In writing a letter for my patient is there anything that I should NOT say? Side effects that can diminish your physical capacity include dizziness, vision issues, edema, fatigue, sleepiness, and balance problems. I've fasioned my entire life around keeping my epilepsy a secret. You may also suffer from mental sluggishness and other cognitive symptoms for as long as a couple of days following each seizure. Returning to the workplace is a big decision after you’ve experienced a stroke. How can I help my patients?Q. She resumed her duties. The Social Security Administration (SSA) has two forms of epilepsy listed among its conditions that potentially cause disability: convulsive epilepsy and non-convulsive epilepsy. A. My patient’s employer requires that I complete a form assessing his/her suitability for employment. Example 3: A police officer returning to active duty after presenting with several complex partial seizures over a short period of time. This is especially true for anyone who works in a job in which a seizure would pose a safety or security risk. The employer must determine, with the input of the applicant or employee (and/or his or her health car provider), whether there may be any type of reasonable accommodation (a change in the way the job is performed, etc.) Do they lose consciousness, and how does this affect them? Why do I need to know about workplace issues for my patients with epilepsy? Often standardized forms have not been designed for people with paroxysmal disorders such as epilepsy. These fact sheets contain information and activities on epilepsy. Remember that each is specific to the individual patient’s medical condition. A federally-funded resource for determining accommodation options, the Department of Labor's Job Accommodation Network (JAN), is available by calling 1-800-ADA-WORK (232-9675) or by email. Please consult your doctor or other health professional for advice regarding your epilepsy. Pay attention to your doctor’s orders. For more information, see JAN’s website and their resources concerning accommodations for persons with epilepsy. After making a degree of recovery from brain injury, you may feel that you are ready to return to work. Epilepsy May Occur Again After Surgery The courage to have epilepsy surgery is usually rewarded by a lifetime without seizures, but epilepsy may return … Frequently, employers will attempt to base their determination on the opinion of an occupational physician retained on a contract basis, even if that physician has limited expertise in the relevant area of medicine and/or knowledge about the individual’s medical history. What type of medical information will employers wish to receive?Q. In this case, it will be important to be able to counter the potentially conclusory opinion of that physician with an authoritative and carefully considered opinion that only the treating physician can provide. A. Can I Continue Working with a Seizure Disorder? The following information will be helpful to include when filling out forms or writing letters: iii. 4. currently receive Social Security benefits? Status epilepticus (SE) is a medical emergency that starts when a seizure hits the 5-minute mark (or if there’s more than one seizure within 5 minutes). You may be confused and unresponsive for some time following each seizure you experience. Accommodations that you believe would minimize risks to safety resulting from seizures on this job (e.g., permitting work on a day shift, rather than at night, to minimize sleep disruption that may trigger seizures), viii. First, if appropriate, based on the type of medical inquiry raised by the employer, the physician should confirm that the patient does indeed have epilepsy, and describe the seizure type(s), their frequency and impact on the patient’s functioning (with and without the use of anti-seizure medication). Such an assessment must be based on a reasonable medical judgment that relies on the most reliable and objective evidence available. This is an Attorney Advertisement – Not an Attorney Referral Service Am I legally responsible if my patient is injured at work? However, the effects of brain injury can bring many changes to different aspects of life, including employment. If someone’s epilepsy is controlled (they don’t have seizures) they are unlikely to need more time off work than other employees. If they still have seizures, the need for time off work might depend on the type of seizures they have and the time they need to recover. Epilepsy and its impact on your working life Epilepsy is currently defined as a tendency to have recurrent seizures (sometimes called fits) and it affects approximately 1 in 100 people. Consider using these resources to help focus your thoughts and actions. Anti-seizure medications also cause side effects that can affect your mental capacity to perform your everyday job duties. Thankfully, the employee did not go through with it, but after a short leave of absence, he claimed he was ready to return to work. Detailed information should be provided on reasonable precautions that can be taken to avoid harm in the event a seizure occurs (such as providing rubber matting on floors to cushion falls and protective guards around machinery) and on avoiding seizure precipitants such as sleep deprivation. Broad statements are likely to be interpreted too conservatively, often without consideration of accommodations. This is especially true for anyone who works in a job in which a seizure would pose a safety or security risk. If you’re among those who continue to struggle with seizures even with consistent medical care and prescribed use of anti-seizure medications, then your condition may prevent you from continuing to work. The unemployment rate for people with epilepsy is two to three times that of the general population. In this way, the letter can help counter any stereotyped views about epilepsy that the employer may have. That documentation must not only including physician notes and statements that record and report the frequency and severity of the seizures you experience, but also the pre and post-seizure symptoms you have. What can be done to optimize my patient’s safety after s/he starts work?Q. Consent is not required to utilize our services. By submitting above, I agree to the privacy policy and disclaimer and consent to be contacted by an agent via phone call or text message at the phone number(s) listed above, including wireless number(s). The Equality Act 2010 stipulates that employers have to make reasonable adjustments to help an individual with epilepsy enter into/continue to work by ensuring that the individual isn't at a disadvantage compared to someone without epilepsy. In fact, accidents caused by epilepsy more often than average involve only the driver’s vehicle, result in less serious injury, and occur in less populated areas(9). Earlier return to work may be considered for drivers with a normal EEG who have no epileptic-form activity and normal examination by a neurologist specializing in epilepsy. I'm 56 now. Q. Seizure episodes certainly affect your mental capacity, not only during the episode, but for a period of time following the seizure as well. By requesting a free evaluation, the user will be provided with the name of an independent lawyer or advocate who will contact the user to do the evaluation. By submitting a free evaluation, I acknowledge that I understand and agree to the disclaimer and privacy policy. This information may help establish that an individual has a disability covered under the Americans with Disabilities Act (ADA), and therefore is protected from discrimination.1. Physician advocacy in the form of employer education on epilepsy generally can also be helpful. What are their seizures like, how often do they happen and how do they affect them? If You Have Arthritis, Can You Qualify for SSDI Benefits? In general (although court rulings may vary somewhat based on differences in state law), a physician would have no liability based on harm to the patient, co-workers or the public (caused by workplace accidents or other mishaps related to the patient’s epilepsy or treatment), providing the physician gives the patient and the employer accurate information concerning the patient’s epilepsy and related matters such as potential medication side effects. A. For those with active seizure disorders, it may be as high as 50%. Does the applicant plan to stop working soon and stay out of work for at least 12 months? Do they need an ambulance to be called and is there someone who can do this for them? expect to be out of work for at least 12 months? Being found eligible for Social Security Disability (SSD) benefits with a seizure disorder can be difficult. The seizure may last a few seconds or up to 5 minutes. How can I speak to my patient’s risk for having workplace accident which may harm him or others? (This answer from the FMCSA website) It is an advertising service paid for by the lawyers and advocates whose names are provided in response to user requests and it is not an attorney referral service. 3) Suggesting limits that can easily be dealt with through accommodations such as "should be barred from heights" (there are all kinds of safety belts and attachments readily available) or "should avoid work on concrete floors" (rubber matting and other modifications can be very effective). Even after a seizure episode subsides, you may have other post-seizure, physical symptoms, like high blood pressure, nausea, headaches and drowsiness. In addition to the seizures you experience, the medications required for managing your condition can also affect your physical capacity to perform your job. The main symptom that affects your physical capacity to perform your standard job duties is the occurrence of seizure episodes. about 20-30 minutes to know what happened and then around 1-2 hours to be able to stand a take a few steps. People who experience epilepsy have recurrent seizures due to the condition. Difficulties getting back to work or study, give yourself time to recover. Do you have examples of successful advocacy letters?Q. Requests to work from home; A private, quiet area to rest after having a seizure; A mat, carpet or soft area to cushion a fall; Ability to seek medical treatment, or time to adjust to medication during the workday; and, Ability to bring a service animal to work.  This is very dangerous because if you’ve been drinking or taking other drugs you may be more likely to vomit during the seizure and you will not have adequate control over your gag and cough reflexes This can lead to aspirating (inhaling) stomach contents into the lungs which can be fatal. Q. For instance, work which involve heights, water, heavy or unguarded machinery, firearms or driving has a … Calls may be auto-dialed/pre-recorded. Q. Neither this site nor any lawyer or advocate associated with it is affiliated in any way with or endorsed by the Social Security Administration. For information on these resources and others that can assist with obtaining and retaining employment, patients may be referred to the Epilepsy Foundation’s Career Support Center, a free informational online tool that assists individuals with epilepsy in their employment searches. Q. As amended, the ADA covers all impairments that limit major bodily functions, including neurological functioning, even if the condition is controlled by medication and/or is episodic. A seizure is caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the normal message passing between brain cells. What Is an On-the-record Decision and How Do I Request One? This article (Cornaggia) may be helpful to send along with your letter. Seizures result from the misfiring of electrical impulses in the brain and result in the temporary disruption of normal brain functions. Example 4: A young man with generalized tonic-clonic seizures desires to return to a banking/mail room position. Second, in order to support the conclusion that the individual is qualified for the position, the physician should be informed of the specific job duties involved and provide a detailed opinion on the extent to which the patient can safely perform those duties. What questions will the SSA ask regarding my case? How can I help my patients? It varies from three months to a year, depending on the laws in your state. How Severe Does my Arthritis Need to be to Qualify? Work restrictions for sudden incapacitation restrict functional work activities that may affect the health and safety of the worker Work restrictions for an unacceptable risk for seizures may include a “minimum waiting period” before returning to work. Ability to Work and Social Security Disability, Social Security Disability Insurance (SSDI), How to Apply for Social Security Disability. There are certain jobs that may be unsuitable for people who suffer with uncontrolled seizures, however, including working: The type of seizures you have and how often they occur; Time of day seizures typically occur; Whether the seizures are controlled by medication; The potential risks if a seizure happens in the workplace. During a seizure, you may experience loss of consciousness, uncontrolled shaking, or may appear temporarily catatonic – freezing in place and being unaware of anything that is happening around you. If, after returning from her telework accommodation, the employee later requests another accommodation related to her seizures (such as a shift change) and the need for accommodation is not obvious, the employer may ask for documentation explaining why the new accommodation is needed, but may not ask for documentation establishing that she has epilepsy. The seisure is diffrent than ones previously experienced. Example 1: A middle-aged man who was trained as an aircraft inspector and is having 1-2 partial complex seizures annually with a new medication. While individual factors should be taken into consideration, recent studies suggest that people who have occasional seizures are at very low risk for workplace accidents or absenteeism. There are two primary categories of seizures: epileptic and non-epileptic. 1. I’m just a physician. How should I respond?Q. Copyright Disability-Benefits-Help.org 2020. Q. 5. Seizure times of occurrence (if applicable), vi. Extent to which seizures are controlled with medication or other measures, vii. Often workplace safety can be improved with relatively modest accommodations on the part of the employer. Your application for SSD benefits must meet the documentation requirements for one of these two listings, or your medical documentation and other details of your application must satisfy the requirements for a “medical vocational allowance” in order for you to be approved for benefits. Example 3: A police officer returning to active duty after presenting with several complex partial seizures over a short period of time. The type of work you are expected to perform everyday affects whether or not you’re able to maintain employment even when you experience pronounced side effects from your anti-seizure medications. Though non-epileptic seizures may also be recurrent, those who suffer from them don’t technically have a seizure disorder, but instead have another condition with seizures as a symptom. Can Social Security Disability Insurance/Supplemental Security Income benefits be payed retroactively? wishes to return to work after having a seizure on the job. They can be downloaded and used for educational purposes. Why do I need to know about workplace issues for my patients with epilepsy?Q. I've been 'in the closet' since I was 20 about my epilepsy. The more frequently you experience seizures, the less likely it will be that you’re able to continue to work. Unless the form allows you to accurately depict your patient’s condition and capacity for employment, it is often preferable to leave portions of the form incomplete, attaching a letter that fully explains the situation. Whether the workplace is unionized, in which case the rights of an employer to take actions, such as to reassign employees or place employees on leave, may be addressed in the collective bargaining agreement. In writing a letter for my patient is there anything that I should NOT say? Contributor: Paul A. Garcia, MDReviewed: Patricia O. Shafer RN, MNAugust 31, 2013. The person does not wake up or have normal behavior after a seizure. The more frequently you experience seizures, the less likely it will be that you’re able to continue to work. Example 5: A young man with nocturnal partial complex seizures in remission seeks a job as a commercial driver. How to Qualify For SSD With Cancer Infographic, May is National Arthritis Awareness Month. You may find that you’ve been released to return to work on paper, even if … Congress amended the ADA, effective January 1, 2009, to make it considerably easier for an individual to show that he or she has a disability and therefore is protected from discrimination under the law. Yes, below are some examples of letters that have helped to get people with epilepsy back to appropriate employment. He was inappropriately screened out by the occupational medicine service adn the following letter resulted in his reinstatement. Furthermore, people with epilepsy who manage to gain employment, tend to earn less than people who do not have epilepsy. Information is available at: Epilepsy Foundation or by contacting the Foundation’s Programs and Resources Department at 1.800.332.1000.____________________________________________________________________________________________¹ Under the ADA, which prohibits employers with 15 or more employees from discriminating against persons with disabilities, including epilepsy, employers are permitted to seek information and to refer an employee for physical examinations to confirm that the individual has a covered disability and is able to safely and efficiently perform the job. Physicians play a critical role in helping ensure that their patients with epilepsy are fairly considered for employment opportunities. How long do they need to recover from a seizure? The person had a seizure in water. Q. To qualify for Social Security disability, you must expect to be disabled for at least 12 months. Do they have any warning before a seizure (sometimes called an aura)? Fill out the form on this site for a free evaluation of your disability claim. A. What does “ambulate effectively” mean in the Blue Book? Returning to work after brain injury. Physicians are in the unique position of being able to advocate for appropriate employment opportunities based on medical evidence. Not all patients benefit from contemporary seizure medications and other treatments though. Return to Work. Speech problems, memory issues, concentration difficulties, and pronounced nervousness can all be among the medication side effects that diminish your ability to effectively maintain gainful employment. If you’ve experienced two or more seizures in your life, then you have a seizure disorder. How Long Does it Take to Be Approved for Disability Benefits? (Cornaggia). Records from your medical doctor must also include documentation of the side effects you experience from your medications. Prior to the amendment, persons with epilepsy and other disabilities generally were not covered if their conditions were controlled with medication or other measures (e.g., prosthetic devices). I feel I'd never work again if I disclosed I was epilepic. 2. Find out the attorney or advocate in your area who is responsible for the advertisement, click here. Either can be potentially disabling, preventing you from working. 2) Use of the classic "should be barred from working with moving machinery". Do you have examples of successful advocacy letters? that would eliminate the risk, if any, or reduce it to an acceptable level. A. What type of epilepsy do they have? Disability-Benefits-Help.org is not a lawyer or law firm. I have always taken 2 days off work after I have one. I blackout for about 5-10 minutes sometimes longer. A seizure is a burst of electrical activity in your brain. Q. August is Spinal Muscular Atrophy Awareness Month. Thank you for your letter of October 15, 1999, a follow up letter to your original letter of July 26, 1999, requesting OSHA's interpretation of 29 CFR 1904, Recording and Reporting Occupational Injuries and Illnesses, as it applies to an injury due to an epileptic seizure at work. I can't afford health insurance now. The person does not have a medical ID bracelet (instructions explaining what to do). After she suffered more seizures on the job, CRMC placed Olsen on paid administrative leave in August 2008. 2-3 days and I feel about 100%. A new-onset seizure is a seizure that happens for the first time. Q. How often you have seizures and the severity of the side effects you have from your medications may both result in you being unable to work due to your seizure disorder. Non-epileptic seizures, on the other hand, are the result of another medical condition. You can ask your doctor for a medical certificate for the recovery period if you need one ; Concerns about repeat seizures or are having a difficult recovery period, ask a family member or trusted friend to check in on you while you recover. If your doctor has diagnosed you as having a seizure disorder, states will require that you are treated for that condition with medication designed to prevent seizures and that your seizures are under … How can I speak to my patient’s risk for having workplace accident which may harm him or others?Q. Drivers who are seizure-free and off anticonvulsant medication(s) for at least 5 years after a single unprovoked seizure can be certified. Q. related to seizures or epilepsy is not very well substantiated and probably fairly small. Another seizure starts before the person has fully returned to a state of awareness, after a previous seizure. Importantly, the ADA requires that, prior to denying a job opportunity to an employee or applicant with epilepsy (or another disability) based on safety or health risks, the employer must conduct an individualized assessment of the person’s ability to safely perform the essential functions of the job. 3. Drivers who are seizure-free and off anticonvulsant medication(s) for at least 5 years after a single unprovoked seizure can be certified. 6. After head trauma, drugs and alcohol greatly increase the likelihood of having a seizure. One of the skills that sets Lori apart is her extensive training and certification in concussion management. Drivers who have had one unprovoked seizure by definition do not have epilepsy (2 or more unprovoked seizures). The letter should highlight the individual’s ability to perform the essential functions of the job, rather than focusing on his or her limitations. There are, however; few You have a higher risk for another seizure within the next 2 years. The main symptom that affects your physical capacity to perform your standard job duties is the occurrence of seizure episodes. Am I legally responsible if my patient is injured at work?Q. With modern understanding of epilepsy and the greater number of more effective medications, most who suffer from seizure disorders are able to keep their condition relatively under control. My patient’s employer requires that I complete a form assessing his/her suitability for employment. Example 4: A young man with generalized tonic-clonic seizures desires to return to a banking/mail room position. If you do not plan to stop working, this site cannot assist you because you will not qualify for the program. A. The duration of the monitoring is to be assessed on a case-by-case basis at the discretion of the treating neurologist. Based on these provisions, it is clear that persons with epilepsy are covered under the ADA in virtually all cases. ... Seizures that begin after the age of 25 are usually secondary to some form of organic brain disease. To ensure your application meets eligibility requirements, you’ll need to work closely with your primary care doctor. What causes a seizure? Regardless, Jeff added that there are steps almost any employer can take to address safety concerns after an employee has a seizure at work. An Upstate pizza delivery driver is thanking two men who saved her after she had a seizure and crashed into a pond. The person has thrown up and may have breathed in some vomit. Some people recover immediately while others may take minutes to hours to feel like their usual self. While on leave, Olsen consulted a neurologist, who gave her a letter approving her return to work. After disclosing to a doctor that I had epilepsy years ago. Q. Fact sheets: What is epilepsy? What can be done to optimize my patient’s safety after s/he starts work? After returning to work: Annual review by a neurologist with submission of a written report. The person doesn’t “come to” or isn’t breathing after the seizure ends. Patients may also benefit from the services of vocational rehabilitation specialists, who can assess their suitability for job opportunities and provide technical assistance to the patient and employers. Today it is unusual if machinery has not already had such a guard system installed. A seizure may start in one part of your brain, or both sides may be affected. Q. I’m just a physician. Returning to Work After a Concussion Lori Mercer is an Occupational Therapist who has been working with InMotion Health Centre since 2013. Almost all moving machinery has guards or can be modified for safety. A. Carefully read any paperwork you are given after a medical visit, especially if your doctor is part of the workers’ comp insurance company’s network. My client rightfully was concerned whether it had an obligation to return him to work with little more than a conclusory prescription pad note stating, “Johnny can return to work … The best available evidence about an individual’s medical suitability for a job typically comes from his or her treating physician in the form of a detailed opinion letter. Or even obtaining or keeping your drivers license. In November 2008, a seizure caused her to fall, resulting in a head wound that required staples. I understand medicine, not employment law and vocational rehabilitation. History of work-related injuries shoudl be considered, if relevant, C. Reassurance of workplace safety and worker reliability based on medical literature. Substantial medical documentation is required no matter which way your application may be approved. As the seizure ends, the postictal phase occurs - this is the recovery period after the seizure. It will be particularly helpful to provide suggestions on specific types of reasonable accommodation(s) that could be devised to enable the individual to successfully perform the job duties. What type of medical information will employers wish to receive? Tongue bites and cheek bites last much longer though : A. Do they have seizures? Copyright © 2020, American Epilepsy Society, Epilepsy Fellowship In-service Training Examination (EpiFITE), Research + Training Fellowships for Clinicians, EF Clinical Research Apprenticeship [PDF], ILAE/AES Translational Research Task Force, FAES: Fellow of the American Epilepsy Society. For example, machine operators, truck drivers, or others who control or operate vehicles or machinery as their core job responsibility cannot continue to work if their seizure disorder is uncontrolled. How should I respond? Physician's Guide - Responding to Work Site Safety IssuesThis Web site module is designed specifically for the physician in order to present a template and examples of responses to employers about workplace safety issues. In writing a letter for my patient is there anything that I should NOT say. Example 2: A middle-aged hospital accountant with complex partial seizures – she wishes to return to work after having a seizure on the job. You may also wish to consider seeking the help of a Social Security attorney or advocate to help increase your chances of being approved for SSD benefits. You’ve had seizures that don’t affect your consciousness or driving You may still qualify for a licence if these are the only type of seizure you’ve ever had and the first one was 12 months ago. A. The person is pregnant, injured, or has diabetes. Common mistakes that may unintentionally hinder your patient’s application include: 1) Use of vague terminology such as "should avoid activities that would put himself or others at risk". I understand medicine, not employment law and vocational rehabilitation.