Multiple Sclerosis (MS) is a chronic, unpredictable disease of the central nervous system that disrupts communication between the brain and the rest of the body. Since MS often begins affecting individuals between the ages of 20 and 50, which are peak working years, continued employment is a major concern. A diagnosis of MS does not automatically mean the end of a career; many people successfully continue working after implementing necessary adaptations. Maintaining employment provides financial benefits, a sense of purpose, and intellectual engagement, contributing positively to a person’s quality of life.
Assessing Work Feasibility with MS
The decision of how long and in what capacity an individual can work depends on personal, medical, and occupational factors. MS-related fatigue is one of the most common symptoms impacting job performance, affecting up to 90% of people with the condition. Even with low physical impairment, fatigue and cognitive symptoms can significantly reduce an employee’s productivity.
Cognitive dysfunction affects roughly half of all people with MS, manifesting as issues with memory, attention, information processing, and concentration. The severity and type of symptoms are often related to the specific course of the disease, such as relapsing-remitting MS versus a progressive form. Work capacity is reduced not only by physical disability but also independently by heat sensitivity and emotional distress.
A person’s specific job role also influences feasibility. Sedentary or flexible roles are often easier to maintain than those requiring significant physical activity or high stress, such as physical trades. Assessing work capacity involves considering the individual’s overall symptom burden, the demands of their occupation, and any co-existing conditions.
Legal Protections and Workplace Accommodations
Employees in the United States are protected under the Americans with Disabilities Act (ADA), which recognizes MS as an impairment. The ADA requires employers with 15 or more employees to provide “reasonable accommodations” to a qualified employee with a disability. This is required provided the accommodation does not cause “undue hardship” to the business.
MS is covered because its symptoms are often episodic, but they substantially limit major life activities when active. A reasonable accommodation is any modification to the job or work environment that allows an employee to perform the essential functions of their position. Common adjustments include flexible work schedules, such as modified start times or part-time options, to manage unpredictable fatigue.
Workplace changes might involve moving the workstation to a quieter area, providing an ergonomic chair, or securing a parking space closer to the entrance to conserve energy. Assistive technology can also be provided, such as adaptive keyboards, screen magnification software, or voice-to-text software. The process begins with the employee disclosing their condition and formally requesting the necessary changes.
Strategies for Managing MS Symptoms on the Job
Managing MS symptoms effectively at work relies heavily on proactive, personal strategies focused on energy conservation and cognitive support. Fatigue requires careful energy pacing throughout the workday. This involves strategically scheduling the most demanding tasks for times when energy levels are highest, such as in the morning, and incorporating short, planned rest breaks before exhaustion sets in.
To counter cognitive challenges, employees can implement organizational strategies to maximize focus and memory. Using calendars, digital reminders, and comprehensive to-do lists helps externalize information that might be difficult to retain. It is also helpful to request that complex instructions or assignments be provided in writing to reduce the need for constant recall. Minimizing distractions and focusing on completing one task at a time, rather than multitasking, can improve concentration and efficiency.
Heat sensitivity can temporarily worsen MS symptoms like fatigue and weakness. This can be addressed through personal cooling techniques, such as wearing cooling vests or neck wraps, and ensuring the workspace has adequate climate control. Regular light exercise and maintaining good sleep hygiene are also important self-management practices that help reduce the overall burden of fatigue and stress.
Navigating the Transition to Disability Support
When MS symptoms progress to a point where working, even with accommodations, is no longer possible, various financial supports are available. These options primarily consist of private Long-Term Disability (LTD) insurance and government-funded Social Security Disability Insurance (SSDI). LTD insurance is a private policy, often obtained through an employer, which replaces a portion of the former salary.
SSDI is a federal program that requires the individual to have worked long enough and paid sufficient Social Security taxes to be eligible. To qualify for SSDI, applicants must demonstrate an inability to engage in “substantial gainful activity.” Physicians need to document significant deficits in areas such as gait, vision, cognition, or fatigue.
Early planning is highly recommended. Many private LTD policies require the employee to also apply for SSDI. Earning a reduced salary or working part-time may negatively impact future benefits.