Under the Americans with Disabilities Act of 1990 (ADA) and its amendments, people living with chronic pain may receive reasonable accommodations that enable them to work (1). Living with chronic pain can make it extremely challenging to hold down a full-time or part-time job. For example, studies show that 35-50% of patients with fibromyalgia, a widespread chronic pain condition, are not working (6). Painful symptoms and a substantial investment of time and money in clinical care hinder many fibromyalgia patients’ ability to work on a traditional schedule (6). Unemployment amongst fibromyalgia patients is associated with poverty, weaker social networks, and even worse health outcomes (6).
Job accommodations adjust the work environment or responsibilities to support a person with a disability in fulfilling their role (5). Although laws requiring employers to provide reasonable accommodations are in place, many people living with chronic pain and other disabilities still face barriers, bias, and discrimination in the workplace (2). Employers are responsible for ensuring that requesting and receiving work accommodations is seamless for employees experiencing chronic pain. Additionally, healthcare providers can partner with patients to better manage the symptoms of their illness and its resulting social and economic toll (6).
Chronic pain is defined as pain that lasts three months or longer and can be a symptom of various conditions, including migraines, back and neck pain, and even cancer treatment (3). Roughly one in ten adults throughout the world live with chronic pain (3). People living with chronic pain may struggle to manage pain, navigate work relationships, and make or request workplace accommodations that allow them to balance their responsibilities and pain (3). Although laws mandating reasonable accommodations exist, those living with chronic pain are often still the target of ableist bias in the workplace, making it difficult for them to request accommodations (2). For example, a literature review found that mentioning disability at any point in the hiring process appeared to trigger an adverse reaction from the employer (2). As a result, many job-seekers with chronic pain may feel that requesting accommodations during the hiring process is unsafe.
Various kinds of reasonable accommodations may be fashioned by employers for employees living with chronic pain. For example, reasonable accommodations for migraines include dimmer lighting, anti-fragrance policies in the office, or the ability to work from home (7). For employees with chronic neck and back pain, updating their desk setup to be more ergonomic or using assistive devices to carry heavy loads can help alleviate pain symptoms during the workday (4). Employees may also need to take longer or more frequent breaks or rearrange the order or schedule of their workday to accommodate their needs (4).
Employers are responsible for making disclosing a disability and a need for reasonable accommodations smooth and non-threatening (2). Often, employers can provide reasonable accommodations without undue hardship on the business and at a low cost (2). Providing work accommodations helps ensure that people living with chronic pain have equal access to employment opportunities and can maintain social connections and a sense of purpose in their lives. Furthermore, healthcare providers can take a biopsychosocial approach to working with patients with chronic conditions, wherein they aim to treat both the physical symptoms of chronic pain and the effects it has on aspects of patients’ lives.
References
1. “ADA Amendments Act of 2008 Frequently Asked Questions.” US Department of Labor, Jan 1 2009, ADA Amendments Act of 2008 Frequently Asked Questions | U.S. Department of Labor (dol.gov)
2. Ameri, Mason and Terri R. Kurtzberg, “The disclosure dilemma: requesting accommodations for chronic pain in job interviews.” Journal of Cancer Survivorship, vol. 16, pp. 152-164, Feb 2 2022. doi: 10.1007/s11764-021-01142-3
3. Grant, Mary et al. “The work of return to work. Challenges of returning to work when you have chronic pain: a meta-ethnography.” BMJ open vol. 9,6 e025743. 20 Jun. 2019, doi:10.1136/bmjopen-2018-025743
4. Guerin, Lisa. “Getting a Workplace Accommodation for Back Pain and Back Problems.” Disability Secrets, https://www.disabilitysecrets.com/resources/getting-workplace-accommodation-back-pain-and-back-proble
5. “Job Accommodations.” U.S. Department of Labor. https://www.dol.gov/general/topic/disability/jobaccommodations
6. Mukhida, K et al. “Does work have to be so painful? A review of the literature examining the effects of fibromyalgia on the working experience from the patient perspective.” Canadian journal of pain = Revue canadienne de la douleur vol. 4,1 268-286. 3 Dec. 2020, doi:10.1080/24740527.2020.1820858
7. Riggins, Nina, and Lorenzo Paris. “Legal Aspects of Migraine in the Workplace.” Current pain and headache reports vol. 26,12 (2022): 863-869. doi:10.1007/s11916-022-01095-x