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Lupus is a widespread and chronic autoimmune disease that, for unknown reasons, causes the immune system to attack the body's own tissue and organs, including the joints, kidneys, heart, lungs, brain, blood, or skin. The immune system normally protects the body against viruses, bacteria, and other foreign materials. In an autoimmune disease like lupus, the immune system loses its ability to tell the difference between foreign substances and its own cells and tissue. The immune system then makes antibodies directed against "self." There are several forms of lupus: cutaneous, systemic, drug-induced, neonatal, and overlap syndrome or mixed connective tissue disease.
Although lupus can affect any part of the body, the most common symptoms are achy joints, frequent fevers, arthritis, fatigue, skin rashes, kidney problems, chest pain with deep breathing, a butterfly-shaped rash across the cheek and nose, photosensitivity, impaired vision, Raynaud's phenomenon, and seizures. No single set of symptoms is uniformly specific to lupus and no laboratory test can prove lupus conclusively; symptoms may disappear for no apparent reason and remain in remission for weeks, months, or even years.
Lupus 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 Lupus
People with lupus 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 lupus 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:
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 college professor with lupus requested the accommodation of an office with windows to utilize natural lighting.
Because professors with more seniority were offered the offices with windows, the employer wasn’t sure if, because of a union agreement, it would be possible to override the seniority issue. JAN suggested the use of full-spectrum lighting that has nearly the same effect as the natural lighting and can be found in task lighting, desk and floor lamps, light boxes, and torchieres, as well as replacement bulbs for existing lighting. The college decided to change out the lighting in stages and consult with the employee and her doctor to determine how that could be done effectively.
A health care worker with lupus had low vision.
She was having difficulty viewing her computer screen and paper copies. The individual was accommodated with a large monitor, screen magnification software, hand/stand magnifier for paper copies, and a closed circuit television system.
A corporate trainer with lupus had difficulty standing and walking when giving presentations.
The individual was accommodated with a scooter for getting around the work-site and a stand/lean stool to support her weight when standing.
An insurance clerk with arthritis from systemic lupus erythematosus 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.
An engineer with lupus was having difficulty completing all of his work in the office due to fatigue.
The individual was accommodated with frequent rest breaks, a flexible schedule, and work from home on a part-time basis.
A claims representative with lupus was sensitive to fluorescent light in his office and to the radiation emitted from his computer monitor.
The overhead lights were changed from fluorescent to broad spectrum by using a special filter that fit onto the existing light fixture. The individual was also accommodated with a glare guard and flicker-free monitor.
An executive secretary with lupus had severe back pain due to arthritis.
The individual was accommodated with an adjustable height workstation to alternate between sitting and standing, an adjustable keyboard and mouse tray, and an ergonomic chair with lumbar support.
A systems analyst with lupus had migraine headaches.
The individual was moved from a cubicle office to a separate workspace away from distractions and noise. He was then able to use task lighting instead of overhead fluorescent lighting and adjust the temperature control when necessary.