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About Bleeding Disorder
Bleeding disorders are a group of conditions that result in poor blood clotting and extended bleeding time. People with bleeding disorders do not bleed more quickly than other people, just for a longer period of time. Some bleeding disorders are present at birth and are caused by rare inherited disorders. Others develop during certain illnesses or treatments. Von Willebrand disease and hemophilia are the most common hereditary bleeding disorders affecting at least 1% of the population.
Generally, bleeding disorders make it difficult to stop bleeding when an injury occurs. With von Willebrand disease, prolonged bleeding may occur with minor cuts or during dental work. With hemophilia, internal bleeding into the joints is more common, especially into the knees, elbows, and ankles. This can cause stiffness and decreased range of motion and strength in the extremities and may ultimately cause chronic joint deformities. Some individuals who have joint deformities may undergo joint replacement operations.
There are many plasma proteins called factors that are involved in the blood coagulation process, and if one or more are missing or deficient, the blood clotting process is affected. Treatment may consist of replacing the missing factors via nasal spray or injection to prevent bleeds before they start. Other individuals may have a need for infusions in life-threatening situations.
Bleeding Disorder and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Bleeding Disorder
People with bleeding disorders may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with bleeding disorders will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
A mental health employee with hemophilia was restricted by her physician from repetitive bending and twisting at the waist.
JAN suggested the employee use a reacher to pick up lighter objects to prevent bending.
An office worker with a bleeding disorder was limited in the amount of time she could work at a keyboard.
JAN suggested using speech recognition software to decrease keyboarding time and suggested implementing an ergonomic workstation.
An insurance clerk was experiencing pain in her back, neck, and hands from sitting for long periods of time doing computer work.
She was accommodated with speech recognition software, an ergonomic chair, and an adjustable sit/stand workstation.
A forklift driver had difficulty grasping the steering wheel due to sensitivity from a bleeding disorder.
The forklift was fitted with a spinner ball to eliminate the need for grasping.