Employment and Epilepsy

A productive and satisfying work life is important to a person’s overall quality of life and to having a healthy attitude toward oneself. Most persons with epilepsy are capable of productive and gratifying employment, but they may face severe discrimination in the job market. Employers may discriminate because of the stigma associated with epilepsy, misconceptions about its medical and social aspects, unfounded fears of legal and medical liability, and the misconception that people with epilepsy are not as productive as others. These biases have led to discrimination and considerable hardship, but new laws have begun to change the landscape of employment opportunities for people with epilepsy and other disabilities.

Employment and Disclosure
A person with epilepsy whose seizures are not well controlled should prepare for the possibility that a seizure may occur at work. The preparation will depend on the type and frequency of seizures. The first and most important step is to discuss the seizures with the supervisor and coworkers. They will be the first ones to see the seizure and to administer first aid. Depending on the work environment, the people, the relationships with coworkers, and the nature of the seizures, a person with epilepsy may choose to tell only a few people or everyone in the workplace. The person with epilepsy should never rely entirely on one coworker, however, especially if the seizures are frequent or intense, because that person may be on vacation or out of the office when a seizure occurs.

How should I tell my coworkers?
People can be told individually or in a group. Here area few tips to follow when discussing your epilepsy:

1. It is often a good idea to review first aid measures in a group setting. Others in your workplace need to know what happens during a seizure. The explanation should be reassuring. It is normal for them to be frightened when first watching a seizure, so they should be told that the risk of serious injury is small, and that the seizure does not cause pain.
2. Your coworkers should know what is going to happen when you have a seizure such as how you may behave before, during, and after the seizure, and what they should and should not do if one occurs.
3. Your coworkers should be told not to stick something in your mouth during a seizure, because the belief about swallowing the tongue is a myth.
4. They should know when to call for medical personnel or an ambulance, but it should be emphasized that this is rarely necessary for a person with epilepsy who has a single seizure. Your local Epilepsy Foundation affiliate may be able to provide in-service education in the workplace. First aid cards, a videotape, and other educational materials are available from the Foundation.
5. If your coworkers feel comfortable it might be a good idea to ask one of them to write down how long the seizure lasted and what happened during the seizure.
6. Coworkers should know that you may be confused after a seizure but should be left alone if you are in a safe place and seem to be all right. They should not hold or restrain you unless it is absolutely necessary for safety.
7. When you have fully recovered from the seizure and returned to work, you should acknowledge what happened, thank the people who were helpful, and ask if they have any questions.

Additional Resources
Vocational Rehabilitation: An Employment Guide for People with Epilepsy

Employment Rights
Some employers still discriminate against those with epilepsy, even though such discrimination generally is illegal under the Americans with Disabilities Act (ADA), which was passed in 1990.† Therefore, before applying for a job, it may be helpful for a person with epilepsy to speak with a representative of the local affiliate of the Epilepsy Foundation about the relevant laws and the restrictions preventing employers from asking questions about a job applicant’s health. The applicant also could speak with the protection and advocacy staff of the state human rights commission, the Equal Employment Opportunities Commission (EEOC), or a social worker who specializes in employment issues.

The ADA applies to all employers, employment agencies, labor organizations, and joint labor-management committees in which at least 15 employees work for each working day in each of 20 or more calendar weeks. The ADA excludes the federal government or other employers that receive a certain level of federal support (because they are subject to other similar regulations), as well as Indian tribes and private-membership clubs that are exempt from taxation.

Title I of the ADA provides that people with disabilities cannot be excluded from employment unless they are unable to perform the essential requirements of the job. An employer may not discriminate in:

• Recruitment, advertising, and job application procedures
• Hiring, upgrading, promotion, demotion, tenure, transfer, layoff, termination, return from layoff, and rehiring
• Rates of pay or other compensation and changes in compensation
• Job assignment, job classification, position descriptions, lines of progression, structures, and seniority lists
• Leaves of absence, sick leave, or other leave
• Fringe benefits, whether or not administered by the employer
• Selection and financial support for training, including apprenticeships, professional meetings, conferences and other related activities, and selection for leaves of absence to pursue training
• Activities sponsored by the employer, including social and recreational programs
• Any other term, condition, or privilege of employment