Cataplexy is the sudden loss of voluntary muscle tone or temporary paralysis that is often triggered by extreme emotion, such as laughter or fear. Cataplexy by itself is considered a rare disease. Most episodes are short in duration, lasting a few seconds up to five minutes. These episodes tend to have few, if any, residual effects. Some people with narcolepsy can have cataplectic attacks almost daily, while there are some people with narcolepsy that have never experienced cataplexy.
During a cataplectic attack the person will remain conscious; however, the person may experience jaw dropping, which can cause speech limitations, or eyelids drooping, which can interfere with vision. Other symptoms may include balance issues, upper extremity weakness, and/or collapsing.
While a cataplectic attack is usually very short in duration and leaves no residual effects, there may be symptoms that would require workplace accommodations. Some of the most common limitations stemming from a cataplectic attack are weakened speech, vision issues, trouble balancing, upper extremity weakness, and/or collapsing.
Cataplexy and the Americans with Disabilities Act
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. 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 an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Cataplexy
People with cataplexy 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 cataplexy 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:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
An applicant disclosed that she has cataplexy and mentioned concerns with the on-the-job travel duties required for the position.
Occasional travel via rental car is listed as a function of the job to attend conferences. The employer agrees to arrange for transportation via bus instead of rental car if the applicant is selected for the position.
A paralegal would have weakness and numbness in her dominant hand immediately following a cataplectic attack.
To continue her case documentation, she was accommodated with a one-handed keyboard and speech recognition software.
A newspaper editor would temporarily have impaired speech shortly after a cataplectic attack.
To maintain constant communication with her colleagues, she was accommodated with an instant messaging program on her computer.
An accountant was experiencing stress due to an increased workload, resulting in more frequent cataplectic attacks.
To accommodate him, his employer restructured his position to only include the essential functions. The employer also referred him to the company Employee Assistance Program (EAP) to help manage his stress.
A secretary with cataplexy would experience an attack after a fit of laughter, causing her to fall out of her chair.
She was accommodated with an office chair with arm rests and a lap belt so she would not fall to the floor.
A warehouse worker would collapse during a cataplectic attack.
To ensure workplace safety, his work area was covered with rubber matting to cushion his fall and he was provided a harness for times he had to climb up a ladder.
An employee diagnosed with cataplexy raised concerns about the large amount of walking needed to get to the printer from her workstation.
The employer moves the employee’s workstation to be closer to the location of the printer.
An applicant disclosed that she has cataplexy.
The employer is concerned with how to handle a situation should the applicant lose consciousness at work. The applicant and the employer sit down and create a plan of action so that if the applicant is chosen for the position, supervisors will know how to respond in the event this occurs.
A supervisor has noticed that occasionally an employee with cataplexy will slump over at his desk and fears that the employee will injure himself by falling out of the office chair.
The employee and supervisor agree that an office chair without wheels and larger armrests would reduce this possibility considerably. The employer decides to provide the employee a new chair as an accommodation.
An employee diagnosed with cataplexy reported that speaking with his supervisor can sometimes lead to his condition flaring up due to high levels of stress.
As an accommodation, the employer decides that the supervisor will correspond with the employee via e-mail rather than in person as much as possible.
JAN Publications & Articles Regarding Cataplexy
Accommodation and Compliance Series
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