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About Multiple Sclerosis
Multiple sclerosis is a chronic autoimmune disease of the central nervous system. It causes destruction of myelin (a protein that forms a protective coating around nerve cells) in the central nervous system. When myelin is destroyed signals traveling through the nerve cells are interrupted or delayed, resulting in various neurologic symptoms occurring at different locations throughout the body. The progress, severity, and specific symptoms of multiple sclerosis in any one person cannot yet be redacted, but advances in research and treatment are giving hope to those affected by the disease.
Multiple sclerosis is often characterized by a pattern of exacerbation and remission. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. Possible symptoms include fatigue, loss of coordination, muscle weakness, spasticity, numbness, slurred speech, visual difficulties, paralysis, muscle cramps, bladder or bowel problems, and sexual dysfunction.
The initial symptoms of MS are most often difficulty walking; abnormal sensations such as numbness or "pins and needles"; and pain and loss of vision due to optic neuritis, an inflammation of the optic nerve. Less common initial symptoms may include tremor; lack of coordination; slurred speech; sudden onset of paralysis, similar to a stroke; and decline in cognitive function.
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. 11
Multiple Sclerosis 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 Multiple Sclerosis
People with multiple sclerosis 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 multiple sclerosis 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 teacher with multiple sclerosis was having difficulty communicating with students because his speech became soft and slurred when he was fatigued.
He was given a personal speech amplifier so he would not have to strain to project his voice, and he was allowed to schedule his classes so he could take periodic breaks.
An engineer with multiple sclerosis was experiencing heat sensitivity.
She was provided a private office where the temperature could be lower than in the rest of the facility. She was also encouraged to communicate with coworkers by telephone or e-mail when possible to reduce the amount of walking she had to do.
A claims representative for an insurance agency was having difficulty reading files due to a vision impairment caused by multiple sclerosis.
His employer purchased a stand magnifier and added task lighting to his workstation.
An employee with multiple sclerosis had fallen multiple times at work, resulting in disruption to the workplace.
After the employer told the employee that the issue needed to be addressed, the employee asked the employer to add a railing along the wall from her desk to the restroom, breakroom, and copy machine room. The employer installed the railing as requested and that addressed the issue.
A retail store manager with multiple sclerosis uses a scooter to move distances throughout the store.
She also has an accessible parking space near the rear entrance of the store.
An insurance agency employee with multiple sclerosis and anxiety requested that the employer permit her to use a service dog on the job for mobility and stress reduction.
The employer agreed to allow the employee to bring her service animal to work, provided training to staff on service animals as workplace accommodations, and installed new doors that were easier for the individual to open.
An operations clerk for a large distribution center was having difficulty working at full production due to fatigue caused by multiple sclerosis.
Her employer moved her to a shift that was not as busy so caused less stress and made less physical demands of the clerk. The clerk was also able to take more frequent breaks on the new shift.
A clerical worker was having difficulty concentrating and remembering job tasks due to cognitive impairment caused by multiple sclerosis.
Her employer added sound-baffle panels to reduce distractions in her work area. In addition, her employer gave her written job duties at the beginning of each day and provided a notebook that contained outlines of what each job duty entailed.
A manager with multiple sclerosis working for a publishing company was having difficulty transferring from her wheelchair to the toilet in the employee restroom.
Her employer installed additional grab bars.
An attorney with multiple sclerosis was having difficulty carrying documents to meetings at various locations due to upper extremity weakness.
His employer purchased a portable cart that was easy to get in and out of his car.
JAN Publications & Articles Regarding Multiple Sclerosis
Accommodation and Compliance Series
Consultants' Corner Articles
- A Support Person as an Accommodation
- Accommodations for Housekeeping/Janitorial Workers with Motor Impairments
- Accommodations Related to Commuting To and From Work
- Best Practices for Addressing Requests for Ergonomic Chairs
- Confidentiality of Medical Information under the ADA
- Hidden Disabilities: Confidentiality and Travel