The painful condition can limit a person’s productivity, force them to take time off, or even cause them to leave a job.
Finding — and keeping — a job that works within the limitations imposed by rheumatoid arthritis can be a challenge for many people who live with the painful disease.
One recent study reported that nearly one-third of people with rheumatoid arthritis (RA) had to quit working within five years of their diagnosis.
In this study, nearly half of the patients with RA held paying jobs at the onset. At the end of five years, 60 percent were still working while 29 percent had quit due to their RA symptoms. Another 9 percent had left work for other reasons.
The researchers noted that people with RA holding manual jobs were at the most risk for RA-related work disability.
This isn’t the first study that has come to these conclusions.
A 2012 study in the journal Mayo Clinic Proceedings reported that 1 of 5 people with RA isn’t working two years after being diagnosed and 1 in 3 people living with RA leaves the workforce after five years.
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The issue of working with RA is such a widespread problem that EULAR (the European League Against Rheumatism) has an ongoing Health Professionals Project devoted to increasing work participation for people with RA across Europe.
The organization and the Arthritis Foundation have both held events and put out public service announcements with the theme of keeping people with RA actively working.
The impact that RA has on the career and professional life is potentially serious.
A 2010 study showed that people living with RA are at least 53 percent less likely to work than the general population.
The Arthritis Foundation website states that “A 2015 study in the Journal of Occupational and Environmental Medicine found that people with RA missed nearly 14 workdays a year, compared to fewer than 10 days in people who didn’t have the condition. Those missed workdays added up to nearly $252 million in lost revenues nationally. Even if you’re able to work, RA symptoms can affect your productivity — a phenomenon known as presenteeism.”
This is due to a variety of factors.
Often, the pain, fatigue, and medication side effects that come along with RA can be unpredictable.
Some days, a person living with RA may be able to work, exercise, and be productive.
Other days, the same person may struggle with everyday tasks, lack of sleep, debilitating pain, disabling stiffness, joint swelling, or drug side effects such as nausea, headache, lightheadedness, and drowsiness.
People living with RA and similar conditions may also experience other symptoms such as brain fog or cognitive sluggishness, muscle spasms, flu-like symptoms, general malaise, and discomfort.
The pain and joint immobility associated with RA can also be severe.
Depending on the affected joints, an employee may face limitations with typing, sitting, or standing for extended periods of time, crouching down, bending, driving, writing, and lifting objects.
Some people with RA may have their vocal chords impacted, further limiting their career choices or on-the-job skills.
Whether or not to disclose RA to an employer is a tricky situation to navigate.
In some instances, if an employee is able to get by without bringing attention to their disability initially, they may be better off so they don’t attract unwanted attention.
Repeated absences from RA or poor on-the-job performance because of the condition can lead to the firing of people with RA or prevent them from getting promotions.
Under the ADA (Americans with Disability Act) and FMLA (Family Medical Leave Act) laws, current or future employers cannot discriminate against an employee who lives with a medical condition or disability.
But that can sometimes be a difficult thing to prove.
Under the law, attempts at reasonable workplace accommodations must be made if requested by a qualifying disabled employee.
People with a chronic illness or serious health condition such as RA can take up to three months unpaid medical leave per year if they are unable to work because of their health.
Examples of workplace accommodations for arthritis patients might include an ergonomic desk chair, ergonomic keyboard, dictation software, talk-to-type capabilities on a computer, extra breaks to stretch, a sit-stand desk, and lumbar cushions.
In addition, people with arthritis can also request time off for medical appointments, the option to telecommute when possible, flexible hours, a flexible wardrobe, typing gloves, a close parking spot, and ice packs available in the break room.
An occupational therapist or physical therapist may also be able to offer additional suggestions to RA patients or their employers when it comes to workplace modifications and accommodations.
Some employers may also offer temporary or permanent disability to employees who become sick or injured while working.
The Social Security Administration’s SSDI (Social Security Disability Insurance) program is another option for whenever a person with RA cannot continue working.
Getting approved for disability benefits is not easy, though.
Often, the employee with RA must have a period of not working at all (read: no income) for an extended period of time in order to be approved.
Experts suggest hiring an attorney who specializes in workman’s compensation and SSDI/disability to help expedite the process and better a person’s chances of being approved.
However, once an RA patient is no longer working and is collecting disability payments, strict rules fall into place regarding earned income, student loans, and other items.
The nonprofit health organization CreakyJoints has some resources for people with RA who are considering applying for disability benefits through the government.
Under a proposal being considered by the Trump administration, the social media accounts of disabled persons will be monitored for posts that portray them as looking like they aren’t disabled.
Rheumatoid arthritis, while often debilitating and painful can be unpredictable and invisible, making it difficult to “prove” that you are disabled to someone surveying social media photos.
Many people with RA choose to try to keep working as long as possible and keep their condition mostly under wraps whenever they can.
“I have told some friends at work about my RA and fibro, but not many. My boss knows about it, but only to an extent,” Jennifer Smith, 29, a Pennsylvania resident who has had RA for four years and fibromyalgia for seven years, told Healthcare Website. “I haven’t had to ask for accommodations yet and feel embarrassed to ask anyway. I don’t think I’d be treated any differently, but you never know. I’ve heard and read some horror stories from other RA patients when it comes to their jobs and employers. Some people with a chronic illness are treated horribly. And going on disability seems like a nightmare, although I know it might be my only option someday.”
Smith added she’d really have to think about it when the time came to quit working — something that she feels is inevitable when looking at the journey of fellow patients online.
What Smith and other folks living with RA should keep in mind when applying for or switching jobs is the type of career they choose.
While education and professional training may be limiting factors, there are certain jobs that are better for people who have RA.
Truck drivers and schoolteachers often not a great choice for RA patients, Neither are factory or warehouse workers.
Jobs that allow for flexible hours, telecommuting, and low stress are often better choices for people with RA. So are freelance and part-time work that doesn’t involve a lot of lifting, bending, crouching, or too much typing without dictation software or computer ergonomics.
Healthcare Website has written about the best and worst jobs for RA, as well as jobs that carry with them a higher risk for RA (first responders is one example of many).
There’s also the overall economic burden and impact of the disease.
Some states offer services such as an Occupational Vocational Rehabilitation unit that helps disabled people find work. The SSDI’s Ticket to Work program also allows people on disability to go back to work and test if they are able to begin working again.
“According to the CDC, arthritis and other rheumatic conditions are among the leading causes of work disability for adults in the U.S.,” Hazel L. Breland, PhD, OTR/L, FAOTA, CLA, president of the Association of Rheumatology Professionals, told Healthcare Website. “As a member of the inter-professional rheumatology team, occupational therapists work with people living with RA to address their difficulty with activities of daily living (i.e., self-care of one’s body), instrumental activities of daily living (i.e., activities within the home and community) and work-related concerns. Individuals with RA most often seek effective OT strategies to help manage their overall function to do what they need and want to do, joint protection, fatigue, coping with changes to their work productivity.”
The American College of Rheumatology also provides resources for people who are looking for work while living with RA.
If you are experiencing discrimination on the job because of your RA, you may file a complaint with the Equal Employment Opportunity Commission, here.