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Published January 2003

MS in workplace:
tips for employers

By Kimberly Hilden
SCBJ Assistant Editor

Every hour in the United States, at least one person is diagnosed with multiple sclerosis, a chronic disease that attacks the central nervous system, the National Multiple Sclerosis Society reports.

The diagnosis usually comes with a lot of preconceived notions by the patient about “what could happen,” said Dr. Nancy Lellelid, a neurologist with The Everett Clinic and a member of the Pacific Northwest Alliance of Multiple Sclerosis Centers.

MS — what it is

Multiple sclerosis is a neurological disease that affects a third of a million people in the United States and about 10,000 people in Washington state. It can cause blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue and even paralysis and blindness. These problems may be permanent or they may come and go.

MS symptoms, which vary from person to person and exacerbation to exacerbation, result when inflammation and breakdown occur in myelin, the protective sheath surrounding the nerve fibers of the central nervous system. In MS, myelin is destroyed and replaced by scars of hardened “sclerotic” patches of tissue, interfering with the transmission of nerve signals.

While advances have been made in the treatment of MS, there is still no cure, and its cause has not been determined.

Different courses of MS

n Relapsing-remitting: This form of MS is characterized by its clearly defined flare-ups, or exacerbations, of symptoms, which are followed by partial or complete recovery periods.

n Primary-progressive: This form of MS is characterized by nearly continuous worsening of the disease from the onset, with no distinct relapses or remissions.

n Secondary-progressive: This form of MS is characterized by an initial period of relapsing-remitting disease followed by a steadily worsening disease course.

n Progressive-relapsing: This form of MS is characterized by a steadily worsening disease course from the onset with clear, acute flare-ups, with or without recovery. In contrast to relapsing-remitting, periods between relapses in progressive-relapsing include continuing disease progression.

— National Multiple Sclerosis Society

Resources

To learn more about the Americans with Disabilities Act or to order ADA publications, call the ADA Information Line at 800-514-0301 (voice) or 800-514-0383 (TDD), or visit the ADA Web site, www.ada.gov.

To learn more about tax credits available for small businesses and tax deductions available for businesses of all sizes to help offset some of the costs of improving accessibility for customers or employees with disabilities, visit www.usdoj.gov/crt/ada/taxpack.htm on the Web.

ADAptations Inc.

Address: 227 Bellevue Way NE, Suite 694, Bellevue, WA 98004-5721
Phone: 877-746-2227
E-mail: susan@adaptationsinc.com
Web site: www.adaptationsinc.com

There’s the fear of having the disease progress, whether that means eventually needing a wheelchair or developing cognitive problems. And there’s the uncertainty of how the disease will affect everyday life, including time spent in the workplace.

That uncertainty often is felt by employers and employees alike, Lellelid said.

“I spend so much of my time trying to help patients help employers understand what can be done to modify the workplace and what patients’ skills are,” Lellelid said.

One thing that employers need to know about MS is that it affects each patient differently, both in symptoms and in progression.

According to the National Multiple Sclerosis Society, about 70 percent of those initially diagnosed with MS have the relapsing-remitting variety, in which their symptoms will flare up for a time before diminishing or disappearing for a period of weeks, months or years.

A person with this type of MS, for example, might suffer from extreme fatigue, dizziness or bladder problems one week and then feel fine for the next month or two. Over time, however, a percentage of these patients develop secondary-progressive MS, in which their symptoms steadily worsen with or without the flare-ups.

In the past decade, however, MS drug therapies have come onto the market, helping patients experience less severe relapses, less often and enabling them to live their lives “productively and independently,” Lellelid said, adding that “we should keep these people working.”

Under the Americans with Disabilities Act, employers are required to make “reasonable accommodations” — those not posing “undue hardship” on the employer or a “direct threat” to health or safety at work — to enable a person with a disability, including those diagnosed with MS, to do his or her job.

Such accommodations can include changing work hours to accommodate fatigue or allowing the employee to telecommute on some days, said Susan Duncan, founder of ADAptations Inc., a Bellevue-based consulting firm focused on designing accessible environments at work and at home.

Employers also can provide reserved parking close to the building for an employee with mobility impairment, or, if that’s not possible, provide a motorized, portable scooter to get them from the parked car to the workplace.

“With MS, the energy level is what gets zapped so quickly,” Duncan said. “You have to watch your every move.”

Inside the workplace itself, employers should ensure that break rooms and bathrooms are accessible, Duncan said.

If the employee is using a wheelchair, make sure the lunchroom microwave is within reach. And levers, rather than knobs, make opening doors and operating faucets easier for MS patients who may be suffering from poor coordination or numbness in body parts.

Because people with MS can suffer from problems with bowel or bladder function, moving an employee with MS closer to the bathroom can also be a help, Duncan said.

According to the National Multiple Sclerosis Society, employers also can:

  • Allow an employee to use earned or unpaid leave for necessary treatment.
  • Allow an employee to provide equipment or devices that the employer is not required to furnish.
  • Adjust or modify examinations, training materials and policies.
  • Buy or modify equipment or devices.

“There really are a lot of companies that modify workplaces, modify hours, to keep people employed,” Lellelid said.

“The county’s prosecutor’s office has made significant strides for one of its employees, putting in a voice-activated computer,” she said. “... PUD and most major employers here have gone the extra mile to retain employees and keep those skills.”

Related: President of Ashford Clark Personnel lives, works with MS

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