Employees with 

Multiple Sclerosis 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

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

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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 Multiple Sclerosis (MS) 

How prevalent is MS? 

According to the National Multiple Sclerosis Society, approximately 400,000 Americans 

acknowledge having MS, and every week about 200 people are diagnosed. Worldwide, 

MS occurs with much greater frequency in higher latitudes (above 40° latitude) away 

from the equator, than in lower latitudes, closer to the equator (National Multiple 

Sclerosis Society, n.d.). 

MS is more common among Caucasians (particularly those of northern European 

ancestry) than other races, and is almost unheard of in some populations, such as 

Eskimos. Certain outbreaks or clusters of MS have been identified, but their significance 

is not known. In certain populations, a genetic marker has been linked to MS. A 

particular genetic trait occurs more frequently in people with MS than in those who do 

not have the disease (National Multiple Sclerosis Society, n.d.). 

The average age of onset is usually between 20 and 40, although it also can occur in 

older individuals. MS is twice as common in women compared to men (National Multiple 

Sclerosis Society, n.d.). 

What is MS? 

MS is a chronic autoimmune disease of the central nervous system. It causes 

destruction of myelin (a protein that forms a protective coating around nerve cells) in the 

central nervous system. When myelin is destroyed signals traveling through the nerve 

cells are interrupted or delayed, resulting in various neurologic symptoms occurring at 

different locations throughout the body. The progress, severity, and specific symptoms 
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of MS in any one person cannot yet be predicted, but advances in research and 

treatment are giving hope to those affected by the disease (National Multiple Sclerosis 

Society, n.d.). 

What are the symptoms of MS?

MS is often characterized by a pattern of exacerbation and remission. Symptoms may 

be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. 

Possible symptoms include fatigue, loss of coordination, muscle weakness, spasticity, 

numbness, slurred speech, visual difficulties, paralysis, muscle cramps, bladder or 

bowel problems, and sexual dysfunction (National Multiple Sclerosis Society). 

The initial symptoms of MS are most often difficulty walking; abnormal sensations such 

as numbness or "pins and needles"; and pain and loss of vision due to optic neuritis, an 

inflammation of the optic nerve. Less common initial symptoms may include tremor; lack 

of coordination; slurred speech; sudden onset of paralysis, similar to a stroke; and 

decline in cognitive function (National Multiple Sclerosis Society, n.d.). 

What causes MS? 

Studies show that MS is the result of a number of factors rather than a single factor. 

Most likely, genetics plays a role in determining a person's susceptibility to MS. The 

disease is not entirely genetically controlled, although first-degree relatives of 

individuals with MS have a 20- to 40-fold increased risk of developing the disease. 

Exposure to environmental factors, such as a virus or bacteria, also plays a role, 

although the specific factors have not yet been identified. Another likely factor is a 

defective regulation of the normal immune response that leads to unwarranted attacks 

by the body's defense mechanisms (an auto-immune process) (National Multiple 

Sclerosis Society, n.d.). 

How is MS treated?

According to the National Multiple Sclerosis Society, there are currently 5 federally 

approved medications that treat MS. Four of them: Avonex, Betaseron, Rebif, and 

Copaxone have been shown to be effective in modifying the natural course of relapsing 

MS. Clinical experience suggests they are most effective if taken early in the disease. 

The fifth drug, Novantrone, is effective in slowing down MS that is rapidly worsening or 

becoming progressive. Steriods may be used to shorten acute attacks. Many other 

therapies are being clinically tested, and researchers feel hopeful that more treatments 

for MS will be available in the near future. In addition to medications, there are also 

many therapies to moderate or relieve MS symptoms, including physical therapy, 

exercise, vocational and cognitive rehabilitation, attention to diet, adequate rest, and 

counseling (National Multiple Sclerosis Society, n.d.). 
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MS and the Americans with Disabilities Act 

Is MS 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 MS 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. 

When requesting an accommodation, do employees with MS have to tell their 

employers that they have MS? 

Under the ADA, when an employee requests an accommodation, an employer can 

require sufficient medical documentation to determine whether the employee has a 

disability and needs the requested accommodation. According to the Equal Employment 

Opportunity Commission, sufficient medical documentation can include the name of the 

medical condition (EEOC, 2000). However, the employee may want to begin by giving a 

more general description of the condition, such as saying “I have a neurological 

impairment,” and see if that suffices. However, such a limited description does not tell 

the employer that the individual has an impairment that substantially limits a major life 

activity because it is vague. 

To increase the chance that the employer will settle for the use of a vague term, the 

employee may want to provide a letter from his/her doctor that confirms the existence of 

a "neurological impairment,” but then goes on to give concrete information about how 

the condition substantially limits a major life activity. The inclusion of concrete 

information may satisfy the employer. However, if the employer insists on knowing the 

diagnosis and the individual refuses to divulge it, the employer probably has a valid 

reason to refuse to provide the requested accommodation. 
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Accommodating Employees with MS

(Note: People with MS 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 MS 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 MS 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 MS been consulted regarding possible accommodations? 

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

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

whether additional accommodations are needed? 

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

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 

Cognitive Impairment: 

• Provide written job instructions when possible

• Prioritize job assignments 

• Allow flexible work hours 

• Allow periodic rest breaks to reorient 

• Provide memory aids, such as schedulers or organizers

• Minimize distractions 
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• 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 

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 
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Speech Impairment: 

• Provide speech amplification, speech enhancement, or other communication 

device 

• Use written communication, such as email or fax 

• Transfer to a position that does not require a lot of communication 

• Allow periodic rest breaks 

Vision Impairment: 

• Magnify written material using hand/stand/optical magnifiers 

• Provide large print material or screen reading software 

• Control glare by adding a glare screen to the computer 

• Install proper office lighting 

• Allow frequent rest breaks 

Situations and Solutions: 

A claims representative for a government agency was having difficulty reading files due 

to vision impairment caused by MS. His employer purchased a stand magnifier and 

added task lighting to his workstation. 

A manager with MS working for a publishing company was having difficulty transferring 

from her wheelchair to the toilet in the employee restroom. Her employer installed 

additional grab bars. 

An attorney with MS was having difficulty carrying documents to meetings at various 

locations due to upper extremity weakness. His employer purchased a portable cart that 

was easy to get in and out of his car. 

An operations clerk for a large distribution center was having difficulty working at full 

production due to fatigue caused by MS. Her employer moved her to a shift that was not 

as busy so caused less stress and made less physical demands of the clerk. The clerk 

was also able to take more frequent breaks on the new shift. 

An engineer with MS was experiencing heat sensitivity. She was provided a private 

office where the temperature could be lower than in the rest of the facility. She was also 

encouraged to communicate with coworkers by telephone or email when possible to 

reduce the amount of walking she had to do. 

A resource nurse with MS was having difficulty accessing her workstation. Her employer 

widened the floor space in her workstation to allow her easier access from her 

wheelchair and added an adjustable keyboard tray, monitor holder, and telephone tray. 

In addition, the employee was provided a flexible schedule so she could continue her 

medical treatment. 
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A clerical worker was having difficulty concentrating and remembering job tasks due to 

cognitive impairment caused by MS. Her employer added sound-baffle panels to 

reduce distractions in her work area. In addition, her employer gave her written job 

duties at the beginning of each day and provided a notebook that contained outlines of 

what each job duty entailed. 

A teacher with MS was having difficulty communicating with students because his 

speech became soft and slurred when he was fatigued. He was given a personal 

speech amplifier so he would not have to strain to project his voice, and he was allowed 

to schedule his classes so he could take periodic breaks. 

Products: 

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

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

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

lists are accessible through this system; however, JAN provides these lists and many 

more that are not available on the Web site upon request. 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. 

Independent Living Research Utilization (ILRU) Program 

2323 S Shepherd, Suite 1000 

Houston, TX 77019 

Direct: (713)520-0232 

TTY: (713)520-0232 

Fax: (713)520-5785 

ilru@ilru.org 

http://www.bcm.tmc.edu/ilru 

A national center for information, training, research, and technical assistance in 

independent living. They operate the IL NETWORK with the National Council on 

Independent Living (NCIL), organizations, and individuals involved in independent living 

nationwide. 
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Multiple Sclerosis Foundation, Inc. 

6350 North Andrews Avenue 

Fort Lauderdale, FL 33309-2130 

Toll Free: (800)225-6495 

Direct: (954)776-6805 

Fax: (954)938-8708 

admin@msfocus.org 

http://www.msfocus.org 

Contemporary national, nonprofit organization that provides free support services and 

public education for persons with Multiple Sclerosis, newsletters, toll-free phone 

support, grants for research, information, and referrals. 

Multiple Sclerosis Society of Canada 

175 Bloor Street E., Suite 700, North Tower 

Toronto, ON M4W3R-8 

Toll Free: (800)268-7582 

Direct: (416)922-6065 

Fax: (416)922-7538 

info@mssociety.ca 

http://www.mssociety.ca 

The Multiple Sclerosis Society of Canada's mission is to be a leader in finding a cure for 

multiple sclerosis and enabling people affected by MS to enhance their quality of life. 

National Multiple Sclerosis Society 

PO Box 4527 

New York, NY 10163 

Toll Free: (800)344-4867 

http://www.nationalmssociety.org 

The National Multiple Sclerosis Society is dedicated to ending the devastating effects of 

multiple sclerosis. 
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References 

Equal Employment Opportunity Commission. (1992). Definition of the term disability. 

Retrieved September 1, 2009, from http://www.eeoc.gov/policy/docs/902cm.html 

Equal Employment Opportunity Commission. (2000). Enforcement guidance on 

disability-related inquiries and medical examination of employees under the

Americans with Disabilities Act. Retrieved September 5, 2008, from 

http://www.eeoc.gov/policy/docs/guidance-inquiries.html 

National Multiple Sclerosis Society. (n.d.). FAQs about MS. Retrieved September 1, 

2009, from http://www.nationalmssociety.org/about-multiple-sclerosis/FAQsabout-MS/index.aspx

 
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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.