# Presentation: 625845

## Information pulled from the
Job Accommodation Network
 (JAN)
http://www.jan.wvu.edu/media/atoz.htm

- Job Accommodation Network
-  (JAN)
- http://www.jan.wvu.edu/media/atoz.htm

##      Accommodations

- Addison’s disease is a rare endocrine or hormonal disorder that affects about 1 in 100,000 people that occurs in all age groups and affects men and women equally. It is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non-exposed parts of the body.

-  *Easy access to snacks and a refrigerator*

-  *Flexible work schedule, liberal use of leave time, allowed to work from home*

-  *Reduce effects of cold workplace by allowing space heaters or specially designed clothes*

-  *Wheelchair or scooters to accommodate for difficulty standing or moving*

## Accommodations

- HIV (Human Immunodeficiency Virus) is the virus that causes AIDS. AIDS (Acquired Immunodeficiency Syndrome) is the diagnosis an HIV-infected person receives after developing one of the AIDS indicator illnesses defined by the Centers for Disease Control. An HIV positive person who has not had any serious illnesses can also receive an AIDS diagnosis on the basis of certain blood tests. HIV is passed from one person to another through blood-to-blood and sexual contact. HIV transmission can occur when blood, semen, vaginal fluid, or breast milk from an infected person enters the body of an uninfected person.

**Weight Loss:**
- Ergonomic chair with extra padding.Arm supports.Alternate working positions to prevent sores from forming. Have access to refrigerator.

**Chronic Diarrhea:**
- Work-site near restroom. Flexible work schedule to allow for restroom breaks.

**Fatigue/Weakness:**Reduce/eliminate lifting, walking, etc.Flexibility to sit or stand. Rest area with cot .Later start time.Frequent rest breaks.Shorten work day and extend work week.

**Psychological Implications:**
- Identify stressors and reduce stress.Educate coworkers, but keep person and his/her condition confidential.Time off for counseling or therapy.Provide praise and positive reinforcement.

**Neurological complications :**
- Eliminate need to use sharp objects.Provide protective clothing/equipment.Modify job tasks requiring fine finger dexterity.Reduce noise.

## Attendance Issues:

- 	Allow use of paid or unpaid leave for medical treatment.Allow use of paid or unpaid leave or flexible scheduling for
-             counseling.Provide a self-paced workload or the ability to modify daily schedule.
**Maintaining Concentration:**
- 	Reduce distractions in the workplace.Provide space enclosures or a private office.Plan for uninterrupted work time.Allow for frequent breaks.Divide large assignments into smaller tasks and steps.Restructure job to include only essential functions.
**Difficulty Staying Organized and Meeting Deadlines:**
- 	Provide clerical support.Make a daily to-do list.

- Alcoholism, also called "alcohol dependence," is a disease the
- at includes four symptoms: craving (a strong need, or compulsion, to drink); loss of control (the inability to limit one's drinking on any given occasion); physical dependence (withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking); and tolerance (the need to drink greater amounts of alcohol in order to "get high").

**Difficulty Handling Stress: **
-      Provide praise and positive
-         reinforcement.     Refer to counseling and
-        employee assistance programs.
-     Allow for the ability to modify daily
-        schedule.    Allow for frequent breaks.    Do not mandate job-related social
-        functions where there would be
-        exposure to alcohol.

##  Make certain the ventilation system is not distributing pollutants throughout the work site from locations within or outside of the building.

- MCS/EI is an inability to tolerate an environmental chemical or class of foreign chemicals. It develops from exposure to substances in the environment and may result in intolerance to even very low level exposure to chemicals. MCS/EI causes different symptoms in different people. Symptoms may include: headaches, dizziness, fatigue, nausea, breathing difficulties, tightening of the throat, difficulty concentrating, memory loss, learning disorders, eczema, arthritis-like sensations, and muscle pain. A person who experiences limitations due to MCS/EI may have any of the above mentioned symptoms when exposed to such irritants as fragrances, cleaning agents, smoke, pesticides, molds, office machines, car exhaust, paint, new carpeting, solvents, and poor indoor air quality among other irritants.

-  Make certain the ventilation system is not distributing pollutants throughout the work site from locations within or outside of the building.
- Air purification systems throughout the building or in personal workstations.
-  Keep a work environment which is free of pollutants such as fragrances, toxic cleaning agents, pesticides, exhaust fumes, tobacco smoke, etc.
-  Provide adequate exhaust systems to                 remove fumes from copiers and similar office machines.

## Loss or absence of all or part of a limb.

- Modify the work-site to make it accessible.
- Provide parking close to the work site.
- Provide an accessible entrance.
- Install automatic door openers.
- Provide an accessible restroom and break room.
- Keyboard/data entry **— **One-handed keyboards, typing tutorials for one-hand or missing digits, speech recognition software, large-key keyboards, foot mouse, touchpads, trackballs and head pointing systems.
- Writing **—** Grip aids-writing cuffs, action arm orthotic devices, recoding devices for note taking, note-takers and clipboards.
- Telephone use **—** Speaker-phones, telephones with programmable number storage, phone holders and telephone headsets.
- Climbing **— **Stair-lifts, wheelchair platform lifts, climbing wheelchairs, rolling safety ladders with handrails, work platforms, and hydraulic personnel lifts.
- Standing **—** Sit/stand stools, stand supports, task stools, anti-fatigue matting, and rest breaks.
- Lifting/carrying **—** Material handling lifts, cranes, hoists, powered carts/scooters, hydraulic lift carts, lift-tables, lightweight carts with large wheels, and tailgate lifts.
- Driving **—** Hand controls, automatic clutching systems, left-foot gas pedals, automatic transmissions, and designated parking.
- Walking **—** Canes, crutches, rolling walkers with seats, wheelchairs, and powered wheelchairs/scooters.

## Muscle weakness in hands, arms, legs or the muscles of speech, swallowing, or breathing: Flexible work schedule, liberal use of leave time, being allowed to work from home, elimination of physical exertion and workplace stress.

**Twitching and cramping of muscles, especially those in the hands and feet: **Ergonomic equipment, foot rests, and heated clothing and heaters are useful for controlling stationary postures and cold work areas. For computer access, speech recognition, alternative input devices, one-handed keyboards and alternative keyboards can help.
**Impairment of the use of the arms and legs: **A wheelchair or scooter may accommodate individuals who have difficulty moving around a workplace. For building access, accessible parking, ramps, stairs with chair lifts, and elevators are helpful.
**"Thick speech" and difficulty in projecting the voice in more advanced stages:  **May be accommodated by typing information into the computer and using speech output , using voice amplification, or a communication aid.
**Dealing with workplace stress:** Reduction or elimination of stress in the current position, transfer to a less stressful position, flexible schedule to recover from any effects caused by workplace stress, and work at home to avoid workplace stress.

- Often referred to as "Lou Gehrig's disease,“ it is a progressive neurodegenerative disease that attacks nerve cells in the brain and the spinal cord.

## Difficulty Handling Stress and Emotions: 

- According to National Institute of Mental Health (NIMH) “more than 19 million adult Americans ages 18 to 54 have anxiety disorders.” These disorders include Generalized Anxiety Disorder, Panic Disorder with or without Agoraphobia, Obsessive-Compulsive Disorder, Acute Stress Disorder, Post-Traumatic Stress Disorder, Social Phobia, and Specific Phobias.

**Difficulty Handling Stress and Emotions****: **
- Provide praise and
-   positive reinforcement.
- Refer to counseling and
-   employee assistance
-   programs.
- Allow telephone calls
-   during work hours to
-   doctors and others for
-   needed support.
- Provide sensitivity training
-   to coworkers.
- Allow the employee to
-   take a break to use stress
-   management techniques
-   to cope with frustration.

**Dealing with Change****: **
- Recognize that a change in
-   the office environment or of
-   supervisors may be difficult
-   or a person with an anxiety
-   disorder.
- Maintain open channels of
-   communication between the
-   employee and the new and
-   old supervisor in order to
-   ensure an effective
-   transition.
- Provide weekly or monthly
-   meetings with the employee
-   to discuss workplace issues
-   and productions levels.

**Working Effectively with Supervisors: **
- Provide positive praise and
-   reinforcement.
- Provide written job instructions .
- Develop written work
-   agreements that include the
-   agreed upon accommodations,
-   clear expectations of
-   responsibilities and the
-   consequences of not meeting
-   performance standards.
- Allow for open communication to
-   managers and supervisors.
- Establish written long term and
-   short term goals.
- Develop strategies to deal with
-   problems before they arise.
- Develop a procedure to evaluate
-   the effectiveness of the
-   accommodation.

## Reduce or eliminate physical exertion and workplace stress.

- Schedule periodic rest breaks away from the workstation.
- Allow a flexible work schedule, flexible use of leave time, and work from home.
- Implement ergonomic workstation design.
- Provide a scooter or other mobility aid if walking cannot be reduced.
- Provide arm supports.
- Provide writing and grip aids.
- Provide a page turner and a book holder .
- Provide a note taker.
- Modify the work-site to make it accessible.
- Provide parking close to the work-site.
- Provide an accessible entrance.
- Install automatic door openers.
- Provide an accessible restroom and break room.

- Arthritis includes approximately 100 inflammatory and noninflammatory diseases that affect the body's joints, connective tissue, and other supporting tissues such as tendons, cartilage, blood vessels, and internal organs. There are more than 100 different types of arthritis and the cause of most types is unknown.

## Speaking/Communicating:

- Asperger Syndrome, sometimes called "high-functioning autism," is one of five pervasive developmental disorders known as the Autism Spectrum Disorders (NIMH, 2006). People with Asperger Syndrome typically have average or above-average cognitive ability, but have extreme social deficits.

**Speaking/Communicating:**
- For people with Asperger Syndrome, poor communication may be the result of underdeveloped social skills.
- Provide advance notice of topics to be discussed in meetings.
- Provide advance notice of date of
- meeting when employee is required to speak .
- Allow employee to provide written response in lieu of verbal response.
- Allow employee to have a friend or coworker attend meeting to reduce or eliminate the feeling of intimidation.

**Time Management:**
- This limitation can affect their ability to complete the task within a specified timeframe. It may also be difficult to prepare for, or to begin, less-desirable work activities.
- Divide large assignments into several small tasks.
- Set a timer to make an alarm after assigning ample time to complete a task.
- Provide a checklist of assignments Supply an electronic or handheld organizer.
- Use a wall calendar to emphasize due dates .

**Maintaining Concentration:**
- Purchase a noise canceling headset.
- Hang sound absorption panels.
- Provide a white noise machine.
- Relocate employee's office space away from audible distractions and visual distractions.
- Install space enclosures (cubicle walls).
- Reduce clutter in the employee's work environment.

## Managing Fatigue: Flexible work schedule, liberal use of leave time, being allowed to work from home, a reduction or elimination of physical exertion and workplace stress, scheduled rest breaks away from the workstation, and using ergonomic equipment to implement ergonomic workstation design. 

**Difficulty Performing Activities of Daily Living: **Eating aids, grooming aids, and other independent living aids may help.
**Difficulty with Speech:** Provide voice amplification, speech enhancement, or other communication devices, using written communication (use of writing aids may help), such as e-mail or fax, transferring to a position that does not require a lot of communication, and allowing periodic rest breaks may be effective modifications for individuals who have difficulty speaking.
**Problems using a Computer:** Individuals with ataxia could benefit from typing aids. Also, speech recognition, switches, and alternative input devices could be effective alternatives in some situations.
**Difficulty Standing and Walking: **A wheelchair or scooter may accommodate these limitations when moving around a workplace. Stand/lean stools and adjustable workstations also help individuals convert standing areas to sitting workstations.

- Friedreich's, the best known inherited ataxia, and other cerebellar ataxias are impairments of the nervous system, most of which are inherited. They share many of the same symptoms, including unsteadiness and inability to co-ordinate movement.

## Reduce visual and auditory distractions

- Attention deficit-hyperactivity disorder (AD/HD) is a neurobiological disorder that affects three to five percent of American children and adults.  The common characteristics of AD/HD are impulsivity, inattention, and/or over-activity (DSM-IV, 1994). Although individuals may have both inattention and hyperactivity symptoms, many individuals predominantly display one symptom more than another.

- Assist with time management

- Provide written
-  instructions

- Use a variety of charts to help organize

- Provide a coach to help with appropriate social cues

- Provide private workspace where employee will not disturb others by tapping, humming, or fidgeting

- Allow breaks for physical outlet

- Separate tasks to be easier to handle

## The major symptom of most back impairments is back pain, which can be localized or widespread radiating from a central point in the back. Sciatica is pain starting in the lower back and traveling down one or both legs. 

- The major symptom of most back impairments is back pain, which can be localized or widespread radiating from a central point in the back. Sciatica is pain starting in the lower back and traveling down one or both legs.

## Reduce distractions in the work area

- Allow flexible scheduling
- Allow longer or more frequent breaks
- Make daily TO-DO lists and check items off as they are complete
- Use several calendars to mark meetings and deadlines
- Provide positive praise and reinforcement
- Provide written job instructions
- Recognize that a change in the office environment or of supervisors may be difficult for a person with bipolar disorder

- Bipolar disorder, also known as manic-depressive illness, is a mental illness involving episodes of serious mania and depression. Bipolar disorder tends to run in families and is believed to be inherited in many cases. A person's mood can swing from overly "high" and irritable (mania) to sad and hopeless (depressed), and then back again, with periods of normal mood in between.

## Accommodation ideas for individuals with bladder conditions, including interstitial cystitis:

**Frequent and/or urgent need to use the restroom: **Implement frequent restroom breaks, moving the workstation closer to the restroom, and working at home.
**Need for medical treatment during work hours: **Flexible use of leave time, modification of attendance policy and schedule may be helpful to individuals who need to receive medical treatment during the workday.
**Lifting: **Accommodations for lifting limitations vary, depending on the situation. Accommodations may include assistance with lifting, lifting devices, or a transfer to another job that does not require lifting.
**Fatigue: **Possible solutions include a reduced work schedule, periodic rest breaks, a transfer to a less physically demanding job, and the flexible use of leave time.
**Commuting to and from work: **Possible solutions include allowing more time for the commute (to allow time for restroom breaks), allowing work at home, and a transfer to office closer to home.

## Reduce or eliminate physical exertion and workplace stress.

- Schedule periodic rest breaks away from the workstation.
- Allow a flexible work schedule and flexible use of leave time.
- Allow work from home.
- Modify the work-site to make it accessible.
- Provide parking close to the work-site.
- Install automatic door openers.
- Permit flexible scheduling.
- Provide time off for medical appointments.

- Bleeding disorders are a group of conditions that result in   poor blood clotting and extended bleeding time. People     with bleeding disorders do not bleed more quickly than    other people, just for a longer period of time.

## Install ramps, handrails, and provide handicap parking spaces.

- Install lever style door handles.
- Clear pathways of travel of any unnecessary equipment and furniture.
- Provide written information in large print.
- Change fluorescent lights to high intensity, white lights.
- Increase natural lighting.
- Provide a glare guard for computer monitors.
- Consult a vision specialist particularly with someone who has lost part of or all of their vision.
- Permit flexible scheduling, allow longer or more frequent work breaks.
- Provide additional time to learn new responsibilities.
- Allow for time off for counseling.
- Allow part-time work schedules.
- Reduce distractions in the work area.
- Provide space enclosures or a private office.
- Allow the employee to tape record meetings.
- Provide type written minutes of each meeting.

- TBI is any injury to the brain caused by trauma to the head. If there is trauma to the brain, but the skull is not broken, the TBI is known as a closed head injury.

## Heat Sensitivity:

**Heat Sensitivity:**
- Reduce work-site temperature.Use cool vest or other cooling clothing.Use fan/air-conditioner at the workstation.Allow flexible scheduling and flexible use of leave time.Allow work from home during hot weather.

**Cold Sensitivity: **
- Increase work-site temperature.
- Use portable space heaters.Dress in layers using thermal material or fleece.Wearing gloves. Provide heated clothing.Allow work from home during cold weather.

## Allow flexible work hours.

- Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells. Normal body cells grow, divide, and die in an orderly fashion.

- Allow frequent breaks.
- Allow work from home.

- Reduce or eliminate physical exertion and workplace stress.
- Schedule periodic rest breaks away from the workstation.
- Allow a flexible work schedule and flexible use of leave time.
- Allow work from home.

- Provide flexible schedules.
- Provide flexible leave.
- Allow a self-paced workload with flexible hours.

- Provide adjustable ventilation.
- Keep work environment free from dust, smoke, odor, and fumes.
- Avoid temperature extremes.

## Cerebral palsy is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy. 

- Cerebral palsy is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy.

## Muscle weakness: Flexible work schedule, liberal use of leave time, work from home, a reduction of physical exertion and workplace stress, scheduled rest breaks.

**Impairment of the hands and fingers: **For computer access, speech recognition, alternative input devices, one-handed keyboards_._
**Lack of sensitivity to hot and cold, especially in the hands and feet: **Heated clothing and heaters, portable air conditioners, and fans are useful for controlling work areas that fluctuate dramatically in temperature.
**Impairment of the use of the legs and feet: **A wheelchair may accommodate individuals who have difficulty moving around a workplace.   Ramps, stair and chair lifts, and elevators are helpful.
**Difficulty performing activities of daily living: **Eating aids, grooming aids, and other independent living aids may help.

- Charcot-Marie-Tooth, or CMT, is the most common inherited neurological disorder, affecting approximately 150,000 Americans. CMT patients slowly lose feeling in their feet/legs and hands/arms as nerves to the extremities degenerate. The muscles in the extremities become weakened because of the loss of stimulation by the affected nerves. Additionally, there is a loss of sensory nerve function.

## 	Accommodations for CFS go on a case-by-case basis; but, employers should accommodate based on fatigue/weakness, migraine headaches, depression, anxiety, photosensitivity and temperature sensitivity. 

- 	Accommodations for CFS go on a case-by-case basis; but, employers should accommodate based on fatigue/weakness, migraine headaches, depression, anxiety, photosensitivity and temperature sensitivity.

- CFS is a disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity.  Nonspecific symptoms include pain, impaired memory and/or mental concentration, insomnia, and post-exertion fatigue lasting more than 24 hours.

## Muscle Pain and Stiffness:

- Implement ergonomic workstation design.
- Reduce repetitive tasks or interrupt the tasks with other duties.
- Provide carts and lifting aids.
- Modify work-site temperature and/or dress code.
- Use fan/air-conditioner or heater at the workstation.
- Allow work from home during extremely hot or cold weather.
- Fatigue/Weakness:
- Reduce or eliminate physical exertion and workplace stress.
- Schedule periodic rest breaks away from the workstation.
- Allow a flexible work schedule and flexible use of leave time.
- Allow a self-paced workload.

- While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself. Chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years.

## Cognitive impairment, as used in this publication, refers to disturbances in brain functions, such as memory loss, problems with orientation, distractibility, perception problems, and difficulty thinking logically. 

- Cognitive impairment, as used in this publication, refers to disturbances in brain functions, such as memory loss, problems with orientation, distractibility, perception problems, and difficulty thinking logically.

*Maintain concentration by reducing distractions in the workplace*

*Help stay organized and meet deadlines by making to-do lists and creating calendars*

*Handle Memory Deficits by*
*Allowing the employee to tape record meetings and provide type written minutes of each meeting*

*Write clear expectations of employee’s responsibilities*

*Allow breaks and more time to learn new responsibilities*

## Color filters, such as a special red contact lens worn on one eye or prescription glasses may be used to help some people with a color deficiency. In addition, talking products are available that will scan a color and announce a description of the color. 

- Color filters, such as a special red contact lens worn on one eye or prescription glasses may be used to help some people with a color deficiency. In addition, talking products are available that will scan a color and announce a description of the color.

- Color Vision Deficiency (CVD) is the inability to distinguish between some colors and shades. Most people with this condition can identify some colors. Few people are totally "color blind.

## Accommodations for depression go by a case-by-case basis.  However, when considering the case keep the following things in mind:

- Depressive disorders are serious illnesses that affect a person's mood, concentration, sleep, activity, appetite, social behavior, and feelings. Depressive disorders come in different forms, the most common being major depression (unipolar depression).

**Accommodations for depression go by a case-by-case basis.  However, when considering the case keep the following things in mind:**
-  Recognize that an individual with depression might have a hard time adjusting to change.
-  Maintain stamina during the workday.
-  Assist in making interactions with others more manageable.
-  Assist in time management and organization of information.

## 	Developmental disorders also go on a case-by-basis.  Some suggestions include:

- a mental or physical impairment; and results in
- substantial functional limitations in three or more
- of the following areas of major life activities:
- Self-care.
- Receptive and expressive.
- Language.
- Learning.
- Mobility.
- Self-direction.
- Capacity of independent living.
- Economic self-sufficiency.

- 	Developmental disorders also go on a case-by-basis.  Some suggestions include:

*Provide pictures, symbols, or diagrams instead of words. *

*Read written information to employee.*

*Allow verbal or typed response instead of written response. *

*Provide checklists.*

*Divide large tasks into multiple smaller tasks.*

*Provide additional training or retraining as needed.*

## Allow for storage of medications, such as insulin and/or food.

- Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugar to build up in your blood.

*Allow for storage of medications, such as insulin and/or food.*

*Provide an area to test blood sugar levels and to administer medication.*

*Provide appropriate containers for needles/syringe disposal.*

*Allow frequent rest breaks.*

*Reduce or eliminate strenuous activities.*

*Reduce stress.*

*Educate coworkers on emergency situation procedures and identification of symptoms of hypoglycemia or hyperglycemia.*

## Allow use of paid or unpaid leave for inpatient medical treatment and counseling/support meetings.

- Drug addiction is a chronic, relapsing, and treatable disease. Addiction begins with a conscious choice to use drugs, but addiction is not just "a lot of drug use." Recent scientific research provides overwhelming evidence that not only do drugs interfere with normal brain functioning creating powerful feelings of pleasure, but they also have long-term effects on brain metabolism and activity. At some point, changes occur in the brain that can turn drug abuse into addiction. Those addicted to drugs suffer from a compulsive drug craving and usage and cannot quit by themselves.

*Allow use of paid or unpaid leave for inpatient medical treatment and counseling/support meetings.*

*Provide praise and positive reinforcement.*

*Refer to counseling and employee assistance programs.*

*Reassign to a less stressful job.*

*Reduce distractions in the workplace.*

*Provide workplace supports and extra supervision.*

*Reassign to a position that does not involve exposure to drugs.*

##                                                          ACCOMMODATIONS

- Easily accessible work-site, parking, entrance, restroom, and break area, and workstation.
- Automatic door openers.
- Speech recognition software and writing aids.
- Large-key keyboards and on-screen keyboard software used in conjunction with a mouse.
- Speaker-phones and phone holders (Telephones with programmable number storage).
- Stair-lifts.
- Wheelchair platform lifts.
- Standing frames.
- Canes/crutches.

- Movement disorders characterized by involuntary muscle contractions causing abnormal, often painful, movements or postures. Any part of the body can be affected including the arms, legs, neck, trunk, eyelids, face, or vocal cords.

## Epilepsy is the tendency to have repeated seizures that originate in the brain. There are several types of possible seizures that range from losing consciousness and massive muscles jerks to blank stares.

-                                                                                                  Put employee's name plate on desk and/or door.
-                                                                                                                                                      Label items at desk.
-                                                                                    Use nametags (or other identification) for all employees.
-                                                                                                                                       Avoid isolated workstations.
-                                                                                                                                  Work in teams of two or more.
- Use large-buttons with universal symbols (fire, police, doctor) and clear labels.
- Change schedule so employee is never first person in or last person out.
- Use rubber matting on floor area to cushion a fall.
- Provide area to take nap during breaks or lunch.
- Designate a person to respond to emergencies and know when to call 9-1-1.
- Have auto-dial programmed on phone that connects to supervisor or other numbers.
- Provide a quick, unobstructed exit and post clearly marked directions for exits, fire doors, etc.
- Allow employee time to recuperate from seizure (leave employee alone).
- Educate coworkers and supervisors on how to respond/react when employee has a seizure on the job.
- Use flicker-free monitor (LCD display, flat screen), monitor glare guard, "computer glasses," and take frequent breaks from tasks involving computer.
- Replace fluorescent lights with full spectrum lighting, use desk or floor lamps, and use natural lighting source (window) instead of electric light.

- Keep aisles clear of clutter.

## Provide written job instructions.

- FMS is a complex, chronic condition which causes widespread pain and fatigue as well as a variety of other symptoms. The name "fibromyalgia" comes from "fibro" meaning fibrous tissues (such as tendons and ligaments), "my" meaning muscles, and "algia" meaning pain. Unlike arthritis, FMS does not cause pain or swelling in the joints. Rather, it produces pain in the soft tissues located around joints and in skin and organs throughout the body.

- Prioritize job assignments and provide more structure.
- Allow periodic rest periods to reorient.
- Provide memory aids, such as schedulers or organizers.
- Minimize distractions.
- Provide task lighting.
- Reduce job stress.
- Provide arm supports.
- Provide writing and grip aids.

- Provide a page turner and a book holder.
- Provide task lighting.
- Eliminate fluorescent lighting.
- Provide alternate work space to reduce visual and auditory distractions.
- Implement a "fragrance-free“ workplace policy.
- Provide air purification 	devices.
- Modify work-site temperature and maintain the ventilation system.

## Accommodation ideas for individuals with GI disorders:

**Using the restroom as needed: **Flexible schedule to incorporate restroom breaks, a workstation closer to the restroom, a change in job assignment to a job that allows flexible breaks, and work from home during flare-ups.
**Working while undergoing treatment: **Flexible use of leave time to seek treatment, flexible scheduling to make up time missed for treatment, and part-time work or work from home while recovering from a flare-up.
**Meeting the physical demands of the job: **Job restructuring to remove marginal job functions that are physically demanding, equipment or other accommodations that reduce the physical demands of the job.
**Dealing with workplace stress: **Reduction or elimination of stress in the current position, transfer to a less stressful position, flexible schedule to recover from any effects caused by workplace stress, and work at home to avoid workplace stress.

- Gastrointestinal (GI) disorders affect millions people of all ages - men, women, and children. Examples of GI disorders include Crohn's disease, ulcerative colitis, irritable bowel syndrome, spastic colon, and diverticulitis. Symptoms of GI disorders range from very mild to debilitating.

## Graves' disease (toxic     divuse goiter) is characterized by hyperthyroidism and one or more of the following: goiter, exophthalmos, and pretibial myxedema. Many symptoms and signs are associated with Graves' disease. The more common signs are goiter, moist skin, tremor, eye signs (stare, lid lag, and irritation), nervousness, fatigue, and weakness.

**Managing fatigue:** Flexible work schedule, liberal use of leave time, work from home, a reduction or elimination of physical exertion and stress, scheduled rest breaks away from the workstation, and    ergonomic workstation    design.

**Working specific schedules: **Dayshift rather than a late or rotating shift due to problems with sleep regulation and fatigue.

**Dealing with workplace stress: **Reduction or elimination of stress in the current position, transfer to a less stressful position, and work at home to avoid workplace stress.

**Managing heat sensitivity:** Work-site temperature may need to be modified. A person could also benefit from cooling clothing or having a fan/air-conditioner at the workstation. An individual may also need flexible scheduling, modified dress code, and/or work from home during hot weather.