Transcript Epilepsy in the Workplace - Job Accommodation Network

Accommodations for Epilepsy
in the Workplace
Daniel Tucker, M. S.
Consultant,
Cognitive / Neurological Team
Melanie Whetzel, M. A.
Senior Consultant,
Cognitive / Neurological Team
JAN is a service of the U.S. Department of Labor’s
Office of Disability Employment Policy.
1
Epilepsy in the Workplace
Epilepsy, also called a seizure disorder, is a
chronic neurological condition characterized by
recurrent seizures. A seizure happens when
abnormal electrical activity in the brain causes
an involuntary change in body movement or
function, sensation, awareness, or behavior.
2
Epilepsy in the Workplace
People diagnosed with epilepsy have had at
least two seizures and may have had more than
one type of seizure. The severity of epilepsy and
the type of seizure vary from person to person.
Accommodation needs will also vary from
person to person.
3
Epilepsy in the Workplace
Daily Accommodation Servings
 About 2.3 million people in the United States have
some form of epilepsy
 About 150,000 new cases of seizure disorders and
epilepsy are diagnosed each year
 1 in 10 adults will have a seizure sometime during
their lifetime
4
Epilepsy in the Workplace
ADAAA and Epilepsy
Substantially limiting:
 Neurological functions
 Speaking
 Hearing
 Communicating/interacting with others
5
Epilepsy in the Workplace
Cognitive Limitations:
 Memory
 Time Management
 Stress Management
6
Epilepsy in the Workplace
Motor Limitations:
 Driving
 Balancing/climbing
 Fatigue
 Ensuring Safety
7
Epilepsy in the Workplace
Sensory Limitations:
 Photosensitivity
 Seeing
 Hearing
 Communicating
8
Epilepsy in the Workplace
Other:
 Attendance/Absenteeism
 Personal Care
9
Epilepsy in the Workplace
Disclosure
10
Epilepsy in the Workplace
Why Disclose?
• To ask for job
accommodations
• To receive benefits or
privileges of employment
• To explain an unusual
circumstance
11
Epilepsy in the Workplace
How to Disclose?
The individual must let the employer know:
• An adjustment or change at work is needed
for a reason related to a medical condition
To request accommodation, an individual:
• May use “plain English”
• Need not mention the ADA
• Need not use the phrase “reasonable
accommodation”
12
Epilepsy in the Workplace
Who to Disclose to?
Verbally or in writing, tell the…
• Employer
• Supervisor
• HR representative, or
• Other appropriate person
13
Epilepsy in the Workplace
Job Accommodations
14
Epilepsy in the Workplace
Accommodation Ideas for
Cognitive Impairments
Associated with Epilepsy
15
Epilepsy in the Workplace
Situation: A
receptionist in a large
office had difficulty
remembering
names/faces and
keeping track of the
in/out status of the
various case managers
on staff.
16
Epilepsy in the Workplace
Accommodation Issues: Memory
 Provide written or pictorial instructions or
prompt with verbal cues
 Offer training refreshers
 Use a chart to describe steps to complicated
tasks
 Maintain, safely and securely, paper lists of
crucial information such as passwords
 Use voice recordings of verbal instructions
17
Epilepsy in the Workplace
Accommodation Issues: Memory (cont.)
 Provide the employee directory with pictures
 Use nametags and door/cubicle name
markers
 Provide a building directory or employee
directory by name, floor, unit, etc.
 Label items on the employee’s desk (in-box,
this week’s videos, etc.)
 Use auto-dial phone features to connect
quickly to used numbers
18
Epilepsy in the Workplace
Solution: A Velcro in/out board was provided
with the photo and name of each case manager.
When entering or leaving the office, staff
members would prompt the receptionist as to
their status and he would then move their photo
from the “in” to the “out” column, or vice versa,
thereby allowing him to keep track of case
managers and better serve clients who were
trying to contact them.
19
Epilepsy in the Workplace
Situation: An administrative assistant asked for
accommodations to help her with time
management and prioritization of tasks due to
some cognitive difficulties related to seizure
medication.
20
Epilepsy in the Workplace
Accommodation Issues: Time Management
 Divide large assignments into several small
tasks
 Set a timer to make an alarm
 Provide a checklist of assignments
 Supply an electronic or handheld organizer
and train on how to use effectively
 Use a wall calendar to emphasize due dates
21
Epilepsy in the Workplace
Solution: She was accommodated with a basic
list of job priorities and strategies on how to plug
in unexpected tasks, and a WatchMinder to
assist with time management.
22
Epilepsy in the Workplace
Situation: A call center
employee was having
difficulty managing her
stress during times of
heavy call volume. She
asked for an
accommodation of
fewer calls and more
breaks.
23
Epilepsy in the Workplace
Accommodation Issues: Stress management
 Provide praise and positive reinforcement
 Refer to employee assistance programs
 Allow the employee to make telephone calls
to doctors (and others) for support
 Provide sensitivity training
 Modify work schedule
24
Epilepsy in the Workplace
Solution: Because her employer does not have
to reduce a performance standard, they agreed
to give her two added 15 minute breaks – one in
the morning and one in the afternoon daily. To
make up the time, the employee agreed to come
into work 30 minutes early daily.
25
Epilepsy in the Workplace
Accommodation Ideas for
Motor Impairments
Associated with Epilepsy
26
Epilepsy in the Workplace
Situation: An IT specialist who cannot drive
because of recent seizures had been riding to
work daily with his wife. Her job location
changed, taking her in another direction and she
was unable to take him to work. They live in a
rural area with no public transportation. The
employee has asked for the accommodation of
telework.
27
Epilepsy in the Workplace
Accommodation Issues: Driving:
 Pair the employee with a co-worker who can
drive to meetings or events
 Allow telework or work from home
 Transfer the employee to a position that does
not require driving
 Adjust schedule so the employee can access
public transportation
 Help facilitate a carpool with co-workers for
transportation to/from work
28
Epilepsy in the Workplace
Solution: The employer allows the employee to
telework for the next several months, but
reserved the right to withdraw that
accommodation if the work situation changes or
if the need for the accommodation is extended.
The employer specified this in writing. Based on
state law, if the employee were to have another
seizure, the timeline for the revocation of his
license would have to be extended.
29
Epilepsy in the Workplace
Situation: An inspector employed in a
manufacturing plant used a catwalk for about
half of his daily duties. Because of a new
epilepsy diagnosis, his doctor determined that it
wasn’t safe for him to use the catwalk at all.
The employee disclosed his disability and asked
for an interactive meeting to discuss his options.
30
Epilepsy in the Workplace
Accommodation Issues: Balancing/Climbing:
 Cushion a fall by using rubber matting on
floor and by adding padded edging to corners
and edges
 Install machine guarding
 Use rolling safety ladders with handrails and
locking casters
 Provide head protection
 Provide eye protection
 Use fall protection
31
Epilepsy in the Workplace
Solution: Because no accommodations could
be found that would keep the employee safe on
the catwalk, the employer reviewed open
positions for a reassignment. Out of three open
positions, they were able to find one that best
matched the employee’s skills and didn’t require
climbing or being at heights.
32
Epilepsy in the Workplace
Situation: A cashier
experienced fatigue in the
afternoons on days when
she had longer shifts. She
asked for accommodations
to help her with this.
33
Epilepsy in the Workplace
Accommodation Issues: Fatigue:
 Use anti-fatigue matting on the floor
 Provide flexible start or ending times
 Adjust workweek
 Provide private or secure rest area during
breaks
34
Epilepsy in the Workplace
Solution: Her employer
met with her to discuss
what might be the best
options. Together they
came up with using an
anti-fatigue mat at her
station, a stool during
slower periods, and a
change in schedule from
working 3-4 longer shifts a
week to 5-6 shorter shifts.
35
Epilepsy in the Workplace
Situation: An employee
with epilepsy and a vagus
nerve stimulator has
asked co-workers to run
a hand-held magnet over
his chest when he has a
seizure in order to
shorten its duration. His
coworkers are nervous
about performing this
health-related procedure.
36
Epilepsy in the Workplace
Accommodation Issues: Ensuring Safety in
the Workplace:






Designate a person to respond to emergencies
Keep aisles clear of clutter
Provide a quick, unobstructed exit
Post clearly marked directions for exits, fire doors,
etc.
Know when to (or not to) call 9-1-1
Consult employee’s plan of action to determine how
to respond/react when employee has a seizure on
the job
37
Epilepsy in the Workplace
Solution: The employer asked for medical
documentation from a neurologist to
substantiate the need for the accommodation.
The doctor provides information that states the
employee is in no danger from having the
seizure but simply prefers to have it end earlier,
and holding the magnet over the chest too long
or too close can cause the device to stop. The
employer denied this request, but was willing to
look at alternative effective accommodations.
The ADA does not require employers to provide
health-related procedures as accommodations
38
Epilepsy in the Workplace
Accommodation Ideas for
Sensory Impairments
Associated with Epilepsy
39
Epilepsy in the Workplace
Situation: A clerk who worked in a large factory
area with fluorescent lighting asked that the
lighting be switched out with full-spectrum bulbs.
40
Epilepsy in the Workplace
Photosensitivity:
 Use a flicker-free monitor (LCD display, flat
screen)
 Use a monitor glare guard
 Use a cubicle shield
 Use fluorescent light tube covers
 Allow frequent breaks from tasks involving
computer
41
Epilepsy in the Workplace
Photosensitivity (cont.):
 Provide alternative light sources:
 Replace fluorescent lights with full
spectrum lighting
 Use natural lighting source (window)
instead of electric light
42
Epilepsy in the Workplace
Solution: Due to the size of the factory and the
extent of the lighting, it was not feasible for the
employer to change all of the lighting in the
factory. The clerk was accommodated by the
use of bulb jackets to cover the fluorescent
bulbs within a radius of his workstation, and
provided a cube shield to help further block the
lighting from his area.
43
Epilepsy in the Workplace
Situation: An employee who works in a semisecluded area asks for a policy modification so
that he can use his cell phone to notify a coworker when he has had a seizure. The
employer has a policy forbidding the use of cell
phones in the workplace.
44
Epilepsy in the Workplace
Accommodation Issues:
Seeing/Hearing/Communicating:





Allow the employee time to recuperate from seizure
Identify hand signals or other universal signals that
the employee might use to communicate with
another person
Use PECS (picture exchange communication
system) to communicate
Use paging systems to communicate with coworkers
Provide 2-way radios with texting options
45
Epilepsy in the Workplace
Solution: The employer considers the request
and determines that allowing the use of a cell
phone in this case would be more effective than
purchasing two-way radios to serve the same
purpose. They modify the policy so that this
employee can use his cell phone to call the
designated persons when he has had a seizure.
46
Epilepsy in the Workplace
Other Accommodations
47
Epilepsy in the Workplace
Situation: A new federal employee had missed
17 days the first month of work, and the current
month’s attendance was following the same
pattern. The employee had missed several
days due to seizures, but the majority of the
days missed were for reasons that were
unrelated to her epilepsy. Because she was a
new employee, she had not accrued any leave,
and the employer had forwarded her the
maximum amount of leave possible.
48
Epilepsy in the Workplace
Attendance/Absenteeism:
 Allow employee to remain on the job after a
seizure when possible
 Provide flexible schedule
 Modify an attendance policy
 Provide leave while the employee is adjusting
to medications
 Work a straight shift instead of rotating shifts
49
Epilepsy in the Workplace
Solution: The employer accommodated the
employee by modifying the attendance policy in
order to count the epilepsy/seizure absences as
one occurrence, but was firm about holding this
employee to the attendance policy as it related
to all other absences.
50
Epilepsy in the Workplace
Situation: An employee who has absence
seizures works as a civil engineer in a desk job.
The seizures are momentary ones and the
employee is able to get right back to work
afterwards, requiring only a drink of water. He
asks for the accommodation of having a bottle of
water in his desk drawer to pull out and sip after
he has experienced one of these seizures. The
employer has a no eating/drinking at
workstations policy.
51
Epilepsy in the Workplace
Personal Care:
 Allow the employee to keep a change of
clothes at the workplace
 Provide a private space to regain composure
and perform self-care tasks
 Provide sensitivity training/disability
awareness to coworkers
52
Epilepsy in the Workplace
Solution: The employer denied the
accommodation, citing company policy. The
employee consulted with JAN about a modified
workplace policy that allows an employer to
change a policy for someone with a disability
that they do not modify for anyone else. Once
the employer became aware of this policy, they
allowed the employee to keep a bottle of water
in his desk drawer to sip on when needed, but
did not change the policy for others.
53
Epilepsy in the Workplace
Plan of Action
 A plan of action can be created with the
employee and employer and can include
information such as:



emergency contact information
visual or audible warning signs
how/when to provide on-site medical assistance
54
Epilepsy in the Workplace
Plan of Action (cont.)





how/when to call 9-1-1
how to provide environmental support
who to designate as emergency responders
who to go to for help
how to educate co-workers about epilepsy
55
Epilepsy in the Workplace
Situation: A retail employee had multiple seizures at
work in his first few days on the job. One seizure
caused a fall that left him unconscious. 911 was called
to transport the employee to the emergency room. The
ER doctor would not release the employee to return to
work until he had obtained a release from a neurologist.
The employee returned to work with the medical
documentation. The employer agreed and gave the
employee unpaid leave in order to take care of the
medical appointment. The employee didn’t want to go to
a neurologist, so he returned to the emergency room,
saw another doctor who would release him to work, and
reported to work.
56
Epilepsy in the Workplace
Solution: The employer requested medical info
from an appropriate and qualified medical
professional. During this conversation, the
employee stated that he would get information
from his psychologist, but that he refused to take
medication and refused to see a neurologist.
The employer kept the employee on unpaid
leave until they had received the medical
information from the qualified and appropriate
medical provider.
57
Epilepsy in the Workplace
Situation: A newly hired software engineer
began to have seizures. His doctor
recommended that he not travel for several
months, at least until they were able to find out
more about the seizures and get him on some
medication that could reduce the risk of future
seizures. He would not be able to drive for six
months from the date of the last seizure.
58
Epilepsy in the Workplace
Solution: The essential functions of this
employee’s job required travel by air, then by
rental car to areas he would need to be to
collaborate with others. Because the employer
does not have to remove essential functions
from a position, and no viable accommodation
could be provided, the employer decided to
terminate the employee. There were no open
positions for reassignment. The employer could
have another employee hired, trained, and
doing the job before this employee would be
released to drive.
59
Epilepsy in the Workplace
Questions?
60
Epilepsy in the Workplace
Contact




(800)526-7234 (V) & (877)781-9403 (TTY)
AskJAN.org & [email protected]
(304)216-8189 via Text
janconsultants via Skype
61
Epilepsy in the Workplace
References
Accommodation and Compliance Series: Employees with
Epilepsy
http://askjan.org/media/epilepsy.html
The ADA: Applying Performance and Conduct Standards to
Employees with Disabilities
http://www.eeoc.gov/facts/performance-conduct.html
Questions & Answers about Epilepsy in the Workplace and the
Americans with Disabilities Act (ADA)
http://www.eeoc.gov/laws/types/epilepsy.cfm
SOAR - Searchable Online Accommodation Resource
http://askjan.org/soar/seizure.html
62
Epilepsy in the Workplace
References (cont.)
Consultants' Corner: Epilepsy, Driving, and Employment
• http://askjan.org/corner/vol05iss02.htm
For specific information about a state's regulations involving
driving with epilepsy, see:
• http://www.epilepsyfoundation.org/living/wellness/transportation/
drivinglaws.cfm
63