CHICAGO (CBS) — Businesses across the world are looking out for everyone’s safety by requiring masks – but what if the customer can’t wear a mask for medical reasons?

It is a rare and tricky circumstance, but it has come up right here in the Chicago area. CBS 2’s Tim McNicholas on Monday explored the approaches businesses can take.

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Before Steven Liftka takes his bike out, he makes sure he has a note from his doctor with him.

“I just cannot breathe underneath a mask at all,” he said.

The note explains that Liftka has autism and feels claustrophobic with a mask.

“That way, if anyone comes up and says, ‘Hey, why aren’t you wearing a mask?’ I can say to them, ‘I am high-functioning autistic and due to my ability, I cannot wear a mask,” he said.

Liftka tried to order a sandwich to go from Subway in July, but was told to leave the store. He said he tried to explain himself and show the note, but Subway still turned him away.

“I was feeling pretty angry,” Liftka said.

With companies rightfully focused on COVID-19 safety, medical exemptions can be a tricky terrain.

The state says if a customer cannot wear a mask, the business should make a reasonable accommodation whenever possible.

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“But it doesn’t mean that they can just march in and not wear a mask,” said Tamar Heller, the head of disability and human development at the University of Illinois at Chicago. “For example, they could have brought the food outside to him and asked him to wait outside, and they could have brought him his order.”

Liftka said someone from the Subway did call him the following week to say next time, he can either order online or call over the phone and they will bring it out.

The state also said people should either reach out to the business ahead of time to request a special accommodation, or do so upon arrival.

“Maybe if the governor could come up with something for people who are autistic, maybe a badge, a sticker – get more information about autism,” Liftka said.

The Illinois Department of Public Health said when requesting accommodations, you do not need to prove your medical condition. Legally, it is enough just to explain it.

Still, Liftka is keeping his doctor’s note with him in case it comes up again.

The owner of the Subway where Liftka was asked to leave said they apologized to him, and they are retraining their team on requirements and exceptions.

Heller said in her work, they have also experimented with different options to help people with autism get more comfortable wearing masks. She encourages people to try different fabrics, or maybe even try masks that are not too snug on the ears.

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Tim McNicholas