Legal Gaps in Workplace Accommodations for Polygenic Risk Scores

A routine medical visit may now include a polygenic risk score that estimates an individual’s future likelihood of developing conditions such as heart disease, diabetes, or cancer. When an employee presents such a result and requests a less physically demanding role or reduced stress to mitigate the projected risk, current U.S. law permits the employer to refuse the accommodation. The legal framework does not obligate employers to adjust work duties based on a predicted, rather than an existing, health condition.

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Traditional genetic tests focus on single-gene mutations that cause disorders like Huntington’s disease; polygenic risk scores, by contrast, scan dozens of genetic variants and combine them into a cumulative risk estimate. The Genetic Information Nondiscrimination Act of 2008 (GINA) bars employers from firing workers because of genetic test results, while the Americans With Disabilities Act (ADA) protects individuals who have an active disability. Neither statute, however, requires employers to provide accommodations aimed at preventing a future health event identified by polygenic analysis.

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I. Glenn Cohen, a professor at Harvard Law School who studies bioethics and the law, notes that polygenic risk scores “are going to become an increasing part of your life.” He and other legal and public-health scholars argue that the rapid adoption of these genomic tools has outpaced the statutes designed to regulate genetic information in the workplace.

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Employees who receive high-risk scores may face denial of workplace adjustments that could lower their projected disease risk, leaving them vulnerable to adverse health outcomes without employer support. Employers, meanwhile, confront uncertainty about their legal duties, potentially exposing themselves to litigation if future regulations reinterpret existing protections.

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Under GINA, an employer may not use an employee’s genetic test results as a basis for termination or adverse employment actions. The ADA extends protection only to individuals who presently meet the definition of a disability. Because polygenic risk scores predict future conditions rather than confirm current impairment, neither law compels the provision of preventive accommodations.

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Legal commentators caution that the absence of explicit rules creates a “policy gap” where workers could be dismissed or denied reasonable adjustments despite possessing predictive genetic information. They emphasize the need to reassess whether existing nondiscrimination statutes adequately address the preventive dimension of modern genomic medicine.

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> “These polygenic risk scores are going to become an increasing part of your life,” — I. Glenn Cohen, Professor of Law, Harvard Law School

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> “To me, it’s a great opportunity to reopen questions about what the rules should be — questions that, from a policy perspective, are legitimately hard.” — I. Glenn Cohen, Professor of Law, Harvard Law School

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No federal regulation currently defines employer obligations for accommodations based on projected health risks derived from polygenic scoring. Consequently, stakeholders lack a clear legal standard, and the literature reflects divergent interpretations of how GINA and the ADA might be applied to such scenarios.

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Scholars suggest that the emergence of polygenic risk scoring presents an impetus for legislators and regulators to revisit genetic nondiscrimination and disability statutes, aiming to align legal responsibilities with the preventive potential of personalized genomic medicine.

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