Ask the Advocate: How to Get Workplace Accommodations with Tardive Dyskinesia
A patient advocate with tardive dyskinesia talks about his experiences working with the condition and requesting accommodations at his job to manage it.
Tardive dyskinesia (TD) may cause involuntary movements in various parts of your body, such as your tongue, face, neck, torso, or limbs. These movements might make it challenging for you to do certain activities, including some tasks at work.
In a 2023 survey of people with TD in the United States, roughly 74% said the condition had negatively affected their work. Nearly one-third of survey participants said that TD had caused them to miss work, and more than two-thirds said it had reduced their productivity at work.
Many of the survey participants also reported experiencing negative reactions to their symptoms from other people, including employers or co-workers. These reactions can add to the challenges of managing the condition at work.
Some people with TD might benefit from workplace accommodations — changes to a work environment or job that help people with disabilities perform their essential job functions and enjoy equal employment benefits and privileges. Educating employers or co-workers about TD might also help some people manage work-related challenges related to the condition.
Deciding whether you want to ask for workplace accommodations or tell your employer or co-workers about your condition is a personal choice.
We spoke with Dan B., a 64-year-old resident of Los Angeles who works in sales, to learn about his experiences working with TD and requesting workplace accommodations.
This interview has been edited for brevity, length, and clarity.
How does TD affect you at work?
I've been at my current job for 6 years, and it's been really hard with the TD for the past year and a half. The TD has been coming on for several years, but it's gotten worse in the past year and a half to 2 years.
I work in phone sales for a living. I'm very good at my job, and the clients can't see my symptoms on the phone, which makes it easier to deal with. It's easier to get sales on the phone than it would be face-to-face.
But people in my office have difficulty looking me in the eye. It's very obvious, and it has isolated me from building relationships with anybody in the office, other than a couple of people I work very close to.
Before my jaw symptoms got really bad, I had developed office friendships with a few people on the other side of the office. They still acknowledge me and talk with me a little bit, but they don't want to look me in the eye.
I used to be very gregarious and outgoing, and now I'm really isolated. I don't carry on conversations anymore because my co-workers can't handle it. They're too embarrassed or too uncomfortable to look at me.
Have you asked for accommodations to manage the condition?
Yes — my boss lets me work from home when my jaw is really bad.
It keeps me from being stressed about having to be seen by my co-workers.
There's nothing formal in writing. We just approach it on a day-to-day basis. I text him in the morning, saying, 'My jaw is really bad today. Can I work from home?' And he has always said yes. It's usually a couple of times a week that I don't go into the office and I work from home.
We're also moving offices on June 1, and things will be a little different there. It will just be 5 or 6 of us in the new office, rather than 30. Everybody will know about my symptoms, and I might even get my own area to work in, so that will be a good move.
I haven't approached many of my co-workers to explain the condition, but I did approach the ones that I work close to. I told them that the symptoms were part of a health condition I have.
Do you have tips for others who are managing TD at work?
It depends on the relationship that you have with your boss — but if you can, I would be honest. Let them know what you've got and what causes it.
I explained the condition to my boss. I'm not sure he understood it all, but I basically told him that it's a side effect of medication that I use for my Tourette syndrome, and it's something that I can't control.
I have a close relationship with him, which helps. Our team is small and tight-knit. His door is always open. Even if he's busy, he'll let us come in and ask questions or talk.
If you're in an environment where your boss sits in an office that's not easily accessible or they're managing a lot of people, I'm sure the dynamics would be different.
Learn more about workplace accommodations
A workplace accommodation is an adjustment to a job, work environment, or hiring process that helps someone with a disability successfully perform their job tasks and enjoy equal employment opportunities.
You have a legal right to reasonable accommodations under Title I of the Americans with Disabilities Act (ADA) if you:
are qualified for the job
meet the legal definition of having a disability
need a job accommodation due to your disability
work for an organization that has at least 15 employees
Most organizations with fewer than 15 employees aren't legally required to provide reasonable accommodations, but they may voluntarily choose to do so.
You can visit the Job Accommodation Network to learn more about your rights and to find tips on requesting accommodations.
Dan B. is a 64-year-old resident of Los Angeles, California, who works in sales. He developed tardive dyskinesia symptoms in his jaw and other parts of his body as a side effect of treatment with haloperidol (Haldol), a medication that his doctor prescribed for Tourette syndrome. He loves animals, has lived in multiple states across the country, and values the friendships that he has developed with people across those states.
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