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About Chronic Fatigue Syndrome
In order to receive a diagnosis of CFS, a patient must satisfy two criteria. First, an individual must have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis. Second, an individual must concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern, or severity; erratic sleep; and malaise lasting more than 24 hours.
In addition to the primary defining symptoms of CFS, some CFS patients have reported a number of other symptoms. They include gastrointestinal, pain, nausea, photosensitivity, respiratory and skin issues, and weight changes. A majority of CFS patients also report mild to moderate symptoms of anxiety or depression. The treatment of CFS focuses on symptom management. Chronic fatigue syndrome has also been called myalgic encephalomyelitis (ME) and post exertional fatigue syndrome.
Chronic Fatigue Syndrome 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 Chronic Fatigue Syndrome
People with CFS 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 arthritis 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?
- 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 customer service representative with chronic fatigue syndrome and memory and concentration problems had difficulty answering some customer questions.
She was accommodated with written materials to help her remember information and a private office to reduce distractions.
A teacher with chronic fatigue syndrome had difficulty meeting the physical demands of her job and was exhausted by early afternoon.
She was provided with a teacher’s aid, her off-hour was moved to the afternoon, and she was excused from afternoon recess duty.
A student with chronic fatigue syndrome had difficulty keeping up with class notes.
He was accommodated with a laptop computer to use in class.
An employee with sickle cell anemia has disclosed that they are experiencing limitations due to chronic fatigue.
The individual has noticed that the quality of her work suffers near the end of their shift and is requesting accommodations to help with this. The employer agrees to modify the individual’s schedule so that she has a 1-2 hour break in the middle of the shift as an accommodation so that the individual can rest before resuming the work shift. To accomplish this, the employer extends the individual’s shift end-time so the individual works a normal amount of hours despite this long break.
A flight attendant with chronic fatigue syndrome was missing a lot of work due to fatigue.
Her doctor recommended that she reduce the amount of traveling she was doing. She wanted to continue working full-time so requested reassignment to an office job.
A therapist with chronic fatigue had difficulty maintaining the stamina needed to work full time
Part of the problem was that she had a difficult commute to and from work every day. She asked her employer if she could telework two times a week and do her paperwork on those days. Her employer had never had an employee telework before so decided to allow it on a trial basis to determine whether it would work. After trying it for a month, the employer agreed to allow the employee to continue teleworking.
A school psychologist with chronic fatigue syndrome was having difficulty working at full production.
She was allowed to schedule appointments in the morning, which gave her uninterrupted time in the afternoon to complete paperwork. She was also allowed to schedule several short rest breaks throughout the day and use of sick leave as needed.
An operating-room nurse with chronic fatigue syndrome had difficulty rotating schedules.
She was accommodated with a permanent day schedule.
A design engineer with chronic fatigue syndrome had difficulty working full-time.
He was allowed to work-at-home three days a week.
A daycare director with chronic fatigue syndrome had difficulty getting to work on time and maintaining a full-time schedule.
She was allowed a later start time and a part-time schedule.
A social worker with chronic fatigue syndrome experienced headaches and photosensitivity.
Accommodations included changing the lighting in her workstation from fluorescent lighting to task lighting, adding a glare guard to her computer monitor, providing window blinds, and implementing other workstation changes to enhance ergonomics.