Article

Psoriasis and Eczema at Work: Your ADA and FMLA Rights

How the ADA and FMLA protect workers with psoriasis, eczema, and other chronic skin conditions, including coverage based on skin and immune system functions, flares that come and go, why creams, biologics, and light therapy do not erase coverage, contagion myths and appearance-based treatment, accommodations for irritants, gloves, uniforms, and treatment, documentation and confidentiality, FMLA intermittent leave, retaliation, and deadlines.

8 min read

How Psoriasis and Eczema Can Qualify as Disabilities

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 psoriasis as a skin disease caused by a problem with the immune system that produces itchy or sore patches of thick, red skin with silvery scales, and it describes eczema, also called dermatitis, as a term for several types of skin swelling that most often cause dry, itchy skin and rashes, with atopic dermatitis being the most common type. Under 29 CFR 1630.2(h)(1), a physical impairment includes any physiological disorder or condition or cosmetic disfigurement affecting a body system, and the skin and immune systems are both named. Under 42 U.S.C. Section 12102 and 29 CFR 1630.2(i), major life activities include caring for oneself, performing manual tasks, sleeping, and working, as well as the operation of major bodily functions, including functions of the immune system, and 1630.2(i)(1)(ii) adds functions of the special sense organs and skin. Coverage is decided individually rather than by diagnosis alone, and a small patch that causes no real limitation may not qualify, but the ADA's definition of disability is meant to be construed broadly, and the question is how the condition limits you compared with most people in the general population, for example cracked, painful skin on your hands that limits manual tasks or itching that disrupts sleep.

Flares, Remission, and Why Treatment Does Not Erase Coverage

MedlinePlus says psoriasis can last a lifetime and that its symptoms come and go, with flares that can be triggered by infections, stress, dry skin, injury to the skin, and certain medicines, and it says eczema may get better or worse over time but is often a long-lasting disease. Some people with psoriasis also develop psoriatic arthritis, which MedlinePlus says causes pain, stiffness, and swelling of the joints. Under 29 CFR 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, so the question is how your skin affects you during a flare, not on a good day. Under 42 U.S.C. Section 12102(4)(E) and 29 CFR 1630.2(j)(1)(vi), the helpful effects of mitigating measures such as medication are ignored, so creams, pills, injections, or biologic medicines that keep your skin clear do not erase coverage. MedlinePlus lists topical treatments, body-wide medicines that affect the immune response, and phototherapy with ultraviolet light as psoriasis treatments, and under 1630.2(j)(4)(ii), the burdens associated with following a particular treatment regimen, such as repeated light therapy sessions or daily skin care, may be considered in deciding whether an impairment is substantially limiting.

Visible Skin, Contagion Myths, and Being Regarded as Disabled

MedlinePlus says psoriasis isn't contagious and doesn't spread to other people, and it says eczema is not contagious. Under 29 CFR 1630.2(l)(1), you are regarded as having a disability if you are subjected to a prohibited action because of an actual or perceived physical impairment, whether or not the impairment substantially limits a major life activity, and prohibited actions include refusal to hire, demotion, placement on involuntary leave, termination, harassment, and denial of any other term, condition, or privilege of employment. That means an employer that refuses to hire you, sends you home, or moves you out of a customer-facing role because a manager assumes your rash is contagious or dislikes how your skin looks may be liable even if your condition would not otherwise count as a disability. Under 29 CFR 1630.15(f), an employer can defend a regarded-as claim only by objectively showing the impairment is both transitory, meaning lasting or expected to last six months or less, and minor, which is difficult for a long-lasting skin disease. Jokes, comments about your appearance, or coworkers refusing to share equipment with you because of your skin condition can be evidence of disability harassment.

Accommodations for Irritants, Gloves, Uniforms, and Treatment

Under 42 U.S.C. Section 12111(9), reasonable accommodation may include job restructuring, part-time or modified work schedules, reassignment to a vacant position, and acquisition or modification of equipment, and the EEOC's reasonable accommodation guidance also treats modifying workplace policies as a form of accommodation. MedlinePlus lists soaps and detergents, chemicals and solvents, rubber or latex gloves, rough materials such as wool, dry air, and getting too hot or too cold among the things that can irritate the skin or make atopic dermatitis worse, so depending on your condition, requests might include a different type of gloves or protective equipment, gentler approved cleaning products or less contact with a specific irritant, an exception to a uniform or dress code for a fabric that irritates your skin, a workstation away from heat, cold drafts, or dry air, short breaks to apply prescribed treatments, a schedule change for phototherapy or dermatology appointments, or working from home during a severe flare, 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 or lower a safety standard that is job-related and consistent with business necessity. If no accommodation would let you perform the essential functions of your current job, reassignment to a vacant position you are qualified for may be required as a last resort.

Documentation, Medical Questions, and Confidentiality

When the need for accommodation is not obvious, the EEOC says an employer may ask for reasonable documentation about the disability and the functional limitations involved, but not for your complete medical records. MedlinePlus says psoriasis is usually diagnosed by looking at the skin, sometimes with a skin biopsy, and that patch testing may be used to find the cause of repeated contact dermatitis, so a note from your dermatologist or rheumatologist describing what triggers your flares, how they affect your work, and what changes you need 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 about the nature or severity of a disability unless the examination or inquiry is job-related and consistent with business necessity. Under 42 U.S.C. Section 12112(d) and 29 CFR 1630.14, medical information an employer obtains must be kept in separate, confidential medical files, and supervisors may be told only about necessary work restrictions and accommodations. The EEOC also says reasonable accommodation is always prospective, so it helps to make your request in writing before a flare turns into missed shifts or discipline.

FMLA Leave for Flares, Treatment, and Appointments

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, and eligible employees can generally take up to 12 workweeks of job-protected leave in a 12-month period. Under 29 CFR 825.115(c), a chronic serious health condition is one that requires periodic visits, at least twice a year, for treatment by a health care provider, continues over an extended period of time, and may cause episodic rather than continuing periods of incapacity, and under 825.115(f), an absence for such a condition can qualify even if you do not see a provider during that particular absence. Under 29 CFR 825.202, FMLA leave may be taken intermittently or on a reduced leave schedule when medically necessary, which can cover days lost to a severe flare or skin infection, recovery from a psoriatic arthritis flare, or recurring phototherapy and specialist appointments. Even if you are not eligible for FMLA, unpaid leave can also be a reasonable accommodation under the ADA.

Retaliation and Deadlines

Under 42 U.S.C. Section 12203, an employer may not retaliate against you for requesting an accommodation, opposing disability discrimination, or taking part in an ADA charge or investigation, or coerce, intimidate, threaten, or interfere with you for exercising ADA rights, and under 29 U.S.C. Section 2615, an employer may not interfere with FMLA rights or discriminate against you for using protected leave. Keep a written record of your accommodation requests, each response, any comments about your skin, any flares linked to conditions at work, and any discipline, schedule change, 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. FMLA claims do not go through the EEOC and have their own deadlines, so it helps to get advice from an employment lawyer early.

Primary Sources

Think You Have a Case?

This article is general information, not legal advice. For a review of your situation, get a free consult with the YesLawyer team.

Get Your Free Consult

Related Resources

Guide

How to File an EEOC Complaint (Charge): Deadlines and Steps

Article

ADA Workplace Accommodations: Request and Denial Rights

Article

Arthritis at Work: Your ADA and FMLA Rights

Article

Lupus at Work: Your ADA and FMLA Rights

Article

Intermittent FMLA Leave: Recurring Absence and Reduced Schedule Rights

Article

Can My Employer Share My Medical Information?

Article

Customer and Client Harassment at Work: Employee Rights

Article

Fired After a Disability Accommodation Request: Rights to Check

Article

How Long Can an Employer Take to Approve an ADA Accommodation?