Although chronic fatigue and immune dysfunction syndrome (CFIDS) causes debilitating symptoms, research shows that about half of people with CFIDS (PWCs) are able to work in full- or part-time jobs.

Employment is an important source of self-esteem, financial security and social support for many people, so many people go to great lengths to continue working. It is not uncommon for a working PWC to do nothing outside of work but rest and eat, and many depend upon friends and family members to help them with errands, household activities and other responsibilities to maintain their employment.

Even with this additional support, the debilitating fatigue, memory and information processing difficulties, noise and chemical sensitivities, and other symptoms often require that employers make accommodations in the workplace so PWCs can continue working.

Important Laws
The two disability rights laws that are most relevant to employment are the Americans with Disabilities Act and the Family and Medical Leave Act.

• The Americans with Disabilities Act (ADA) prohibits employers from discriminating against qualified persons with disabilities in hiring, retention, advancement, compensation, job training or other terms of employment. It also requires employers to make "reasonable accommodations" that will permit a disabled person to maintain employment.
• The Family and Medical Leave Act (FMLA) provides an employee with up to 12 weeks of unpaid leave in a calendar year because of their own or a family member's serious health condition.

Debunking the Myths
Many people think that making workplace accommodations for people with disabilities is too expensive or prevents an employer from discharging an unqualified worker. This is not the case.

• 15% of accommodations cost nothing, 51% cost between $1 and $500, 12% cost between $501 and $1,000, and only 22% cost more than $1,000, according to the Job Accommodation Network.
• Accommodations that would place undue hardship on an employer are not required under the ADA.
• Under the ADA, an employee must be qualified for the job -- if the employee can't perform the essential functions of the job with reasonable accommodations, he or she isn't protected under the law.
• Employers may be able to find outside sources of funding to pay for an accommodation or obtain tax credits or deductions to offset the expense.
• Surveys have shown that the cost and possible inconvenience of providing an accommodation are far less than if the employer were to hire and train a new employee.

The Equal Employment Opportunity Commission has an excellent guide to the ADA on its Web site. 

Accommodations for PWCs
Since the symptoms of CFIDS vary from person to person, accommodations will have to be customized based upon the individual situation. However, following are some examples which are generally covered under the ADA and which may help PWCs maintain employment.

• A flexible schedule - Because of the relapsing/remitting nature of CFIDS, allowing the PWC to work at the times he or she is most able can be very helpful, provided it does not produce an undue hardship on the employer. (For example, newspaper writer would probably have to work a set schedule, but a magazine writer might not.)
• Telecommuting - Thanks to technology, telecommuting has proven to be a successful alternative for many PWCs and their employers.
• A quiet place to rest - PWCs may need to take more frequent breaks than other employees and would benefit from having a quiet place to lie down and rest during breaks.
• A chair - Standing can cause dizziness, cardiovascular changes, nausea and other symptoms in PWCs, so it is important to sit while working, whenever possible.
• Memory aids - Problems with thinking and processing information are common in CFIDS, but may be accommodated by providing written job instructions, breaking tasks into smaller parts, minimizing distractions, helping set priorities, etc.
• Clear explanations to other employees - Misunderstandings are common when employees, do not understand CFIDS and the need for extra help. They may resent the accommodations the PWC receives. It is important for both the employer and the PWC to explain the rationale for accommodations and gather support from other employees to avoid interpersonal conflicts in the workplace.

Occupational therapists can be valuable sources of information about accommodations for people with disabilities. The Job Accommodation Network has fact sheets on accommodations for CFIDS, fibromyalgia and many other disabilities.

A Worthwhile Endeavor
In order to accommodate a PWC in the workplace, everyone will have to make certain adjustments. The benefits to both the PWC, in terms of financial security and pride, and the employer, who maintains a trained and experienced employee, are often worth any inconvenience the accomodations may cause.