From the desk of Sarah Small, M.S., CRC, Consultant – Cognitive/Neurological Team
According to the Mayo Clinic, fibromyalgia is believed to be a condition that amplifies the way the brain processes painful sensations. It is characterized by chronic, widespread, musculoskeletal pain and is often accompanied by issues with memory, mood, sleep, and fatigue. These symptoms can cause difficulties in all aspects of life, including work.
Often, there can be confusion as to how to accommodate fibromyalgia in the workplace. When thinking about accommodations, it can be easy to categorize types of limitations that seem to be associated with a physical disability or cognitive impairment. For instance, when an accommodation request is made due to a back impairment, an ergonomic assessment may be appropriate. Does the person need a particular type of chair? Do they need to be able to stand or walk around when needed? Similarly, thinking about an employee using a wheelchair you might ask, is the environment accessible? Does the employee need adjustments to the workstation to help perform the necessary job functions?
Cognitive impairments tend to bring a different set of limitations and accommodation ideas to consider. For example, an employee with a mental health condition may need a flexible schedule or the ability to use leave time to attend a weekly therapy appointment. An employee who struggles with concentration and time management may benefit from a noise cancelling headset or periodic breaks. Someone with a learning disability may need software to help with reading or writing. While each request may vary, it can be easy to start thinking about some of the possible limitations involved when presented with a diagnosis in those areas.
Fibromyalgia is one of the “hidden disabilities” that can present with both physical and cognitive limitations. For this reason, it can be difficult to have a generalized idea of how it may effect someone. What do you do if you have multiple requests from employees with fibromyalgia, but the concerns are all very different? It may feel odd looking at two requests regarding fibromyalgia, one regarding issues with memory and the other involving severe back and neck pain. It is important to remember that all disabilities and medical conditions are individualized.
When presented with two different accommodation requests you would not want to discredit either of them. As the employer, since the condition is not known or obvious, you would be entitled to request medical documentation to help establish whether the condition is a disability and to support the need for what is being requested. As the employee, any information that you can provide about what you are experiencing may help the employer to understand what would be beneficial.
Individuals with fibromyalgia may only ever experience the physical limitations such as the chronic pain and fatigue while others may manage the pain, but struggle with the cognitive aspects that come with the condition. At times the cognitive limitations may become more apparent or worsen due to the side effects of medication. Remember that according to the EEOC there may still be the duty to accommodate even when the issue is stemming from side effects of treatment.
There is currently no cure for fibromyalgia and it can be hard to determine what triggers the condition or brings about the symptoms for someone. Engaging in the conversation and taking it one step at a time as you move through the interactive process will hopefully help to find an effective solution. If you get stuck or simply want to talk through ideas give us a call here at JAN!