregnant workers might 
request? Light duty is a common example.''); id. at S7,049 
(statement of Sen. Patty Murray) (noting that workers need 
accommodations because ``their doctors say they need to avoid heavy 
lifting''); H.R. Rep. 117-27, pt. 1, at 14-17 (discussing Young v. 
United Parcel Serv., Inc., 575 U.S. 206 (2015), a case involving 
light duty for pregnant employees).
---------------------------------------------------------------------------

     Making existing facilities accessible or modifying the 
work environment.\100\ Examples of reasonable accommodations might 
include allowing access to an elevator not normally used by 
employees; moving the employee's workspace closer to a bathroom; 
providing a fan to regulate temperature; moving a pregnant or 
lactating employee to a different workspace to avoid exposure to 
chemical fumes; changing the assigned worksite of the employee; or 
modifying the work space by providing local exhaust ventilation or 
providing enhanced personal protective equipment and training to 
reduce exposure to chemical hazards.\101\ As noted in the 
regulation, this also may include modifications of the work 
environment to allow an employee to pump breast milk at work.\102\
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    \100\ See 42 U.S.C. 12111(9); 29 CFR 1630.2(o)(1)(ii) and 
(o)(2)(i).
    \101\ See, e.g., U.S. Dep't of Lab., Occupational Health & 
Safety Admin., Recommended Practices for Safety and Health Programs, 
https://www.osha.gov/safety-management/hazard-prevention (last 
visited Mar. 18, 2024).
    \102\ On December 29, 2022, President Biden signed the Providing 
Urgent Maternal Protections for Nursing Mothers Act (PUMP Act) (Pub. 
L. 117-328, Div. KK, 136 Stat. 4459, 6093). The law extended 
coverage of the Fair Labor Standards Act of 1938, as amended (FLSA), 
29 U.S.C. 201 et seq., protections for nursing employees to apply to 
most employees. The FLSA provides most employees with the right to 
break time and a place to pump breast milk at work for a year 
following the child's birth. 29 U.S.C. 218d; U.S. Dep't of Lab., 
Field Assistance Bulletin No. 2023-02: Enforcement of Protections 
for Employees to Pump Breast Milk at Work (May 17, 2023), https://www.dol.gov/sites/dolgov/files/WHD/fab/2023-2.pdf; U.S. Dep't of 
Lab., Fact Sheet #73: FLSA Protections for Employees to Pump Breast 
Milk at Work (Jan. 2023), https://www.dol.gov/agencies/whd/fact-sheets/73-flsa-break-time-nursing-mothers. Employees who are not 
covered by the PUMP Act or employees who seek to pump longer than 1 
year may seek reasonable accommodations regarding pumping under the 
PWFA. Further, whether or not employees are covered by the PUMP Act, 
employees may seek under the PWFA any reasonable accommodations 
needed for lactation, including things not necessarily required by 
the PUMP Act such as access to a sink, a refrigerator, and 
electricity. See, e.g., U.S. Dep't of Lab., Notice on Reasonable 
Break Time for Nursing Mothers, 75 FR 80073, 80075-76 (Dec. 21, 
2010) (discussing space requirements and noting factors such as the 
location of the area for pumping compared to the employee's 
workspace, the availability of a sink and running water, the 
location of a refrigerator to store milk, and electricity may affect 
the amount of break time needed). The PUMP Act is enforced by the 
Department of Labor, not the EEOC.

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[[Page 29202]]

     Job restructuring.\103\ Job restructuring might 
involve, for example, removing a marginal function (any nonessential 
job function) that requires a pregnant employee to climb a ladder or 
occasionally retrieve boxes from a supply closet, or providing 
assistance with manual labor.\104\
---------------------------------------------------------------------------

    \103\ See 42 U.S.C. 12111(9)(B); 29 CFR 1630.2(o)(2)(ii).
    \104\ See H.R. Rep. No. 117-27, pt. 1, at 29.
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     Temporarily suspending one or more essential 
function(s). For some positions, this may mean that one or more 
essential function(s) are temporarily suspended, and the employee 
continues to perform the remaining functions of the job. For others, 
the essential function(s) will be temporarily suspended, and the 
employee may be assigned other tasks. For still others, the 
essential function(s) will be temporarily suspended, and the 
employee may perform the functions of a different job to which the 
employer temporarily transfers or assigns them. For yet others, the 
essential function(s) will be temporarily suspended, and the 
employee will participate in the employer's light or modified duty 
program.
     Acquiring or modifying equipment, uniforms, or 
devices.\105\ Examples of reasonable accommodations might include 
providing uniforms and equipment, including safety equipment, that 
account for changes in body size during and after pregnancy, 
including during lactation; providing devices to assist with 
mobility, lifting, carrying, reaching, and bending; or providing an 
ergonomic keyboard to accommodate pregnancy-related hand swelling or 
tendonitis.
---------------------------------------------------------------------------

    \105\ See 42 U.S.C. 12111(9)(B); 29 CFR 1630.2(o)(2)(ii); see 
also H.R. Rep. No. 117-27, pt. 1, at 28.
---------------------------------------------------------------------------

     Adjusting or modifying examinations or policies.\106\ 
Examples of reasonable accommodations include allowing employees 
with a known limitations to postpone examinations that require 
physical exertion. Adjustments to policies also could include 
increasing the time or frequency of breaks to eat or drink or to use 
the restroom.
---------------------------------------------------------------------------

    \106\ See 42 U.S.C. 12111(9)(B); 29 CFR 1630.2(o)(2)(ii); see 
also H.R. Rep. No. 117-27, pt. 1, at 28.
---------------------------------------------------------------------------

    82. Pursuant to 42 U.S.C. 2000gg-3, the following are further 
examples of types of reasonable accommodations and how they can be 
analyzed.\107\
---------------------------------------------------------------------------

    \107\ As with all the examples in this Interpretive Guidance, 
these examples are illustrative only and are not intended to suggest 
that these are the only conditions under which an employee may 
receive a reasonable accommodation, or that the reasonable 
accommodations sought or given in the examples are the only ones 
that should be selected in similar situations.
    For further examples, see the Job Accommodation Network (JAN), 
which provides free assistance regarding workplace accommodation 
issues. See generally Job Accommodation Network [hereinafter JAN], 
https://askjan.org/ (last visited Mar. 25, 2024). Covered entities 
and employees also may seek additional information from the National 
Institute for Occupational Safety and Health (NIOSH). See U.S. Dep't 
of Health & Hum. Servs., Ctrs. for Disease Control & Prevention, 
Nat'l Inst. for Occupational Safety & Health, Reproductive Health 
and The Workplace, https://www.cdc.gov/niosh/topics/repro/default.html (last reviewed May 1, 2023).
---------------------------------------------------------------------------

    Example #26/Telework: Gabriela, a billing specialist in a 
doctor's office, experiences nausea and vomiting beginning in her 
first trimester of pregnancy. Because the nausea makes commuting 
extremely difficult, Gabriela makes a verbal request to her manager 
stating she has nausea and vomiting due to her pregnancy and 
requests that she be permitted to work from home for the next 2 
months so that she can avoid the difficulty of commuting. The 
billing work can be done from her home or in the office.
    1. Known limitation and request for reasonable accommodation: 
Gabriela's nausea and vomiting is a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions; Gabriela needs an adjustment or change 
at work due to the limitation; Gabriela has communicated the 
information to the employer.
    2. Qualified: Gabriela can perform the essential functions of 
the job with the reasonable accommodation of telework.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #27/Temporary Suspension of an Essential Function: 
Nisha, a nurse assistant working in a large elder care facility, is 
advised in the fourth month of her pregnancy to stop lifting more 
than 25 pounds for the remainder of the pregnancy. One of the 
essential functions of the job is to assist patients in dressing, 
bathing, and moving from and to their beds, tasks that typically 
require lifting more than 25 pounds. Nisha sends an email to human 
resources asking that she not be required to lift more than 25 
pounds for the remainder of her pregnancy and requesting a place in 
the established light duty program under which employees who are 
hurt on the job take on different duties while coworkers take on 
their temporarily suspended duties.
    1. Known limitation and request for reasonable accommodation: 
Nisha's lifting restriction is a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions; Nisha needs an adjustment or change at 
work due to the limitation; Nisha has communicated that information 
to the employer.
    2. Qualified: Nisha is asking for the temporary suspension of an 
essential function. The suspension is temporary, and Nisha can 
perform the essential functions of the job ``in the near future'' 
(generally within 40 weeks). It appears that the inability to 
perform the function can be reasonably accommodated through its 
temporary suspension and Nisha's placement in the light duty 
program.
    3. The employer must grant the reasonable accommodation of 
temporarily suspending the essential function (or another reasonable 
accommodation) absent undue hardship. As part of the temporary 
suspension, the employer may assign Nisha to the light duty program.
    Example #28: The scenario is the same as described in Example 
#27 of this appendix, except that the employer establishes that the 
light duty program is limited to 10 slots and all 10 slots are 
filled for the next 6 months. In these circumstances, the employer 
should consider other possible reasonable accommodations, such as 
the temporary suspension of an essential function without assigning 
Nisha to the light duty program, or job restructuring outside of the 
established light duty program. If such accommodations cannot be 
provided without undue hardship, then the employer should consider 
providing a temporary reassignment to a vacant position for which 
Nisha is qualified, with or without reasonable accommodation. For 
example, if the employer has a vacant position that does not require 
lifting patients which Nisha could perform with or without a 
reasonable accommodation, the employer must offer her the temporary 
reassignment as a reasonable accommodation, absent undue hardship.
    Example #29/Temporary Suspension of Essential Function(s): 
Fatima's position as a farmworker usually involves working outdoors 
in the field although there also is indoor work such as sorting 
produce. After she returns from giving birth, Fatima develops 
postpartum thyroiditis, which has made her extremely sensitive to 
heat, and has contributed to muscle weakness and fatigue. She seeks 
the accommodation of a 7-month temporary suspension of the essential 
function of working outdoors in hot weather.
    1. Known limitation and request for reasonable accommodation: 
Fatima's sensitivity to heat, muscle weakness, and fatigue are 
physical or mental conditions related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions; Fatima 
needs an adjustment or change at work due to the limitation; Fatima 
has communicated this information to the employer.
    2. Qualified: Fatima is asking for the temporary suspension of 
an essential function. The suspension is temporary, and Fatima could 
perform the essential functions of the job in the near future (7 
months). It appears that the inability to perform the essential 
function can be reasonably accommodated by temporarily assigning 
Fatima indoor work, such as sorting produce.
    3. The employer must grant the accommodation of temporarily 
suspending the essential function (or another reasonable 
accommodation) absent undue hardship.
    Example #30/Assistance with Performing an Essential Function: 
Mei, a warehouse worker, uses her employer's online accommodation 
portal to ask for a dolly to assist her for 3 months in moving items 
that are bulky, in order to accommodate lifting and carrying 
restrictions due to her cesarean section.
    1. Known limitation and request for reasonable accommodation: 
Mei's lifting and carrying restrictions are physical or mental 
conditions related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions; Mei needs an adjustment 
or change at work due to the limitation; Mei has communicated this 
information to the employer.

[[Page 29203]]

    2. Qualified: Mei can perform the essential functions of the job 
with the reasonable accommodation of a dolly.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #31/Appropriate Uniform and Safety Gear: Ava is a police 
officer and is pregnant. They ask their union representative for 
help getting a larger size uniform and larger size bullet proof vest 
in order to cover their growing pregnancy. The union representative 
asks management for an appropriately-sized uniform and vest for Ava.
    1. Known limitation and request for reasonable accommodation: 
Ava's inability to wear the standard uniform and safety gear is a 
physical or mental condition related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions; Ava needs 
an adjustment or change at work due to the limitation; Ava's 
representative has communicated this information to the employer.
    2. Qualified: Ava can perform the essential functions of the job 
with the reasonable accommodation of appropriate gear.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #32/Temporary Suspension of Essential Function(s): 
Darina is a police officer and is 3 months pregnant. She talks to 
human resources about being taken off of patrol and put on light 
duty for the remainder of her pregnancy to avoid physical 
altercations and the need to physically subdue suspects, which may 
harm her pregnancy. The department has an established light duty 
program that it uses for officers with injuries that occurred on the 
job.
    1. Known limitation and request for reasonable accommodation: 
Darina's inability to perform certain patrol duties is a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions; Darina needs 
an adjustment or change at work due to the limitation; Darina has 
communicated this information to the employer.
    2. Qualified: The suspension of the essential functions of 
patrol duties is temporary, and Darina can perform the essential 
functions of the job in the near future (within generally 40 weeks). 
It appears that the temporary suspension of the essential functions 
can be accommodated through the light duty program.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #33/Temporary Suspension of Essential Function(s): Rory 
works in a fulfillment center where she is usually assigned to a 
line that requires moving 20-pound packages. After returning from 
work after giving birth, Rory lets her supervisor know that she has 
a lifting restriction of 10 pounds due to sciatica during her 
pregnancy that continues postpartum. The restriction is for 6 
months. The employer does not have an established light duty 
program. There are other lines in the warehouse that do not require 
lifting more than 10 pounds.
    1. Known limitation and request for reasonable accommodation: 
Rory's lifting restriction is a physical or mental condition related 
to, affected by, or arising out of pregnancy, childbirth, or related 
medical conditions; Rory needs an adjustment or change at work due 
to the limitation; Rory has communicated this information to the 
employer.
    2. Qualified: The suspension of the essential function of 
lifting packages that weigh up to 10 pounds is temporary, and Rory 
can perform the essential function in the near future (6 months). It 
appears that the temporary suspension of the essential function 
could be accommodated by temporarily assigning her to a different 
line.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #34/Unpaid Leave: Tallah, a newly hired cashier at a 
small bookstore, has a miscarriage in the third month of pregnancy 
and asks a supervisor for 10 days of leave to recover. As a new 
employee, Tallah has only earned 2 days of paid leave, she is not 
covered by the FMLA, and the employer does not have a company policy 
regarding the provision of unpaid leave. Nevertheless, Tallah is 
covered by the PWFA.
    1. Known limitation and request for reasonable accommodation: 
Tallah's need for time for recovery is a physical or mental 
condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions; Tallah needs an 
adjustment or change at work due to the limitation; Tallah has 
communicated this information to the employer.
    2. Qualified: After the reasonable accommodation of leave, 
Tallah will be able to perform the essential functions of the job 
with or without accommodation.
    3. The employer must grant the accommodation of unpaid leave (or 
another reasonable accommodation) absent an undue hardship.
    Example #35/Unpaid Leave for Prenatal Appointments: Margot 
started working at a retail store shortly after she became pregnant. 
She has an uncomplicated pregnancy. Because she has not worked at 
the store very long, she has earned very little leave and is not 
covered by the FMLA. In her fifth month of pregnancy, she asks her 
supervisor for the reasonable accommodation of unpaid time off 
beyond the leave she has earned to attend her regularly scheduled 
prenatal appointments.
    1. Known limitation and request for reasonable accommodation: 
Margot's need to attend health care appointments is a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions; Margot needs 
an adjustment or change at work due to the limitation; Margot has 
communicated the information to the employer.
    2. Qualified: Margot can perform the essential functions of the 
job with the reasonable accommodation of leave to attend health care 
appointments.
    3. The employer must grant the accommodation of unpaid time off 
(or another reasonable accommodation) absent undue hardship.
    Example #36/Unpaid Leave for Recovery from Childbirth: Sofia, a 
custodian, is pregnant and will need 6 to 8 weeks of leave to 
recover from childbirth. Sofia is nervous about asking for leave, so 
Sofia asks her mother, who knows the owner, to do it for her. The 
employer has a sick leave policy, but no policy for longer periods 
of leave. Sofia is not eligible for FMLA leave because her employer 
is not covered by the FMLA.
    1. Known limitation and request for reasonable accommodation: 
Sofia's need to recover from childbirth is a physical or mental 
condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions; Sofia needs an adjustment 
or change at work due to the limitation; Sofia's representative has 
communicated this information to the employer.
    2. Qualified: After the reasonable accommodation of leave, Sofia 
will be able to perform the essential functions of the job with or 
without reasonable accommodation.
    3. The employer must grant the accommodation of unpaid leave (or 
another reasonable accommodation) absent undue hardship.
    Example #37/Unpaid Leave for Medical Appointments: Taylor, a 
newly hired member of the waitstaff, requests time off to attend 
therapy appointments for postpartum depression. As a new employee, 
Taylor has not yet accrued sick or personal leave and is not covered 
by the FMLA. Taylor asks her manager if there is some way that she 
can take time off.
    1. Known limitation and request for reasonable accommodation: 
Taylor's need to attend health care appointments is a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions; Taylor needs 
an adjustment or change at work due to the limitation; Taylor has 
communicated this information to the employer.
    2. Qualified: Taylor can perform the essential functions of the 
job with a reasonable accommodation of time off to attend the health 
care appointments.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent an undue hardship.
    Example #38/Unpaid Leave: Claudine is 6 months pregnant and asks 
for leave so that she can attend her regular check-ups. The clinic 
where Claudine gets her health care is an hour drive away, the 
clinic frequently gets delayed, and Claudine has to wait for her 
appointment. Depending on the time of day, between commuting to the 
appointment, waiting for the appointment, and seeing her provider, 
Claudine may miss all or most of an assigned day at work. Claudine's 
employer is not covered by the FMLA, and Claudine does not have any 
sick leave left. Claudine asks human resources for time off as a 
reasonable accommodation so she can attend her medical appointments.
    1. Known limitation and request for reasonable accommodation: 
Claudine's need to attend health care appointments is a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions; Claudine needs 
an adjustment or change at work due to the limitation; Claudine has 
communicated that information to the employer.

[[Page 29204]]

    2. Qualified: Claudine can perform the essential functions of 
the job with a reasonable accommodation of time off to attend health 
care appointments.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #39/Telework: Raim, a social worker, is pregnant. As her 
third trimester starts, she is feeling more fatigue and needs more 
rest. She asks her supervisor if she can telework and see clients 
virtually so she can lie down and take rest breaks between client 
appointments.
    1. Known limitation and request for reasonable accommodation: 
Raim's fatigue is a physical or mental condition related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions; Raim needs an adjustment or change at work due 
to the limitation; Raim has communicated that information to the 
employer.
    2. Qualified: Assuming the appointments can be conducted 
virtually, Raim can perform the essential functions of the job with 
the reasonable accommodation of working virtually. If there are 
certain appointments that must be done in person, the reasonable 
accommodation could be a few days of telework a week and then other 
accommodations that would give Raim time to rest, such as assigning 
Raim in-person appointments at times when traffic will be light so 
that they are easy to get to, or setting up Raim's assignments so 
that on the days when she has in-person appointments she has breaks 
between them. Or the reasonable accommodation can be the temporary 
suspension of the essential function of in-person appointments.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #40/Temporary Workspace/Possible Temporary Suspension of 
Essential Function(s): Brooke, a research assistant who is in her 
first trimester of pregnancy, asks the lead researcher in the 
laboratory for a temporary workspace that would allow her to work in 
a well-ventilated area because her work involves hazardous chemicals 
that her health care provider has told her to avoid. There are 
several research projects she can work on that do not involve 
exposure to hazardous chemicals.
    1. Known limitation and request for reasonable accommodation: 
Brooke's need to avoid the chemicals related to maintaining her 
health or the health of her pregnancy is a physical or mental 
condition related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions; Brooke needs an 
adjustment or change at work due to the limitation; Brooke has 
communicated this information to the employer.
    2. Qualified: If working with hazardous chemicals is an 
essential function of the job, Brooke may be able to perform that 
function with the accommodation of a well-ventilated work area, a 
chemical fume hood, local exhaust ventilation, and/or personal 
protective equipment such as chemical-resistant gloves, a lab coat, 
and a powered air-purifying respirator. If providing these 
modifications would be an undue hardship or would not be effective, 
Brooke can still be qualified with the temporary suspension of the 
essential function of working with the hazardous chemicals because 
Brooke's inability to work with hazardous chemicals is temporary, 
and Brooke can perform the essential functions of the job in the 
near future (within generally 40 weeks). Her need to avoid exposure 
to hazardous chemicals also can be accommodated by allowing her to 
focus on the other research projects.
    3. The employer must grant the accommodation (or another 
reasonable accommodation), absent undue hardship. If the employer 
cannot accommodate Brooke in a way that allows Brooke to continue to 
perform the essential function(s) of the position, the employer 
should consider providing alternative reasonable accommodations, 
including temporarily suspending one or more essential functions, 
absent undue hardship.
    Example #41/Temporary Transfer to Different Location: Katherine, 
a budget analyst who has cancer also is pregnant, which creates 
complications for her cancer treatment. She asks her manager for a 
temporary transfer so that she can work out of an office in a larger 
city that has a medical center that can address her medical needs 
due to the combination of cancer and pregnancy. Katherine is able to 
do all her essential functions for the original office from the 
employer's other location and can continue to work full-time while 
obtaining treatment.
    1. Known limitation and request for reasonable accommodation: 
Katherine's need for treatment at a particular medical facility 
related to maintaining her health or the health of the pregnancy is 
a physical or mental condition related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions; 
Katherine needs an adjustment or change at work due to the 
limitation; Katherine has communicated that information to the 
employer.
    2. Qualified: Katherine is able to perform the essential 
functions of the job and work full-time with the reasonable 
accommodation of a temporary transfer to a different location.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship. A reasonable 
accommodation can include a workplace change to facilitate medical 
treatment, including accommodations such as leave, a schedule 
change, or a temporary transfer to a different work location needed 
in order to obtain treatment.
    Example #42/Pumping Breast Milk: Salma gave birth 13 months ago 
and wants to be able to pump breast milk at work. Salma works for an 
employment agency that sends her to different jobs for a day or week 
at a time. Salma asks the person at the agency who makes her 
assignments to ensure she will be able to take breaks and have a 
space to pump breast milk at work at her various assignments.
    1. Known limitation and request for reasonable accommodation: 
Salma's need to express breast milk is a physical or mental 
condition related to, affected by, or arising out pregnancy, 
childbirth, or related medical conditions; Salma needs an adjustment 
or change at work due to the limitation; Salma has communicated this 
information to the employer.
    2. Qualified: Salma is able to perform the essential functions 
of the jobs to which she is assigned with the reasonable 
accommodation of being assigned to workplaces where she can pump at 
work.
    3. The agency must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #43/Commuting: Jayde is a retail clerk who gave birth 2 
months ago. Because of childbirth, Jayde is experiencing urinary 
incontinence, constipation, and hemorrhoids. Jayde normally commutes 
by driving 45 minutes; because of the limitations due to childbirth, 
it is painful for Jayde to sit in one position for an extended 
period, and Jayde may need a bathroom during the commute. Jayde 
requests the reasonable accommodation of working at a different, 
closer store for 2 months. The commute to this other store is only 
10 minutes.
    1. Known limitation and request for reasonable accommodation: 
Jayde's urinary incontinence, constipation, and hemorrhoids are 
physical or mental conditions related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions; Jayde 
needs an adjustment or change at work due to the limitation; Jayde 
has communicated this information to the employer.
    2. Qualified: Jayde can perform the essential functions of the 
job with the reasonable accommodation of a temporary assignment to a 
different location.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.
    Example #44/Medications Affected by Pregnancy: Riya is a data 
analyst who is pregnant, and her health care provider recommended 
that she stop taking her current ADHD medication and switch to 
another medication. As Riya is adjusting to her new medication, she 
finds it more difficult to concentrate and asks for more frequent 
breaks, a quiet place to work, and for her tasks to be divided up 
into smaller duties.
    1. Known limitation and request for reasonable accommodation: 
Riya's difficulty concentrating due to her change in medication is a 
physical or mental condition related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions; Riya needs 
an adjustment or change at work due to the limitation; Riya has 
provided this information to the employer.
    2. Qualified: Riya can perform the essential functions of the 
job with the reasonable accommodation of more frequent breaks, a 
quiet place to work, and division of her tasks into smaller duties.
    3. The employer must grant the accommodation (or another 
reasonable accommodation) absent undue hardship.

1636.3(j) Undue Hardship

1636.3(j)(1) Undue Hardship--In General

    83. The PWFA provides that ``undue hardship'' shall be construed 
under the

[[Page 29205]]

PWFA as it is under the ADA and as set forth in this part.\108\ This 
part, at Sec.  1636.3(j)(1), reiterates the definition of undue 
hardship provided in the ADA statute and regulation, which explains 
that undue hardship means significant difficulty or expense incurred 
by a covered entity.\109\ Because the definition of undue hardship 
under the PWFA follows the ADA, under the PWFA the term ``undue 
hardship'' means significant difficulty or expense in, or resulting 
from, the provision of the accommodation. The ``undue hardship'' 
provision takes into account the financial realities of the 
particular employer or other covered entity. However, the concept of 
undue hardship is not limited to financial difficulty. ``Undue 
hardship'' refers to any accommodation that would be unduly costly, 
extensive, substantial, or disruptive, or that would fundamentally 
alter the nature or operation of the business.\110\
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    \108\ 42 U.S.C. 2000gg(7).
    \109\ 42 U.S.C. 12111(10)(A); 29 CFR 1630.2(p); see Enforcement 
Guidance on Reasonable Accommodation, supra note 12, at text after 
n.112.
    \110\ See 29 CFR part 1630, appendix, 1630.2(p). The ADA defines 
``undue hardship'' at 42 U.S.C. 12111(10).
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    84. As under the ADA, if an employer asserts undue hardship 
based on cost, then there will be a determination made regarding 
whose financial resources should be considered.\111\ Further, in 
determining whether an accommodation causes an undue hardship an 
employer cannot simply assert that a needed accommodation will cause 
it undue hardship and thereupon be relieved of the duty to provide 
accommodation. Rather, an employer will have to present evidence and 
demonstrate that the accommodation will, in fact, cause it undue 
hardship. Whether a particular accommodation will impose an undue 
hardship for a particular employer is determined on a case-by-case 
basis. Consequently, an accommodation that poses an undue hardship 
for one employer at a particular time may not pose an undue hardship 
for another employer, or even for the same employer at another 
time.\112\
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    \111\ See 29 CFR part 1630, appendix, 1630.2(p).
    \112\ See 29 CFR part 1630, appendix, 1630.15(d).
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    85. As the Commission has stated under the ADA, ``[u]ndue 
hardship must be based on an individualized assessment of current 
circumstances that show that a specific reasonable accommodation 
would cause significant difficulty or expense.'' \113\
---------------------------------------------------------------------------

    \113\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at text accompanying n.113.
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    86. Additionally, an employer cannot demonstrate undue hardship 
based on employees', clients', or customers' fears or prejudices 
toward the employee's pregnancy, childbirth, or related medical 
conditions, nor can an employer demonstrate undue hardship based on 
the possibility that the provision of an accommodation would 
negatively impact the morale of other employees.\114\ Employers, 
however, may be able to show undue hardship where the provision of 
an accommodation would be unduly disruptive to other employees' 
ability to work.
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    \114\ See 29 CFR part 1630, appendix, 1630.15(d) (explaining 
that under the ADA an employer cannot show undue hardship based on 
employees' fears or prejudices toward the individual's disability or 
by showing that the provision of the accommodation has a negative 
impact on the morale of its other employees but not on the ability 
of these employees to perform their jobs); Enforcement Guidance on 
Reasonable Accommodation, supra note 12, at text surrounding n.117; 
cf. Groff v. DeJoy, 600 U.S. 447, 472 (2023) (providing that, under 
the Title VII undue hardship standard, an employer may not justify 
refusal to accommodate based on other employees' bias or hostility).
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    87. Consistent with the ADA, a covered entity asserting that a 
reasonable accommodation will cause an undue hardship must offer 
other reasonable accommodations that it can provide, absent undue 
hardship.\115\ Additionally, if the employer can provide only part 
of the reasonable accommodation absent undue hardship--for example, 
the employer can provide 6 weeks of leave absent undue hardship but 
the 8 weeks that the employee is seeking would cause undue 
hardship--the employer must provide the reasonable accommodation up 
to the point of undue hardship. Thus, in the example, the employer 
would have to provide 6 weeks of leave and then consider whether 
there are other reasonable accommodations it could provide for the 
remaining 2 weeks that would not cause an undue hardship.
---------------------------------------------------------------------------

    \115\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at text after n.116.
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1636.3(j)(2) Undue Hardship Factors

    88. Section 1636.3(j)(2) sets out factors to be considered when 
determining whether a particular accommodation would impose an undue 
hardship on the covered entity using the factors from the ADA 
regulation.\116\
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    \116\ See 29 CFR 1630.2(p).
---------------------------------------------------------------------------

    89. Examples Regarding Undue Hardship:
    Example #45/Undue Hardship: Patricia, a convenience store clerk, 
requests that she be allowed to switch from full-time to part-time 
work for the last 3 months of her pregnancy due to extreme fatigue. 
The store assigns two clerks per shift. If Patricia's hours are 
reduced, the other clerk's workload will increase significantly 
beyond his ability to handle his responsibilities. The store 
determines that such an arrangement will result in inadequate 
coverage to serve customers in a timely manner, keep the shelves 
stocked, and maintain store security. It also would be infeasible 
for the store to hire a temporary worker on short notice at this 
time. Based on these facts, the employer likely can show undue 
hardship based on the significant disruption to its operations and, 
therefore, can refuse to reduce Patricia's hours. The employer, 
however, must offer other reasonable accommodations, such as 
providing a stool and allowing rest breaks throughout the shift, 
assuming they do not cause undue hardship.
    Example #46/Undue Hardship: Shirin, a dental hygienist who is 
undergoing IVF treatments, needs to attend medical appointments for 
the IVF treatment near her house every other day and is fatigued. 
She asks her supervisor if the essential function of seeing patients 
can be temporarily suspended, so that she does not see patients 3 
days a week and instead can work from home on those days assisting 
with billing and insurance claims, work for which she is qualified. 
Temporarily suspending the essential function of seeing patients and 
allowing Shirin to work at home may be an undue hardship for the 
employer because there is only one other hygienist and there is not 
enough work for Shirin to do remotely. However, the employer must 
offer other reasonable accommodations, such as a schedule that would 
allow Shirin breaks between patients, part-time work, permitting her 
to work from home for 1 or 2 days, or a reduced schedule, assuming 
they do not cause undue hardship.
    Example #47/Undue Hardship: Cynthia, an office manager working 
in a large building, has asthma that she controls with medication. 
Because of her pregnancy, her asthma becomes worse, and she requests 
a ban on airborne irritants and chemicals (e.g., fragrances, sprays, 
cleaning products) in the building. The employer could potentially 
show that ensuring a workplace completely free of any scents or 
irritants would impose a significant financial and administrative 
burden on it, as a ban would be difficult to enforce and encompass a 
wide variety of hygiene and cleaning products. Nevertheless, the 
employer must offer alternative accommodations, such as providing an 
air purifier, minimizing the use of irritants in her vicinity, or 
allowing her to telework, assuming they do not cause undue hardship.

1636.3(j)(3) Undue Hardship--Temporary Suspension of an Essential 
Function(s)

    90. In certain circumstances, the PWFA requires an employer to 
accommodate an employee's temporary inability to perform one or more 
essential functions. Therefore, Sec.  1636.3(j)(3) provides 
additional factors that may be considered when determining whether 
the temporary suspension of one or more essential functions causes 
an undue hardship. These additional factors include: the length of 
time that the employee will be unable to perform the essential 
function(s); whether, through the methods listed in Sec.  
1636.3(f)(2)(iii) (describing potential reasonable accommodations 
related to the temporary suspension of essential function(s)) or 
otherwise, there is work for the employee to accomplish; \117\ the 
nature of the essential function(s), including its frequency; 
whether the covered entity has provided other employees in similar 
positions who are unable to perform essential function(s) of their 
positions with temporary suspensions of those function(s) and other 
duties; if necessary, whether or not there are other employees, 
temporary employees, or third parties who can perform or be 
temporarily hired to perform the essential function(s) in question; 
and whether the essential function(s) can be postponed or remain 
unperformed for any length of time and, if so, for how long.
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    \117\ The employer is not required to make up work for an 
employee.
---------------------------------------------------------------------------

    91. As with other reasonable accommodations, if the covered 
entity can establish that accommodating an employee's temporary 
suspension of an essential function(s) would impose an undue 
hardship

[[Page 29206]]

if extended beyond a certain period of time, the covered entity 
would only be required to provide that accommodation for the period 
of time that it does not impose an undue hardship. For example, 
consider the situation where an employee seeks to have an essential 
function suspended for 6 months. The employer can go without the 
function being accomplished for 4 months, but after that, it will 
create an undue hardship. The employer must accommodate the 
employee's inability to perform the essential function for 4 months 
and then consider whether there are other reasonable accommodations 
that it can provide, absent undue hardship, for the remaining time.
    92. Section 1636.3(j)(3)(iv) is intended to account for 
situations where the covered entity has provided a similar 
accommodation to other employees. If the covered entity has 
temporarily suspended essential functions for other employees in 
similar positions before, it would tend to demonstrate that the 
accommodation is not an undue hardship. The reverse, however, is not 
true. A covered entity's failure to temporarily suspend an essential 
function(s) in the past does not tend to demonstrate that the 
accommodation creates an undue hardship because reasonable 
accommodation can include changing workplace procedures or rules.

1636.3(j)(4) Undue Hardship--Predictable Assessments 118
---------------------------------------------------------------------------

    \118\ The term ``predictable assessments'' also is seen in the 
ADA regulations, where it applies to establishing coverage. In the 
ADA, ``predictable assessments'' are impairments that will ``in 
virtually all cases'' be considered a disability covered by the ADA. 
29 CFR 1630.2(j)(3). As used in this PWFA rule, however, the term 
relates to accommodations, not limitations or disabilities.
---------------------------------------------------------------------------

    93. The Commission has identified a limited number of simple 
modifications that will, in virtually all cases, be found to be 
reasonable accommodations that do not impose an undue hardship when 
requested by a qualified employee due to pregnancy.
    94. These modifications are: (1) allowing an employee to carry 
or keep water near and drink, as needed; (2) allowing an employee to 
take additional restroom breaks, as needed; (3) allowing an employee 
whose work requires standing to sit and whose work requires sitting 
to stand, as needed; and (4) allowing an employee to take breaks to 
eat and drink, as needed.\119\ These accommodations are low cost and 
unlikely to affect the overall financial resources of the covered 
entity, the operations of the facility, or the ability of the 
facility to conduct business.\120\ By identifying these predictable 
assessments, the Commission seeks to improve how quickly employees 
will be able to receive certain simple, common accommodations for 
pregnancy under the PWFA and thereby reduce litigation.
---------------------------------------------------------------------------

    \119\ The first and fourth categories of predictable assessments 
are related but separate. The first category of accommodations 
addresses an employee's ability to carry water on the employee's 
person while they perform their job duties, or their ability to have 
water nearby while working, without requiring the employee to take a 
break to access and drink it. The fourth category of accommodations 
addresses an employee's ability to take additional, short breaks in 
performing work (either at the employee's work location or a break 
location) to eat and drink (including beverages that are not water). 
Additionally, depending on the worksite, any employee may be able to 
eat or drink at the work location without taking a break.
    \120\ As explained in the NPRM, the Commission identified these 
modifications based on the legislative history of the PWFA and 
analogous State laws. 88 FR 54734.
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    95. The Commission emphasizes that the predictable assessments 
provision does not alter the meaning of the term ``reasonable 
accommodation'' or ``undue hardship.'' Employers should still 
conduct an individualized assessment when one of these 
accommodations is requested by a pregnant employee to determine if 
the requested accommodation causes an undue hardship, and employers 
may still bring forward facts to demonstrate that the proposed 
accommodation imposes an undue hardship for its business under its 
own particular circumstances. Instead, the provision informs covered 
entities that the individualized assessment of whether one of the 
straightforward and simple modifications listed in paragraphs 
(j)(4)(i) through (iv) is a reasonable accommodation that would 
cause undue hardship will, in virtually all cases, result in a 
determination that the four modifications are reasonable 
accommodations that will not impose an undue hardship under the PWFA 
when they are requested as workplace accommodations by an employee 
who is pregnant.
    96. Examples Regarding Predictable Assessments:
    Example #48/Predictable Assessments: Amara, a quality inspector 
for a manufacturing company, experiences painful swelling in her 
legs, ankles, and feet during the final 3 months of her pregnancy. 
Her job requires standing for long periods of time, although it can 
be performed sitting as well. Amara asks the person who assigns her 
daily work for a stool to sit on while she performs her job. Amara's 
swelling in her legs and ankles is a physical or mental condition 
related to, affected by, or arising out of pregnancy. Amara's 
request is for a modification that will virtually always be a 
reasonable accommodation that does not impose an undue hardship. The 
employer argues that it has never provided a stool to any other 
worker who complained of difficulty standing, but points to nothing 
that suggests that this modification is not reasonable or that it 
would impose an undue hardship on the operation of the employer's 
business. The employer has not established that providing Amara a 
stool imposes an undue hardship.
    Example #49/Predictable Assessments: Jazmin, a pregnant teacher 
who typically is only able to use the bathroom when her class is at 
lunch, requests additional bathroom breaks during her sixth month of 
pregnancy. Jazmin's need for additional bathroom breaks is a 
physical or mental condition related to, affected by, or arising out 
of pregnancy. The employer argues that finding an adult to watch 
over the Jazmin's class when she needs to take a bathroom break 
imposes an undue hardship. However, there are several teachers in 
nearby classrooms, aides in some classes, and an administrative 
assistant in the front office, any of whom, with a few minutes' 
notice, would be able to provide supervision either by standing in 
the hallway between classes or sitting in Jazmin's classroom to 
allow Jazmin a break to use bathroom. The employer has not 
established that providing Jazmin with additional bathroom breaks 
imposes an undue hardship.
    Example #50/Predictable Assessments: Addison, a clerk 
responsible for receiving and filing construction plans for 
development proposals, needs to maintain a regular intake of water 
throughout the day to maintain a healthy pregnancy. They ask their 
manager if an exception can be made to the office policy prohibiting 
liquids at workstations. Addison's need to maintain a regular intake 
of water is a physical or mental condition related to, affected by, 
or arising out of pregnancy. Here, although the manager decides 
against allowing Addison to bring water into their workstation, he 
proposes that a table be placed just outside the workstation and 
gives permission for Addison to access water placed on the table as 
needed. The employer has satisfied its obligation to provide a 
reasonable accommodation.

Undue Hardship--Consideration of Prior or Future Accommodations

    97. An employer may consider the current impact of past and 
current cumulative costs or burdens of accommodations that have 
already been granted to other employees or the same employee, when 
considering whether a new request for the same or a similar 
accommodation imposes an undue hardship. For example, where an 
employer is already allowing two of the three employees who are able 
to open the store to arrive after opening time on certain days, it 
could pose an undue hardship to grant the accommodation of a delayed 
arrival time to the third employee on those same days.
    98. The fact that an employer has provided the same or similar 
accommodations in the past may indicate that the accommodation can 
be provided without causing an undue hardship. Additionally, even if 
an employer previously failed to provide an employee a similar type 
of accommodation, if the employer intends to assert that providing 
the accommodation to another employee would pose an undue hardship, 
the employer should engage in the interactive process with the 
employee regarding the currently requested accommodation and 
determine whether the same conditions that previously imposed an 
undue hardship still exist. Ultimately, whether a particular 
accommodation will impose an undue hardship for an employer is 
determined on a case-by-case basis.
    99. While an employer may consider the impact of prior 
accommodations granted to the employee currently seeking an 
accommodation, the mere fact that an employee previously received an 
accommodation or, indeed, several accommodations, does not establish 
that it would impose an undue hardship on the employer to grant a 
new accommodation.
    100. Thus, for example, the fact that an employer already has 
provided an employee with an accommodation, such as the

[[Page 29207]]

temporary suspension of an essential function due to their 
pregnancy, does not establish that providing this accommodation due 
to a post-pregnancy limitation would be an undue hardship. Instead, 
the employer would have to provide evidence showing that continuing 
the temporary suspension would impose an undue hardship. This 
showing could include, for example, evidence demonstrating why and 
how the cumulative impact of having already provided the 
accommodation during pregnancy makes the current impact of providing 
it post-pregnancy rise to the level of significant difficulty or 
expense.
    101. A covered entity cannot demonstrate that a reasonable 
accommodation imposes an undue hardship based on the possibility--
whether speculative or near certain--that it will have to provide 
the accommodation to other employees in the future.\121\ Relatedly, 
a covered entity that receives numerous requests for the same or 
similar accommodations at the same time (for example, parking spaces 
closer to the factory) cannot fail to provide all of them simply 
because processing the volume of current or anticipated requests is, 
or would be, burdensome or because it cannot grant all of them. 
Rather, the covered entity must evaluate and provide reasonable 
accommodations on a case-by-case basis unless, or until, doing so 
imposes an undue hardship.
---------------------------------------------------------------------------

    \121\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at n.113.
---------------------------------------------------------------------------

    102. Finally, for the purposes of an employer asserting undue 
hardship based on the impact of prior or future accommodations, as 
with any assertion of an undue hardship, ``[g]eneralized conclusions 
will not suffice to support a claim of undue hardship. Instead, 
undue hardship must be based on an individualized assessment of 
current circumstances that show that a specific reasonable 
accommodation would cause significant difficulty or expense.'' \122\
---------------------------------------------------------------------------

    \122\ See id., text at n.113.
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Undue Hardship and Safety

    103. An employer's contention that the accommodation an employee 
requests would cause a safety risk to co-workers or clients will be 
assessed under the PWFA's undue hardship standard. For example, 
consider a qualified pregnant employee in a busy fulfillment center 
that has narrow aisles between the shelves of products. The employee 
asks for the reasonable accommodation of a cart to use while they 
are walking through the aisles filling orders. The employer's 
assertion that the aisles are too narrow and its concern for the 
safety of other workers being bumped by the cart could be raised as 
a defense based on undue hardship, specifically Sec.  
1636.3(j)(2)(v), but the employer will have to demonstrate that the 
accommodation would actually pose an undue hardship.
    104. If a particular reasonable accommodation causes an undue 
hardship because of safety, just as with any other situation where 
an employer cannot provide the requested accommodation, the employer 
must provide an alternative reasonable accommodation, if there is 
one available that does not impose an undue hardship. Importantly, 
assertions by employers that employees create a safety risk merely 
by being pregnant (as opposed to a safety risk that stems from an 
accommodation for a pregnancy-related limitation) should be 
addressed under Title VII's bona fide occupational qualification 
(BFOQ) standard and not under the PWFA.\123\
---------------------------------------------------------------------------

    \123\ See, e.g., UAW v. Johnson Controls, 499 U.S. 187, 211 
(1991) (striking down the employer's fetal protection policy that 
limited the opportunities of women); Everts v. Sushi Brokers LLC, 
247 F. Supp. 3d 1075, 1082-83 (D. Ariz. 2017) (relying on Johnson 
Controls and denying BFOQ defense in a case regarding a pregnant 
employee as a restaurant server, noting that, ``[u]nlike cases 
involving prisoners and dangers to customers where a BFOQ defense 
might be colorable, the present situation is exactly the type of 
case that Title VII guards against''); EEOC v. New Prime, Inc., 42 
F. Supp. 3d 1201, 1213-14 (W.D. Mo. 2014) (relying on Johnson 
Controls and denying a policy allegedly in place for the ``privacy'' 
and ``safety'' of women employees was a BFOQ); Enforcement Guidance 
on Pregnancy Discrimination, supra note 24, at (I)(B)(1)(c).
---------------------------------------------------------------------------

1636.3(k) Interactive Process

    105. The PWFA states that the interactive process will typically 
be used to determine an appropriate reasonable accommodation.\124\ 
Section 1636.3(k) largely adopts the explanation of the interactive 
process in the regulation implementing the ADA.\125\ Section 
1636.3(k) defines the interactive process as an informal, 
interactive process and states that the process should identify the 
known limitation and the adjustment or change at work that is needed 
due to the limitation, if either of these are not clear from the 
request, as well as potential reasonable accommodations.
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    \124\ 42 U.S.C. 2000gg(7).
    \125\ See 29 CFR 1630.2(o)(3).
---------------------------------------------------------------------------

    106. There are no rigid steps that must be followed when 
engaging in the interactive process under the PWFA, and information 
provided by the employee does not need to be in any specific format, 
include specific words, or be on a specific form.
    107. In many instances, the appropriate reasonable accommodation 
may be obvious to either or both the employer and the employee with 
the known limitation so that the interactive process can be a brief 
discussion. The request and granting of the accommodation can occur 
in a single informal conversation or short email exchange.\126\
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    \126\ 42 U.S.C. 2000gg-1(2) (Sec.  1636.4(b)) prohibits a 
covered entity from requiring a qualified employee with a PWFA 
limitation to accept an accommodation other than any reasonable 
accommodation arrived at through the interactive process.
---------------------------------------------------------------------------

    108. Examples Regarding the Interactive Process:
    Example #51/Interactive Process: Marge works at an assembly 
plant. She is 5 weeks pregnant. She knows that staying hydrated is 
important during pregnancy. She texts her supervisor that she is 
pregnant and that she needs to carry water with her and use the 
bathroom more frequently. Her supervisor explains how Marge can call 
for a substitute when she needs a break, and Marge uses that system 
when she needs to drink water or go to the bathroom.
    Example #52/Interactive Process: Launa is a customer service 
representative. She is 6 weeks pregnant. Some mornings she has 
morning sickness. She has found that eating small amounts during the 
morning helps to control it. Launa uses the company's internal 
message system to tell her supervisor that she is pregnant and 
either needs to take breaks to eat or needs to eat in her cubicle, 
and that she may need a break if she is feeling nauseous. Her 
supervisor agrees.
    109. In some instances, for example to determine an appropriate 
reasonable accommodation, the employer and employee may engage 
further in the interactive process. The process is not composed of 
rigid steps but is an opportunity for the covered entity and 
employee to participate in a dialogue to quickly identify a 
reasonable accommodation that enables the employee to address their 
limitation through a reasonable accommodation that does not pose an 
undue hardship. The interactive process also may provide an 
opportunity for the covered entity and the employee to discuss how 
different accommodations will provide the employee with equal 
employment opportunity and what accommodation the employee 
prefers.\127\
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    \127\ During the interactive process, especially if it is 
lengthened due to, for example, equipment being ordered or the 
employee waiting for information from or an appointment with a 
health care provider, the employer should determine how to address 
the employee's needs while the interactive process is ongoing. See, 
e.g., Enforcement Guidance on Reasonable Accommodation, supra note 
12, at n.89 (discussing a situation when the employee is waiting for 
reassignment). The Commission has discussed a similar situation with 
regard to postponing an employee's evaluation pending the employee 
receiving a requested reasonable accommodation. EEOC, Technical 
Assistance on Applying Performance and Conduct Standards to 
Employees with Disabilities, Examples 8 & 11 (2008) https://www.eeoc.gov/laws/guidance/applying-performance-and-conduct-standards-employees-disabilities. See also supra in the Interpretive 
Guidance in section 1636.3(h) under Interim Reasonable 
Accommodations.
---------------------------------------------------------------------------

    110. While the interactive process is an informal exchange of 
information, there are still certain rules that apply. The ADA 
restrictions on when employers are permitted to ask disability-
related questions and require medical examinations apply to all such 
inquiries or examinations, whether employers make them of people 
with or without disabilities, including questions that an employer 
asks during the interactive process under the PWFA.\128\ For 
example, an employer who requires an employee who requests an 
accommodation due to a pregnancy-related limitation to fill out a 
form identifying their physical and mental impairments would have 
difficulty demonstrating that this disability-related inquiry is 
job-related and consistent with business necessity, as required by 
the ADA.\129\ Further, if a covered entity has sufficient 
information from the employee to determine whether they have a PWFA 
limitation and need an adjustment or change at work due to the 
limitation, requiring the

[[Page 29208]]

employee to provide additional information could be a violation of 
the PWFA's anti-retaliation provision (42 U.S.C. 2000gg-2(f)) (Sec.  
1636.5(f)) or the PWFA's prohibition on taking adverse action in 
response to a request for reasonable accommodation (42 U.S.C. 
2000gg-1(5)) (Sec.  1636.4(e)). If an employer decides to seek 
supporting documentation in response to a request for a PWFA 
reasonable accommodation, the restrictions limiting supporting 
documentation set forth in Sec.  1636.3(l) apply. Finally, any 
medical information obtained during the interactive process under 
the PWFA must be maintained on separate forms and in separate 
medical files and be treated as a confidential medical record, in 
accordance with the ADA's rules on the confidentiality of medical 
information, as explained in section 1636.7(a)(1) of this appendix 
under Prohibition on Disability-Related Inquiries and Medical 
Examinations and Protection of Medical Information. Of particular 
relevance to the PWFA, the fact that an employee is pregnant, has 
recently been pregnant, or has a medical condition related to 
pregnancy or childbirth is medical information. Similarly, 
disclosing that an employee is receiving or has requested an 
accommodation under the PWFA or has limitations for which they 
requested or are receiving a reasonable accommodation under the 
PWFA, usually amounts to a disclosure that the employee is pregnant, 
has recently been pregnant, or has a related medical condition.
---------------------------------------------------------------------------

    \128\ See 42 U.S.C. 12112(d); 29 CFR 1630.13, 1630.14.
    \129\ 42 U.S.C. 12112(d)(4)(A); 29 CFR 1630.14(c).
---------------------------------------------------------------------------

Recommendations for an Interactive Process

    111. Appropriate reasonable accommodations are best determined 
through a flexible interactive process that includes both the 
employer and the employee with the known limitation. Employers and 
employees may use some of the steps noted in paragraph 112 of this 
section, if warranted, to address requests for reasonable 
accommodations under the PWFA, but the Commission emphasizes that, 
as under the ADA, a covered entity and an employee do not have to 
complete all or even some of these steps. The Commission expects 
that typically a simple conversation will be sufficient for 
employers to obtain all the information needed to determine the 
appropriate reasonable accommodation. As with the ADA, a covered 
entity should respond expeditiously to a request for reasonable 
accommodation and act promptly to provide the reasonable 
accommodation.\130\
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    \130\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at Question 10. Following the steps laid out for the 
interactive process is not a defense to liability if the employer 
fails to provide a reasonable accommodation that it could have 
provided absent undue hardship.
---------------------------------------------------------------------------

    112. If an employer has not obtained enough information to 
determine the appropriate reasonable accommodation through the 
initial request or a simple conversation or email exchange, the 
flexible interactive process may continue. For example, when an 
employee with a known limitation has requested a reasonable 
accommodation regarding the performance of the essential functions 
of the job, the covered entity, using a problem-solving approach, 
may, as needed:
    a. Analyze the particular job involved and determine its purpose 
and essential functions;
    b. Consult with the employee with a known limitation to 
ascertain what kind of accommodation is necessary given the known 
limitation;
    c. In consultation with the employee with the known limitation, 
identify potential accommodations and assess the effectiveness each 
would have in enabling the employee to perform the essential 
functions of the position. If the employee's limitation means that 
they are temporarily unable to perform one or more essential 
functions of the position, the parties also must consider whether 
suspending the performance of one or more essential functions may be 
a part of the reasonable accommodation if the known limitation is 
temporary and the employee could perform the essential function(s) 
in the near future; and
    d. Consider the preference of the employee to be accommodated 
and select and implement the accommodation that is most appropriate 
for both the employee and the covered entity.\131\
---------------------------------------------------------------------------

    \131\ See 29 CFR part 1630, appendix, 1630.9.
---------------------------------------------------------------------------

    113. Steps (b) to (d) outlined in paragraph 112 of this section 
can be adapted and applied to requests for reasonable accommodations 
related to the application process and to benefits and privileges of 
employment. In those situations, in step (c), the consideration 
should be how to enable the applicant with a known limitation to be 
considered for the position in question or how to provide an 
employee with a known limitation with the ability to enjoy equal 
benefits and privileges of employment.
    114. In some instances, neither the employee requesting the 
accommodation nor the covered entity may be able to readily identify 
an appropriate accommodation. For example, an applicant needing an 
accommodation may not know enough about the equipment used by the 
covered entity or the exact nature of the work site to suggest an 
appropriate accommodation. Likewise, the covered entity may not know 
enough about an employee's known limitation and its effect on the 
performance of the job to suggest an appropriate accommodation. In 
these situations, the steps in paragraph 112 of this section may be 
helpful as part of the employer's reasonable effort to identify the 
appropriate reasonable accommodation. In addition, parties may 
consult outside resources such as State or local entities, non-
profit organizations, or the Job Accommodation Network (JAN) for 
ideas regarding potential reasonable accommodations.\132\
---------------------------------------------------------------------------

    \132\ See JAN, supra note 107. See also U.S. Dep't of Lab., 
Occupational Safety & Health Admin., Ergonomics-Solutions to Control 
Hazards, https://www.osha.gov/ergonomics/control-hazards (last 
visited Apr. 3, 2024); U.S. Dep't of Health & Hum. Servs., Ctrs. for 
Disease Control & Prevention, Nat'l Inst. for Occupational Safety & 
Health, Reproductive Health and The Workplace, https://www.cdc.gov/niosh/topics/repro/ (last reviewed May 1, 2023).
---------------------------------------------------------------------------

Engaging in the Interactive Process

    115. A covered entity's failure to engage in the interactive 
process, in and of itself, is not a violation of the PWFA, just as 
it is not a violation of the ADA. However, a covered entity's 
failure to initiate or participate in the interactive process with 
the employee after receiving a request for reasonable accommodation 
could result in liability if the employee does not receive a 
reasonable accommodation even though one is available that would not 
have posed an undue hardship.\133\ Relatedly, an employee's 
unilateral withdrawal from or refusal to participate in the 
interactive process can constitute sufficient grounds for failing to 
provide the reasonable accommodation.\134\
---------------------------------------------------------------------------

    \133\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at Question 6.
    \134\ See id.
---------------------------------------------------------------------------

    116. In situations where employers are permitted to seek 
supporting documentation, because employees may experience 
difficulty obtaining appointments with health care providers, 
especially early in pregnancy, the covered entity should be aware 
that it may take time for the employee to find a health care 
provider and provide documentation. Delay caused by the difficulty 
an employee faces in obtaining information from a health care 
provider in these circumstances should not be considered a 
withdrawal from or refusal to participate in the interactive 
process. If there is such a delay, an employer should consider 
providing an interim reasonable accommodation.
    117. As set out in Example #53 of this appendix, if an employee 
requests an accommodation but then is unable to engage in the 
interactive process because of an emergency, an employer should not 
penalize the employee but rather should wait and restart the 
interactive process once the employee returns.
    Example #53/Interruption of Interactive Process: Beryl is a 
quality control inspector at a labware manufacturing plant. She is 
in the early stage of pregnancy, and Beryl's employer does not know 
that she is pregnant. In the middle of her shift, Beryl suddenly 
experiences cramping and bleeding. She tells her supervisor that she 
thinks she is having a miscarriage and needs to leave. The next 
afternoon, Beryl's partner calls the supervisor and explains that 
Beryl will be resting at home for the next 24 hours. Following time 
at home, Beryl returns to the workplace and follows up with her 
supervisor regarding her emergency departure.
    The bleeding and cramping Beryl experienced is a physical or 
mental condition related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions, and Beryl 
identified an adjustment or change needed at work (leave). Thus, 
Beryl made a request for a reasonable accommodation under the PWFA, 
and it serves to start the PWFA interactive process.
    The employer received Beryl's request, but the interactive 
process was interrupted by the emergency situation that required 
immediate action. The interactive process resumed when Beryl's 
partner spoke with the supervisor and provided further information 
regarding Beryl's condition. When Beryl spoke with her supervisor 
upon her return, she reengaged in the interactive process. Through 
this continued conversation, the

[[Page 29209]]

employer was able to gather sufficient information to determine that 
Beryl had a limitation under the PWFA and was entitled to a 
reasonable accommodation. The employer must grant Beryl leave for 
the time she took off because of her miscarriage unless it can 
establish that doing so would be an undue hardship. Moreover, if the 
employer is one that automatically assigns points or penalizes 
employees for unexcused absences, Beryl should not be penalized for 
using the leave because she was entitled to the accommodation of 
leave.\135\
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    \135\ There also may be other types of situations where the 
employer is on notice of the need for accommodation but then the 
interactive process is interrupted. See, e.g., King v. Steward 
Trumbull Mem'l Hosp., Inc., 30 F.4th 551, 568 (6th Cir. 2022) 
(``Anti-discrimination laws sometimes require employers to 
accommodate unexpected circumstances. Sudden illnesses and episodic 
flare-ups are, by nature, difficult to plan for and can be quite 
disruptive to those who fall ill and those around them. But that 
does not mean that accommodating a sudden flare-up will cause undue 
hardship merely because handling these situations requires more 
flexibility.'')
    Some workplace attendance policies explicitly provide for 
unexpected absences by, for example, not penalizing workers who 
experience an emergency health situation. See Enforcement Guidance 
on Reasonable Accommodation, supra note 12, at text accompanying 
n.74. Providing this type of leave to some workers but not to 
workers affected by pregnancy, childbirth, or related medical 
conditions could be a violation of Title VII. Finally, if the worker 
does not qualify for coverage under the PWFA, there may be other 
laws, like the ADA or the FMLA, that would apply.
---------------------------------------------------------------------------

1636.3(l) Limits on Supporting Documentation

    118. A covered entity is not required to seek supporting 
documentation from an employee who requests an accommodation under 
the PWFA. If a covered entity decides to seek supporting 
documentation, the covered entity is permitted to do so only when 
reasonable under the circumstances to determine whether the employee 
has a physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions 
(a limitation) and needs an adjustment or change at work due to the 
limitation. When seeking documentation is reasonable, the employer 
is limited to seeking documentation that itself is reasonable.
    119. The restrictions on a covered entity seeking supporting 
documentation are enforceable through different parts of the PWFA. 
As set out in Sec.  1636.4(a)(3), as part of 42 U.S.C. 2000gg-1(1), 
a covered entity may not fail to provide a reasonable accommodation 
based on the employee's failure to provide supporting documentation 
if the covered entity's request for supporting documentation 
violates the standards set out in Sec.  1636.3(l). Moreover, as 
discussed in section 1636.5(f) of this appendix under Possible 
Violations of 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) Based on 
Seeking Supporting Documentation During the Reasonable Accommodation 
Process and Disclosure of Medical Information, a covered entity may 
violate the PWFA's retaliation provisions by seeking documentation 
or information in circumstances beyond those that are permitted 
under Sec.  1636.3(l). This is the case whether or not the employee 
provides the documentation or information sought by the employer and 
whether or not the employer grants the accommodation.
    120. In addition to the PWFA regulation, covered entities are 
reminded that the ADA's limitations on disability-related inquiries 
and medical exams apply to all ADA-covered employers.\136\ These ADA 
limitations protect all of the covered entity's employees whether 
they have disabilities or not and whether they are seeking an ADA 
reasonable accommodation or not. Thus, employers responding to 
reasonable accommodation requests under the PWFA should be mindful 
of the ADA's limitations on the employer's ability to make 
disability-related inquiries or require medical exams in response to 
these requests.\137\ For example, separate from requirements imposed 
by the PWFA and Sec.  1636.3(l), a covered entity may not ask an 
employee who requests an accommodation under the PWFA if the 
employee has asked for other reasonable accommodations in the past 
or whether the employee has preexisting conditions, because these 
questions are disability-related inquiries, i.e., questions that are 
likely to elicit disability-related information, and they are not 
job-related and consistent with business necessity in these 
circumstances. Further, an employer may not require that an employee 
seeking an accommodation under the PWFA complete specific forms that 
ask for information regarding ``impairments'' or ``major life 
activities.'' These are disability-related inquiries and, because 
they are not job-related and consistent with business necessity in 
these circumstances, they would violate the ADA.
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    \136\ The PWFA and title I of the ADA apply to the same 
entities. Therefore, all entities covered by title I of the ADA also 
are covered by the PWFA.
    \137\ For further discussion of this topic, see infra section 
1636.7(a)(1) of this appendix under Prohibition on Disability-
Related Inquiries and Medical Examinations and Protection of Medical 
Information.
---------------------------------------------------------------------------

    121. The Commission notes that pregnant employees may experience 
limitations and, therefore, require accommodations, before they have 
had any pregnancy-related medical appointments. Pregnant employees 
also may experience difficulty obtaining an immediate appointment 
with a health care provider early in a pregnancy or finding a health 
care provider at all. The Commission encourages employers who choose 
to seek supporting documentation, when that is permitted under Sec.  
1636.3(l), to consider the best practice of granting interim 
reasonable accommodations if an employee indicates that they have 
tried to obtain documentation and it will be provided at a later 
date.



1636.3(l)(1) Seeking Supporting Documentation Only When Reasonable 
Under the Circumstances

    122. The Commission expects that most PWFA interactive processes 
will consist of simple exchanges of information between employees 
and employers, such as brief conversations or emails, and that many 
of these will be concluded very shortly after the employee with a 
known limitation requests a reasonable accommodation, without any 
requests for further information. Once an employer has determined an 
appropriate reasonable accommodation, such as through these types of 
simple communications, no further interactive process is necessary.
    123. The PWFA does not require employers to seek supporting 
documentation from employees requesting accommodations. Under the 
PWFA, a covered entity may seek supporting documentation only if it 
is reasonable under the circumstances for the covered entity to 
determine whether the employee has a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions (a limitation) and needs an adjustment or 
change at work due to the limitation.
    124. Under Sec.  1636.3(l), situations when it would be 
reasonable under the circumstances for a covered entity to seek 
supporting documentation include, for example, if a pregnant 
employee asks for the temporary suspension of an essential 
function(s) that involves climbing ladders due to dizziness and the 
danger of falling, then the employer may, but is not required to, 
seek reasonable documentation, which is the minimum that is 
sufficient to confirm the physical or mental condition--i.e., 
dizziness and increased risk related to falling; confirm that the 
physical or mental condition is related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions 
(together ``a limitation''); and describe the adjustment or change 
at work needed due to the limitation--i.e., how high the employee 
may climb, the types of actions the employee should avoid, and how 
long the modification will be needed. As another example, if an 
employee requests an accommodation for a known limitation but has 
only a vague idea of what type of accommodation would be effective 
and the employer also does not know of a potential accommodation, it 
would be reasonable under the circumstances for the employer to seek 
supporting documentation describing the adjustment or change at work 
needed due to the limitation to help identify the needed 
accommodation. The employer also may consult resources such as 
JAN.\138\
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    \138\ See JAN, supra note 107.
---------------------------------------------------------------------------

    125. Section 1636.3(l) provides five examples of when it would 
not be reasonable under the circumstances for the employer to seek 
supporting documentation.

1636.3(l)(1)(i)--Obvious

    126. Under the PWFA, it is not reasonable under the 
circumstances for an employer to seek supporting documentation when 
the physical or mental condition related to, affected by, or arising 
out of the pregnancy, childbirth, or related medical conditions (the 
limitation) and the adjustment or change at work that is needed due 
to the limitation are obvious.
    127. In practice, the Commission expects this example will 
usually apply when the

[[Page 29210]]

employee is obviously pregnant.\139\ Whether someone is 
``obviously'' pregnant can depend on a number of factors, and not 
everyone who is pregnant looks the same, but there is a large subset 
of pregnant workers who most individuals would agree are 
``obviously'' pregnant, i.e., the pregnancy is showing and onlookers 
easily notice by looking. To limit problems that can arise in some 
instances when employers attempt to determine if someone is pregnant 
by looking at them, the regulation requires the employee to confirm 
the limitation and the adjustment or change at work needed due to 
the limitation through self-confirmation as defined in Sec.  
1636.3(l)(4). This may happen in the same conversation where the 
employee requests an accommodation.
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    \139\ ``Obvious'' means that the condition is apparent without 
being mentioned. In terms of pregnancy itself, this may depend on 
physical appearance, i.e., whether the pregnancy is ``showing.'' 
This is a concept that the Commission has used previously regarding 
pregnancy discrimination. Enforcement Guidance on Pregnancy 
Discrimination, supra note 24, at (I)(A)(1)(a) (discussing the 
``obviousness'' of pregnancy and a discrimination claim).
---------------------------------------------------------------------------

    128. Thus, for example, when an obviously pregnant employee 
confirms they are pregnant and asks for a different size uniform or 
related safety gear, the limitation and the adjustment or change at 
work needed due to the limitation are obvious, and the employer may 
not seek supporting documentation. In situations where some 
information is obvious and other information is not, the employer 
may seek supporting documentation relevant only to the non-obvious 
issue. Thus, if an obviously pregnant employee requests the 
reasonable accommodation of leave related to childbirth and recovery 
and confirms that they are pregnant, it may be reasonable under the 
circumstances for the employer to seek supporting documentation 
about the length of leave for recovery, but it would not be 
reasonable to seek supporting documentation regarding the 
limitation. Of course, the employer does not have to seek supporting 
documentation and can simply engage the employee in a discussion 
about how much leave the employee will need and when they will need 
it.

1636.3(l)(1)(ii)--Known

    129. The second example of when it would not be reasonable to 
seek supporting documentation is when the employer already has 
sufficient information to determine that the employee has a PWFA 
limitation and the adjustment or change at work needed due to the 
limitation. For example, if an employee already provided 
documentation stating that because of their recent cesarean section 
they should not lift over 20 pounds for 2 months, the employer may 
not seek further supporting documentation during those 2 months 
because the employer already has sufficient information.\140\
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    \140\ This example does not mean that when it is otherwise 
reasonable in the circumstances to seek supporting documentation, an 
employer is prohibited from doing so because the employee has simply 
stated that they have a limitation and need an adjustment or change 
at work due to the limitation. However, the employer also is not 
required to seek documentation and can accept the employee's 
statement.
---------------------------------------------------------------------------

    130. This principle also applies to episodic conditions. If an 
employer already has sufficient information to determine that the 
employee has a PWFA limitation that is episodic (e.g., migraines 
that are related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions), and the adjustment or 
change at work needed periodically due to the limitation (breaks or 
time off), the employer cannot seek additional or new supporting 
documentation every time the condition arises.

1636.3(l)(1)(iii)--Predictable Assessments

    131. The third example of when it is not reasonable under the 
circumstances for an employer to seek supporting documentation is 
based on the common types of pregnancy modifications sought under 
the PWFA. Specifically, it is not reasonable under the circumstances 
for an employer to seek supporting documentation when an employee, 
at any time during their pregnancy, seeks one of the following 
modifications, due to their pregnancy: (1) carrying or keeping water 
near for drinking, as needed; (2) taking additional restroom breaks, 
as needed; (3) sitting, for those whose work requires standing, and 
standing, for those whose work requires sitting, as needed; and (4) 
taking breaks to eat and drink, as needed. In these situations, an 
employee must provide self-confirmation as defined in Sec.  
1636.3(l)(4). Example #10 of this appendix shows how this can be 
part of the request for an accommodation. It is not reasonable to 
seek supporting documentation when an employee is pregnant, seeks 
one of the four listed modifications, and provides self-confirmation 
as defined in paragraph (l)(4) because these are a small set of 
commonly sought modifications that are widely known to be needed 
during an uncomplicated pregnancy.

1636.3(l)(1)(iv)--Lactation

    132. The fourth example of when it is not reasonable under the 
circumstances to seek supporting documentation concerns lactation 
and pumping at work or nursing during work hours. Specifically, it 
is not reasonable under the circumstances to seek supporting 
documentation when the reasonable accommodation is related to a time 
and/or place to pump or any other modification related to pumping at 
work,\141\ and the employee has provided a self-confirmation as set 
out in Sec.  1636.3(l)(4). Likewise, it is not reasonable under the 
circumstances to seek supporting documentation when the reasonable 
accommodation is related to time to nurse during work hours when the 
regular location of the employee's workplace makes nursing during 
work hours a possibility because the child is in close proximity and 
the employee has provided self-confirmation as set out in paragraph 
(l)(4).\142\
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    \141\ See supra note 102 for discussion of the PUMP Act and the 
types of accommodations that may be requested with regard to 
pumping.
    \142\ ``Nursing during work hours'' could include, for example, 
when an employee who always teleworks from home and has their child 
at home takes a break to nurse the child, or when an employee takes 
a break to travel to a nearby daycare center to nurse.
---------------------------------------------------------------------------

    133. It is not reasonable to seek supporting documentation 
regarding pumping or nursing at work because lactation beginning 
around or shortly after birth is an obvious fact. Additionally, and 
pragmatically, health care providers may not be able to provide 
supporting documentation about the details of how a specific 
employee is managing nursing or pumping, as this is not something 
necessarily discussed with a health care provider. This example does 
not, however, apply to all reasonable accommodations related to 
lactation; thus, this example would not apply if a lactating 
employee requested full-time remote work due to a condition that 
makes pumping difficult.

1636.3(l)(1)(v)--Employer's Own Policies or Practices

    134. The fifth example of when it would not be reasonable under 
the circumstances for a covered entity to seek supporting 
documentation relates to an employer's own policies or practices. If 
the requested accommodation is one that is available to employees 
without known limitations pursuant to the covered entity's policies 
or practices without submitting supporting documentation, then it is 
not reasonable for the employer to seek supporting documentation 
from an employee seeking a similar accommodation under the PWFA. For 
example, if an employer has a policy or practice of requiring 
supporting documentation only for the use of leave for 3 or more 
consecutive days, it would not be reasonable to ask someone who is 
using the same type of leave due to a known limitation under the 
PWFA to submit supporting documentation when they request leave for 
2 or fewer days.\143\
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    \143\ Conversely, if regular employer policies or practices 
would require documentation when the PWFA would not, or would 
require more documentation than the PWFA would allow in a situation 
where the employee is requesting an accommodation under the PWFA, 
the PWFA's restrictions on supporting documentation would apply.
---------------------------------------------------------------------------

1636.3(l)(2) Reasonable Documentation

    135. Under the PWFA, reasonable accommodations are available for 
physical or mental conditions related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions. When it 
is reasonable under the circumstances for the covered entity to seek 
supporting documentation, the covered entity is limited to seeking 
documentation that is itself reasonable. When it is reasonable under 
the circumstances for the covered entity to seek supporting 
documentation, the covered entity may require that the supporting 
documentation come from a health care provider.
    136. Confirming the physical or mental condition requires only a 
simple statement that the physical or mental condition meets the 
first part of the definition of ``limitation'' at Sec.  
1636.3(a)(2), (i.e., the physical or mental condition is: an 
impediment or problem, including ones that are modest, minor, or 
episodic; a need or a problem related to maintaining the health of 
the employee or the pregnancy, or that the employee is seeking

[[Page 29211]]

health care related to the pregnancy, childbirth, or a related 
medical condition itself).\144\ The physical or mental condition can 
be a PWFA limitation whether or not such condition is an impairment 
or a disability under the ADA.\145\ Some examples of physical or 
mental conditions that could be limitations are that the employee: 
has a back injury; has swollen ankles; is experiencing vomiting; has 
a lifting restriction; is experiencing fatigue; should not be 
exposed to a certain chemical; should avoid working in the heat; 
needs to avoid certain physical tasks such as walking, running, or 
physical confrontation because of increased risk; needs to attend a 
health care appointment; or needs to recover from a health care 
procedure. Because the physical or mental condition can be something 
like fatigue or vomiting, there is no need for the statement to 
contain a medical diagnosis. Thus, documentation is sufficient under 
Sec.  1636.3(l)(2) even if it does not contain a medical diagnosis, 
as long as it has a simple statement of the physical or mental 
condition.
---------------------------------------------------------------------------

    \144\ Section 1636.3(a)(2).
    \145\ 42 U.S.C. 2000gg(4); see 29 CFR 1630.3(h).
---------------------------------------------------------------------------

    137. The supporting documentation should confirm that the 
physical or mental condition is related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions. The 
supporting documentation need not state that the pregnancy, 
childbirth, or related medical conditions are the sole, the 
original, or a substantial cause of the physical or mental condition 
at issue because the statute only requires that the physical or 
mental condition be ``related to, affected by, or arising out of'' 
pregnancy, childbirth, or related medical conditions.\146\ If 
relevant, the documentation should include confirmation that the 
``related medical condition'' is related to pregnancy or childbirth.
---------------------------------------------------------------------------

    \146\ 42 U.S.C. 2000gg(4); see supra in section 1636.3(a)(2) of 
this appendix under Related to, Affected by, or Arising Out of.
---------------------------------------------------------------------------

    138. The employer also may seek reasonable documentation to 
describe the adjustment or change at work that is needed due to the 
limitation and an estimate of the expected duration of the need for 
the adjustment or change. This may be, for example: no heavy lifting 
for approximately 4 months; cannot stand for more than 30 minutes at 
a time until the end of the pregnancy; the maximum amount of weight 
involved in the lifting restriction and the approximate length of 
the restriction; the approximate number of and length of breaks; the 
kind of support or equipment needed and for approximately how long; 
a change in the type of protective equipment or ventilation needed 
and for approximately how long it will be needed; the need to limit 
movement and be allowed to lie down when necessary and for 
approximately how long the employee will need to limit movement; a 
change in work location and the approximate length of time of the 
change; a period of leave expected to be needed for recovery or to 
attend health care appointments; or the essential function(s) that 
should be temporarily suspended and for how long.
    139. Where the supporting documentation meets the standards 
described in this section, it is sufficient to determine whether the 
employee has a physical or mental condition related to, affected by, 
or arising out of pregnancy, childbirth, or related medical 
conditions (a limitation) and needs an adjustment or change at work 
due to the limitation. Accordingly, a covered entity that has 
received sufficient documentation but fails to provide an 
accommodation based on the failure to provide sufficient 
documentation, or continues to seek additional documentation or 
information, risks liability under 42 U.S.C. 2000gg-1(1) (Sec.  
1636.4(a)(3)) and/or 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)).
    140. Examples Regarding Documentation: \147\
---------------------------------------------------------------------------

    \147\ The conditions described in these examples also may be 
disabilities under the ADA and therefore may entitle the employee to 
an accommodation under the ADA, regardless of whether they are 
entitled to one under the PWFA.
---------------------------------------------------------------------------

    Example #54/Reasonable Documentation: Amelia recently returns to 
work after giving birth and recovery from childbirth. Amelia 
requests that she not be required to lift more than 30 pounds due to 
a back injury arising out of her pregnancy. Amelia's employer can 
use the interactive process to identify Amelia's limitation and what 
accommodation will address her limitation. Amelia's employer may, 
but is not required to, seek supporting documentation; in this 
situation, the employer decides to seek supporting documentation 
from Amelia. At Amelia's request, her obstetrician emails the human 
resources department, explaining that Amelia's recent pregnancy has 
caused a back injury and that she should avoid lifting more than 30 
pounds for approximately the next 3 months. This is sufficient 
documentation to confirm that Amelia has a limitation--a physical or 
mental condition (a back injury, which is an impediment or problem) 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions--and to describe an adjustment or change 
at work that is needed due to the limitation (avoid lifting more 
than 30 pounds for approximately the next three months). Because 
this is sufficient documentation, the covered entity failing to 
provide Amelia an accommodation based on a lack of documentation may 
violate 42 U.S.C. 2000gg-1(1) (Sec.  1636.4(a)(3)), and the covered 
entity trying to obtain additional documentation or information 
related to Amelia's request for a reasonable accommodation may 
violate 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)).
    Example #55 Reasonable Documentation: Rachna is 6 months 
pregnant and has just learned that she has preeclampsia. She 
requires limited activity and bed rest for the remainder of her 
pregnancy to limit the risks to her health and the health of her 
pregnancy. Rachna's employer can use the interactive process to 
identify Rachna's limitation and what accommodation will address her 
limitation. Rachna's employer may, but is not required to, seek 
supporting documentation; in this situation, the employer decides to 
seek supporting documentation from Rachna. Rachna provides her 
employer with a note from her midwife saying that, because of risks 
related to her health and the health of her pregnancy, Rachna needs 
to limit activities that involve sitting or standing, needs bed rest 
as much as possible, and should not commute to work for the 
remaining 3 months of her pregnancy. This is sufficient 
documentation to confirm that Rachna has a limitation--a physical or 
mental condition (maintaining the health of the employee or the 
employee's pregnancy) related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions--and to 
describe the change at work that is needed (limiting activities 
involving sitting and standing, lying down as much as possible, and 
not commuting for the remainder of her pregnancy). Because this is 
sufficient documentation, the covered entity failing to provide 
Rachna an accommodation based on a lack of documentation may violate 
42 U.S.C. 2000gg-1(1) (Sec.  1636.4(a)(3)), and the covered entity 
trying to obtain additional documentation or information related to 
her request for a reasonable accommodation may violate 42 U.S.C. 
2000gg-2(f) (Sec.  1636.5(f)).
    141. Because a covered entity is limited to the minimum 
supporting documentation necessary, a covered entity may not require 
that a pregnancy be confirmed through a specific test or method. 
Moreover, such a requirement could implicate the ADA's provisions 
that medical examinations only are permitted when they are job-
related and consistent with business necessity.\148\
---------------------------------------------------------------------------

    \148\ 42 U.S.C. 12112(d)(4)(A).
---------------------------------------------------------------------------

    142. Additionally, covered entities may not require that 
supporting documentation be submitted on a specific form, but only 
that documentation meets the requirements of Sec.  1636.3(l)(2). If 
covered entities offer an optional form for employees to use in 
submitting supporting documentation, the covered entities may wish 
to review preexisting forms they have for reasonable accommodations 
or leave to ensure their compliance with the PWFA. For example, the 
PWFA does not require that an employee have a ``serious health 
condition'' and the statute does not use the term ``major life 
activity,'' so employer forms or other employer communications 
seeking supporting documentation for PWFA-related reasonable 
accommodations should not use this terminology.

1636.3(l)(3) Limitations on a Covered Entity Seeking Supporting 
Documentation From a Health Care Provider

    143. When it is reasonable under the circumstances for the 
covered entity to seek supporting documentation, a covered entity 
may require that the supporting documentation comes from a health 
care provider. The regulation contains a non-exhaustive list of 
possible health care providers that is based on the non-exhaustive 
list provided in the Commission's ADA policy guidance.\149\
---------------------------------------------------------------------------

    \149\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at Question 6.
---------------------------------------------------------------------------

    144. The covered entity may not require that the health care 
provider who is submitting documentation be the provider treating 
the employee for the condition at issue, as long as the health care 
provider is able to confirm the physical or mental

[[Page 29212]]

condition; confirm that the physical or mental condition is related 
to, affected by, or arising out of pregnancy, childbirth, or related 
medical conditions (together ``a limitation''); and describe the 
adjustment or change at work that is needed due to the limitation. 
The covered entity may not require that an employee be examined by a 
health care provider of the covered entity's choosing.

1636.3(l)(4) Self-Confirmation of Pregnancy or Lactation

    145. For the purposes of supporting documentation under the 
PWFA, self-confirmation is a simple statement in which the employee 
confirms, as set forth in Sec.  1636.3(l)(1)(i), (iii) and (iv), the 
limitation and adjustment or change that is needed at work due to 
the limitation. The self-confirmation statement can be made in any 
manner and can be made as part of the request for reasonable 
accommodation under Sec.  1636.3(h)(2). For example, self-
confirmation may be spoken, it may be recorded or live, or it may be 
written on paper or electronically, such as in an email or text. 
Self-confirmation does not need to use any particular words or 
format, does not need to be written on a form, does not need to be a 
particular length, does not need to be notarized or otherwise 
verified, and does not need to be accompanied by documentary or 
physical evidence. In many instances, the self-confirmation will be 
part of what the employee communicates when they start the 
reasonable accommodation process. Example #10 of this appendix, 
where an employee tells a manager of her need for more frequent 
bathroom breaks and explains that the breaks are needed because the 
employee is pregnant, is an example of self-confirmation of 
pregnancy.

Interaction Between the PWFA and the ADA

    146. Employers covered by the PWFA also are covered by the 
ADA.\150\ The ADA's statutory text includes express restrictions on 
when a covered entity may require medical exams and make disability-
related inquiries.\151\ These restrictions apply to all the 
interactions between covered entities and their employees, 
regardless of whether an individual has a disability. Thus, for 
example, if an employee is requesting a reasonable accommodation 
under the PWFA, the ADA's restrictions apply and prevent an employer 
from seeking the employee's entire medical record or asking the 
employee if they have received accommodations in the past because 
these inquiries are likely to elicit information about a disability 
and are not job-related and consistent with business necessity in 
these circumstances. Independent of these ADA restrictions, Sec.  
1636.3(l)(2) also prohibits seeking this type of documentation under 
the PWFA because it goes beyond the definition of reasonable 
documentation. Finally, depending on the facts, seeking such 
information could violate 42 U.S.C. 2000gg-2(f).
---------------------------------------------------------------------------

    \150\ 42 U.S.C 12111(5) (ADA); 42 U.S.C. 2000gg(2) (PWFA).
    \151\ 42 U.S.C. 12112(d), 12112(d)(4)(A).
---------------------------------------------------------------------------

    147. The ADA provides for the confidentiality of medical 
information, subject to limited disclosure rules.\152\ These rules 
apply to medical information in the employer's possession, including 
information obtained by an employer from disability-related 
inquiries or medical exams, or information obtained as part of the 
reasonable accommodation process.\153\ That an employee is pregnant, 
has recently been pregnant, or has a medical condition related to 
pregnancy or childbirth is medical information. The ADA requires 
that employers keep such information confidential and only disclose 
it within the confines of the ADA's limited disclosure rules. 
Similarly, disclosing that an employee is receiving or has requested 
a reasonable accommodation under the PWFA usually amounts to a 
disclosure that the employee is pregnant, has recently been 
pregnant, or has a related medical condition and thus must be 
treated as confidential medical information as well. This is 
explained further in section 1636.7(a)(1) of this appendix under 
Prohibition on Disability-Related Inquiries and Medical Examinations 
and Protection of Medical Information.
---------------------------------------------------------------------------

    \152\ 42 U.S.C. 12112(d)(3)(B); 29 CFR 1630.14(b)(1), (c)(1), 
(d)(4); EEOC, Enforcement Guidance on Disability-Related Inquiries 
and Medical Examinations of Employees Under the ADA, at text 
accompanying nn.9-10 (2000) [hereinafter Enforcement Guidance on 
Disability-Related Inquiries], http://www.eeoc.gov/laws/guidance/enforcement-guidance-disability-related-inquiries-and-medical-examinations-employees (``The ADA requires employers to treat any 
medical information obtained from a disability-related inquiry or 
medical examination . . . as well as any medical information 
voluntarily disclosed by an employee, as a confidential medical 
record. Employers may share such information only in limited 
circumstances with supervisors, managers, first aid and safety 
personnel, and government officials investigating compliance with 
the ADA.''); EEOC, Enforcement Guidance: Preemployment Disability-
Related Questions and Medical Examinations, at text accompanying n.6 
(1995) [hereinafter Enforcement Guidance: Preemployment Disability-
Related Questions], https://www.eeoc.gov/laws/guidance/enforcement-guidance-preemployment-disability-related-questions-and-medical. 
https://www.eeoc.gov/laws/guidance/enforcement-guidance-preemployment-disability-related-questions-and-medical (``Medical 
information must be kept confidential.''). In addition, Federal 
agencies are covered by the Privacy Act of 1974, as amended, 5 
U.S.C. 552a, and many Federal agencies maintain equal employment 
opportunity records subject to a Privacy Act System of Records 
Notice.
    \153\ See Enforcement Guidance on Disability-Related Inquiries, 
supra note 152, at General Principles (``The ADA requires employers 
to treat any medical information obtained from a disability-related 
inquiry or medical examination (including medical information from 
voluntary health or wellness programs), as well as any medical 
information voluntarily disclosed by an employee, as a confidential 
medical record.'') and text after n.12 (``[T]he ADA's restrictions 
on inquiries and examinations apply to all employees, not just those 
with disabilities.'').
---------------------------------------------------------------------------

    148. If there is a situation where an employee requests an 
accommodation and both the PWFA and the ADA could apply, the 
employer should apply the provision that it would be less demanding 
for the employee to satisfy. For example, assume a pregnant employee 
has diabetes that is exacerbated by the pregnancy and needs breaks 
to eat or drink. Under the PWFA, the covered entity cannot seek 
supporting documentation (as set forth in Sec.  1636.3(l)(1)(iii)) 
and this is the provision that the employer should apply.

IV. 1636.4 Nondiscrimination With Regard to Reasonable Accommodations 
Related to Pregnancy

1636.4(a) Failing To Provide Reasonable Accommodation

    1. The statute at 42 U.S.C. 2000gg-1(1) prohibits a covered 
entity from not making a reasonable accommodation for a qualified 
employee with a known limitation related to pregnancy, childbirth, 
or related medical conditions unless the covered entity can 
demonstrate that the accommodation would impose an undue hardship on 
the operation of its business. This provision of the PWFA uses the 
same language as the ADA, and the rule likewise uses the language 
from the corresponding ADA regulation.\154\ Because 42 U.S.C. 
2000gg-1(1) uses the same operative language as the ADA, it should 
be interpreted in a similar manner.
---------------------------------------------------------------------------

    \154\ See 42 U.S.C. 12112(b)(5)(A); 29 CFR 1630.9(a).
---------------------------------------------------------------------------

    2. This section is violated when a covered entity fails to make 
reasonable accommodation to a qualified employee with a known 
limitation, absent undue hardship.\155\ However, a covered entity 
does not violate 42 U.S.C. 2000gg-1(1) merely by refusing to engage 
in the interactive process; for a violation, there also must have 
been a reasonable accommodation that the employer could have 
provided absent undue hardship.
---------------------------------------------------------------------------

    \155\ The regulation in Sec.  1636.4, following the language in 
the statute, uses the phrase ``known limitations related to 
pregnancy, childbirth, or related medical conditions.'' 42 U.S.C. 
2000gg-1(1), (3)-(5). Given the definition in the statute of ``known 
limitation'' (42 U.S.C. 2000gg(4)), the phrase ``known limitations 
related to pregnancy, childbirth, or related medical conditions'' in 
Sec.  1636.4 and 42 U.S.C. 2000gg-1 should be understood to mean 
that the known limitations are related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions or that 
``known limitations'' mean physical or mental conditions related to, 
affected by, or arising out of pregnancy, childbirth, or related 
medical conditions.
---------------------------------------------------------------------------

1636.4(a)(1) Unnecessary Delay in Providing a Reasonable 
Accommodation

    3. An unnecessary delay in providing a reasonable accommodation 
to the known limitations related to pregnancy, childbirth, or 
related medical conditions of a qualified employee may result in a 
violation of the PWFA if the delay constitutes a failure to provide 
a reasonable accommodation. This can be true even if the reasonable 
accommodation is eventually provided, when the delay was 
unnecessary. Unnecessary delay that can be actionable under this 
section can occur at any time during the accommodation process 
including, but not limited to, responding to the initial request, 
during the interactive process, or in implementing the accommodation 
once the request is approved. Delay by a third-party administrator 
acting on behalf of the covered entity is attributable to the 
covered entity.

[[Page 29213]]

    4. Section 1636.4(a)(1) sets out the factors that are used when 
determining whether a delay in the provision of a reasonable 
accommodation violates the PWFA. Section 1636.4(a)(1) sets out the 
factors already identified in the ADA guidance \156\ and adds three 
additional factors, described in paragraphs 5, 6, and 7 of this 
section.
---------------------------------------------------------------------------

    \156\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at Question 10 & n.38. The Enforcement Guidance notes 
that these are ``relevant factors'' but not that these are the only 
factors.
---------------------------------------------------------------------------

    5. First, whether providing the accommodation was simple or 
complex is a factor to be considered. Under the PWFA, there are 
certain modifications, set forth in Sec.  1636.3(j)(4), that will 
virtually always be found to be reasonable accommodations that do 
not impose an undue hardship: (1) allowing a pregnant employee to 
carry or keep water near and drink, as needed; (2) allowing a 
pregnant employee to take additional restroom breaks, as needed; (3) 
allowing a pregnant employee whose work requires standing to sit and 
whose work requires sitting to stand, as needed; and (4) allowing a 
pregnant employee to take breaks to eat and drink, as needed. If 
there is delay in providing these accommodations to a qualified 
employee with a known limitation, it will virtually always be found 
to be unnecessary because of the presumption that these 
modifications will be reasonable accommodations that do not impose 
an undue hardship.
    6. Second, whether the covered entity offered the employee an 
interim reasonable accommodation during the interactive process is a 
factor to be considered. The offer of an interim reasonable 
accommodation can be made at any time following the request for 
accommodation. The provision of an interim accommodation will 
decrease the likelihood that an unnecessary delay will be found. 
Under this factor, the interim reasonable accommodation should be 
one that enables the employee to keep working as much as possible; 
the provision of leave will not be considered as a factor that can 
excuse delay, unless the employee selects, or requests, leave as an 
interim reasonable accommodation.\157\
---------------------------------------------------------------------------

    \157\ The restriction on using leave as an interim accommodation 
is based on 42 U.S.C. 2000gg-1(4) and 2000gg-2(f).
---------------------------------------------------------------------------

    7. Third, the length of time for which the employee will need 
the reasonable accommodation is another factor to be considered. 
Given that limitations related to, affected by, or arising out of 
pregnancy, childbirth, or related medical conditions are frequently 
temporary, an unnecessary delay in providing an accommodation may 
mean that the period necessitating the accommodation could pass 
without action simply because of the delay.

1636.4(a)(2) Refusing an Accommodation

    8. An employee with a known limitation is not required to accept 
a reasonable accommodation. However, if the rejection of the 
reasonable accommodation results in the employee being unable to 
perform the essential functions of the job, the employee is not 
qualified. This provision mirrors the language from a similar 
provision in the ADA regulation,\158\ with the inclusion of 
employees who are qualified under Sec.  1636.3(f)(2).
---------------------------------------------------------------------------

    \158\ See 29 CFR 1630.9(d).
---------------------------------------------------------------------------

1636.4(a)(3) Covered Entity Failing To Provide a Reasonable 
Accommodation Due to Lack of Supporting Documentation

    9. A covered entity cannot defend the failure to provide an 
accommodation based on the lack of supporting documentation if: the 
covered entity did not seek supporting documentation; seeking 
supporting documentation was not reasonable under the circumstances 
as defined in Sec.  1636.3(l)(1); the covered entity sought 
documentation beyond that which is reasonable as defined in Sec.  
1636.3(l)(2); or the covered entity did not provide the employee 
sufficient time to obtain and provide the supporting documentation 
sought.

1636.4(a)(4) Choosing Among Possible Accommodations

    10. The covered entity must provide an effective accommodation, 
i.e., one that meets the employee's needs or limitations. If there 
is more than one effective accommodation, the employee's preference 
should be given primary consideration.\159\ However, the employer 
providing the accommodation has the ultimate discretion to choose 
among effective reasonable accommodations.\160\ The employer may 
choose, for example, the less expensive accommodation, the 
accommodation that is easier for it to provide, or, generally, the 
accommodation that imposes the least hardship.\161\ In the situation 
where the employer is choosing among effective reasonable 
accommodations and does not provide the accommodation that is the 
employee's preferred accommodation, the employer does not have to 
show that it is an undue hardship to provide the employee's 
preferred accommodation.
---------------------------------------------------------------------------

    \159\ See 29 CFR part 1630, appendix, 1630.9.
    \160\ Id.
    \161\ Id.
---------------------------------------------------------------------------

    11. A covered entity's ``ultimate discretion'' in choosing a 
reasonable accommodation is limited by certain other considerations. 
First, 42 U.S.C. 2000gg-1 (Sec.  1636.4(a)(4)) requires that the 
accommodation must provide the qualified employee with a known 
limitation with equal employment opportunity.\162\ By this, the 
Commission means an opportunity to attain the same level of 
performance, experience the same level of benefits, or otherwise 
enjoy the same terms, conditions, and privileges of employment as 
are available to the average similarly situated employee without a 
known limitation, which includes the individual who needs the 
accommodation when they are without the known limitation.\163\ This 
may be shown by evidence of the opportunities that would have been 
available to the employee seeking the accommodation had they not 
identified a known limitation or sought an accommodation, or other 
evidence that tends to demonstrate that the accommodation provided 
to the employee did not provide equal employment opportunity. 
Depending on the facts, selecting the accommodation that does not 
provide equal opportunity could violate 42 U.S.C. 2000gg-1(1), 
2000gg-1(5), or 2000gg-2(f).\164\
---------------------------------------------------------------------------

    \162\ See also Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at Question 9, Example B.
    \163\ See 29 CFR part 1630, appendix, 1630.9; 29 CFR part 1630, 
appendix, 1630.2(o) (explaining that reassignment should be to a 
position with equivalent pay, status, etc., if the individual is 
qualified, and if the position is vacant within a reasonable amount 
of time); see also Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at text following n.80 (``However, if both the 
employer and the employee voluntarily agree that transfer is 
preferable to remaining in the current position with some form of 
reasonable accommodation, then the employer may transfer the 
employee.''); cf. EEOC, Compliance Manual on Religious 
Discrimination, (12-IV)(A)(3) (2021) [hereinafter Compliance Manual 
on Religious Discrimination], https://www.eeoc.gov/laws/guidance/section-12-religious-discrimination (stating that in the context of 
a religious accommodation, an accommodation would not be reasonable 
``if it requires the employee to accept a reduction in pay rate or 
some other loss of a benefit or privilege of employment and there is 
an alternative accommodation that does not do so''); EEOC, 
Enforcement Guidance: Unlawful Disparate Treatment of Workers With 
Caregiving Responsibilities, Example 5 (2007), https://www.eeoc.gov/laws/guidance/enforcement-guidance-unlawful-disparate-treatment-workers-caregiving-responsibilities (explaining how a worker can be 
a comparator for themselves).
    \164\ Depending on the facts, this could be a violation of Title 
VII's prohibition on sex discrimination as well.
---------------------------------------------------------------------------

    12. Second, 42 U.S.C. 2000gg-1(2) prohibits a covered entity 
from requiring a qualified employee affected by pregnancy, 
childbirth, or related medical conditions to accept an accommodation 
other than any reasonable accommodation arrived at through the 
interactive process.
    13. Third, 42 U.S.C. 2000gg-1(4) prohibits a covered entity from 
requiring a qualified employee with a known limitation to take 
leave, whether paid or unpaid, if there is a reasonable 
accommodation that will allow the employee to continue to work, 
absent undue hardship.
    14. Fourth, 42 U.S.C. 2000gg-1(5) prohibits a covered entity 
from taking adverse action in terms, conditions, or privileges of 
employment against a qualified employee on account of the employee 
requesting or using a reasonable accommodation to the known 
limitations related to the pregnancy, childbirth, or related medical 
conditions of the employee.
    15. Fifth, 42 U.S.C. 2000gg-2(f) prohibits retaliation and 
coercion by covered entities.
    16. These limitations to the ``ultimate discretion'' of a 
covered entity to choose among effective accommodations are 
described in the discussions of Sec. Sec.  1636.4(b), (d), and (e) 
and 1636.5(f).
    17. Example Regarding Failing To Provide Equal Employment 
Opportunity:
    Example #56/Failing To Provide Equal Employment Opportunity: 
Yasmin's job requires her to travel to meet with clients. Because of 
her pregnancy, she is not able to travel for 3 months. She asks that 
she be allowed to conduct her client meetings via

[[Page 29214]]

video conferencing. Although this accommodation would allow her to 
perform her essential job functions and would not impose an undue 
hardship, her employer reassigns her to smaller, local accounts. 
Being assigned only to these accounts is not an effective 
accommodation because it limits Yasmin's opportunity to compete for 
promotions and bonuses as she had in the past. This could be a 
violation of 42 U.S.C. 2000gg-1(1), because Yasmin is denied an 
equal opportunity to compete for promotions; thus, her employer has 
failed to provide her a reasonable accommodation. The employer's 
actions also could violate 42 U.S.C. 2000gg-1(5) and 2000gg-2(f), or 
Title VII's prohibition against pregnancy discrimination.

1636.4(b) Requiring a Qualified Employee To Accept an Accommodation

    18. The statute at 42 U.S.C. 2000gg-1(2) prohibits a covered 
entity from requiring a qualified employee to accept an 
accommodation other than any reasonable accommodation arrived at 
through the interactive process. Pursuant to this provision in the 
PWFA and Sec.  1636.4(b), a covered entity cannot require a 
qualified employee to accept an accommodation such as light duty or 
a temporary transfer, or delay of an examination that is part of the 
application process, without engaging in the interactive process, 
even if the covered entity's motivation is concern for the 
employee's health or pregnancy.
    19. The statute at 42 U.S.C. 2000gg-1(2) does not require that 
the employee have a limitation, known or not; thus, a violation of 
42 U.S.C. 2000gg-1(2) could occur if a covered entity believes that 
a qualified employee is pregnant and decides, without engaging in 
the interactive process with the employee, that the employee needs a 
particular accommodation, and unilaterally requires the employee to 
accept the accommodation, even though the employee has not requested 
it and can perform the essential functions of the job without it. 
For example, this provision could be violated if an employment 
agency, without discussing the situation with the candidate, decides 
that a candidate recovering from a miscarriage needs an 
accommodation in the form of not being sent to certain jobs that the 
agency views as too physical. Similarly, a violation could result if 
an employer decides to excuse a qualified pregnant employee from 
overtime as an accommodation without the employee seeking an 
accommodation and the employer and the employee engaging in the 
interactive process.\165\
---------------------------------------------------------------------------

    \165\ These actions also could violate Title VII's prohibition 
of disparate treatment based on sex. See Enforcement Guidance on 
Pregnancy Discrimination, supra note 24, at (I)(B)(1).
---------------------------------------------------------------------------

    20. Additionally, a violation could occur if a covered entity 
receives a request for a reasonable accommodation and unilaterally 
imposes an accommodation that was not requested by the qualified 
employee without engaging in the interactive process.
    21. Example Regarding Requiring an Employee To Accept an 
Accommodation:
    Example #57/Requiring an Employee To Accept an Accommodation: 
Kia, a restaurant server, is pregnant. She asks for additional 
breaks during her shifts as her pregnancy progresses because she 
feels tired, and her feet are swelling. Her employer, without 
engaging in the interactive process with Kia, directs Kia to take 
host shifts for the remainder of her pregnancy, because it allows 
her to sit for long periods. The employer has violated 42 U.S.C. 
2000gg-1(2) (Sec.  1636.4(b)), because it required Kia to accept an 
accommodation other than one arrived at through the interactive 
process, even if Kia's earnings did not decrease and her terms, 
conditions, and privileges of employment were not harmed.
    Moreover, if the host shift does not provide Kia with equal 
terms, conditions, and privileges of employment (e.g., Kia's wages 
decrease or Kia no longer can earn tips), the covered entity also 
may have violated 42 U.S.C. 2000gg-1(1) (requiring reasonable 
accommodation absent undue hardship); 2000gg-1(5) (prohibiting 
adverse action in terms, conditions, or privileges of employment); 
and/or 2000gg-2(f) (prohibiting retaliation) (Sec. Sec.  1636.4(a) 
and (e) and 1636.5(f)).
    22. Finally, this provision also could be violated if a covered 
entity has a rule that requires all qualified pregnant employees to 
stop a certain function--such as traveling--automatically, without 
any evidence that the particular employee is unable to perform that 
function.

1636.4(c) Denying Opportunities to Qualified Employees

    23. The statute at 42 U.S.C. 2000gg-1(3) prohibits a covered 
entity from denying employment opportunities to a qualified employee 
with a known limitation if the denial is based on the need of the 
covered entity to make reasonable accommodations to the known 
limitations related to, affected by, or arising out of pregnancy, 
childbirth, or related medical conditions of the qualified employee. 
Thus, an employee's known limitation and need for a reasonable 
accommodation cannot be part of the covered entity's decision 
regarding hiring, discharge, promotion, or other employment 
decisions, unless the reasonable accommodation would impose an undue 
hardship on the covered entity.
    24. This provision in the PWFA uses language similar to that of 
the ADA, and Sec.  1636.4(c) likewise uses language similar to the 
corresponding ADA regulation.\166\ Section 1636.4(c) encompasses 
situations where the covered entity's decision is based on the 
future possibility that a reasonable accommodation will be needed, 
i.e., 42 U.S.C. 2000gg-1(3) prohibits a covered entity from making a 
decision based on its belief that an employee may need a reasonable 
accommodation in the future regardless of whether the employee has 
asked for one or not. Thus, under Sec.  1636.4(c), this prohibition 
would include situations where a covered entity refuses to hire a 
pregnant applicant because the covered entity believes that the 
applicant will need leave to recover from childbirth, regardless of 
whether the covered entity knows the exact amount of leave the 
applicant will require, or whether the applicant has mentioned the 
need for leave as a reasonable accommodation to the covered entity.
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    \166\ See 42 U.S.C. 12112(b)(5)(B); 29 CFR 1630.9(b).
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1636.4(d) Requiring a Qualified Employee To Take Leave

    25. A covered entity may not require a qualified employee to 
take leave, whether paid or unpaid, if another reasonable 
accommodation can be provided to the employee's known limitations 
related to pregnancy, childbirth, or related medical conditions 
absent undue hardship.
    26. This provision does not prohibit a covered entity from 
offering leave as a reasonable accommodation if leave is the 
reasonable accommodation requested or selected by the qualified 
employee, or if it is the only reasonable accommodation that does 
not cause an undue hardship. As provided in Sec.  1636.3(i)(3), both 
paid leave (accrued, short-term disability, or another employer 
benefit) and unpaid leave are potential reasonable accommodations 
under the PWFA.

1636.4(e) Adverse Action on Account of Requesting or Using a 
Reasonable Accommodation

    27. The PWFA contains overlapping provisions that protect 
employees, applicants, and former employees seeking or using 
reasonable accommodations. Importantly, nothing in the PWFA limits 
which provision an employee may use to protect their rights.
    28. One of these provisions is 42 U.S.C. 2000gg-1(5), which 
prohibits adverse action in the terms, conditions, or privileges of 
employment against a qualified employee on account of the employee 
requesting or using a reasonable accommodation to the known 
limitations related to the pregnancy, childbirth, or related medical 
conditions of the employee.
    29. The protections provided by 42 U.S.C. 2000gg-1(5) are likely 
to have significant overlap with 42 U.S.C. 2000gg-2(f), which 
prohibits retaliation. However, the PWFA's anti-retaliation 
provisions apply to a broader group of individuals and actions than 
42 U.S.C. 2000gg-1(5) does.
    30. ``Terms, conditions, or privileges of employment'' is a term 
from Title VII, and the Commission has interpreted it to encompass a 
wide range of activities or practices that occur in the workplace 
including, but not limited to: discriminatory work environment or 
atmosphere; duration of work (such as the length of an employment 
contract, hours of work, or attendance); work rules; job assignments 
and duties; and job advancement (such as training, support, and 
performance evaluations).\167\ In addition, for the purposes of 42 
U.S.C. 2000gg-1(5), ``terms, conditions, or privileges of 
employment'' can include hiring, discharge, or compensation.
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    \167\ 42 U.S.C. 2000e-2(a)(1); Compliance Manual on Terms, 
Conditions, and Privileges of Employment, supra note 69, at 613.1(a) 
(stating that the language is to be read in the broadest possible 
terms and providing a list of examples).

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[[Page 29215]]

    31. This provision prohibits a covered entity from taking a 
harmful action against a qualified employee. For example, this 
provision prohibits a covered entity from penalizing an employee for 
having requested or used an accommodation that the covered entity 
had granted previously.
    32. Examples Regarding Adverse Action in Terms, Conditions, or 
Privileges of Employment:
    Example #58/Adverse Action in Terms, Conditions, or Privileges 
of Employment: Nava took leave to recover from childbirth as a 
reasonable accommodation under the PWFA, and, as a result, failed to 
meet the sales quota for that quarter, which led to a negative 
performance appraisal. The negative appraisal could be a violation 
of 42 U.S.C. 2000gg-1(5) because Nava received it due to the use of 
a reasonable accommodation. If an employee receives the reasonable 
accommodation of leave, a production standard, such as a sales 
quota, may need to be prorated to account for the reduced amount of 
time the employee works.\168\
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    \168\ See Enforcement Guidance on Reasonable Accommodation, 
supra note 12, at Question 19.
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    33. Also, an employer may violate this provision if there is 
more than one reasonable accommodation that does not impose an undue 
hardship, and the employer, after the interactive process, chooses 
the accommodation that causes an adverse action with respect to the 
terms, conditions, or privileges of employment, despite the 
existence of an alternative accommodation that would not do so.
    Example #59/Adverse Action in Terms, Conditions, or Privileges 
of Employment: Ivy asks for additional bathroom breaks during the 
workday because of pregnancy, including during overtime shifts. 
After talking to Ivy, Ivy's supervisor decides Ivy should simply not 
work overtime, because during the overtime shift there are fewer 
employees and the supervisor does not want to bother figuring out 
coverage for Ivy's bathroom breaks, although it would not be an 
undue hardship to do so. As a result, Ivy is not assigned overtime 
and loses earnings. The employer's actions could violate 42 U.S.C. 
2000gg-1(5) because Ivy suffered the adverse action of not being 
assigned to overtime and losing wages because she used a reasonable 
accommodation.
    Example #60/Adverse Action in Terms, Conditions, or Privileges 
of Employment: Leah asks for telework due to morning sickness. 
Through the interactive process, it is determined that either 
telework or a later schedule combined with an hour rest break in the 
afternoon would allow Leah to perform the essential functions of her 
job without imposing an undue hardship. Although Leah prefers 
telework, the employer would rather Leah be in the office. It would 
not be a violation of 42 U.S.C. 2000gg-1(5) to offer Leah the 
schedule change/rest break, instead of telework, as a reasonable 
accommodation.
    34. The facts set out in Examples #58 and #59 of this appendix 
also could violate 42 U.S.C. 2000gg-1(1) and 2000gg-2(f).

V. 1636.5 Remedies and Enforcement

    1. In crafting the PWFA remedies and enforcement section, 
Congress recognized the advisability of using the existing 
mechanisms for redress of other forms of employment discrimination. 
The regulation at Sec.  1636.5(a), (c), (d), and (e) follows the 
language of the statute.

1636.5(a) Remedies and Enforcement Under Title VII

    2. The enforcement mechanisms, procedures, and remedies 
available to employees and others covered by Title VII apply to the 
PWFA.\169\ Thus, employees covered by section 706 of Title VII may 
file charges alleging violations of the PWFA with the Commission, 
and the Commission will investigate them using the same process as 
set out in Title VII.\170\ Similarly, the Commission will use the 
same rules to determine the time limits for filing a charge; if the 
State or locality in which the charge has been filed has a law 
prohibiting sex discrimination, pregnancy discrimination, or 
specifically providing accommodations for pregnancy, childbirth, or 
related medical conditions, the deadline to file a charge will be 
300 days.\171\
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    \169\ 42 U.S.C. 2000gg-2(a), (d), (e).
    \170\ See 29 CFR part 1601.
    \171\ See EEOC v. Dolgencorp, LLC, 899 F.3d 428, 433-34 (6th 
Cir. 2018) (applying the 300-day time limit to a charge alleging 
failure to provide a reasonable accommodation under the ADA filed in 
Tennessee where the state statute prohibited discrimination against 
individuals with disabilities but did not provide for reasonable 
accommodations, noting, ``[t]he relevant question is whether the 
state agency has the power to entertain the claimant's disability 
discrimination claim, not whether state law recognizes the same 
theories of discrimination as federal law'').
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1636.5(e) Remedies and Enforcement Under Section 717 of the Civil 
Rights Act of 1964

    3. The applicable procedures and available remedies for 
employees covered by section 717 of the Civil Rights Act of 1964, 42 
U.S.C. 2000e-16, apply under the PWFA. Employees covered by section 
717 of Title VII may file complaints with the relevant Federal 
agency which will investigate them, and the Commission will process 
appeals using the same process as set out in Title VII for Federal 
employees. Thus, the Commission's implementing regulations found at 
29 CFR part 1614 (Federal sector equal employment opportunity) apply 
to the PWFA as well.

Damages

    4. As with other Federal employment discrimination laws, the 
PWFA provides for recovery of pecuniary and non-pecuniary damages, 
including compensatory and punitive damages. The statute's adoption 
by reference of section 1977A of the Revised Statutes of the United 
States, 42 U.S.C. 1981a, also imports the limitations on the 
recovery of compensatory damages and punitive damages generally 
applicable in employment discrimination cases, depending on the size 
of the employer. Punitive damages are not available in actions 
against a government, government agency, or political subdivision. 
This part lays out these requirements involving damages in separate 
paragraphs under Sec.  1636.5(a) through (e).

1636.5(f) Prohibition Against Retaliation

    5. The anti-retaliation provisions of the PWFA should be 
interpreted broadly, like those of Title VII and the ADA, to 
effectuate Congress' broad remedial purpose in enacting these 
laws.\172\ The protections of these provisions extend beyond 
qualified employees with known limitations and cover activity that 
may not yet have occurred, such as a circumstance in which a covered 
entity threatens an employee with termination if they file a charge 
or requires an employee to sign an agreement that prohibits such 
individual from filing a charge with the Commission.\173\
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    \172\ See Enforcement Guidance on Retaliation and Related 
Issues, supra note 89, at (II)(A)(1) (describing the broad 
protection of the participation clause); id. at (II)(A)(2), (2)(a) 
(describing the broad protection of the opposition clause).
    \173\ See EEOC, Enforcement Guidance on Non-Waivable Employee 
Rights under EEOC Enforced Statutes, (II) (1997), https://www.eeoc.gov/laws/guidance/enforcement-guidance-non-waivable-employee-rights-under-eeoc-enforced-statutes (``[P]romises not to 
file a charge or participate in an EEOC proceeding are null and void 
as a matter of public policy. Agreements extracting such promises 
from employees may also amount to separate and discrete violations 
of the anti-retaliation provisions of the civil rights statutes.'').
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1636.5(f)(1) Prohibition Against Retaliation

    6. The types of conduct prohibited, the standard for determining 
what constitutes retaliatory conduct, and the individuals protected 
under the PWFA are the same as they are under Title VII.\174\ 
Accordingly, this provision prohibits discrimination against 
employees who engage in protected activity, which includes 
```participating' in an EEO process or `opposing' discrimination.'' 
\175\ Title VII's anti-retaliation provision is broad and protects 
an employee from conduct, whether related to employment or not, that 
a reasonable person would have found ``materially adverse,'' meaning 
that the action ``well might have dissuaded a reasonable worker from 
making or supporting a charge of discrimination.'' \176\ 
Additionally, Title VII's anti-retaliation provision protects 
employees, applicants, and former employees.\177\ The same 
interpretations apply to the PWFA's anti-retaliation provision.\178\
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    \174\ See 42 U.S.C. 2000gg-2(f)(1) (using the same language as 
42 U.S.C. 2000e-3(a)).
    \175\ See Enforcement Guidance on Retaliation, supra note 89, at 
(II)(A); see also id. at (II)(A)(1), (2) (describing protected 
activity under Title VII's anti-retaliation clause).
    \176\ Burlington N. & Santa Fe Ry. Co. v. White, 548 U.S. 53, 68 
(2006) (internal citations and quotation marks omitted).
    \177\ See 42 U.S.C. 2000e-3(a). The statute at 42 U.S.C. 2000gg-
2(f)(1) applies to an ``employee'' which 42 U.S.C. 2000gg(3) defines 
to include applicants. The statute at 42 U.S.C. 2000gg(3) relies on 
the Title VII definition of employee, which includes former 
employees, where relevant. See also Robinson v. Shell Oil Co., 519 
U.S. 337, 346 (1997) (finding former employees are protected under 
Title VII's anti-retaliation provision).
    \178\ All retaliatory conduct under Title VII (and the ADA), 
including retaliation that takes the form of harassment, is 
evaluated under the legal standard for retaliation. See Enforcement 
Guidance on Retaliation, supra note 89, at (II)(B)(3).

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[[Page 29216]]

    7. Section 1636.5(f) contains three other provisions based on 
the statutory language and established anti-retaliation concepts 
under Title VII and the ADA.
    8. First, 42 U.S.C. 2000gg-2(f)(1) protects ``any employee,'' 
not only ``a qualified employee with a known limitation''; 
therefore, an employee, applicant, or former employee need not 
establish that they have a known limitation or are qualified (as 
those terms are defined in the PWFA) to bring a claim under 42 
U.S.C. 2000gg-2(f)(1).\179\
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    \179\ See Enforcement Guidance on Retaliation, supra note 89, at 
(II)(A)(3).
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    9. Second, a request for a reasonable accommodation under the 
PWFA constitutes protected activity, and therefore retaliation for 
such a request is prohibited.\180\
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    \180\ See id. at (II)(A)(2)(e) and Example 10.
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    10. Third, an employee, applicant, or former employee does not 
have to be actually deterred from exercising or enjoying rights 
under this section for the retaliation to be actionable.\181\
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    \181\ See id. at (II)(B)(1), (2) (stating that the retaliation 
``standard can be satisfied even if the individual was not in fact 
deterred'' and that ``[i]f the employer's action would be reasonably 
likely to deter protected activity, it can be challenged as 
retaliation even if it falls short of its goal'').
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1636.5(f)(2) Prohibition Against Coercion

    11. The PWFA's anti-coercion provision uses the same language as 
the ADA's interference provision, with one minor variation in the 
title of the section.\182\ The scope of the PWFA anti-coercion 
provision is broader than the anti-retaliation provision; it reaches 
those instances ``when conduct does not meet the `materially 
adverse' standard required for retaliation.'' \183\ Following the 
language of 42 U.S.C. 2000gg-2(f)(2) and consistent with the ADA's 
analogous interference provision, Sec.  1636.5(f)(2) protects 
individuals, not qualified employees with a known limitation under 
the PWFA. Thus, the individual need not be an employee, applicant, 
or former employee and need not establish that they have a known 
limitation or that they are qualified (as those terms are defined in 
the PWFA) to bring a claim for coercion under the PWFA.\184\
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    \182\ The ADA uses the phrase ``Interference, coercion, or 
intimidation'' to preface the prohibition against interference (42 
U.S.C. 12203(b)), whereas the PWFA uses ``Prohibition against 
coercion'' (42 U.S.C. 2000gg-2(f)(2)). The language of the 
prohibitions is otherwise identical.
    \183\ See Enforcement Guidance on Retaliation, supra note 89, at 
(III).
    \184\ See id.
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    12. The purpose of this provision is to ensure that employees 
are free to avail themselves of the protections of the statute. 
Thus, consistent with the ADA regulation for the analogous 
provision, Sec.  1636.5(f)(2) includes ``harass'' in the list of 
prohibitions; the inclusion is intended to characterize the type of 
adverse treatment that may in some circumstances violate the 
coercion provision.\185\ Section 1636.5(f)(2) also states that an 
individual does not actually have to be deterred from exercising or 
enjoying rights under this section for the coercion to be 
actionable.\186\
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    \185\ See 29 CFR 1630.12(b); see also Enforcement Guidance on 
Retaliation, supra note 89, at text accompanying n.177 (stating, 
with regard to the ADA, that ``[t]he statute, regulations, and court 
decisions have not separately defined the terms `coerce,' 
`intimidate,' `threaten,' and `interfere.' Rather, as a group, these 
terms have been interpreted to include at least certain types of 
actions which, whether or not they rise to the level of unlawful 
retaliation, are nevertheless actionable as interference.'').
    \186\ See Enforcement Guidance on Retaliation, supra note 89, at 
(II)(B)(1), (2) (noting that actions can be challenged as 
retaliatory even if the person was not deterred from engaging in 
protected activity).
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    13. Importantly the coercion provision does not apply to any and 
all conduct or statements that an individual finds intimidating; it 
only prohibits conduct that is reasonably likely to interfere with 
the exercise or enjoyment of PWFA rights.\187\
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    \187\ See id at (III) (discussing the ADA's interference 
provision).
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    Some examples of coercion include:
     coercing an individual to relinquish or forgo an 
accommodation to which they are otherwise entitled;
     intimidating an applicant from requesting an 
accommodation for the application process by indicating that such a 
request will result in the applicant not being hired;
     issuing a policy or requirement that purports to limit 
an employee's rights to invoke PWFA protections (e.g., a fixed leave 
policy that states ``no exceptions will be made for any reason'');
     interfering with a former employee's right to file a 
PWFA lawsuit against a former employer by stating that a negative 
job reference will be given to prospective employers if the suit is 
filed; and
     subjecting an employee to unwarranted discipline, 
demotion, or other adverse treatment because they assisted a 
coworker in requesting a reasonable accommodation.\188\
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    \188\ See id.
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Possible Violations of 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) Based on 
Seeking Supporting Documentation During the Reasonable Accommodation 
Process and Disclosure of Medical Information

    14. Seeking documentation or information that goes beyond the 
parameters laid out in Sec.  1636.3(l) when an employee requests a 
reasonable accommodation under the PWFA may violate 42 U.S.C. 
2000gg-2(f) (Sec.  1636.5(f)) because seeking such information or 
documentation might well dissuade a reasonable person from engaging 
in protected activity, such as requesting a reasonable 
accommodation, or might constitute coercion. Circumstances under 
which going beyond the parameters of Sec.  1636.3(l) may violate 42 
U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) include:
     Seeking supporting documentation or information in 
response to an employee's request for reasonable accommodation when 
it is not reasonable under the circumstances for the covered entity 
to determine whether the employee has a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions (a limitation) and needs an adjustment or 
change at work due to the limitation, whether or not the employee 
provides the documentation or information and whether or not the 
employer grants the accommodation.
     Continued efforts to obtain more information or 
supporting documentation when sufficient information or supporting 
documentation has already been provided to allow the employer to 
determine whether the employee has a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions (a limitation) and the adjustment or 
change at work that is needed due to the limitation, whether or not 
the employee provides the documentation or information and whether 
or not the employer grants the accommodation.\189\
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    \189\ This is based on a similar policy adopted under the ADA. 
See Enforcement Guidance on Disability-Related Inquiries, supra note 
152, at Question 11 (``[W]hen an employee provides sufficient 
evidence of the existence of a disability and the need for 
reasonable accommodation, continued efforts by the employer to 
require that the individual provide more documentation and/or submit 
to a medical examination could be considered retaliation.''). The 
Commission notes that if the covered entity can show that it had a 
good faith belief that the submitted documentation was insufficient 
and thus sought additional documentation, its actions would not be 
retaliatory because they would lack the requisite intent.
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    15. Disclosing medical information, threatening to disclose 
medical information, or requiring an employee to share their medical 
information other than in the limited situations set out in section 
1636.7(a)(1) of this appendix under Prohibition on Disability-
Related Inquiries and Medical Examinations and Protection of Medical 
Information also may violate 42 U.S.C. 2000gg-2(f) (Sec.  1636.5(f)) 
because such actions might well dissuade a reasonable person from 
engaging in protected activity, such as requesting a reasonable 
accommodation, or might constitute coercion.\190\
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    \190\ As described in detail infra in section 1636.7(a)(1) of 
this appendix under Prohibition on Disability-Related Inquiries and 
Medical Examinations and Protection of Medical Information, the 
ADA's rules on medical confidentiality apply to medical information 
obtained under the PWFA and allow for disclosure of such information 
only in specific, limited circumstances. See 42 U.S.C. 12112(d)(3); 
29 CFR 1630.14; Enforcement Guidance on Disability-Related 
Inquiries, supra note 152, at text accompanying nn.9-10; Enforcement 
Guidance: Preemployment Disability-Related Questions, supra note 
152, at text accompanying n.6.
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    16. Actions that the courts or the Commission have previously 
determined may be retaliation or interference under Title VII or the 
ADA may violate the retaliation and coercion provisions of the PWFA 
as well. Depending on the facts, a covered entity's retaliation for 
activity protected under the PWFA also may violate 42 U.S.C. 2000gg-
1(1) (because these actions may make the accommodation ineffective) 
or 2000gg-1(5) (prohibiting adverse actions) (Sec.  1636.4(a) and 
(e)).
    17. The following examples could violate 42 U.S.C. 2000gg-2(f) 
and also may violate 42 U.S.C. 2000gg-1(1), (5) or other laws.
    Example #61/Retaliatory Performance Appraisal: Perrin requests a 
stool to sit on

[[Page 29217]]

due to her pregnancy which makes standing difficult. Lucy, Perrin's 
supervisor, denies Perrin's request. The corporate human resources 
department instructs Lucy to grant the request because there is no 
undue hardship. Angry about being told to provide the reasonable 
accommodation, Lucy thereafter gives Perrin an unjustified poor 
performance rating and denies Perrin's request to attend training 
that Lucy approves for Perrin's coworkers.
    Example #62/Retaliatory Surveillance: Marisol files an EEOC 
charge after Cyrus, her supervisor, refuses to provide her with the 
reasonable accommodation of help with lifting following her cesarean 
section. Marisol also alleges that after she requested the 
accommodation, Cyrus asked two coworkers to: conduct surveillance on 
Marisol, including watching her at work; note with whom she 
associated in the workplace; suggest to other employees that they 
should avoid her; and report her breaks to Cyrus, who said he kept a 
record of this information ``just in case.''
    Example #63/Seeking Supporting Documentation Beyond Sec.  
1636.3(l): Mara provides her employer with a note from her health 
care provider explaining that she is pregnant and will need the 
functions of her position that require her to be around certain 
chemicals to be temporarily suspended. Mara's supervisor requires 
that Mara confirm the pregnancy through an ultrasound, even though 
the employer already has sufficient information to determine whether 
Mara has a physical or mental condition related to, affected by, or 
arising out of pregnancy, childbirth, or related medical conditions 
(a limitation) and needs an adjustment or change at work due to the 
limitation.
    Example #64/Dissuaded from Requesting an Accommodation: During 
an interview at an employment agency, Arden tells the human 
resources staffer, Stanley, that Arden is dealing with complications 
from their recent childbirth and may need time off for doctor's 
appointments during their first few weeks at work. Stanley counsels 
Arden that needing leave so soon after starting will be a ``black 
mark'' on their application and that it would be a waste of time for 
the employment agency to try to find work for Arden.
    Example #65/Threatening Future Employment: Merritt, who gets 
jobs through an employment agency, is fired after requesting an 
accommodation under the PWFA. The employment agency refuses to refer 
Merritt to other employers, telling Merritt that the agency only 
refers workers who will not cause any trouble.
    Example #66/Disciplined for Assisting Other Employees: Jessie, a 
factory union steward, ensures that workers know about their rights 
under the PWFA and encourages employees with known limitations to 
ask for reasonable accommodations. Jessie helps employees navigate 
the reasonable accommodation process and provides suggestions of 
possible reasonable accommodations. Factory supervisors, annoyed by 
the number of PWFA reasonable accommodation requests, write up 
Jessie for trivial timekeeping violations and other actions that had 
not been deemed worthy of discipline prior to Jessie assisting other 
employees with their PWFA accommodation requests.
    Example #67/Negative Reference: While she was pregnant, Laila 
requested and received the reasonable accommodation of a temporary 
suspension of the essential function of moving heavy boxes and 
placement in the light duty program. After giving birth, Laila tells 
her employer that she has decided to resign and stay home for a 
year. Her employer responds that if Laila follows through and 
resigns now, the employer will have no choice but to give her a 
negative reference because Laila demanded an accommodation but did 
not have the loyalty to come back after having her baby.
    Example #68/Seeking Supporting Documentation Beyond Sec.  
1636.3(l): Robbie, a retail worker, is pregnant. Her job requires 
her to stand at a cash register. Because of her pregnancy, Robbie 
has difficulty standing for long periods of time. Robbie explains 
the situation to the manager, who requires Robbie to produce a 
signed doctor's note saying that Robbie is pregnant and needs to 
sit. Because Robbie is pregnant and has requested one of the simple 
modifications that will virtually always be found to be a reasonable 
accommodation that does not impose an undue hardship, and she has 
confirmed the limitation and her need for the modification due to 
the limitation, the manager is not permitted to seek supporting 
documentation, as set forth in Sec.  1636.3(l)(1)(iii).
    Example #69/Disciplined Through Workplace Policy: Tina gave 
birth and started a new job. She is experiencing urinary 
incontinence related to, affected by, or arising out of childbirth 
and needs time to attend a medical appointment. Her new employer has 
a policy that employees cannot be absent during the first 90 days of 
work. Tina requests and is given the reasonable accommodation of 
time to attend her medical appointment, but then is issued a 
disciplinary write-up for missing work during her first 90 days.
    Example #70/Retaliatory Failure to Provide Interim Reasonable 
Accommodation: Dominique is lactating and, based on the 
recommendation of her health care provider, requests additional 
safety gear and protection to reduce the risk that chemicals she 
works with will contaminate her breast milk. The equipment has to be 
ordered, and the employer puts Dominique on unpaid leave while 
waiting for the equipment, although there is available work that 
Dominique could perform that would not require her to be around the 
chemicals while she waits for the additional safety gear. 
Additionally, her supervisor tells human resources staff that he is 
tired of accommodating Dominique because she asked for 
accommodations during her pregnancy as well and there has to be an 
end to her requests.
    Example #71/Retaliation for Requesting Safety Information: Wynne 
is pregnant and is in a probationary period as a janitor. She asks 
her supervisor for safety information about the cleaning products 
that she handles as part of her job and explains it is to help her 
determine if she needs to ask for a reasonable accommodation 
regarding exposure to the chemicals. Her supervisor tells her not to 
worry and warns her that trying to get this kind of information will 
mark her as a troublemaker. During her first review near the end of 
the probationary period, the supervisor notes that, for an entry-
level janitor, Wynne asks many questions and behaves like a 
troublemaker. The supervisor terminates Wynne even though she was 
performing satisfactorily.
    Example #72/Seeking Supporting Documentation Beyond Sec.  
1636.3(l): An employer adopts a policy requiring everyone who 
requests a reasonable accommodation to provide medical documentation 
in support of the request. Cora, a production worker who is 8 months 
pregnant, requests additional bathroom breaks. The employer applies 
the policy to her, refusing to provide the accommodation until she 
submits supporting documentation, even though under Sec.  
1636.3(l)(1)(iii) the employer is not permitted to seek 
documentation in this situation.
    Example #73/Seeking Supporting Documentation Beyond Sec.  
1636.3(l) and Failure to Provide Accommodation: An employer adopts a 
policy requiring everyone who requests a reasonable accommodation to 
provide supporting documentation. Fourteen months after giving 
birth, Alex wants to continue to pump at work, which is beyond the 
length of time the PUMP Act requires. She explains her request to 
her supervisor and asks that she have breaks to pump and that the 
room provided have a chair, a table, access to electricity and 
running water. Alex's employer refuses to grant the accommodations 
unless Alex provides supporting documentation from her health care 
provider. Alex cannot provide the information, so she stops pumping. 
In addition to potentially violating 42 U.S.C 2000gg-2(f), the 
employer cannot use the lack of supporting documentation as a 
defense to the failure to provide the accommodations because seeking 
documentation was not reasonable under the circumstances as set 
forth in Sec.  1636.3(l)(1)(iv) and thus these actions may violate 
42 U.S.C 2000gg-1(1) (Sec.  1636.4(a)(3)).
    Example #74/Retaliatory Waiver of Rights: An employer adopts a 
policy under which an employee who files a claim with the EEOC or 
another outside agency automatically waives their right to have a 
complaint processed through the employer's internal complaint 
procedure. Rebecca submitted an internal complaint to her supervisor 
after her request for a reasonable accommodation was denied and, a 
month later, filed a charge with the EEOC. The employer notified her 
that it would stop investigating her internal complaint until the 
EEOC matter was resolved, but that she would be free to pursue the 
internal resolution of her complaint if she withdrew her EEOC 
charge. The employer's policy is retaliatory because it adversely 
affects the employee by stripping her of an employment privilege for 
filing a charge with the EEOC.
    Example #75/Disclosure of Medical Information: Caroline 
requested and received an accommodation under the PWFA in the form 
of a lifting restriction due to a back injury related to her 
pregnancy. Caroline's

[[Page 29218]]

accommodation was granted early in her third trimester. Two weeks 
after her accommodation went into effect, during a team meeting, 
Caroline's supervisor went around the table describing each team 
members' duties, sighing as she explained that Caroline had a back 
injury due to pregnancy that prevented her from lifting and that 
Caroline's injury was the reason that other team members had extra 
duties. At each biweekly team meeting for the next two months, 
Caroline's supervisor noted that team members continued to be 
assigned extra duties because of Caroline's back injury. In addition 
to potential violation 42 U.S.C 2000gg-2(f), this disclosure of 
medical information violates the ADA's confidentiality rules, as it 
does not fit within any of the five disclosure exceptions.
    Example #76/Retaliatory Harassment: Benita requested and 
received an accommodation under the PWFA in the form of a one-hour 
delayed start time due to morning sickness related to her pregnancy. 
Benita's coworkers are aware that she is receiving the accommodation 
due to a condition related to her pregnancy. A few days after 
Benita's accommodation is granted, her coworkers start to make 
unwelcome, critical comments about her ``late'' arrivals on a 
frequent basis, including that other pregnant individuals were able 
to start work on time during their pregnancies, that being able to 
``work during pregnancy is mind over matter,'' and calling her 
``lazy'' and a ``slacker.'' The coworkers schedule meetings that 
begin a half hour before Benita arrives in the office and complain 
to Benita's supervisor that she arrives late to those meetings. 
Because she cannot attend the meetings, Benita falls behind on her 
work.

1636.5(g) Limitation on Monetary Damages

    18. The PWFA at 42 U.S.C. 2000gg-2(g), using the language of the 
Civil Rights Act of 1991, 42 U.S.C. 1981a(a)(3), provides a 
limitation on damages based on a ``good faith effort'' to provide a 
reasonable accommodation. The covered entity bears the burden of 
proof for this affirmative defense. This limitation on damages 
applies to violations of 42 U.S.C. 2000gg-1(1) (Sec.  1636.4(a)) 
only. It does not apply to any other provisions of the PWFA.

VI. 1636.7 Relationship to Other Laws

1636.7(a)(1) Relationship to Other Laws in General

    1. The PWFA does not limit the rights of individuals affected by 
pregnancy, childbirth, or related medical conditions under a 
Federal, State, or local law that provides greater or equal 
protection. It is equally true that a Federal, State, or local law 
that provides less protection for individuals affected by pregnancy, 
childbirth, or related medical conditions than the PWFA does not 
limit the rights provided by the PWFA.
    2. Federal laws, including, but not limited to, Title VII, the 
ADA, the FMLA, the Rehabilitation Act, the PUMP Act, and Title IX of 
the Education Amendments of 1972, 20 U.S.C. 1681 et seq., provide 
protections for employees affected by pregnancy, childbirth, or 
related medical conditions. Numerous States and localities also have 
laws that provide accommodations for pregnant employees.\191\ All of 
the protections for employees affected by pregnancy, childbirth, or 
related medical conditions in these laws are unaffected by the PWFA. 
If these laws provide greater protections than the PWFA, the greater 
protections will apply. For example, the State of Washington's 
Healthy Starts Act provides that certain accommodations, including 
lifting restrictions of 17 pounds or more, cannot be the subject of 
an undue hardship defense.\192\ If an employee in Washington is 
seeking a lifting restriction as a reasonable accommodation for a 
pregnancy-related reason under the Healthy Starts Act, an employer 
in Washington cannot argue that a lifting restriction of 20 pounds 
is an undue hardship, even though that defense could be raised if 
the claim were brought under the PWFA.
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    \191\ U.S. Dep't of Lab., Women's Bureau, Employment Protections 
for Workers Who Are Pregnant or Nursing, www.dol.gov/agencies/wb/pregnant-nursing-employment-protections (last visited Mar. 25, 
2024).
    \192\ Wash. Rev. Code 43.10.005(1)(d).
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    3. Section 1636.7(a) also applies to Federal or State 
occupational health and safety laws and collective bargaining 
agreements (CBAs). Thus, nothing in the PWFA limits an employee's 
rights under laws such as the OSH Act or under a CBA if either of 
those provide protection greater than or equal to that of the PWFA.

The PWFA and Title VII

    4. The PWFA uses many terms and definitions from Title VII, and 
conduct that is the subject of PWFA claims also may give rise to 
claims under Title VII. For example, a qualified pregnant employee 
who sought leave for recovery from childbirth and was terminated may 
have a claim under both Title VII for sex discrimination and the 
PWFA for failure to accommodate, adverse employment action, or 
retaliation.\193\
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    \193\ See 42 U.S.C. 2000gg-1(1), (5); 2000gg-2(f).
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    5. Under Title VII, employees affected by pregnancy, childbirth, 
or related medical conditions may be able to receive accommodations 
if they can identify a comparator similar in their ability or 
inability to work.\194\ Under the PWFA, qualified employees with 
physical or mental conditions related to, affected by, or arising 
out of pregnancy, childbirth, or related medical conditions are 
entitled to reasonable accommodations (absent undue hardship) 
whether or not other employees have those accommodations and whether 
or not the affected employees are similar in their ability or 
inability to work as employees not so affected. Additionally, if the 
covered entity offers a neutral reason or policy to explain why 
qualified employees affected by pregnancy, childbirth, or related 
medical conditions cannot access a specific benefit, the qualified 
employee with a known limitation under the PWFA still may ask for a 
waiver of that policy as a reasonable accommodation. Under the PWFA, 
the employer must grant the waiver, or another reasonable 
accommodation, absent undue hardship. If, for example, an employer 
denies a qualified pregnant employee's request to join its light 
duty program as a reasonable accommodation because the program is 
for employees with on-the-job injuries, it may be a reasonable 
accommodation for the employer's light duty program policy to be 
waived. Finally, employers in this situation should remember that if 
there are others to whom the benefit is extended, the Supreme Court 
stated in Young v. UPS that ``[the employer's] reason [for refusing 
to accommodate a pregnant employee] normally cannot consist simply 
of a claim that it is more expensive or less convenient to add 
pregnant women to the category of those . . . whom the employer 
accommodates.'' \195\ Thus, if the undue hardship defense of the 
employer under the PWFA is based solely on cost or convenience, that 
defense could, under certain fact patterns, nonetheless lead to 
liability under Title VII.
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    \194\ 42 U.S.C. 2000e(k).
    \195\ 575 U.S. at 229.
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    6. Finally, nothing in the PWFA, this part, or this Interpretive 
Guidance should be interpreted to reduce or limit any protections 
provided by Title VII.

The PWFA and the ADA

    7. The PWFA uses many terms and definitions from the ADA. 
Conduct that is the subject of PWFA claims also may give rise to 
claims under the ADA. For example, an employee with postpartum 
depression seeking a reasonable accommodation to attend treatment 
whose employer fails to provide the accommodation may have a claim 
under both the PWFA and the ADA (and possibly also Title VII). 
Similarly, an employee who has a physical or mental condition 
related to, affected by, or arising out of pregnancy, childbirth, or 
related medical conditions may have both a known limitation under 
the PWFA and a disability under the ADA (where the physical or 
mental condition substantially limits a major life activity, 
including a major bodily function--in other words, the individual 
would have an ``actual'' ADA disability).\196\ In such case, the 
employee may be entitled to accommodation, absent undue hardship, 
under both the PWFA and the ADA.
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    \196\ 42 U.S.C. 12102(1); 29 CFR 1630.2(g).
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    8. While it will depend on the specific facts, if an employee 
could be covered under either the PWFA or the ADA, a covered 
entity's analysis, in most cases, should begin with the PWFA because 
the definition of ``known limitation'' under the PWFA covers 
situations when the ADA does not apply.\197\
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    \197\ 42 U.S.C. 2000gg(4).
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    9. Requests for accommodation under the PWFA may be 
indistinguishable from requests for accommodation under the ADA and 
there will be situations in which both statutes apply. In one 
instance, the PWFA known limitation also may be an ADA disability. 
In another, employees with existing disabilities may seek ADA 
coverage for those, while also invoking the PWFA to address 
limitations related to pregnancy, childbirth, or related medical 
conditions interacting with an existing disability. In these 
situations, employees with disabilities may require additional or 
different accommodations and are entitled to them,

[[Page 29219]]

absent undue hardship, under the PWFA and/or the ADA.
    10. There also will be situations where an employee with a 
disability who has an accommodation under the ADA seeks and is 
granted an accommodation under the PWFA. For example, an employee 
who uses an adaptive keyboard as an ADA reasonable accommodation 
temporarily may be assigned to a new position as part of an 
accommodation under the PWFA because an essential function of their 
original position has been temporarily suspended. In this situation, 
the employer must continue to provide the adaptive keyboard as an 
ADA reasonable accommodation if it is necessary for the employee to 
perform the essential functions of the new position.
    11. Because an individual may be covered by both the ADA and the 
PWFA, and the PWFA provides at 42 U.S.C. 2000gg-5(a)(1) that nothing 
in the statute shall be construed to invalidate or limit the powers, 
remedies, and procedures under any Federal law that provides greater 
or equal protection for individuals affected by pregnancy, 
childbirth, or related medical conditions, a covered entity must 
apply the law that provides the worker the most protection.
    12. Examples Regarding Disability and Pregnancy:
    Example #77/Disability and Pregnancy: Roxy is an accountant who 
has developed gestational hypertension and preeclampsia late in her 
pregnancy, causing damage to her kidneys. As a result, Roxy needs 
leave for periodic medical appointments to protect her own health 
and the health of her pregnancy. Because Roxy's condition is both a 
physical or mental condition related to, affected by, or arising out 
of pregnancy, childbirth, or related medical conditions and a 
condition that substantially limits one of her major bodily 
functions (kidney function), it qualifies as both a limitation under 
the PWFA and a disability under the ADA. Absent undue hardship, the 
employer must provide Roxy with the accommodation she requires due 
to her pregnancy (under the PWFA) and her disability (under the 
ADA). Of course, one effective accommodation may be sufficient to 
satisfy requirements under both statutes in this instance.
    Example #78/Disability and Pregnancy: Farah is a nurse who has 
diabetes, and her employer has provided her with the accommodation 
of breaks to eat small meals throughout the day and breaks to check 
her insulin levels. When Farah becomes pregnant, she experiences 
morning sickness that makes it difficult for her to eat in the 
morning. As a result, she needs more breaks for eating later in the 
day and occasionally needs a break to rest while at work. Absent 
undue hardship, the employer must provide Farah with the additional 
accommodations she requires due to her pregnancy under the PWFA.
    13. In cases where both the ADA and PWFA apply, if an employer 
fails to provide an accommodation the employee could potentially 
file a claim for failure to accommodate under both the ADA and the 
PWFA. They also could file a separate ADA claim if they experienced 
disparate treatment based on a disability.

Prohibition on Disability-Related Inquiries and Medical Examinations 
and Protection of Medical Information

    14. Important protections from the ADA that apply to all covered 
employees continue to apply when employees are seeking 
accommodations under the PWFA. First, the rules limiting the ability 
of covered entities to make disability-related inquiries or require 
medical exams in the ADA apply to all disability-related inquiries 
and medical exams including those made in the context of requests 
for PWFA accommodation.\198\ For example, a covered entity may not 
ask an employee who is seeking an accommodation under the PWFA 
whether the employee has asked for other accommodations in the past 
or has preexisting conditions because these questions are likely to 
elicit information about a disability and are not job-related and 
consistent with business necessity in this context. Similarly, an 
employer's response to an employee's request for accommodation under 
the PWFA that requires the employee to complete a release permitting 
the employer to obtain the employee's complete medical records would 
not be job-related or consistent with business necessity.
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    \198\ See 42 U.S.C. 12112(d); 29 CFR 1630.13, 1630.14.
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    15. Second, under the ADA, covered entities are required to keep 
medical information of all applicants, employees, and former 
employees (whether or not those individuals have disabilities) 
confidential, with limited exceptions.\199\ The Commission has 
repeatedly stated that the requirement applies to all medical 
information in the employer's possession, whether obtained through 
inquiries pursuant to the ADA or otherwise.\200\ Thus, this 
protection applies to medical information obtained under the PWFA, 
including medical information provided voluntarily and medical 
information provided as part of the reasonable accommodation 
process. Moreover, as a practical matter, in many circumstances 
under the PWFA, the medical information obtained by an employer may 
involve a condition that could be a disability; rather than an 
employer attempting to parse out whether to keep certain information 
confidential or not, all medical information should be kept 
confidential.\201\ Therefore, medical information obtained under the 
PWFA is subject to the ADA requirement that information regarding 
the medical condition or history of any employee be collected and 
maintained on separate forms and in separate medical files and be 
treated as a confidential medical record.\202\
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    \199\ 42 U.S.C. 12112(d)(3)(B); 29 CFR 1630.14(b)(1)(i) through 
(iii), (c)(1), (d)(4); Enforcement Guidance on Disability-Related 
Inquiries, supra note 152, at text accompanying nn.9-10 (``The ADA 
requires employers to treat any medical information obtained from a 
disability-related inquiry or medical examination . . ., as well as 
any medical information voluntarily disclosed by an employee, as a 
confidential medical record. Employers may share such information 
only in limited circumstances with supervisors, managers, first aid 
and safety personnel, and government officials investigating 
compliance with the ADA.'') and text after n.12 (``[T]he ADA's 
restrictions on inquiries and examinations apply to all employees, 
not just those with disabilities.''); Enforcement Guidance: 
Preemployment Disability-Related Questions, supra note 152, at text 
accompanying n.6 (``Medical information must be kept 
confidential.'').
    \200\ See supra note 199. This policy also appears in numerous 
EEOC technical assistance documents. See, e.g., EEOC, Visual 
Disabilities in the Workplace and the Americans with Disabilities 
Act, at text preceding n.43 (2023), https://www.eeoc.gov/laws/guidance/visual-disabilities-workplace-and-americans-disabilities-act#q8 (``With limited exceptions, an employer must keep 
confidential any medical information it learns about an applicant or 
employee.'').
    \201\ Requests for accommodation under the PWFA also may overlap 
with FMLA issues, and the FMLA requires medical information to be 
kept confidential as well. 29 CFR 825.500(g).
    \202\ 42 U.S.C. 12112(d)(3)(B); 29 CFR 1630.14(b)(1), (c)(1), 
and (d)(4)(i); see Enforcement Guidance: Preemployment Disability-
Related Questions, supra note 152, at text accompanying the question 
``Can medical information be kept in an employee's regular personnel 
file?''
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    16. That an employee is pregnant, has recently been pregnant, or 
has a medical condition related to pregnancy or childbirth is 
medical information. The ADA requires that employers keep such 
information confidential and only disclose it within the confines of 
the limited disclosure rules described in paragraphs 17 and 18 of 
this section. Similarly, disclosing that an employee is receiving or 
has requested an accommodation under the PWFA, or has limitations 
for which they requested or are receiving a reasonable accommodation 
under the PWFA, usually amounts to a disclosure that the employee is 
pregnant, has recently been pregnant, or has a related medical 
condition.
    17. As set forth at 29 CFR 1630.14, under the ADA, medical 
information must be collected and maintained on separate forms and 
in separate medical files and be treated as a confidential medical 
record, except that:
    (i) Supervisors and managers may be informed regarding necessary 
restrictions on the work or duties of the employee and necessary 
accommodations;
    (ii) First aid and safety personnel may be informed, when 
appropriate, if the disability might require emergency treatment; 
and
    (iii) Government officials investigating compliance with the ADA 
shall be provided relevant information on request.
    18. In addition to what is stated in the ADA regulation: covered 
entities (iv) may disclose the medical information to State workers' 
compensation offices, State second injury funds, or workers' 
compensation insurance carriers in accordance with State workers' 
compensation laws; and (v) may use the medical information for 
insurance purposes.\203\ All these disclosure exceptions apply to 
medical information obtained under the PWFA. Disclosing medical 
information in any circumstances, other than those set forth in 
these five recognized disclosure exceptions, violates the ADA's 
confidentiality rule.
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    \203\ See Enforcement Guidance: Preemployment Disability-Related 
Questions, supra note 152, at text accompanying the heading 
``Confidentiality.''
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    19. In addition, as explained in section 1636.5(f) of this 
appendix under Possible Violations of 42 U.S.C. 2000gg-2(f)

[[Page 29220]]

(Sec.  1636.5(f)) Based on Seeking Supporting Documentation During 
the Reasonable Accommodation Process and Disclosure of Medical 
Information, disclosing medical information, threatening to disclose 
medical information, or requiring an employee to share their medical 
information other than in the limited situations set out in 
paragraphs 17 and 18 of this section also may violate 42 U.S.C. 
2000gg-2(f) (Sec.  1636.5(f)).\204\ Given the protections for 
confidential medical information under the ADA and the potential of 
violating 42 U.S.C. 2000gg-2(f), if a covered entity is under an 
obligation to disclose medical information received under the PWFA 
in any circumstances other than those provided in this Interpretive 
Guidance, before doing so it should inform the individual to whom 
the information relates of its intent to disclose the information; 
identify the specific reason for the disclosure; and provide 
sufficient time for the individual to object.
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    \204\ See, e.g., Haire v. Farm & Fleet of Rice Lake, Inc., No. 
2:21-CV-10967, 2022 WL 128815, at *8-*9 (E.D. Mich. Jan. 12, 2022) 
(disclosing personal and confidential information about an 
employee's medical condition and mental health episodes to her 
coworkers could constitute retaliation under Title VII); Holtrey v. 
Collier Cnty. Bd. of Cnty. Comm'rs, No. 2:16-CV-00034, 2017 WL 
119649, at *3 (M.D. Fla. Jan. 12, 2017) (determining that an 
employer's disclosure of its employee's confidential medical 
information about his genito-urinary system to his coworkers and 
subordinates could constitute retaliation under FMLA, relying on 
Title VII's definition of ``materially adverse action'').
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    20. Finally, nothing in the PWFA, this part, or this 
Interpretive Guidance should be interpreted to reduce or limit any 
protections provided by the ADA.

1636.7(a)(2) Limitations Related to Employer-Sponsored Health Plans

    21. The statute at 42 U.S.C. 2000gg-5(a)(2) states that nothing 
in the PWFA shall be construed to require an employer-sponsored 
health plan to pay for or cover any item, procedure, or treatment 
and, further, that nothing in the PWFA shall be construed to affect 
any right or remedy available under any other Federal, State, or 
local law with respect to any such payment or coverage requirement. 
For example, nothing in the PWFA requires, or forbids, an employer 
to pay for health insurance benefits for an abortion.

1636.7(b) Rule of Construction

    22. The statute at 42 U.S.C. 2000gg-5(b) provides a ``rule of 
construction'' stating that the PWFA is ``subject to the 
applicability to religious employment'' set forth in section 702(a) 
of the Civil Rights Act of 1964, 42 U.S.C. 2000e-1(a). The relevant 
portion of section 702(a) provides that Title VII shall not apply to 
a religious corporation, association, educational institution, or 
society with respect to the employment of individuals of a 
particular religion to perform work connected with the carrying on 
by such corporation, association, educational institution, or 
society of its activities.\205\ Section 1636.7(b) reiterates the 
PWFA statutory language and adds that nothing in 42 U.S.C. 2000g-
5(b) or this part should be interpreted to limit the rights of a 
covered entity under the U.S. Constitution or the rights of an 
employee under other civil rights statutes. As with assertions of 
section 702(a) of the Civil Rights Act of 1964 in Title VII matters, 
when 42 U.S.C. 2000gg-5(b) is asserted by a respondent employer, the 
Commission will consider the application of the provision on a case-
by-case basis.\206\
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    \205\ The PWFA makes no mention of section 703(e)(2) of the 
Civil Rights Act of 1964, which provides a second statutory 
exemption for religious educational institutions in certain 
circumstances.
    \206\ The case-by-case analysis of religious defenses asserted 
in response to a charge under the PWFA is consistent with the 
Commission's framework evaluating similar defenses under other 
statutes the Commission enforces. See Compliance Manual on Religious 
Discrimination, supra note 163, at (12-I)(C).
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VII. 1636.8 Severability

    1. The PWFA at 42 U.S.C. 2000gg-6 contains a severability 
provision regarding the statute. Section 1636.8 repeats the 
statutory provision and also addresses the Commission's intent 
regarding the severability of the Commission's regulations in this 
part and this Interpretive Guidance.
    2. Following Congress' rule for the statute, in places where 
this part uses the same language as the statute, if any of those 
identical regulatory provisions, or the application of those 
provisions to particular persons or circumstances, is held invalid 
or found to be unconstitutional, the remainder of this part and the 
application of that provision of this part to other persons or 
circumstances shall not be affected.
    3. In other places, where this part or this Interpretive 
Guidance provide additional guidance to carry out the PWFA, 
including examples of reasonable accommodations, following Congress' 
intent regarding the severability of the provisions of the statute, 
it is the Commission's intent that if any of those regulatory 
provisions or the Interpretive Guidance or the application of those 
provisions or the Interpretive Guidance to particular persons or 
circumstances is held invalid or found to be unconstitutional, the 
remainder of this part or the Interpretive Guidance and the 
application of that provision of this part or the Interpretive 
Guidance to other persons or circumstances shall not be affected.

[FR Doc. 2024-07527 Filed 4-15-24; 11:15 am]
BILLING CODE 6570-01-P