How to accommodate an emerging disability: Postural Orthostatic Tachycardia Syndrome.

• Author: Davenport, Anniken

Some disabilities are so obvious that employers know how to reasonably accommodate them. But what about rare or emerging disabilities? Finding information about these potentially ADA-covered disorders is harder. And that makes it harder still to design reasonable accommodations. One such emerging disorder is Postural Orthostatic Tachycardia Syndrome, or POTS.

A COVID-19 connection

Postural Orthostatic Tachycardia Syndrome is an autonomic nervous system disorder characterized by erratic irregular heart rate, dizziness and fainting (especially after standing up), headache and fatigue.

Some patients become so impaired they must use wheelchairs or risk fainting. POTS has received national media coverage recently. That makes it more likely that one of your employees will seek and receive a diagnosis and therefore request ADA accommodations or need time off under the FMLA for diagnosis and treatment.

POTS diagnoses have increased dramatically in the last year and have been linked to COVID-19 infection. Between 2% to 14% of those testing positive for COVID-19 develop POTS. Up to 61% experience some of its symptoms. Given how many people have tested positive for COVID, that's a significant number of potential POTS sufferers.

POTS does not have a cure, but there are mitigating treatments. One disorder characteristic is low blood volume, which may be alleviated by drinking plenty of water and consuming more salt. Patients may also be prescribed beta blockers to slow their heart rates. They may be told to wear compression socks, which help keep blood flowing upon standing up. Still others receive physical therapy to learn how to exercise without fainting.

ADA and FMLA implications

People who develop POTS symptoms severe enough to interfere with one or more major life activities are disabled under the ADA.

They probably have a serious health condition under the FMLA. Certainly, fainting, fatigue and...