Employees with Fibromyalgia 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

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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contact JAN. 

Authored by Beth Loy, Ph.D. Updated 04/19/11. 
Practical Solutions • Workplace Success 

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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 Fibromyalgia 

How prevalent is fibromyalgia? 

The exact prevalence of fibromyalgia in the U.S. population has not been thoroughly 

studied, but conservative estimates place the total between three to five percent of the 

general population (Fibromyalgia Network, n.d.). 

What is fibromyalgia? 

Fibromyalgia 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, fibromyalgia 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 (National Fibromyalgia Partnership, Inc., 2004). 

What are the symptoms and associated syndromes of fibromyalgia?

Deep muscular pain is the most common symptom of fibromyalgia. Usually starting at 

the neck and shoulders and spreading to other parts of the body over time, the pain 

varies according to the time of day, weather, sleep patterns, and stress level. People 

with fibromyalgia may also have fatigue, sleep disorder, irritable bowel syndrome, 

chronic headaches, skin and temperature sensitivity, cognitive impairment, depression 

and anxiety, and irritable bladder (Fibromyalgia Network, n.d.). 
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What causes fibromyalgia? 

The cause of fibromyalgia remains elusive, but there are many triggering events thought 

to precipitate its onset. A few examples would be an infection (viral or bacterial), an 

automobile accident or the development of another disorder, such as rheumatoid 

arthritis, lupus, or hypothyroidism. These triggering events probably do not cause 

fibromyalgia, but rather, they may awaken an underlying physiological abnormality that 

is already present (Fibromyalgia Network, n.d.). 

How is fibromyalgia treated? 

The most effective treatment approaches for fibromyalgia symptoms use a combination 

of medications, non-drug therapies, and other strategies to reduce pain (Fibromyalgia 

Network, n.d.). 

Fibromyalgia and the Americans with Disabilities Act

Is a fibromyalgia 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 Regulations . . ., 2011). Therefore, some people with fibromyalgia 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 (ADAAA, 2008). For more information about how to 

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

Compliance Series: The ADA Amendments Act of 2008 at 

http://AskJAN.org/bulletins/adaaa1.htm. 

Accommodating Employees with Fibromyalgia

(Note: People with fibromyalgia 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 FMS 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 the fibromyalgia 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? 
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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 the fibromyalgia been consulted regarding possible 

accommodations? 

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

with the fibromyalgia to evaluate the effectiveness of the accommodations and to 

determine whether additional accommodations are needed? 

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

Accommodation Ideas: 

Concentration Issues: 

 Provide written job instructions when possible 

 Prioritize job assignments and provide more structure 

 Allow flexible work hours and allow a self-pace workload 

 Allow periodic rest periods to reorient 

 Provide memory aids, such as schedulers or organizers 

 Minimize distractions 

 Reduce job stress 

Depression and Anxiety: 

 Reduce distractions in work environment 

 Provide to-do lists and written instructions 

 Remind employee of important deadlines and meetings 

 Allow time off for counseling 

 Provide clear expectations of responsibilities and consequences 

 Provide sensitivity training to co-workers 

 Allow breaks to use stress management techniques

 Develop strategies to deal with work problems before they arise 

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

 Provide information on counseling and employee assistance programs 

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 
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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 

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

Migraine Headaches: 

 Provide task lighting 

 Eliminate fluorescent lighting 

 Use computer monitor glare guards 

 Reduce noise with sound absorbent baffles/partitions, environmental sound 

machines, and headsets 

 Provide alternate work space to reduce visual and auditory distractions

 Implement a "fragrance-free" workplace policy 

 Provide air purification devices 

 Allow flexible work hours and work from home

 Allow periodic rest breaks

Skin Sensitivity: 

 Avoid infectious agents and chemicals 

 Provide protective clothing 

Sleep Disorder: 

 Allow flexible work hours and frequent breaks 

 Allow work from home 

Temperature Sensitivity: 

 Modify work-site temperature and maintain the ventilation system 

 Modify dress code 
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 Use fan/air-conditioner or heater at the workstation and redirect vents 

 Allow flexible scheduling and work from home during extremely hot or cold 

weather 

 Provide an office with separate temperature control 

Situations and Solutions: 

An administrative assistant with fibromyalgia working for a utility company reported neck 

pain and upper body fatigue. Her duties included typing, answering the telephone, and 

taking written messages. She was accommodated with a telephone headset to reduce 

neck pain and eliminate the repetitive motion of lifting the telephone from the cradle, a 

portable angled writing surface and writing aids to take written messages, a copy holder 

to secure documents, and forearm supports to use when typing. 

A nurse with fibromyalgia working in a county health clinic experienced a great deal of 

fatigue and pain at work. The nurse typically worked evening shifts but her doctor 

recommended a schedule change so she could regulate her sleep patterns. 

Accommodations suggestions included changing her shift from evening to day, 

restructuring the work schedule to eliminate working two consecutive twelve hour shifts, 

reducing the number of hours worked to part time, and taking frequent rest breaks. 

A guidance counselor for a large high school experienced severe bouts of irritable bowl 

syndrome, depression, and fatigue as a result of fibromyalgia. He experienced difficulty 

in opening the heavy doors to the entrance of the school and had to make frequent trips 

to the bathroom. The individual's employer complained that he was spending too much 

of his time away from his office and therefore was not available for students. The 

employer moved the employee's office to a location closer to the faculty restroom, 

added an automatic entry system to the main doors, and allowed flexible leave time so 

the employee could keep appointments with his therapist. 

An individual employed as a patient rights advocate had carpal tunnel syndrome and 

fibromyalgia. She had difficulty keyboarding, writing, and transporting supplies to 

presentations. The employer installed speech recognition software for word processing, 

provided her with writing aids, and gave her lightweight portable carts to assist with 

transporting materials. 

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 

Direct: (202)693-7880 

TTY: (202)693-7881 

Fax: (202)693-7888 

infoODEP@dol.gov 

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 Fibromyalgia Syndrome Association, Inc. 

6380 E. Tanque Verde, Suite D 

Tucson, AZ 85715 

Direct: (520)733-1570 

Fax: (520)290-5550 

http://www.afsafund.org/ 

AFSA is dedicated to research, education, and patient advocacy for fibromyalgia. AFSA 

is the only charitable organization whose primary mission is to seed research in 

fibromyalgia. 
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Arthritis Foundation

P.O. Box 7669 

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. 

Centers for Disease Control and Prevention

1600 Clifton Rd NE 

Atlanta, GA 30333 

Toll Free: (800)311-3435 

Direct: (404)639-3311 

TTY: (404)639-3312 

http://www.cdc.gov/ 

The Centers for Disease Control and Prevention are dedicated to protecting the health 

and safety of people - at home and abroad, providing credible information to enhance 

health decisions, and promoting health through strong partnerships. 

Fibromyalgia Network

PO Box 31750 

Tucson, AZ 85751 

Toll Free: (800)853-2929 

http://www.fmnetnews.com/ 

The Fibromyalgia Network provides educational materials on fibromyalgia. 

National Fibromyalgia Partnership, Inc.

PO Box 160 

Linden, VA 22642-0160 

Toll Free: (866)725-4404 

Fax: (866)666-2727 

http://www.fmpartnership.org/ 

The National Fibromyalgia Partnership, Inc., offers quality educational materials and 

speaker presentations on fibromyalgia and related conditions. 
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National Organization for Rare Disorders (NORD)

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. 

Oregon Fibromyalgia Foundation

1221 SW Yamhill Suite 303 

Portland, OR 97205 

Direct: (503)892-8811 

http://www.myalgia.com/ 

The Oregon Fibromyalgia Foundation provides information, literature, and treatment 

options for individuals with fibromyalgia. 
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References

Americans with Disabilities Act of 1990, as Amended, 42 U.S.C.A. § 12101 et seq. 

(2008). 

EEOC Regulations to Implement the Equal Employment Provisions of the Americans 

With Disabilities Act, as Amended, 29 C.F.R. § 1630 (2011). 

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

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

Retrieved September 3, 2008, from http://AskJAN.org/links/ADAtam1.html 

Fibromyalgia Network. (n.d.). Fibromyalgia basics – symptoms, treatments and 

research. Retrieved September 3, 2008, from 

http://www.fmnetnews.com/pages/basics.html 

National Fibromyalgia Partnership, Inc. (2004). Fibromyalgia: symptoms, diagnosis, 

treatment & research. Retrieved September April 19, 2011, from 

http://www.fmpartnership.org/EngMonograph-04.htm 
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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.