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Working full-time - do you have reasonable adjustments

Posted: Sun Aug 18, 2013 12:12 am
by Cristinaflake
You might know that CFS/ME/Fibromyalgia are covered by the Disability Discrimination Act, and therefore employers need to consider the application of reasonable adjustments at work.

I would like to ask everyone in full time employment about their agreed reasonable adjustments at work, with examples if possible and assessment of the usefulness of these in managing the condition in a sustainable way (without recurring work-related relapses). Thanks in advance for your input.

Re: Working full-time - do you have reasonable adjustments

Posted: Sun Aug 18, 2013 10:33 am
by Lisesuffolk
I currently work part time as I couldn't cope with full -time working and use part time days, weekends and annual leave to 'recover' from work.
I can swap shifts and take leave at quite short notice if I am unable to work rather than take sickness absence, which is a concern. I am quite stressed about work currently as we are now being scored as a team in a league table format, rather than as an individual for reporting purposes, I am very concerned that my performance which has always been satisfactory, is now rated the lowest on the team and I am uncertain what this will mean for the future but I am very concerned about it which isn't helping with my ME at all. I am not sure where to go from here, as I feel that I will now have to perform not only as well as my colleagues but better to work my way up the pecking order, whilst trying to manage daily challenges with the cognitive challenges, aching joints etc. Any advice would be gratefully received

Re: Working full-time - do you have reasonable adjustments

Posted: Mon Aug 19, 2013 3:27 pm
by Dr Charles Shepherd
Here is some advice on employment that I have just given to a similar query:

Re: Working with ME
by Dr Charles Shepherd on Mon Aug 19, 2013 3:24 pm

Here is some general MEA information on Employment and ME/CFS:

1 We have an MEA information leaflet that covers all aspects of employment, including adjustments at work and strategies for return to work. This leaflet also covers how the 2010 Equality Act and the (previous) Disability Discrimination Act (DDA) applies to employers and employees when it comes to making suitable adjustments (= changes to hours, duties etc) to accommodate employees with ME/CFS.

2 We have two leaflets that cover issues relating to obtaining an ill health retirement pension and how prognosis and permanency should be viewed in relation to applications for retirement on the grounds of permanent ill health in ME/CFS. We also have a leaflet that covers problems relating to permanent health insurance (aka income protection) policies.

3 The DDA and Equality Act may also be relevant to a situation regarding possible dismissal if you are no longer able to cope with the workload. The chapter on Employment in 'Living with ME' (Vermilion paperback available free from any public library) has details of cases where the DDA has been used by people with ME/CFS in employment law disputes. The MEA website news archives has details of more recent employment tribunal cases - if you need to follow this up in due course. Details of an important precedent DDA and ME/CFS case (O'Neill vs Symm and Company) can be found in the DDA section of the MEA booklet below and in the Vermilion paperback.

4 We work with a firm of London solicitors who deal in employment law - but any consultation here would be on a fee paying basis. More information on their services can be found in the current issue of ME Essential magazine.

5 We also have an employment law solicitor who is willing to provide some preliminary free information to MEA members.

6 The MEA purple booklet has a section on employment issues that can be shown to your occupational health department/physician.

7 Information about what to say to an employer about your state of health is covered in an item in the Spring 2011 issue (page 11) of ME Essential magazine.

8 Re DDA and 2010 Equality Act:
I established that ME/CFS comes under the DDA when I appeared as an expert medical witness in the O'Neill vs Symm case. ME/CFS is listed as a condition that comes under the remit of the 2010 Equality Act.

9 If you are continuing to work with ill health or disability you should check whether your employer has a policy of Disability Leave. I have written about Disability Leave in more detail in the current (August) issue of ME Essential magazine.

From what you say it sounds as though you ought to be discussing 'reasonable adjustments' to hours, duties etc with your employer.

If you belong to a union or professional body you should be able to get some legal assistance

MEA website and pdf literature form: http://www.meassociation.org.uk

Re: Working full-time - do you have reasonable adjustments

Posted: Mon Aug 19, 2013 3:43 pm
by Action for M.E.

Lots of people with M.E. share their experiences of how reasonable adjustments have or haven't worked for them in the Employment section of our Online M.E. Centre.

You can read their stories at http://www.actionforme.org.uk/get-infor ... t-stories/

Hope this is useful

Best wishes

Action for M.E.

Re: Working full-time - do you have reasonable adjustments

Posted: Tue Aug 20, 2013 8:45 am
by suedodkin
Further to my post under "working with ME"
In my experience some employers are reluctant to acknowledge the diagnosis and therefore their obligation to make reasonable adjustments. I was unable to work full time but would have loved the opportunity to try one day a week split over 2 half days....
Sue rely the point of GET and pacing is to bring a return to work (phased) as part of that process.
No-one has told me my ME is so severe tat I can never work again, but I am realistic and see that full time work is beyond my capabilities at present. Coupled with the long waits for NHS CFS treatment clinics we are stuck in a catch 22. What is the answer?

Re: Working full-time - do you have reasonable adjustments

Posted: Tue Aug 20, 2013 8:56 am
by Dr Charles Shepherd

Employers that refuse to acknowledge a diagnosis of ME/CFS, and therefore refuse to make any appropriate adjustments at work to help someone with ME/CFS, are almost certainly breaking the law - because ME/CFS is a condition that is recognised in relation to both the DDA and the 2010 Equality Act

If anyone is in this situation they need to take advice from either a union, professional organisation or employment lawyer

Re: Working full-time - do you have reasonable adjustments

Posted: Tue Aug 20, 2013 1:43 pm
by Jessica Bavinton
Here is part of a letter we sometimes write to employers (and, of course, personalise) which might give you some ideas:

Return to Work for CFS/ME
Most people with CFS/ME will be covered by the Disability Discrimination Act (DDA). Therefore, a carefully graded return to work is considered as an adjustment. The return to work programmes for CFS/ME are different from those designed for people coming back to work after other conditions, such as a broken leg or recovery from cancer. There are some unique considerations.

Understanding CFS/ME
Many people have not encountered CFS/ME or have not had the opportunity to understand it, so the first step in supporting your employee may to find out a bit more about the condition. For further information on CFS/ME, please consult the NICE guidelines and Occupational Health guidance (attached).

How can I avoid making the condition worse?
Employers are often concerned about making the condition worse, and are keen to understand how this can be avoided. CFS/ME is exacerbated by over activity, and as such this need to be controlled as much as possible as a person returns to work. Over-activity is whereby an activity type, duration or frequency leads to an unmanageable increase in symptoms.

Your employee may also have specific triggers that will need to be considered, such as sensitivity to light and noise, stress, or will find the multisensory nature of their journey to work difficult to manage.

Learning from others:
The most common reasons some return to work programmes do not lead to a successful and sustained return to work are as follows:
• Starting point too high: ie too many hours
• Increments progressed too quickly
• Increments that are too large
• The journey to work has not been considered in the overall activity plan
• Not waiting until symptoms have stabilised before moving on to the next increment
• Lack of rest breaks or lunch
• Difficulties with colleagues understanding the condition
• Work-life balance not being well achieved due to an over-emphasis on work, sometimes leading to over-activity, poor sleep or stress.
• Interpersonal or work issues not adequately resolved.

We find the most successful return to employment is one that is well supported by professionals who are involved in advising and supporting the employer, too, as well as helping to control the pace at which the return to work is expected. Education and engagement with the employer is fundamental.

I hope this gives you a few ideas, along with the attached that you can share with your employer.

It's also worth asking employers if they are willing to fund rehabilitation and return-to-work support as sometimes they art willing to do so, depending a bit on the sector etc.

Good luck!

A brief leaflet that is a bit limited but at least gives a bit of backup and validity:
http://www.nhshealthatwork.co.uk/images ... eaflet.pdf

Re: Working full-time - do you have reasonable adjustments

Posted: Tue Aug 20, 2013 1:44 pm
by Jessica Bavinton
PS the aforementioned 'attached' didn't attach, so the link was provided instead....

Re: Working full-time - do you have reasonable adjustments

Posted: Tue Aug 20, 2013 2:46 pm
by mack1234
Jessica wrote: "The most common reasons some return to work programmes do not lead to a successful and sustained return to work are as follows ... etc."

I wonder if you could point me towards any reliable solid published independent evidence about this please?

The NHS Plus leaflet seems to imply one thing (e.g.): "Ill-health retirement is a possible outcome although it should only be considered if appropriate treatments (such as CBT or GET) have been explored.

"Cognitive behavioural therapy and graded exercise therapy have been shown to be
effective in restoring the ability to work in those who are currently absent from work"

The largest ever trial (PACE) seems to point in another direction: "Receipt of benefits due to illness or disability increased slightly from baseline to follow-up".

As part funders of this trial the DWP stated: "We believe that the findings of the trial will contribute to the continuingly growing evidence base, which informs the development of health and work related policy, policy based on the large body of evidence showing that work is good for physical and mental wellbeing and that being out of work can lead to poor health and other negative outcomes".

Thank you for your valuable input.