Employees with Lupus 

Accommodation and Compliance Series
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Preface 

The Job Accommodation Network (JAN) is a service of the Office of Disability 

Employment Policy of the U.S. Department of Labor. JAN makes documents available 

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The information is not intended to be legal or medical advice. If legal or medical advice 

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For further information regarding this or any other document provided by JAN, please 

contact JAN. 

Authored by Linda Carter Batiste, J.D. Updated 03/23/10. 
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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction 

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Lupus 

How prevalent is lupus? 

The Lupus Foundation of America estimates that approximately 1,500,000 Americans 

have a form of lupus (Lupus Foundation of America, n.d.). Despite the fact that lupus 

can affect men and women of all ages, it occurs 10 to 15 times more frequently in adult 

females than in adult males. Lupus develops most often between ages 15 and 44 and is 

two to three times more common among African Americans, Hispanics, Asians, and 

Native Americans (Lupus Foundation of America, n.d.). 

What is lupus? 

Lupus is a widespread and chronic autoimmune disease that, for unknown reasons, 

causes the immune system to attack the body's own tissue and organs, including the 

joints, kidneys, heart, lungs, brain, blood, or skin. The immune system normally protects 

the body against viruses, bacteria, and other foreign materials. In an autoimmune 

disease like lupus, the immune system loses its ability to tell the difference between 

foreign substances and its own cells and tissue. The immune system then makes 

antibodies directed against "self." There are several forms of lupus: discoid, systemic, 

drug-induced, and overlap syndrome or mixed connective tissue disease (Lupus 

Foundation of America, n.d.). 

What are the symptoms of lupus? 

Although lupus can affect any part of the body, the most common symptoms are achy 

joints, frequent fevers, arthritis, fatigue, skin rashes, kidney problems, chest pain with 

deep breathing, a butterfly-shaped rash across the cheek and nose, photosensitivity, 

impaired vision, Raynaud's phenomenon, and seizures. No single set of symptoms is 
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uniformly specific to lupus and no laboratory test can prove lupus conclusively; 

symptoms may disappear for no apparent reason and remain in remission for weeks, 

months, or even years (Lupus Foundation of America, n.d.). 

What causes lupus? 

The cause of lupus is unknown, but researchers believe there is a genetic 

predisposition and environmental factors also play a role in triggering the disease. 

Some of the factors that may trigger lupus include infections, antibiotics, ultraviolet light, 

extreme stress, certain drugs, and hormones (Lupus Foundation of America, n.d.). 

How is lupus treated? 

Treatment approaches vary depending on the symptoms of each person. Because the 

characteristics and course of lupus may vary significantly among individuals, a thorough 

medical evaluation and ongoing medical supervision are essential to ensure proper 

diagnosis and treatment. Medications are often prescribed for people with lupus, 

depending on which organs are involved, and the severity of involvement (Lupus 

Foundation of America, n.d.). 

Lupus and the Americans with Disabilities Act 

Is lupus a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC, 1992). Therefore, some people with lupus will have a disability under the ADA 

and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (EEOC, 1992). For more information about how to 

determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm. 
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Accommodating Employees with Lupus 

(Note: People with lupus may develop some of the limitations discussed below, but 

seldom develop all of them. Also, the degree of limitation will vary among individuals. Be 

aware that not all people with lupus will need accommodations to perform their jobs and 

many others may only need a few accommodations. The following is only a sample of 

the possibilities available. Numerous other accommodation solutions may exist.) 

Questions to Consider: 

1. What limitations is the employee with lupus experiencing? 

2. How do these limitations affect the employee and the employee’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the employee with lupus been consulted regarding possible accommodations? 

6. Once accommodations are in place, would it be useful to meet with the employee 

with lupus to evaluate the effectiveness of the accommodations and to determine 

whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding lupus? 

Accommodation Ideas: 

Activities of Daily Living: 

• Allow use of a personal attendant at work 

• Allow use of a service animal at work 

• Make sure the facility is accessible 

• Move workstation closer to the restroom 

• Allow longer breaks 

• Refer to appropriate community services 

• Provide access to a refrigerator 

Cognitive Impairment: 

• Provide written job instructions when possible 

• Prioritize job assignments 

• Allow flexible work hours 

• Allow periodic rest periods to reorient 

• Provide memory aids, such as schedulers or organizers 
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• Minimize distractions 

• Allow a self-paced workload 

• Reduce job stress 

• Provide more structure 

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 work from home 

• Implement ergonomic workstation design 

• Provide a scooter or other mobility aid if walking cannot be reduced 

Fine Motor Impairment: 

 

• Implement ergonomic workstation design 

• Provide alternative computer access 

• Provide alternative telephone access 

• Provide arm supports 

• Provide writing and grip aids 

• Provide a page turner and a book holder 

• Provide a note taker 

Gross Motor Impairment: 

• 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 

• Provide an accessible route of travel to other work areas used by the employee 

• Modify the workstation to make it accessible 

• Adjust desk height if wheelchair or scooter is used 

• Make sure materials and equipment are within reach range 

• Move workstation close to other work areas, office equipment, and break rooms 

Photosensitivity: 

• Minimize outdoor activities between the peak hours of 10:00 am and 4:00 pm 

• Avoid reflective surfaces such as sand, snow, and concrete 

• Provide clothing to block UV rays 

• Provide “waterproof” sun-protective agents such as sun blocks or sunscreens 

• Install low wattage overhead lights 
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• Provide task lighting 

• Replace fluorescent lighting with full spectrum or natural lighting 

• Eliminate blinking and flickering lights 

• Install adjustable window blinds and light filters 

Respiratory Difficulties: 

• Provide adjustable ventilation 

• Keep work environment free from dust, smoke, odor, and fumes 

• Implement a "fragrance-free" workplace policy and a “smoke free” building policy 

• Avoid temperature extremes 

• Use fan/air-conditioner or heater at the workstation 

• Redirect air conditioning and heating vents 

• Provide adequate exhaust systems to remove fumes from office machines 

• Allow individual to wear a respirator mask 

• Allow work from home 

Seizure Activity: 

• Eliminate the need to use sharp objects 

• Eliminate blinking and flickering lights 

• Replace fluorescent lighting with full spectrum or natural lighting 

• Use computer monitor glare guards, adjust monitor intensity and color, and 

decrease the cursor speed of the mouse 

• Provide protective clothing/equipment 

• Modify job tasks requiring fine finger dexterity 

• Allow flexible work hours

• Allow periodic rest breaks

• Allow work from home 

Skin Irritations: 

 

• Avoid infectious agents and chemicals 

• Avoid invasive procedures 

• Provide protective clothing 

Stress Intolerance: 

• Develop strategies to deal with work problems before they arise 

• Provide sensitivity training to coworkers 

• Allow telephone calls during work hours to doctors and others for support 

• Provide information on counseling and employee assistance programs 

 
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Temperature Sensitivity (including Raynaud’s Phenomenon): 

• Modify work-site temperature 

• Modify dress code 

• Use fan/air-conditioner or heater at the workstation 

• Allow flexible scheduling and flexible use of leave time 

• Allow work from home during extremely hot or cold weather 

• Maintain the ventilation system 

• Redirect air conditioning and heating vents 

• Provide an office with separate temperature control 

Vision Impairment: 

• Magnify written material using hand/stand optical magnifiers 

• Provide large print material, screen reading software, and large-size high 

resolution monitor 

• Control glare by adding a glare screen to the computer 

• Install proper office lighting

• Allow frequent rest breaks 

Situations and Solutions: 

A teacher with lupus was restricted from extended periods of typing. She was having 

difficulty creating lesson plans. She was accommodated with speech recognition 

software, an alternative keyboard, and a trackball. 

A corporate trainer with lupus had difficulty standing and walking when giving 

presentations. The individual was accommodated with a scooter for getting around the 

work-site and a stand/lean stool to support her weight when standing. 

A claims representative with lupus was sensitive to fluorescent light in his office and to 

the radiation emitted from his computer monitor. The overhead lights were changed 

from fluorescent to broad spectrum by using a special filter that fit onto the existing light 

fixture. The individual was also accommodated with a glare guard and flicker-free 

monitor. 

An engineer with lupus was having difficulty completing all of his work in the office due 

to fatigue. The individual was accommodated with frequent rest breaks, a flexible 

schedule, and work from home on a part-time basis. 

An executive secretary with lupus had severe back pain due to arthritis. The individual 

was accommodated with an adjustable height workstation to alternate between sitting 

and standing, an adjustable keyboard and mouse tray, and an ergonomic chair with 

lumbar support. 
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A health care worker with lupus had low vision. She was having difficulty viewing her 

computer screen and paper copies. The individual was accommodated with a large 

monitor, screen magnification software, hand/stand magnifier for paper copies, and a 

closed circuit television system. 

A systems analyst with lupus had migraine headaches. The individual was moved from 

a cubicle office to a separate workspace away from distractions and noise. She was 

then able to use task lighting instead of overhead fluorescent lighting and adjust the 

temperature control when necessary. 

Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, upon request JAN provides these 

lists and many more that are not available on the Web site. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

American Autoimmune Related Diseases Association 

22100 Gratiot Ave. 

East Detroit, MI 48021-2227 

Toll Free: (800)598-4668 

Direct: (586)776-3900 

Fax: (586)776-3900 

aarda@aarda.org 

http://www.aarda.org 

The American Autoimmune Related Diseases Association is dedicated to the 

eradication of autoimmune diseases and the alleviation of suffering and the 

socioeconomic impact of autoimmunity through fostering and facilitating collaboration in 

the areas of education, research, and patient services in an effective, ethical, and 

efficient manner. 

Arthritis Foundation 

P O Box 7669 
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Atlanta, GA 30357-0669 

Toll Free: (800)283-7800 

http://www.arthritis.org 

The mission of the Arthritis Foundation is to support research to find the cure for and 

prevention of arthritis and to improve the quality of life for those with arthritis. 

Lupus Canada 

590 Alden Road, Suite 211 

Markham, ON L3R8N-2 

Toll Free: (800)661-1468 

Direct: (905)513-0004 

Fax: (905)513-9516 

lupuscanada@bellnet.ca 

http://www.lupuscanada.org 

Lupus Canada, as a national voluntary organization, in partnership with its members, 

promotes research to find the causes and a cure for lupus, advocates on behalf of the 

lupus community, facilitates and coordinates education and public awareness, and 

supports organizational growth and development. 

Lupus Foundation of America 

2000 L Street, NW 

Suite 710 

Washington, DC 20036 

Toll Free: (800)558-0121 

Direct: (202)349-1155 

Fax: (202)349-1156 

http://www.lupus.org 

This is the main voluntary organization devoted to lupus. The LFA assists local chapters 

in providing services to people with lupus, works to educate the public about lupus, and 

supports lupus research. Through a network of more than 500 branches and support 

groups, the chapters provide education through information and referral services, health 

fairs, newsletters, publications, and seminars. 
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Lupus HealthNet 

Room 262, North Tower, Foothills Hospital Site 

1403 - 29 St., N.W. 

Calgary, AB T2N2T-9 

Direct: (403)670-4480 

http://www.acs.ucalgary.ca/~sedworth/page1.htm 

The Lupus HealthNet mission is to apply knowledge gained from scientific investigation 

to clinical care, to improve patient outcomes through research and programs, to 

encourage knowledge and self-responsibility, to use technology to improve 

communication and information transfer between healthcare providers and sectors, and 

to share knowledge gained in the HealthNet with other chronic illness populations. 

Lupus International 

17985 Sky Park Circle, Suite J 

Irvine, CA 92614 

Toll Free: (888)532-2322 

http://www.lupusinternational.com 

The primary function of Lupus International is to eradicate lupus by supporting lupus 

research, alleviating suffering for lupus patients through patient services and effecting 

early detection of undiagnosed cases through awareness promotion. 

National Institute of Arthritis and Musculoskeletal and Skin Diseases 

National Institutes of Health 

1 AMS Circle 

Bethesda, MD 20892-3675 

Toll Free: (877)22N-IAMS 

Direct: (301)495-4484 

TTY: (301)565-2966 

Fax: (301)718-6366 

niamsinfo@mail.nih.gov 

http://www.niams.nih.gov 

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases 

is to support research into the causes, treatment, and prevention of arthritis and 

musculoskeletal and skin diseases, the training of basic and clinical scientists to carry 

out this research, and the dissemination of information on research progress in these 

diseases. 
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National Jewish Health 

1400 Jackson Street 

Denver, CO 80206 

Toll Free: (800)222-5864 

Direct: (303)388-4461 

http://www.njc.org 

National Jewish is the only medical and research center in the United States devoted 

entirely to respiratory, allergic, and immune system diseases, including asthma, 

tuberculosis, emphysema, severe allergies, AIDS, cancer, and diseases such as lupus. 

National Organization for Rare Disorders 

55 Kenosia Avenue 

PO Box 1968 

Danbury, CT 06813-1968 

Toll Free: (800)999-6673 

Direct: (203)744-0100 

TTY: (203)797-9590 

Fax: (203)798-2291 

orphan@rarediseases.org 

http://www.rarediseases.org/ 

NORD is a unique federation of voluntary health organizations dedicated to helping 

people with rare "orphan" diseases and assisting the organizations that serve them. 

NORD is committed to the identification, treatment, and cure of rare disorders through 

programs of education, advocacy, research, and service. 

 
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References 

Equal Employment Opportunity Commission. (1992). A technical assistance manual on 

the employment provisions (title I) of the Americans with Disabilities Act. 

Retrieved September 5, 2008, from http://askjan.org/links/ADAtam1.html 

Lupus Foundation of America, Inc. (n.d.). Lupus fact sheet. Retrieved September 5, 

2008, from 

http://www.lupus.org/webmodules/webarticlesnet/templates/new_empty.aspx?arti

cleid=351&zoneid=76 
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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.