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FAQ's Focused On Questions of Deaf and Hard of Hearing Consumers

• What can I do if the health care professional refuses to provide an interpreter?
  First try to explain to the health care professional why you need an interpreter to ensure that the communication between you and the health care professional will be effective. If the professional says that you can read his or her lips, explain why lipreading is not effective. For example, explain that many sounds, such as T and D, look identical on the lips; and that lipreading may be particularly difficult in the medical setting because of complex medical terminology. If the professional says that you can communicate by writing notes, explain why this method would not be effective. Keep the TDD printout of your conversation with the professional if you use a TDD.
• Sample Letter Requesting A Sign Language Interpreter
  Sample Letter Requesting a Sign Language Interpreter Suggested to send as soon as you make the appointment, but at least two weeks prior to the date of your appointment. -Date- -Your Doctor's Name- -Your Doctor's Address- Re: -Your Name- Dear Dr. -Doctor's Last Name-: I have an appointment with you on to establish myself as a new patient with your practice and provide you my medical history. Because I am deaf, I will need a sign language interpreter to communicate effectively with you. I therefore request that you provide an interpreter during my appointment. A resource you can contact is SignLanguageInterpreters.com. Thank you. Sincerely, -Your Name-
• Why are two interpreters needed for my appointment?
  Team interpreting is the utilization of two or more interpreters who support each other to meet the needs of a particular communication situation. Depending on both the needs of the participants and agreement between the interpreters, responsibilities of the individual team members can be rotated and feedback may be exchanged. The decision to use a team rather than an individual interpreter is based on a number of factors, including, but not limited to: * length and/or complexity of the assignment, * unique needs of the persons being served, * physical and emotional dynamics of the setting, * avoidance of repetitive stress injuries (RSIs) for interpreters. An interpreter who is hearing may sometimes team with an interpreter who is deaf, called a certified deaf interpreter (CDI).
• If a family member or friend is able to interpret, is that person a 'qualified interpreter'?
  The Department of Justice has answered this question by stating the following in Appendix B to its ADA regulations: In certain circumstances, notwithstanding that the family member or friend is able to interpret or is a certified interpreter, the family member or friend may not be qualified to render the necessary interpretation because of factors such as emotional or personal involvement or considerations of confidentiality that may adversely affect the ability to interpret "effectively, accurately, and impartially." Thus, if a health care professional asks a family member or friend of a patient who is deaf to interpret, and the patient does not want that person to interpret, the patient should ask the professional to provide someone else.
• If an interpreter is necessary to ensure effective communication, the health care professional must provide a 'qualified interpreter.' Who is a 'qualified interpreter'?
  A qualified interpreter is an interpreter who is able to interpret effectively, accurately, and impartially both receptively and expressively, using any necessary specialized vocabulary.
• If the cost of an interpreter for an office visit exceeds the fee for that visit, can the health care professional charge the person who is deaf for providing an interpreter?
  No. The health care professional still must pay for the interpreter. Health care professionals, like lawyers, accountants, and other public accommodations covered by the ADA, are expected to treat the cost of an interpreter as part of the overhead cost of operating a business.
• Who has to pay for the interpreter?
  The health care professional. A health care professional may not charge a person who is deaf or the person's insurance company for the cost of providing an interpreter. The U.S Department of Justice gives the following example in its technical assistance manual: In order to ensure effective communication with a deaf patient during an office visit, a doctor arranges for the services of a sign language interpreter. The cost of the interpreter's services must be absorbed by the doctor.
• What are the two exceptions to the general rule that a health care professional must provide an interpreter when necessary to ensure effective communication?
  First, a health care professional does not have to provide an interpreter if doing so would result in a "fundamental alteration" of the professional's services. However, this exception will probably never apply because a sign language interpreter would not result in a fundamental alteration of a health care professional's services.
• Can a patient bring the patient's own interpreter for an office visit without first asking the health care professional and then bill the health care professional for the cost of the interpreter?
  No. A patient should not do this because the health care professional should be given an opportunity to consult with the patient and make his/her own determination of whether an interpreter is necessary for effective communication.
• Who ultimately decides whether an interpreter is required – the patient or health care professional?
  The health care professional. However, the health care professional should consult with the patient to determine whether an interpreter is necessary for effective communication. The Department of Justice explains in the technical assistance manual: Public accommodations [such as doctors] should consult with individuals with disabilities wherever possible to determine what type of auxiliary aid is needed to ensure effective communication. . . . While consultation is strongly encouraged, the ultimate decision as to what measures to take to ensure effective communication rests in the hands of the public accommodation, provided the method chosen results in effective communication.
• When is an interpreter necessary to ensure effective communication?
  The answer to this question depends upon the length and complexity of the conversation the Deaf person will be having with the health care professional.