What are episodic disabilities?
A common view of a disability is that it is a permanent and unchanging limitation in a person’s activities due to their health. Someone might have a limitation – in their vision, hearing, or ability to walk – that is always a part of their life. They may identify as a person living with a disability. This is in contrast to someone who might have a temporary health condition – such as an injury like a broken leg – that limits their activities for a time but who is unlikely to think of themselves as having a disability.
However, many people have health conditions which are permanent – that is, once acquired, the condition will be with them for the rest of their lives – but where the limitations due to their health change over time. A recent survey of disability in Canada found that while 39% of people with disabilities who were aged 15 years or older experienced continuous limitations, 61% reported that that the limitations they experienced due to their health changed over time. This included people who experienced periods of good health or well-managed disease that was interrupted by periods of illness and disability and people with limitations that progressed or got worse over time.*
Some examples of conditions that can cause episodic disability are mental health conditions such as depression, anxiety disorders, or PTSD, and physical health conditions like arthritis, multiple sclerosis, inflammatory bowel disease, epilepsy, HIV-AIDS, some cancers, many pain conditions, and long COVID.
Some people may experience long periods of good health with little or no effect on their ability to do activities at work or home, but that are punctuated by periods – sometimes called episodes or flares – when their health is worse and affects their activities. One example of someone experiencing “recurrent limitations” might be someone with bipolar disorder whose symptoms are usually well controlled by medication but who may still have periods when they experience difficulty.
For others with episodic disability, it is the severity of their limitations that changes over time. For example, someone with arthritis may always experience some pain, but on some days that pain is greater and has more of an impact on their ability to participate in activities.
Many conditions that can cause episodic disabilities are also invisible or hidden disabilities – that is, the signs and symptoms of the conditions may not be obvious or apparent to other people until symptoms are severe.
How does this affect accommodation and communication in the workplace?
Because episodic conditions are often unpredictable and invisible to others, with intermittent symptoms that fluctuate, they create unique challenges in managing workplace disabilities. In particular, episodic disabilities present challenges to workers, supervisors, disability managers and human resources personnel in balancing:
- workplace health communication and the protection of worker privacy; and
- worker needs for support or accommodations and workplace productivity.
Although chronic conditions resulting in episodic disabilities can be very different in their causes, they often share similar impacts on work, including increased absenteeism, presenteeism (reduced productivity while at work), and unpredictable impacts on the amount or type of work performed.
Studies also find that many workers with episodic disabilities choose not to disclose their health information or accommodation needs, or they delay disclosing until workplace problems are consistent and severe. This can mean that accommodation needs are not addressed or that individuals give up employment temporarily or permanently. The invisibility of many episodic disabilities can also result in misperceptions or stigma about a worker’s abilities. For example, people may assume that a person is not motivated to do a good job when, in fact, symptoms of their condition create challenges with their work tasks.
*Morris, S. P., Fawcett, G., Timoney, L. R., & Hughes, J. (2019). The dynamics of disability: progressive, recurrent or fluctuating limitations. Statistics Canada | Statistque Canada. Available online here: https://www150.statcan.gc.ca/n1/pub/89-654-x/89-654-x2019002-eng.htm
