Leave must be requested 30-days in advance and even then it is dependent on who is already on leave during that time-frame. Sick leave and vacation leave are in the same bucket-- you can't use a Doctors Note from an Inova urgent care office for your job at an Inova outpatient office--they don't care because they just want you to do your job.
Human Resources was aware and hired me knowing that I would be requesting a reasonable accommodation for my ADHD. The first accommodation (despite it being a chronic disability) was only two-months long. The two-month long accommodation allowed me to obtain written, bulleted changes to the workflow. The joke was on me though, a written workflow was not established, therefore management would not provide me with written instructions or a listing of daily duties and responsibilities. The two-month accommodation was useless. Afterwards, HR no longer handled R.A's and I worked through Inova's insurance company who also denied my request for written instructions as a reasonable accommodation. I was told that it was too much of a strain to the company to provide this type of accommodation and that it was inappropriate to record patient data. I didn't bother applying for another accommodation because it felt like the were just going to keep denying it. I didn't need anything about patients; I just needed to know the duties and responsibilities of my position and a workflow. So, there I was, working at a fast-paced, front-desk doctors office without a list of daily requirements. If I got stressed and began to forget steps here or there (a symptom of my ADHD), it was too bad because no one would give me process instructions or a checklist of daily work functions (my reasonable accommodation). Without that information, I struggled at times with patients because they would say things like "well I was here last week and wasn't required to do that" or "it wasn't collected last week". Well, the reason it didn't happen last week is because it was insanely busy and I forgot. Not having a workflow or day-to-day listing of duties and responsibilities seemed like an excellent way for management to NOT BE HELD ACCOUNTABLE. Management would email staff non-stop to remember to do this and that--this and that-- but then there would be days when the managers wouldn't do that thing and they weren't held accountable. Very hypocritical.
I worked three months, 4-days a week by myself while my coworker was on maternity leave. During that time, I was stressed and when I get stressed, I forget things (ADHD issues). Since I was unable to be accommodated with written resources, I would forget to do a few tasks; I would become mentally fatigued, and in some instances I would speak more tersely to patients then they wanted to be spoken too. During that 3-month time frame, they had one back-up employee that came in one day a week from Maryland to Sterling, VA. Her commute was anywhere from 46 to 49 miles and sometimes took 2+ hours to get to the office. She'd arrive around 9 am, which at that point in the day, I would have no idea if she was actually coming that day or just stuck in traffic. During that 3-month stressful time period, my childhood friend passed away unexpectantly and suddenly. Although there were only 6 patients on the doctors schedule for the afternoon, management refused to let me take leave to grieve. Needless to say, I was a hot mess serving the front desk that day-- patients couldn't figure out what was wrong with me-- so I finally just told the manager I was leaving and they could deal with it. Can you imagine a health CARE facility not giving you emergency leave to mourn? Doesn't that seem ironic?
I had received one letter of warning for behavior during my last performance review, because I was forgetting to do some tasks. They said I could always come to them if I needed resources. I said-- that's ridiculous because how is that different then me requesting a reasonable accommodation or written workflow/daily duties. I said one expired and the other one was denied. They didn't really have a response for me, other than I could ask them for help whenever.
Once my coworker returned, management chose to hit me with a letter of warning for my behavior. They should have been thanking me for keeping the office running by myself.
I quit the day they attempted to give me a 3rd written warning for behavior. The reason they used for that 3rd letter was for "cussing at a director." This "cussing" took place at an off-the-clock holiday party in Tysons Corner, VA. I was speaking out loud - I was not aiming my words at the Director. Management had not bothered to poll employees for allergies or food intolerances when planning the holiday "Employee Appreciation" event. I drove 27-miles from my home to this "employee appreciation" event and there wasn't anything that I could eat because everything was covered in butter or cheese and I can't eat products made with milk. Therefore, I ordered a hamburger after spending the first 20-minutes trying to work around what was provided. I paid for my meal, and asked management to compensate me for the meal, since this was an employee appreciation event and they had not accommodated me for my food restrictions. They kept saying that they had already spent the budget, and none of the managers or Director could pay for my meal. There were other employees there who couldn't eat because their weren't gluten-free options and their weren't any protein options that didn't include red-meat. This was extremely frustrating to me. Since I was already standing with the Director asking for them to pay my measly hamburger tab, I frustratingly stated/cursed "this is bull poop" and then I left the event to drive the 27-miles back home. I did not curse at the Director; I was stating a fact. It wasn't even about the money, I can afford to pay for a hamburger, however, if the point of an employee appreciation event is to appreciate your employees, then you need to look at several different ways to accommodate them. That occurred in December 2024; however, the Director went on maternity leave and it wasn't until August 2025 that she and HR used that instance of cursing at an off-site employee appreciate event as the "3rd" letter of warning for my behavior. Again, we were not paid for this event; therefore, it was not a work event. How can I be issued a letter of warning for my behavior if it's not at work? I doubt HR even asked what happened- I would like to know what he thought happened that day but frankly I didn't care. The fact that management & HR was willing to stoop so low, scrape the bucket, reach 8-months back in the year to find something to blame me for-- was reason enough for me to quit on the spot that day. Even if it had occurred on a work site, was it even in the same performance time frame? Is there a statute of limitations for how far in the past management can blame an employee for?
Other Cons: The non-Patient Access Associate staff will treat you like you just got out of high school and have never worked a day in your life-- it doesn't matter how much job experience or educational experience you have from other schools/organizations. The moment you are in the PAA role, you become an idiot that doctors, staff, and patients can treat poorly and with disrespect. Not all doctors, not all staff, not all patients-- just the majority. For example, I have a bachelors degree and 14-years of program management experience - however, management wouldn't take any of my process improvement suggestions into account. Although my coworker and I were a solid team at that office, doctors and medical staff would blatantly ignore our advice and go around to our managers directly - only to get the exact same answer. There is no union; if you have a problem with management, you are most likely on your own - because HR will do what it can to save face for the company.
