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Document Structure: The Accessibility Feature You Don’t Notice Until It’s Not There

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  • Published on: May 13, 2022

“Reading a document with no structure is, frankly, boring. If I see a document with no structure, the first thing I think is, ‘What’s your point? Why did you write this document?’” Sue Martin, an employee with the Department of Veterans Affairs (VA), is visually impaired. Like many other visually impaired individuals, she uses a screen reader, a machine that converts visual information into an audio format, to comprehend any electronic work content she interacts with daily. However, to function correctly, screen readers rely on a robust organizational system, known as document structure, consisting of multiple framework components such as logical heading tags, ordered lists, plain language, meaningful links, and overall readability, to effectively project information to the recipient in a coherent order.

We all rely on document structure to consume information, however, many of us simply consider it to be second nature the way in which the information appears on the screen. Whether you get your information from an online newsletter or your Twitter feed, the structure of the platform — or the framework in which the information is organized on the page or screen — still greatly influences our ability to logically absorb the content. However, for visually impaired individuals such as Ms. Martin who are not able to decipher this logical presentation on electronic platforms including PowerPoint presentations, Word documents, emails, and websites, proper document structure is a key component to designing accessible content. VA’s Office of Information and Technology (OIT) prioritizes document structure in all electronic and print content to ensure that visually impaired Veterans, as well as those in their support network, can access their important health and benefits information.

The Power to Navigate Through Information

An estimated one million Veterans are affected by compromised visibility. Section 508 of the Rehabilitation Act of 1973 requires all Federal agencies to ensure that any technological platforms used for official government purposes can be interpreted by anyone to the extent that it does not cause an “undue burden” for any specific group of people. OIT Accessibility goes a step further by educating the content creators — those individuals designing websites, sending emails, and creating PowerPoint presentations — about their role in integrating accessibility functions, including document structure, into their work products. Martha Wilkes, Designer and Accessibility Strategist in OIT’s Office of the Chief Technology Officer, and Pat Sheehan, Chief of VA’s Section 508 Program Office, both understand how essential properly applied document structure is to make content accessible to visually impaired individuals via a screen reader.

As Mr. Sheehan explains, a properly structured document allows visually impaired individuals to “jump to certain parts of that document and read fairly quickly just as…a sighted person would be able to…by hitting a key with the screen reader.” He goes on to clarify that the “screen reader is going to read from left to right, top to bottom … the screen reader is not going to be able to figure out that [there are] three columns [in the document] unless it's styled properly.” Ms. Martin adds that “Just as the eye is drawn to headlines and headings, so, too, is the screen reader user’s attention drawn to these elements. When I read a document, I often use a keyboard shortcut to navigate the headings before reading [the document] in full … Alternatively, I can scoop up the headings and place them in a list. Each heading and its level is displayed in a vertical list … This allows me to get an idea of the structure and important parts of the document before reading the content.”

Without properly assigned cues, or “tags,” associated with document headings and similar formatting components for the screen reader to follow, the screen reader will interpret the information in consecutive order, regardless of logic. For example, a VA website with the heading “Hospital Locations,” and subheadings “address” and “phone number,” must be tagged in the correct sequential order, according to the respective state, for the screen reader to correctly interpret the information. If the sub-headings are not tagged in the correct order within the document structure, the screen reader could potentially interpret the VA hospital phone number in Vermont immediately after the VA hospital mailing address in Georgia. “It’s totally meaningless,” says Mr. Sheehan.

Organizing with Intention

Furthermore, Ms. Wilkes underscores that proper document structure is multifaceted and goes beyond heading labels. Hyperlinks can be especially burdensome for a visually impaired person if they do not include meaningful content as part of the hyperlink word or phrase. Meaningful links refers to the use of descriptive and actionable language as part of the actual hyperlink, rather than using generic descriptions such as “click here,” “learn more here,” or “find additional details here.” For example, a VA hospital website for a specific state location has a link to a sub-page with additional information about health-related services offered at that location. The text containing the hyperlink on the main VA state page directing the visitor to the respective sub-page should read “learn more about our health services,” instead of directing the site user to “click here” to learn more about those services. If multiple passive link descriptions are used on a website or other electronic platform, the person using the screen reader “will literally hear ‘click here, click here, click here,’ and it's completely unusable to them,” Ms. Wilkes says. “All of these structural elements serve the same purpose for a blind reader as they do for a sighted reader,” says Ms. Martin. With the rapid advancement of modern-day technology, document structure continues to be a dynamic and multi-faceted niche of accessible design that is constantly evolving to integrate new organizational components. When it comes to incorporating all these working parts seamlessly into the document structure system, the devil is in the details.

However, Mr. Sheehan believes there is good reason to be excited because innovative trends in technology, such as artificial intelligence (AI), are making the document structure integration a more seamless process. “AI is helping to proactively identify which documents have correct accessibility structure embedded and which do not…[in this way, it can] discern what the page should look like and how the page should be structured and will automatically tag that page…properly, so it can be read by assistive technology properly, [and] that is very exciting.” For this reason, OIT fluidly incorporates document structure into design accessibility to ensure all Veteran, and their support community, have the same access to the essential health information they need.

Accessibility at VA starts with you. To learn more about accessibility, explore OIT’s Accessibility Guide and watch OIT’s Accessibility videos.

Our commitment to digital and IT transformation is shaped by daily dedication to customer service and the close collaboration of our workforce, managers, and leaders. Ready to join us in improving Veterans’ care? Check out all current information and technology career opportunities on DigitalVA. You can also contact VA’s Office of the Chief Human Capital Officer at 512-326-6600, Monday thru Friday, 7 a.m. to 5 p.m. CST or by submitting a resume to

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Page last updated on May 13, 2022


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