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About Essential Tremors
Essential tremor is a nerve disorder in which tremors (shakes) occur without an identifiable cause when a person is moving or trying to move. Essential tremor of the hands typically occurs when the hands are in use. In contrast, tremors from Parkinson's are most prominent when a person's hands are at his sides or resting in his lap. Essential tremor can involve your hands, head and voice.
Essential tremor is the most common form of abnormal tremor. It resembles an exaggerated shaking. Essential tremor is a relatively benign condition, affecting movement or voice quality, but with no other effects. It involves a rhythmic, moderately rapid tremor of voluntary muscles. Purposeful movements may make the tremors worse, while avoiding hand movements may suppress the tremors completely. There may be difficulty holding or using small objects (such as silverware or writing utensils).
In the workplace, people with essential tremor may have difficulty writing, keyboarding and mousing, grasping small tools or items, and communicating. Limitations may be worsened by fatigue, stress and anxiety, and temperature extremes.
Essential Tremors 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 Essential Tremors
People with essential tremors 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 essential tremors 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 data entry clerk developed essential tremor and was having difficulty keyboarding and mousing with accuracy.
The employer provided an alternative keyboard and mouse, as well as speech recognition software, as an accommodation.
A new hire for an assembler position at a manufacturing plant was assigned to work on assembling small parts to a machine, although they had been hired to assemble large items.
Due to essential tremor the employee was unable to maintain quotas. The employer did not have an open position on the large item assembly line but did agree to provide vacuum pickup tools to aid the employee in assembling the smaller items until a position became available.
An employee with essential tremor experienced a worsening of symptoms when holding a phone receiver.
Answering phone calls was an essential function of the job. The employer provided a headset with a telephone headset lifter so the employee could receive and place calls without having to physically hold the handset.
An electrician with essential tremor, who regularly worked outdoors, noticed that symptoms were worse during the hot summer months and cold winter months.
The employer provided a battery operated fan and warming clothing but the accommodations were not effective. As a next step the employee was provided with leave on days were temperatures were extreme and they began to look at options for reassignment to a position that did not require working outdoors.
A teacher with essential tremor had difficulty accessing areas of the building that did not have automatic doors.
The employer was not able to modify all of the doors in the facility but did agree to add automatic door openers to the doors the employee frequently used and provide door knob grips for other doors that the employee used infrequently.