Article

Parkinson's Disease at Work: Your ADA and FMLA Rights

How the ADA and FMLA protect workers with Parkinson's disease, including coverage based on walking, speaking, manual tasks, and neurological and brain functions, why medication and deep brain stimulation do not erase coverage, equipment and job restructuring accommodations for tremor, movement, and speech changes, schedules, breaks, and working from home when medication wears off, documentation and medical questions, FMLA leave, age-related comments, retaliation, and deadlines.

8 min read

How Parkinson's Disease Can Qualify as a Disability

Title I of the Americans with Disabilities Act applies to private employers with 15 or more employees for 20 or more weeks in the current or preceding calendar year and to state and local government employers; federal workers are covered through the Rehabilitation Act, and many state laws reach smaller employers. MedlinePlus describes Parkinson's disease as a movement disorder that happens when nerve cells in the brain don't produce enough of a brain chemical called dopamine, with symptoms that begin gradually and include trembling, stiffness, slowness of movement, and poor balance and coordination, and it says the disease usually begins around age 60 but can start earlier. Under 42 U.S.C. Section 12102 and 29 CFR 1630.2(i), major life activities expressly include walking, standing, speaking, performing manual tasks, sleeping, concentrating, thinking, and working, as well as the operation of major bodily functions, including neurological and brain functions. Coverage is still decided individually rather than by diagnosis alone, but the ADA's definition of disability is meant to be construed broadly, and a person with a record of such an impairment or who is regarded as having one can also be protected under 29 CFR 1630.2(k) and (l).

Why Medication and Deep Brain Stimulation Do Not Erase Coverage

MedlinePlus says there is no cure for Parkinson's disease, that a variety of medicines sometimes help symptoms dramatically, and that surgery and deep brain stimulation, in which electrodes implanted in the brain send electrical pulses to the parts of the brain that control movement, can help severe cases. Under 42 U.S.C. Section 12102(4)(E) and 29 CFR 1630.2(j)(1)(vi) and (j)(5), whether an impairment substantially limits a major life activity is judged without regard to the helpful effects of mitigating measures such as medication, medical equipment, and other treatment, so an employer cannot deny coverage simply because your tremor is well controlled at work. MedlinePlus says Parkinson's medicines can cause side effects that may be severe, including confusion, nausea, and feeling lightheaded or fainting, and under 29 CFR 1630.2(j)(4)(ii), the negative side effects of medication or the burdens of following a treatment regimen may be considered. MedlinePlus also says medicine may wear off at certain times of day so that symptoms return, and under 1630.2(j)(1)(vii), an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active. A person covered only because the employer regards them as impaired is not entitled to reasonable accommodation under 1630.2(o)(4).

Accommodations for Tremor, Movement, and Speech Changes

MedlinePlus says Parkinson's disease can cause loss of fine hand movements, handwriting that becomes small and difficult to read, difficulty starting or continuing to move, problems with balance and walking, and slowed, quieter speech, and it recommends physical, occupational, and speech therapy and assistive devices to make movement easier. Under 42 U.S.C. Section 12111(9), reasonable accommodation may include making facilities readily accessible, job restructuring, part-time or modified work schedules, reassignment to a vacant position, and acquisition or modification of equipment or devices. Depending on your symptoms, requests might include typing or voice-recognition software instead of handwritten forms, an adapted keyboard or mouse, a chair or workstation closer to the areas you use, less walking between sites, written or email communication in place of some long calls, or trading a fine-motor task with a coworker, as long as the change does not cause undue hardship, which 29 CFR 1630.2(p) defines as significant difficulty or expense. If more than one accommodation would work, the EEOC says your preference should be given primary consideration, but the employer has the ultimate discretion to choose among effective options, and it is not required to eliminate an essential function of the job. The EEOC also says reasonable accommodation is always prospective, so it helps to ask before slower work or missed tasks turn into discipline.

Schedules, Breaks, and Working From Home

MedlinePlus advises people with Parkinson's disease to stay active when they feel well, not overdo it when energy is low, and rest as needed during the day, and it says symptoms can return when a dose wears off. Under the ADA, the EEOC says a modified schedule may involve adjusting arrival or departure times, providing periodic breaks, and altering when certain functions are performed, and that an employer must provide a modified or part-time schedule when required as a reasonable accommodation, absent undue hardship, even if it does not provide such schedules for other employees. That can mean scheduling demanding tasks for the hours when your medication works best, short breaks to take a dose on time or rest, or a later start while your provider adjusts your medicines. The EEOC also says an employer must modify its policy on where work is performed if working at home is needed as a reasonable accommodation, but only if the essential functions can be performed at home and it would not cause undue hardship; the employer may instead choose another accommodation that would be effective.

Documentation and Medical Questions

MedlinePlus says there is no specific test for Parkinson's disease, so it can be difficult to diagnose, and that doctors use a medical history and a neurological examination. When you request an accommodation and the need is not obvious, an employer may ask for reasonable documentation about the disability and the functional limitations that make the accommodation necessary, so a note from your neurologist describing what is affected, such as writing by hand, speaking on long calls, or working when a dose wears off, is usually more useful than a diagnosis alone. Under 42 U.S.C. Section 12112(d)(4)(A), an employer may not require a medical examination of a current employee or ask whether the employee is an individual with a disability or about the nature or severity of the disability unless the examination or inquiry is job-related and consistent with business necessity, so a noticeable tremor alone does not give a manager license to demand your medical history. Under Section 12112(d)(3) and (4), medical information the employer obtains must be kept on separate forms, in separate medical files, and treated as confidential, with limited exceptions such as informing supervisors about necessary work restrictions and accommodations.

Leave and FMLA for Parkinson's Disease

The EEOC's reasonable accommodation guidance says an employee with a disability may need leave for reasons including obtaining medical treatment such as surgery, rehabilitation services, physical or occupational therapy, and recuperating from an illness, which can cover neurology visits, therapy sessions, medication changes, and recovery from deep brain stimulation surgery. Under the Family and Medical Leave Act, 29 CFR 825.113 defines a serious health condition as an illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment by a health care provider. Under 29 CFR 825.115(c), continuing treatment includes a chronic condition that requires periodic visits for treatment at least twice a year, continues over an extended period, and may cause episodic rather than continuing incapacity. Under 29 CFR 825.202, FMLA leave may be taken intermittently or on a reduced leave schedule when medically necessary for planned or unanticipated medical treatment or for recovery. Under 29 CFR 825.110, an eligible employee has worked for the employer for at least 12 months, has at least 1,250 hours of service in the 12 months before leave starts, and works at a location where the employer has at least 50 employees within 75 miles.

Age-Related Comments, Retaliation, and Deadlines

Because Parkinson's disease most often develops later in life, a manager who links your symptoms to your age, for example by suggesting you are too old for the job or should retire, may also run into the Age Discrimination in Employment Act: the EEOC says it forbids age discrimination against people who are age 40 or older, and under 29 U.S.C. Section 630(b) it covers employers with 20 or more employees. Under 42 U.S.C. Section 12203, an employer may not retaliate against you for opposing disability discrimination or taking part in an ADA charge or investigation, or coerce, intimidate, threaten, or interfere with you for exercising ADA rights. Keep a written record of each accommodation or leave request, every response, and any discipline, demotion, schedule cut, pressure to retire, or termination that follows, including dates and the names of the people involved. A charge with the EEOC generally must be filed within 180 calendar days of the discriminatory act, extended to 300 days where a state or local agency enforces a law prohibiting the same kind of discrimination; federal employees generally must contact an agency EEO counselor within 45 days.

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