Multiple sclerosis and employment: Practical guidelines for reasonable job accommodations.

TitleMultiple sclerosis and employment: Practical guidelines for reasonable job accommodations.
Publication TypeJournal Article
AuthorsStuckey J, Johnson KL
JournalInternational Journal of MS Care

Background: Individuals with multiple sclerosis (MS) often face employment challenges. Although over 90% of people with MS report a history of employment, 70% to 80% are unemployed 5 years after diagnosis. The impact of MS on employment can lead to poor job performance, absenteeism, negative feedback from employers, and high risk of job termination. The Americans with Disabilities Act (ADA) and disability laws in most states require employers to provide reasonable accommodations for employees with disabilities who are able to perform the essential functions of their jobs. Health-care providers have a key role in helping to evaluate the impact of MS on employment and developing reasonable job accommodation requests. Objective: To provide practical guidelines for medical providers on development of reasonable job accommodation and modification requests. Employment Considerations: Initial employment challenges are often not reported to health-care providers, as patients may feel work difficulties are unrelated to MS, feel embarrassed to admit problems, or be in denial of symptom progression. Use of screening tools and discussion of the impact of MS on employment can alert providers to accommodation needs. Physical capacity challenges, cognitive impairment, heat sensitivity, vision problems, pain, depression, and fatigue can contribute to performance challenges. An interdisciplinary assessment approach can assist health-care providers in development of job accommodation requests. Medical leave of absence and use of Family and Medical Leave Act benefits can provide job and benefit protection during this process. Although the law requires employers to provide accommodations, an employee must be able to perform the essential functions of the job, and the accommodations must be “reasonable.” Careful examination of the physical, cognitive, and interpersonal demands of the job is critical. Information and Resources: Employment, disability, and accommodation resources will be provided. Specific guidelines on accommodation letter writing and ideas for accommodations based on specific MS-related challenges will be outlined.

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