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About Myasthenia Gravis
The name “Myasthenia Gravis” comes from the Greek and Latin words meaning “grave muscular weakness.” The most common form of myasthenia gravis is a chronic autoimmune neuromuscular disorder that is characterized by fluctuating weakness of the voluntary muscle groups, which worsens with use of the affected muscle. Different muscle groups are affected in different individuals. Certain muscles are more frequently involved, including the ones that control eye movements, eyelids, chewing, swallowing, coughing, and facial expression. Muscles that control breathing and movements of the arms and legs may also be affected. Weakness of the muscles needed for breathing may cause shortness of breath, difficulty taking a deep breath, and coughing. The "gravis" or seriousness of myasthenia is noticeable when breathing muscles are affected.
Myasthenia Gravis 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 Myasthenia Gravis
People with myasthenia gravis 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 myasthenia gravis 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?
- Ability to dictate notes using a voice recorder and have another staff member input the notes (if inputting the information is a marginal function of your job)
- Grip Aids, to help with holding a stylus
- Reallocating documentation duties, if marginal
- Handwriting Recognition Software
- Using Proper Lifting Techniques
- Reallocating lifting duties, if marginal
- Providing assistance moving objects, to reduce weight
- Organizing items in a way that reduces the need to move or lift items
- Reducing weight to be lifted by separating items into smaller groups
- Reassigning an employee to a modified duty position or modifying duties by removing the lifting duties
- Periodic rest breaks to get-up and move around
- Modified break schedule so that you can stretch your legs when needed
- Using break reminder software to remember to get up and move around
- Alternating between sitting and standing while working by using a sit/stand workstation
- Ergonomic/adjustable office chair
- Work at home, where employee can lie down, sit, stand, move freely
Situations and Solutions:
An administrator was having problems handling stress and had some double vision from myasthenia gravis.
He was allowed to take rest breaks, assigned a support person in the workplace, and provided a reader as an accommodation.
A clerical worker with myasthenia gravis was missing a lot of work because of problems breathing, speaking, and walking.
She was allowed to work at home part-time and to communicate via e-mail as an accommodation.
A delivery person was having difficulty loading and unloading his truck due to lower extremity weakness from myasthenia gravis.
He was accommodated with a transfer to a less physically demanding delivery route.
A teacher with myasthenia gravis was having difficulty meeting the physical demands of her job due to muscle fatigue.
She was accommodated with a full-time teaching aid, frequently used supplies/equipment were moved closer to her desk, and she was allowed several short rest breaks during the day.
A hospital employee with myasthenia gravis was having difficulty walking.
She was accommodated with a parking space closer to her work-site and was provided a scooter to use at work.
JAN Publications & Articles Regarding Myasthenia Gravis
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