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Rheumatoid Arthritis in the Workplace

Manage symptoms and ask for accommodations to keep your career moving forward.

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Rheumatoid arthritis (RA) symptoms don’t follow a convenient schedule. If they did, you might only have to deal with sore joints and fatigue when you have the luxury of resting at home.

The 24/7 nature of RA can make you feel your worst when you need to be at your best. If you’re too exhausted to focus, your fingers are too sore to type and your achy wrists prohibit you from lifting anything, it’s hard to get much done on the job – or even make it into work on some days.

A 2015 study in the Journal of Occupational and Environmental Medicine found that people with RA missed nearly 14 workdays a year, compared to fewer than 10 days in people who didn’t have the condition. Those missed workdays added up to nearly $252 million in lost revenues nationally. Even if you’re able to work, RA symptoms can affect your productivity – a phenomenon known as presenteeism.

Repeated absences and reduced productivity can prevent you from moving up the corporate ladder, force you to change jobs, or make it necessary to take early retirement. Still, you don’t have to let your condition derail your career.

“Even though the statistics about being able to work aren’t great, the good news for someone with RA is that, with motivation and support, you should still be able to stay on the job,” says Karen Jacobs, EdD, CPE, OTR/L, an occupational therapist, board-certified ergonomist and clinical professor of occupational therapy at Boston University.

Manage Your Symptoms

RA treatments have come a long way over the last few decades. Early and aggressive therapy with drugs like DMARDs and biologics, can slow disease progression. Keeping your symptoms under control will improve your ability to stay on the job. So it is important to work with your rheumatologist to find the best treatment plan for you and making changes to it as needed to keep your symptoms under control. Maintaining a healthy lifestyle through diet and exercise, as well as complementary therapies, can help, too.

Research shows that good disease control can reduce both absenteeism and presenteeism. A 2016 study in The Journal of Rheumatology found that starting drug treatment within the first three months after diagnosis helped people with RA stay productive at work. Good symptom management can also prevent you from having to take an early retirement, according to another study in Clinical and Experimental Rheumatology.

Ask for Accommodations

Another way to stay at work is to modify your job to fit your symptoms. To get job accommodations you’ll need to ask for them, which means you’ll have tell to your employer that you have a chronic health condition. “A lot of times people with rheumatoid arthritis are a little bit nervous to disclose that they have the condition,” says Jacobs. Know that your company can’t legally fire you just because you have a chronic condition, provided that you’re able to handle the responsibilities outlined in your job description.

Under the Americans with Disabilities Act, any company with more than 15 employees is required to provide reasonable accommodations to anyone with a life-limiting disability. You can request modifications you think will help you perform more effectively at work. For example, you might ask for a more ergonomic workstation if you have a desk job. Or, you could negotiate flexible hours or telecommuting (work from home) for times when symptoms are slowing you down. You may need a flexible dress code so you can wear comfortable shoes when your feet are swollen instead of dress shoes. You can ask for these and other accommodations as soon as you’re hired.

One caveat is that the accommodations can’t cause your employer any undue hardship – meaning they can’t be prohibitively expensive or change the way the company does business.

“And the accommodation request must be reasonable. An individual should not ask for essential functions to be removed from the job description,” says Beth Loy, PhD, principal consultant with the Job Accommodation Network (JAN). In other words, if you’re interviewing for a job that requires you to be on your feet for several hours a day and you know you can’t stand for more than 30 minutes, your company probably won’t be able to modify your job enough to accommodate you.

Yet she stresses that for many companies, accommodations are an easy, low-cost solution. “The majority of accommodations – 59% – don’t cost anything,” she says. “When there is a cost, typically it’s $500, and that’s not very much.”

She suggests asking for accommodations as early as possible, before any issues arise with your job performance. You don’t want the company to put a negative mark in your personnel file if you’re unable to fulfill the responsibilities of your position.

If you’re not sure how to approach your employer, check out other Arthritis Foundation resources and tips. Also visit the Job Accommodation Network website, which offers ideas on accommodation options. Consider joining an Arthritis Foundation support group, where you can get advice from people living with arthritis who are successfully navigating the workforce.

An occupational therapist (OT) can help you design your workspace to fit your physical capabilities. To find an OT in your area, contact the American Occupational Therapy Association.

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