Both Crohn’s disease and its treatment can pose significant challenges to a person’s personal, social and professional life. Symptoms range from minor abdominal cramps to severe infections, and complications are often debilitating and at times life-threatening.
The Americans with Disabilities Act (ADA) is a civil rights law prohibiting discrimination against individuals with disabilities. This law ensures that people with disabilities have the same rights and opportunities as everyone else.
Because the extent to which a person is affected by Crohn’s disease is different, the ADA will classify them as disabled if they:
- Are substantially limited in performing a major life activity.
- Have a record of such an impairment.
- Are regarded as having such an impairment.
The term “major life activity” includes bowel impairment. Crohn’s disease causes physical abnormalities affecting the digestive system, hampering the ability to eat and have normal bowel movements. Thus, the disease meets the ADA’s definition of disability.
What is Crohn’s disease?
Crohn’s disease is a type of inflammatory bowel disease that causes chronic inflammation of the gut (digestive tract). The disease is usually diagnosed in adolescents and adults between ages 20-30, and can be found in men, women and people of all ethnic backgrounds.
Crohn’s disease can affect any part of the gastrointestinal tract (GI tract or gut) from the mouth to the anus. However, it usually affects the last part of the small bowel (ileum) and the beginning of the large bowel or colon. It causes redness and swelling of the gut lining, often penetrating the deeper layers.
What are symptoms of Crohn’s disease?
Crohn’s disease can cause periods of mild or no symptoms (remissions) as well as periods of severe symptoms (flare-ups). These episodic flare-ups can qualify as a disability if they substantially limit a major life activity.
Major signs and symptoms of Crohn’s disease include:
- Persistent diarrhea
- Alternating periods of constipation that may cause bowel obstruction
- Pain or cramps in the abdomen
- Bowel urgency
- Rectal bleeding
- Incomplete bowel evacuation
- Loss of appetite
- Weight loss
- Lethargy and easy fatiguability
What are potential complications of Crohn’s disease?
In advanced cases, Crohn’s disease can cause serious complications:
- Development of colon cancer
- Fissures (painful tears in the lining of the anus, which may bleed especially during bowel movements)
- Stricture (abnormal narrowing of any part of the bowel causing obstruction)
- Fistula (an abnormal path or a channel between one part of the bowel and another or between the bowel and the bladder, vagina or skin)
- Inflammation of the skin, eyes or joints
- Side effects of medications such as weak bones, high blood pressure and certain cancers
- Liver damage
- Blood clots
Can you request a “reasonable accommodation” from your employer?
Under the ADA, an employee with Crohn’s disease can request “reasonable accommodation” from their employer. The ADA defines “reasonable accommodation” as a workplace adjustment that would not impose an undue hardship on the employer. Examples of adjustments may include:
- Moving the employee’s desk near a bathroom.
- Restructuring a job.
- Acquiring or modifying equipment.
- Changing a schedule.
- Reassigning the employee to a vacant position that the employee is qualified for
However, your employer does not have to make adjustments that would not be suitable to the work that needs to be done. For example, if your job requires you to be physically in the workplace, you can’t ask the employer to let you work from home or provide you with a different role, unless there is a vacancy.
Reasonable accommodations may also include paid or unpaid leave for medical appointments, hospitalizations for surgery and medication infusion appointments.
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