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# JAN’S ACCOMMODATION FACT SHEET SERIES

**Job Accommodations for People**

**with Bleeding Disorders**

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.  Some bleeding disorders are present at birth and are caused by rare inherited disorders. Others develop during certain illnesses or treatments. Von Willebrand disease and hemophilia are the most common hereditary bleeding disorders affecting at least 1% of the population.  

Generally, bleeding disorders make it difficult to stop bleeding when an injury occurs.  With von Willebrand disease, prolonged bleeding may occur with minor cuts or during dental work.  With hemophilia, internal bleeding into the joints is more common, especially into the knees, elbows, and ankles.  This can cause stiffness and decreased range of motion and strength in the extremities and may ultimately cause chronic joint deformities.  Some individuals who have joint deformities may undergo joint replacement operations.  

There are many plasma proteins called factors that are involved in the blood coagulation process, and if one or more are missing or deficient, the blood clotting process is affected.  Treatment may consist of replacing the missing factors via nasal spray or injection to prevent bleeds before they start.  Other individuals may have a need for infusions in life-threatening situations.

The following is a quick overview of some of the job accommodations that might be useful for people with bleeding disorders. For a more in depth discussion, access JAN's publications at http://askjan.org/media/atoz.htm.  To discuss an accommodation situation with a consultant, contact JAN directly.

**Gross Motor Impairment:**

· Modify the work-site to make it accessible

· Provide parking close to the work-site

· 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 

· Adjust desk height if wheelchair or scooter is used

· Move workstation close to other work areas, break rooms, and restrooms

**Fine Motor Impairment:**

· Implement ergonomic workstation design

· Provide alternative computer and telephone access

**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

**Recurrent Need for Medical Intervention or Transfusions:**

· Permit flexible scheduling 

· Provide time off for medical appointments

· Allow periodic rest breaks

· Consider work from home

· Allow additional unpaid leave if employee exhausts accrued time off

**Promote an Inclusive Workplace:**

· Provide general disability awareness to coworkers while keeping the individual and his/her condition confidential

· Provide sensitivity training to coworkers and supervisors

· Offer peer counseling to the individual with the bleeding disorder, allow telephone calls to emotional supports, negotiate time for accommodations and time off for counseling or therapy

· Institute an “open-door policy” so employees with disabilities may approach their supervisors candidly

**Resources Specifically for People with Bleeding Disorders**

**ADVOY**

Toll Free: (866)442-3869

http://www.advoy.com

**HANDI**

Toll Free: (800)424-2634

Fax: (212)328-3799

http://www.hemophilia.org/resources/handi.htm

**Hemophilia Galaxy**

Baxter Healthcare Corporation

One Baxter Parkway

Deerfield, IL 60015

Toll Free: (800)423-2090

http://www.hemophiliagalaxy.com/

**National Hemophilia Foundation**

116 W. 32nd Street, 11th Floor

New York, NY 10001

Toll Free: (800)42H-ANDI

Direct: (212)328-3700

Fax: (212)328-3777

info@hemophilia.org

http://www.hemophilia.org

**Passport for Life**

http://www.passportforlife.com

**Project Red Flag**

Direct: (212)328-3705

http://www.projectredflag.org/

**World Federation of Hemophilia**

1425 René Lévesque Blvd. W. 

Suite 1010 

Montreal, Quebec H3G 1T7 

Direct: (514)875-7944

Fax: (514)875-8916

http://www.wfh.org

Updated 3/22/10. 

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.

Fact Sheet Series

Job Accommodations for People with Bleeding Disorders