Employees with 

Myasthenia Gravis 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

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Preface 

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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 Myasthenia Gravis (MG) 

How prevalent is MG? 

According to the Myasthenia Gravis Foundation of America, approximately 14 out of 

100,000 individuals in the U.S. have been diagnosed with MG. Though this totals 

36,000 people, MG is considered under-diagnosed and the prevalence is thought to be 

much higher. Previous studies showed that women are more likely to be affected than 

men are. The most common age at onset is the second and third decades in women 

and the seventh and eighth decades in men. As the population ages, the average age 

at onset increases correspondingly; now males are more often affected than females, 

and the onset of symptoms is usually after age 50 (Howard, 2006). 

What is MG? 

The name “Myasthenia Gravis” comes from the Greek and Latin words meaning “grave 

muscular weakness.” The most common form of MG is a chronic autoimmune 

neuromuscular disorder that is characterized by fluctuating weakness of the voluntary 

muscle groups (Myasthenia Gravis Foundation of America, 2001). 

What are the symptoms of MG? 

MG causes muscle weakness, which worsens with use of the affected muscle. Different 

muscle groups are affected in different patients with MG. Certain muscles are more 

frequently involved, including the ones that control eye movements, eyelids, chewing, 

swallowing, coughing, and facial expression. Muscles that control breathing and 

movements of the arms and legs may also be affected. Weakness of the muscles 

needed for breathing may cause shortness of breath, difficulty taking a deep breath, and 
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coughing. The "gravis" or seriousness of myasthenia is noticeable when breathing 

muscles are affected (Myasthenia Gravis Foundation of America, 2001). 

How is MG treated? 

There is no known cure for MG, but there are effective treatments that allow many 

people with MG to lead full lives. Common treatments include medications, thymectomy, 

and plasmapheresis. Spontaneous improvement and even remission may occur without 

specific therapy. Rest and a well-balanced diet can help reverse the weakness 

(Myasthenia Gravis Foundation of America, 2001). 

MG and the Americans with Disabilities Act

Is MG 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 MG 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 MG 

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

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

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

whether additional accommodations are needed? 

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

Accommodation Ideas:

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 

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

Vision Impairment: 

• 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 

• Magnify written material using hand/stand/optical magnifiers 

• Alternate covering one eye 
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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 

Fine Motor Impairment: 

• Implement ergonomic workstation design 

• Provide alternative computer and 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: 

• Provide parking close to the work-site 

• Install automatic door openers 

• Provide proper ergonomics 

• Make sure materials and equipment at workstation are within reach range 

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

Situations and Solutions: 

A teacher with MG was having difficulty meeting the physical demands of her job due to 

muscle fatigue. She was accommodated with a fulltime teaching aid, frequently used 

supplies/equipment were moved closer to her desk, and she was allowed several short 

rest breaks during the day. 

A delivery person was having difficulty loading and unloading his truck due to lower 

extremity weakness from MG. He was accommodated with a transfer to a less 

physically demanding delivery route. 

A clerical worker with MG was missing a lot of work because of problems breathing, 

speaking, and walking. She was allowed to work at home part-time and to communicate 

via email as an accommodation. 

An administrator was having problems handling stress and had some double vision from 

MG. He was allowed to take rest breaks, assigned a support person in the workplace, 

and provided a reader as an accommodation. 

A hospital employee was having difficulty walking. She was accommodated with a 

parking space closer to her work-site and was provided a scooter to use at work. 
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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. 

Myasthenia Gravis Foundation of America 

1821 University Ave. 

Suite S256 

St. Paul, MN 55104 

Toll Free: (800)541-5454 

Direct: (651)917-6256 

Fax: (651)917-1835 

http://www.myasthenia.org 

The Myasthenia Gravis Foundation of America (MGFA) is the only national volunteer 

health agency dedicated solely to the fight against myasthenia gravis. MGFA, a 

nonprofit organization, was established to carry out the following: "To facilitate the timely 

diagnosis and optimal care of individuals affected by myasthenia gravis and closely 

related disorders and to improve their lives through programs of patient services, public 

information, medical research, professional education, advocacy and patient care." The 

vision of the Foundation is to have a "World Without MG." 
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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 

Howard, J.F. Jr., Myasthenia Gravis Foundation of America. (2006). Myasthenia 

Gravis-a summary. Retrieved September 5, 2008, from 

http://www.myasthenia.org/hp_clinicaloverview.cfm 

Myasthenia Gravis Foundation of America. (2001) Facts about autoimmune 

Myasthenia Gravis. Retrieved September 5, 2008, from 

http://www.myasthenia.org/docs/MGFA_Brochure_FactsAboutMG.pdf 
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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.