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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 Accommodation Solutions: 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
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Warning Signs for Oncoming Seizure:
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- 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:
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- 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:
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- 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 definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such 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?
- 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?
Key Accommodations:
Accommodation Ideas for Cognitive Impairments Associated with Epilepsy
Memory Loss:
Individuals with various disability types may experience memory deficits that can affect their ability to complete tasks, remember job duties, or recall daily actions or activities. Memory difficulties may be a limitation related to the condition itself, a side effect of medication, or only manifest periodically for episodic conditions. Accommodation ideas usually involve modifying the way one obtains, retains, and retrieves information.
Memory Loss Accommodations Continued:
- Provide a voice-activated recorder to record verbal instructions
- Provide written information and instructions
- Post written or pictorial instructions on frequently used machines or for routine procedures
- Provide templates or forms to prompt for needed information
- Provide employee directory with pictures or use nametags and door/cubicle name markers to help employee remember coworkers' faces and names
- Provide reminders of important deadlines via emails, memos, and weekly supervision
- Provide printed minutes of meetings and trainings
- Use sticky notes as reminders of important dates or tasks
- Provide checklists
- Prompt employee with verbal cues (reminders)
- Encourage employee to ask (or email) work-related questions
- Remove marginal job functions to allow more focus on essential functions
- Use color-coding to indicate important information
- Use a daily or weekly task list
- Extend training time and training refreshers when significant workplace changes occur
- Use a wall calendar or planner
- Use notebooks or sticky notes to record information for easy retrieval
- Use electronic organizers, hand held devices, and/or apps
- Use a flowchart to describe the steps involved in a complicated task (such as powering up a system, closing down the facility, logging into a computer, etc.)
- Provide a mentor for daily guidance
- Safely and securely maintain paper lists of crucial information such as passwords
Time Management: Individuals with epilepsy may have difficulty managing time, which can affect their ability to complete tasks within a specified timeframe. It may also be difficult to prepare for, or to begin, some work activities.
- Divide large assignments into several small tasks
- Set a timer to make an alarm
- Provide a checklist of assignments
- Supply an electronic or handheld organizer and train on how to use effectively
- Use a wall calendar to emphasize due dates
- Make daily to-do lists and check items off as completed
Stress Management: Individuals with epilepsy may have seizures when stress is not properly managed. Situations that create stress can vary from person to person, but could likely involve heavy workload, unrealistic timeframes, shortened deadlines, or conflict among coworkers.
- Provide praise and positive reinforcement
- Refer to employee assistance programs
- Allow the employee to make telephone calls to doctors (and others) for support
- Provide sensitivity training
- Allow a service animal
- Allow flexible work environment
- Flexible scheduling
- Modified break schedule
- Leave for medical appointments
- Telework or hybrid telework
Accommodation Ideas for Motor Impairments Associated with Seizures
Balancing/Climbing: Individuals with epilepsy may have difficulty balancing or climbing.
- Cushion a fall by using rubber matting on floor and by adding padded edging to corners and edges
- Install machine guarding
- Use rolling safety ladders with handrails and locking casters
- Provide head protection
- Provide eye protection
- Use fall protection
Fatigue: Individuals with epilepsy may experience fatigue due to a side-effect of medications or to recent seizure activity.
- Use anti-fatigue matting on the floor
- Provide private or secure rest area during breaks
- Allow flexible work environment
- Flexible scheduling
- Modified break schedule
- Leave for medical appointments
- Telework or hybrid telework
Accommodation Ideas for Sensory Impairments Associated with Seizures
Photosensitivity: Individuals with epilepsy may have seizures or headaches due to light sensitivity, which can be exacerbated by light sources such as computer screens or fluorescent lights.
- Use a flicker-free monitor (LCD display, flat screen)
- Use a monitor glare guard
- Use a cubicle shield
- Allow frequent breaks from tasks involving computer
- Provide alternative light sources:
- Replace fluorescent lights with full-spectrum lighting
- Use natural lighting source (window) instead of electric light
- Provide fluorescent light tube covers
- Allow use of light filtering lenses
- Schedule periodic breaks from computer usage
Seeing/Hearing/Communicating: During or after seizures, an employee may temporarily have limited ability to see, hear, or speak.
- Allow the employee time to recuperate from a seizure
- Identify hand signals or other universal signals that the employee might use to communicate with another person
- Use PECS (picture exchange communication system) to communicate
- Use paging systems to communicate with coworkers
- Provide 2-way radios with texting options
- Use alert systems to send message
Other Accommodations
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)
Attendance/Absenteeism: Seizure activity can affect a person’s attendance at work.
- Allow employee to remain on the job after a seizure when possible
- Provide a flexible schedule
- Modify an attendance policy
- Provide leave while the employee is adjusting to medications
- Allow a straight shift instead of rotating shifts
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
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
Accommodation Ideas:
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
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.