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Finding Accommodations that Fit the Lupus Spectrum

An overview of lupus and what might work as accommodations

From the desk of Beth Loy, Ph.D., Principal Consultant/Technical Specialist

One fact about lupus is that it affects individuals differently. Lupus is an autoimmune disorder that causes an individual’s immune system to attack the body’s tissues and organs. Lupus can, and typically does, besiege the brain, heart, lungs, joints, skin, and kidneys. Often considered a nonvisible condition for the most part, it can cause skin lesions due to photosensitivity and a butterfly-shaped rash on the face without a trigger. Other symptoms that are less visible include fatigue, chronic pain, fever, Raynaud’s phenomenon, chest and kidney pain, dry eyes, hives, headaches, and memory loss. Individuals are also more susceptible to viruses like flu and shingles. 

Comorbidities are common with lupus. Although not all-inclusive, Sjögren's syndrome, depression, anxiety, seizure disorder or epilepsy, gastroesophageal reflux disease (GERD), ulcers, osteoporosis, arthritis, and thyroid imbalance are commonplace. Treatment for lupus is often a long-term process involving managing symptoms and side effects. Let’s look at a few of the accommodation situations we’ve worked through at the Job Accommodation Network (JAN).

A pharmacist worked for a large chain of pharmacies. Because of her lupus, she started having difficulty standing for long periods. Her lupus also caused her to become very fatigued during extremely hot temperatures. She requested modified scheduling, an anti-fatigue mat, and a stand/lean stool. Her employer purchased the equipment and worked with her on her schedule during the summer months.

An employee relations manager with lupus requested a schedule change to daylight hours because his vision is deteriorating and he cannot see effectively in the dark. The employer initially stated that he could take public transportation. After talking with JAN he requested a reassignment to a management position that was open as a reasonable accommodation. The employer granted the reassignment.

A medical secretary, tasked with following her boss on hospital rounds once a week, had lupus and arthritis. Due to her limitations becoming more significant, she found it difficult to perform this job task. As an accommodation, her employer provided her with a mobility scooter that she could use to do rounds. She was able to use her iPad with a holder attached to the scooter as her notepad.

A production employee with lupus worked in a manufacturing facility and could no longer work more than 8 hours of his 12-hour shift. He requested a reduction of the hours in his shift. The employer argued that working 12 hours is a qualification standard that it does not want to modify. The employer provided the employee with several reassignment offers with less pay, one of which the employee decided to take.

A customer service representative at a call center had lupus and depression. She requested six weeks of leave while she adjusted to her new medication. The employer granted the six weeks and then another two weeks after the employee requested an extension. The employer documented the leave as an accommodation and leave under the Family and Medical Leave Act (FMLA).

Because accommodations for lupus can vary from lighting changes to flexible scheduling, it is important to evaluate an employee based on the specific limitations and essential job functions. For more information on accommodations for lupus, see JAN’s A to Z by Disability: Lupus.

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