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About Epilepsy/Seizure Disorder
Epilepsy is the tendency to have repeated seizures that originate in the brain. There are several types of possible seizures that range from losing consciousness and massive muscles jerks to blank stares. For example, generalized tonic clonic seizures, also called grand mal seizures, look like the individual suddenly cries or falls; the individual may lose consciousness. On the other hand, generalized absence seizures or petit mal seizures look like a blank stare, beginning and ending abruptly, lasting only a few seconds.
JAN's Effective Accommodation Practices (EAP) Series: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.
Plan of Action:
In the event that a seizure does occur in the workplace, it is wise to be prepared. Preparation begins with a plan of action.
Can you remember back to elementary school? Think back to practice for a fire drill. Everyone in the entire school knew the plan and was prepared for the fire drill. Everyone knew who was in charge, what responsibilities each person had, how quickly to respond to an alarm, and how to exit the building. That type of preparedness made the fire drill work efficiently.
A plan of action is very similar to an elementary school fire drill. A plan of action is an emergency preparedness tool. It can be used to prepare for, or respond to, emergency situations that arise when a person has a seizure on the job. 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
- 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
A properly implemented plan of action may reduce the confusion, panic, or fear that co-workers or customers experience if they see an employee having a seizure on the job. When the plan of action is “in action,” one designated person calls a spouse or emergency contact. One designated person watches over the employee. No one provides incorrect or unnecessary medical assistance (CPR, for example). No one overreacts to the emergency because everyone is prepared for it, can identify it, and respond appropriately to it.
A sample plan of action is provided. Please use it as guidance on how to write a plan of action. Employers are not required by the ADA to use the following form, nor are employees with epilepsy required by the ADA to use the form.
- Sample Plan of Action
Warning Signs for Oncoming Seizure:
- John will experience nausea.
- John’s face or shoulder/arm will jerk involuntarily.
- Warning signs give John 3-4 minutes before seizure activity begins.
- John will signal designated co-worker using 2-way radio (with texting) to inform of oncoming seizure.
- Action Plan:
- Using his hand or arm, gently lead John to designated safe area.
- If necessary, help John into a seated or laying position.
- If necessary, loosen any restrictive clothing (such as a tie or scarf).
- During seizure (which lasts from 2 - 5 minutes), John will not need medical attention.
- When seizure subsides, offer John a cool cloth for his face or a cool drink.
- If John is disoriented, identify yourself and identify his location/surroundings.
- Additional Comments:
- Two designated co-workers will carry radios to hear John’s emergency signal.
- Supervisor will call John’s emergency contact person.
- Based upon John’s documentation provided by his neurologist, ambulance/medical attention is not required unless John falls or hits his head.
Epilepsy/Seizure 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 Epilepsy/Seizure Disorder
People with epilepsy 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 epilepsy 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?
Driving: People with epilepsy may have driving restrictions. For specific information about a state’s regulations involving driving with epilepsy, see: Epilepsy Foundation: State Driving Laws Database:
- 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
Ensuring Safety in the Workplace: Take some universal precautions to ensure 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 (see "Plan of Action" section for additional information)
Personal Care: During or after a seizure, people with epilepsy may exhibit behaviors such as crying, drooling, spitting, or urinating. As a result, the person may need time following a seizure to engage in activities of daily living such as grooming and changing clothes.
- 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
Situations and Solutions:
A student with epilepsy used hedge-cutters and other landscaping tools in a training program.
For safety, JAN suggested steel-toed shoes, shin guards, and hand protection.
A welder with epilepsy wanted to make his work area safe when he had a seizure.
JAN suggested a welder's helmet with additional padding and using a safety switch on his welding machines.
An administrator with epilepsy needed an emergency communication system to inform someone that she had a seizure.
JAN suggested using a two way radio.
An engineer with epilepsy had difficulty managing multiple tasks.
JAN suggested color-coding on-going projects, using wall charts to track progress, and prioritizing tasks for the employee.
Charmaine is an employee with epilepsy who needs to disclose her disability and ask for an accommodation of a flexible schedule while she adjusts to new medication.
She is having difficulty waking and has been late three days in a row. She is wary of disclosing her medical condition, but doesn’t want to get into disciplinary action. Charmaine decides to disclose and provides medical documentation. Since her work doesn’t depend on or affect others, the employer found no hardship to flex her daily schedule as long as she gets her time in between the core business hours of 8:00 am to 6:00 pm.
An educational consultant with epilepsy had driving restrictions.
JAN suggested allowing another team member to drive to site-visit locations and telework whereby she could communicate via e-mail and submit paperwork electronically.