Employers often face situations where employee performance issues are caused directly by a medical condition. But, what if the employee never sought an accommodation under the ADA? Does the employer have to engage in an interactive dialogue to explore accommodations before dealing with the performance issue? In the post ADAAA world, there is no black or white answer. When dealing with underperforming employees, employers must consider many medical conditions as potentially ADA qualifying and subject to accommodation, while simultaneously minimizing the risk of a “regarded as disabled” claim.