Employment and Multiple Sclerosis: Recent Perspectives from Adults with MS

Background: Given their high levels of unemployment, people with MS can benefit from vocational rehabilitation interventions.

Objectives: (1) To determine the demographic and disease predictors of employment, (2) To identify factors influencing job acquistion and retention

Methods: A random sample of 1,924 adults with MS in 9 National Multiple Sclerosis Society chapters provided demographic, illness, and employment concerns data. Multinomial logistic regression results indicated predictors of employment, and participant ratings of 38 employment concerns determined factors influencing success in job acquistion and retention.

Results: In comparisons between unemployed adults with MS and those employed full or part-time, critical variables included gender, age, financial status, and severity and duration of MS. Compared to unemployed adults with MS, individuals employed part-time were more likely to be female, younger, better educated, more financially secure and less severely impaired by MS. Compared to unemployed adults with MS, adults with MS employed full-time were more likely to be either women or men who were younger, better educated, more financially secure, with a shorter duration of MS and fewer cognitive and physical limitations. The following concerns items received the highest importance and satisfaction ratings (i.e., employment strengths): People with MS...are encouraged to take control of their lives, have the same maternity and family leave options as other workers, are provided the same retirement benefits as other workers, and are made aware of employer expectations in the same way as other employees. High importance but low satisfaction items (i.e., employment concerns) included: People with MS...understand the provisions of the Affordable Care Act, know how to discuss their job accommodation needs with their employers, can request a review of their accommodation needs without fear of retaliation, understand the employment provisions of the Americans with Disabilities Act As Amended, are considered for other jobs in the same company if their MS prevents them from returning to their former jobs, and understand the benefits of disclosing disability to their employers.

Conclusions: Findings underscore the importance of the disease-demographics predictive model and the need for progressive worksite accommodations; educational and vocational training; ergonomic job modificatons; and reasonable accommodation consultation at the workplace. Employment concerns data indicate that adults with MS need help understanding (a) the provisions of national health insurance and disability civil rights legislation, (b) effective ways to disclose disability and request accommodations so as to avoid retaliation from their employers, and (c) strategies for identifying or developing job alternatives in the same company.