I’m an Employer

Facts

• When not well controlled, arthritis can prevent us from working and is one of the top causes of long-term disability in Canada.Source: Life with Arthritis in Canada – Public Health Agency of Canada, 2010
• Working-aged Canadians with arthritis are twice as likely to report not being in the workforce compared to those without arthritis (52% vs. 25%), highlighting an increased need for support for starting and staying in work.

Those who are working report significant challenges:

• 41 per cent of employed Canadians with arthritis indicate that arthritis makes it difficult to carry out their work responsibilities
• Over one-third report that arthritis makes it difficult to travel to and from work
• Over one-third believe that their condition has affected their career development

Source: The Arthritis Society “Fit for Work” Study: Findings, Challenges for the Future and Implications for Action, 2013

According to a 2011 survey of osteoarthritis patients:

• 35 per cent of working Canadians with osteoarthritis have taken sick days because of pain
• 19 per cent have reduced their work hours
• 14 per cent have taken a short-term disability leave from work
• 80 per cent have indicated that osteoarthritis affects their ability to perform their job

Whether or not your condition currently has a significant impact on your employment, taking steps to protect your joints at work and to seek the support you need can help you stay healthy and productive.

Beyond physical symptoms, people with arthritis may also experience additional challenges that can make it more difficult for them to cope with and discuss arthritis at work.  Here are some common interpersonal and emotional challenges that people with arthritis may face in the workplace:

• Feelings of isolation, stress, guilt, despair and helplessness
• Feeling that nothing can be done to improve the situation
• Not wanting to be thought of as a poor worker especially when the job is physical
• Pushing themselves too hard because they want to be a team player
• Fearing people will think they lack motivation or interest when they are unable to do a task
• Feeling that chances for advancement might disappear because of the limitations others think they have
• Fearing arthritis might be seen as too costly to the organization or their department
• Feeling that irritability resulting from pain may hurt relationships with co-workers
• Fearing that because symptoms are episodic and they can sometimes do tasks that they can’t during a flare-up, co-workers might think they’re faking it
• Wanting to wait until their symptoms are severe before seeking help for fear of looking sick
• Fear that necessary accommodations like flexible work hours might be resented as “special treatment”
• Using all their energy for work and having nothing left for family and friends
• Worrying that their health information won’t be kept private
• Fearing they might be discriminated against or lose their job

Dr Diane Lacaille et al. – “Problems faced at work due to inflammatory arthritis”
Robert D Wilton, Disability Disclosure in the Workplace. Just Labour, 2014

This resource provides information about workplace practices that have been identified as helpful by people living with arthritis. To determine how feasible these practices are to implement, consider the legal requirements in your region, the size, location and type of work of your organization, and its capacity to make changes.  While it may be difficult to implement all of them at once, focus on starting with one or two and building from there.  The list includes practices that can help make your organization more accessible overall, as well as suggestions for accommodating individual employees on a case-by-case basis.

Inclusive Practices 

A Physically Accessible Workplace: This involves the design of spaces to make it easy for people with disabilities to navigate their work environment. This could include:

• Accessible parking spaces
• Automatic door openers
• Easy grip lever handles
• Elevators
• Ramps
• Unisex accessible washroom
• Bathroom stalls that are large enough for a mobility scooter
• Raised toilet seats
• Grab bars in bathrooms
• Railings
• Relocating an employee’s workstation closer to a parking lot, restroom, office equipment, or other location

An Ergonomic Workplace: Ergonomics investigates the interaction between people and their environments. The goal of ergonomics is to ensure a work station and work environment that best fits the employee in their role. This can be achieved through use of:

• Ergonomic assessments
• Adjustable chairs
• Sit/Stand workstations
• Accessible workstations
• Alternative computer equipment (i.e. keyboards, mice, monitors)
• Chairs with head support
• Ergonomic tools such as auto-dialers, document/book holders, door knob grips, ergonomic scissors, grip aids, and telephone headsets
• Modified control equipment
• Stand/lean stools
• Speech recognition software
• Lifting aids for heavy materials

Scheduling flexibility: This provides an alternative to the regular schedule of a role and allows an employee to vary their days of work and/or arrival or departure time within agreed upon parameters. This could include:

• Flex time: Changing or varying normal work hours or work days to accommodate fatigue or medical appointments, allowing for evening or weekend work if needed
• Compressed work week: Increasing the number of hours in a work day and decreasing the number of work days in a week
• Job sharing: Sharing the responsibilities, hours and salary of at least one full-time job between two employees
• Alternate location: Working from home or other location for all or a portion of the work week
• More frequent breaks: Taking shorter, more frequent breaks rather than one longer break

Employee Education: This involves providing employees with the information and resources to better understand arthritis, to reduce strain on their joints at work, maintain a healthy lifestyle, and self-manage their arthritis symptoms. This can include:

• Information related to arthritis, health and wellness through employee communication channels such as an intranet site, newsletter or email 
• Online learning about joint health at work and/or arthritis self-management through an internal Learning Management System (LMS)
• Raising awareness of existing accommodation policies and the accommodation process
• Training on how to protect joints while sitting/standing/lifting/driving
• Ensuring employees understand benefit plans and options available to them 

Employee Benefits: Providing employees with a benefits plan and offering extended benefits can make a big difference to employees with arthritis and enable them to thrive. Some of the benefits may include:

• Health insurance
• Reimbursement of prescribed medications
• Physiotherapy or occupational therapy
• Counselling or access to an Employee Assistance Program (EAP)
• Massage therapy
• Orthotics, braces, or other supports
• Short-term and long-term disability leave
• Sick leave and time off for appointments

Policies and Practices: Organizational policies and practices that account for the needs of employees with chronic health conditions like arthritis can help maximize employee productivity. These can include:

• Accessibility and Accommodation Policies
• Diversity, Equity and Inclusion Policies
• Leave of Absence Policies
• Absenteeism Policy
• Accessible and inclusive recruitment and hiring practices
• Return-to-Work practices to support employees who have been away on leave

Accommodation processes: Within Canada, an employer has the duty to accommodate an employee with a disability to the point of undue hardship. Developing a clear accommodation process and working collaboratively with employees to determine appropriate accommodations creates a win-win situation for everyone. These processes can include:

• Communicating to employees about existing accommodation policies and processes
• Making job candidates aware of accommodations available throughout the hiring process
• Supporting employees to disclose a disability and request accommodations
• Working with an employee to develop an accommodation plan
• Managing changes within a team/department, such as modified duties or scheduling
• Monitoring, assessing and revising accommodations as needed

Health & Wellness Promotion: A large part of managing arthritis symptoms involves maintaining a healthy lifestyle and diet. Supports that promote overall health and wellness can greatly benefit a person living with arthritis. These might include:

• Onsite gym facilities or a discounted gym membership
• Stretch breaks
• A stationary bike in a break room or pedal workstations
• Sit/stand desks
• Onsite showers
• Bike parking
• A health spending account
• Access to healthy food options at work or in the vicinity

Your employees with arthritis might have specific needs not identified here. It’s important to maintain open communication and check in with employees to ensure they have the supports needed to thrive at work.

Sources:

The Canadian Arthritis Patient Alliance (CAPA), “Arthritis in the Workplace: Resources for Patients by Patients.”
Episodic Disabilities Employment Network, “EDEN Fact Sheets.”
Joint Health Network, “Canada’s Best Workplaces for Employees Living with Arthritis Program.”
Job Accommodation Network, “Accommodating Employees with Arthritis.”

• Employer Checklist
• Policy guidelines and templates (coming in 2021)

Under the Canadian Human Rights Act and provincial/territorial human rights legislation, employers have an obligation to ensure that people who are able to work aren’t unfairly excluded from employment based on prohibited grounds of discrimination, such as disability.

This is called the duty to accommodate, which means that an employer is expected to remove barriers to an individual’s participation in employment where conditions can be adjusted without undue hardship.  This may require that alternative arrangements be made to ensure full participation of an individual.

Sometimes accommodation is not possible because it would cause an organization undue hardship.  Before refusing to provide accommodation, an organization would first need to demonstrate that the cost would be so great as to change the nature of the organization or to threaten its viability, or that the accommodation would pose significant health or safety risks.  There is no precise legal definition of undue hardship, each situation should be assessed individually.  Considerations such as inconvenience, moderate costs, or the perceptions and preferences of other employees are not valid reasons for refusing to accommodate.  Studies have shown that accommodations often cost nothing or very little and can save organizations money by retaining skilled employees and reducing the need for recruitment and training of new staff.

While employees have a right to accommodation to the point of undue hardship, they are not guaranteed their preferred method of accommodation if another option is available that meets their needs. For example, an employee who experiences arthritis-related fatigue might ask to work from noon-8 p.m. every day instead of 9 a.m.-5 p.m., but if this isn’t possible, they might be permitted to work from home in the mornings on days when their symptoms are bad.

Taking a proactive approach to creating an accessible and inclusive workplace can help reduce the need for individual accommodations and ultimately benefit all employees, not just those with a disability. Policies and practices that increase flexibility and accessibility help prevent barriers before they occur and keep business running smoothly, rather than waiting until an issues arises.

Accommodation isn’t just the law, it also makes good business sense, as it can increase employee productivity and reduce economic loss due to absences or turnover.

Accommodation

In Canada, employers have a duty to accommodate employees with disabilities to the point of undue hardship. This means that businesses may be required to modify policies, practices, or spaces to meet the needs of an employee with a disability, unless the organization provides sufficient evidence that they can’t afford the accommodation or that it would cause a risk to health or safety.

Accommodations are put in place in response to the specific needs of an individual.  They involve removing barriers that prevent employees with disabilities from successfully completing their work.  These could include:

• Scheduling accommodations
• Modifying or restructuring duties
• Modifying the physical environment
• Providing access to assistive devices and equipment
• Adapting policies and procedures

Most employers report no or low cost for accommodating employees with disabilities.  Accommodation is a retroactive approach to meeting the needs of a particular employee.  In contrast, accessibility is a proactive approach to anticipating the diverse needs of employees and designing a workplace with fewer barriers to begin with.

Accessibility or Design for Inclusion

Accessibility means that something is designed to be useable by the greatest number of people without requiring adaptation or modification to remove barriers.  Many regions in Canada have laws in place that require employers to meet certain accessible employment standards.  These may include requirements related to:

• Recruitment processes
• Workplace information
• Talent and performance management processes
• Communication about policies
• Accommodation policies and practices
• Return to work processes

In addition, employers may be required to meet other accessibility standards, such as communication, design of public space, transportation, and customer service. 

Unlike accommodation, which removes barriers on an individual, case-by-case basis, accessibility doesn’t just benefit employees with disabilities, but the organization as a whole.  For example, while installing a ramp improves access for people who use a wheelchair or other mobility device, it also makes it easier for a person pushing a stroller or cart to access the space.  Similarly, allowing for flexible scheduling doesn’t just benefit someone with numerous doctor’s appointments, but also people who may need to leave work early to care for a child or family member.  Providing the option of sit/stand desks for all employees can improve the health of anyone in a sedentary role.  While creating an accessible workplace can reduce barriers before they arise, individual accommodations may still be needed in some circumstances.   

Accommodation and Accessibility [PDF 694 kB]

As a leading advocate for access to effective treatment options for people with chronic pain caused by arthritis, the Arthritis Society has developed a toolkit to encourage more employers to fund medical cannabis coverage through their company-sponsored employee benefit plans, modelled on our own benefits program. We have worked with a team of well-recognized doctors, pharmacists, and other experts in the field to develop the program and supporting toolkit.

This program provides a cost-effective, sustainable and progressive way of ensuring that scientifically validated use of prescribed medical cannabis can be supported through your company’s benefit plan in the same way that other prescription drugs are accessed through these plans.

What's in the toolkit

The tools and resources included in the program are as follows:

• Process outline for creating your own program
• Sample coverage program
• Sample Substance Management Policy
• Sample questionnaire for engaging your employees
• Sample employee program introduction
• Sample employee Q&A

Request a toolkit

You can also read more about this program in our announcement.

For more information about the Arthritis Society’s program, or about implementing medical cannabis coverage in your own employee benefits program, please contact us.

Driving

Lifting

Work Stations

Taking Care of your body at work [PDF]

Top 10 Exercises [PDF]

• Employer checklist [PDF]
• Resources from the Canadian Arthritis Patient Alliance