Seizures and Employment: Practical Guide to Working Safely with Epilepsy (2025)

You can do your job and protect your health. The hard part is knowing when to disclose, how to ask for accommodations, and how to keep coworkers safe without inviting stigma. I’ve been the person writing emergency cards and coaching teammates after a scary moment-right after a meeting where my hands wouldn’t stop shaking. If you want a straight path through the mess of policy, paperwork, and people, you’re in the right place.

Quick promise: this guide gives you the essentials to stay employed, safe, and respected. Expect concrete steps, scripts, and a simple plan you can run this week. I’ll point to credible sources like the EEOC, CDC, and the Job Accommodation Network so you know where the rules and numbers come from. And yes, I’ll talk about those awkward conversations, too.

If you’re skimming, here’s the bottom line: you don’t have to choose between a paycheck and your health. You do need a plan. This is it.

TL;DR: Key takeaways and what to do now

• The law is on your side. In the U.S., epilepsy is covered under the ADA when it limits a major life activity. That unlocks reasonable accommodations unless they cause undue hardship. EEOC guidance says employers must keep medical info confidential and work through an “interactive process.”
• Disclosure is a strategy, not a confession. Tell your employer if you need changes, time off, or a safety plan. You don’t have to share every medical detail-just what affects work and what helps.
• Most accommodations are cheap or free. JAN’s 2025 snapshot shows most cost $0; when there is a cost, the average is a few hundred dollars, not thousands. Common wins: flexible breaks, remote/hybrid options, task swaps, lighting changes.
• Safety is simple to teach. Seizure first aid fits on an index card: time the seizure, clear hazards, don’t restrain, roll onto side when it’s safe, call emergency services if it lasts past 5 minutes or if injury occurs.
• Your plan needs three parts: work adjustments, a short emergency protocol, and documentation. Start with a one-page request and a brief note from your clinician spelling out work limits and recommended supports.

What you’re likely trying to get done (your “jobs to be done”):

• Decide whether and when to disclose epilepsy at work.
• Ask for (and get) the right accommodations.
• Build a simple safety plan that doesn’t scare people.
• Handle interviews, performance reviews, and promotions without stigma.
• Know what to do if your employer resists, or if a seizure happens on the job.

Know your rights: ADA, confidentiality, and the fine print

Think of the legal stuff as your guardrails. In the U.S., the Americans with Disabilities Act (ADA) and its amendments cover epilepsy because it can substantially limit brain and neurological function, even if seizures are infrequent with medication. The Equal Employment Opportunity Commission (EEOC) enforces this and updates guidance. Employers must provide reasonable accommodations so you can perform essential job functions unless it causes undue hardship. They also have to keep your medical info confidential-stored separately from normal HR files.

What counts as a reasonable accommodation? Changes that help you do essential tasks: schedule flexibility, short recovery breaks after a seizure, remote work, dimming or changing lighting, screen filters, task swaps away from heights or open water, a quiet room, or time off for medical appointments. Leave can be an accommodation. If your job has safety-sensitive tasks, employers should run an individualized risk assessment, not rely on stereotypes.

Direct threat analysis is narrow. An employer can limit duties only if your condition poses a significant risk of substantial harm that can’t be reduced by accommodation. That assessment must be based on objective medical evidence, not fear of the unknown.

Medical questions are limited. Before a job offer, employers can’t ask about your health. After an offer, they can ask the same medical questions of everyone in your job category. On the job, they can request documentation only if accommodation is requested or if they have objective evidence you can’t safely do essential tasks. Your diagnosis stays private-managers can be told only about restrictions or necessary supports.

Other protections you might use: Family and Medical Leave Act (FMLA) for qualifying employers; state paid sick leave; workers’ compensation if you’re injured during a seizure at work; short-term disability insurance for recovery time. If you’re outside the U.S., similar principles apply: UK Equality Act 2010 (reasonable adjustments), Canada’s human rights laws, Australia’s Fair Work Act, and EU equal treatment directives. The words change; the core idea doesn’t: equal access plus sensible adjustments.

Evidence you can trust: CDC estimates about 1.2% of U.S. adults have active epilepsy, and about 1 in 26 people will develop epilepsy during their lifetime. EEOC technical assistance documents confirm epilepsy is typically covered under the ADA. The Job Accommodation Network’s annual data show most accommodations cost little or nothing and improve retention.

Step-by-step playbook: from disclosure to accommodations

This is the fastest path from “I’m winging it” to “I have a plan.” Tweak as needed.

1. Clarify your job’s essentials. Grab your job description. Highlight essential functions. Mark anything that becomes risky or harder during or after seizures (e.g., ladders, strobe lighting, strict attendance, heavy machinery, customer-facing recovery time).
2. Track triggers and recovery. Two weeks of notes will do. Note sleep, stress, lighting, medication timing, and what recovery looks like for you (e.g., 20 minutes of fog; sensitivity to screens; need for quiet).
3. Draft your request. Keep it short. Example: “I have a neurological condition that can affect me intermittently. To do my job safely and effectively, I request the following accommodations: (1) flexible 15-minute breaks as needed for symptom recovery; (2) anti-glare filters and a desk lamp instead of overhead fluorescents; (3) remote work on days following a seizure if I experience postictal symptoms. I can perform all essential duties with these supports.”
4. Get a one-page clinician letter. Ask your neurologist or primary care clinician to state: diagnosis as needed (or “neurological condition”), functional limitations (not medical history), expected frequency/duration of episodes, and recommended accommodations. Tip: Ask them to write in plain language and tie recommendations to job tasks.
5. Send the request to HR. Email HR with your request and attach the clinician letter. Subject line: “ADA Accommodation Request.” Ask for a meeting to start the interactive process. Loop in your manager only on what affects work, not medical details.
6. Prepare your safety plan. One page, shared with HR and your manager. Include: (a) what colleagues may see; (b) simple first aid steps; (c) when to call emergency services; (d) your emergency contact; (e) how you prefer to resume work after. Keep medical specifics minimal, practical, and aligned with sources like CDC first aid guidance.
7. Run a time-limited trial. Suggest a 30-60 day trial for accommodations, then review. This calms fears and gives you data. Propose objective measures: error rates, output, safety incidents (ideally zero), attendance stability.
8. Document everything. Keep a folder with requests, notes, dates, and outcomes. If things sour, this history matters. If they go well, it helps you renew accommodations or switch roles smoothly.
9. Update during reviews or promotions. When duties change, update your plan. Promotions shouldn’t reset your rights.
10. Escalate if needed. If HR stalls or denies without a good reason, ask for a written explanation. You can file a charge with the EEOC-deadlines are usually 180-300 days from the issue. A brief consult with an employment attorney or a disability rights group can help you assess your options.

Decision rule you can use today:

• Disclose now if you need work changes, a safety plan, regular leave, or if your role includes tasks that could create real harm during a seizure.
• Consider holding back if you’re fully controlled, have no job-safety exposure, and don’t need adjustments. Still, stash a safety card in your desk and with a trusted coworker.
• In interviews, focus on abilities and essential functions. You don’t have to disclose. If you request accommodations for an assessment (e.g., extra breaks), keep it simple and job-related.

Script for the meeting (simple and clear): “I can do the essential parts of this job. Because my condition can flare up, I’m asking for [list 2-3 changes]. These are low-cost and common. I’d like to try them for 60 days and check results.”

Personal side note: I keep my own emergency card in my laptop sleeve. My spouse, Graham Tylor, nudged me to add a line-“Please time the event”-after I had one at home and he forgot to check the clock. It helped us ask smarter questions at my next appointment. Small details like that matter at work, too.

Real-world scenarios, safety plans, and examples

These are based on common roles and real accommodation patterns documented by the Job Accommodation Network and clinician guidance.

Office/remote knowledge work

• Challenges: fluorescent lighting, screen flicker, tight back-to-back meetings, fatigue after a seizure.
• Accommodations: anti-glare screen, task lamp or LED lighting, meeting buffer blocks, flexible breaks, remote option after an event, calendar visibility for focus time.
• Safety plan: coworkers know basic first aid; manager knows whom to call; you keep a recovery snack and water nearby.

Retail/hospitality

• Challenges: long standing hours, unpredictable shifts, visual/sound triggers, crowded spaces.
• Accommodations: predictable scheduling, shorter shifts, a stool, swap of duties during recovery, avoiding strobe-heavy areas, short recovery breaks.
• Safety plan: a designated coworker covers the register; aisle cleared; manager notes time and follows the first aid steps.

Manufacturing/field work

• Challenges: ladders, open water, heavy machinery, hot environments.
• Accommodations: avoid work at heights or near moving machinery; partner system; reassignment of high-risk tasks if seizures are uncontrolled; PPE adjustments that don’t obscure vision; cooling breaks.
• Safety plan: task pre-checks; supervisor trained on when to stop work; clear route to a safe area. Employers do a specific hazard assessment, not a blanket ban.

Drivers and driving-adjacent roles

• Challenges: commercial driving often has licensing rules; private commuting is separate from job functions.
• Accommodations: temporary reassignment to non-driving tasks while meeting state seizure-free requirements; remote work; flexible start times if medication changes impact mornings.
• Safety plan: confirm local medical reporting rules with your clinician; document temporary job adjustments during treatment changes.

Photosensitive epilepsy

• Challenges: video editing, emergency vehicle lights near an open window, fire alarm strobes, VR demos.
• Accommodations: workstation away from flashing sources, screen filters, reduced brightness, 120 Hz+ monitors, “reduce motion” settings, permission to look away or step out during alarms once safe.

What a one-page safety plan looks like

• What you might see: “Brief loss of awareness; arm jerking; may fall; may be confused after.”
• What to do: “Start timing. Clear sharp objects. Cushion head with a folded jacket. Don’t restrain or put anything in the mouth. When movements stop, roll onto side if safe. Stay with me.”
• Call 911/emergency if: “Seizure lasts more than 5 minutes, a second starts right away, injury occurs, I have trouble breathing, or you’re unsure.”
• Aftercare: “I may need 15-30 minutes in a quiet room and water. I’ll signal when I’m okay to return or go home.”
• Contacts: “HR extension; my emergency contact.”

Manager play: what to say after an event

• “You’re safe. Take the time you need. We’ll cover your tasks for the next hour.”
• “I’d like to set a time to review accommodations so you have what you need.”
• Avoid: medical cross-examination, asking about medications, or telling the team details. Share only the safety steps.

Co-worker micro-training (2 minutes)

• Keep it plain: time it, protect from injury, don’t restrain, roll to side after, call for help if it goes past 5 minutes.
• Normalize: “This is common and manageable. We have a plan.”

If you need a personal story to break the ice: I tell folks my cat, Miso, once triggered my aura by knocking over a glass at 3 a.m. Sleep debt is real. People laugh, then listen when I say a 10-minute break the next day can prevent a bigger problem.

Data notes: The Job Accommodation Network reports that most accommodations cost nothing; when costs occur, the average is in the low hundreds. CDC figures show epilepsy is common enough that every mid-size employer will likely have multiple employees affected.

Checklists, tools, and mini‑FAQ

Employee checklist (use this week)

• List essential functions and hazards in your role.
• Track triggers and recovery for two weeks.
• Draft a short accommodation request with 2-3 specific changes.
• Ask your clinician for a one-page functional letter.
• Write a one-page safety plan with plain-language first aid.
• Email HR to start the interactive process; suggest a 60-day trial.
• Teach one trusted coworker the first aid steps; share your safety card.
• Document outcomes and adjust during your review.

Manager checklist

• Separate medical info from personnel files; share only need-to-know restrictions.
• Focus on essential functions; brainstorm accommodations with the employee.
• Offer a time-limited trial and clear success metrics.
• Train the immediate team on first aid without sharing medical details.
• Revisit the plan during duty changes, promotions, or medication shifts.
• Use objective risk assessments, not assumptions. Document your reasoning.

Co-worker quick card (index-size)

• Time it. Protect from injury. Don’t restrain. Turn on side after movements stop. Call for help at 5 minutes or if injured.
• Stay until the person is alert. Offer water and a quiet spot.
• Don’t put anything in the mouth. Don’t crowd. Give space and calm.

Mini‑FAQ

• Do I have to tell my employer I have epilepsy? No-unless you want accommodations or a safety plan. If your job has obvious high-risk tasks, it’s smart to disclose so you can adjust duties safely.
• Can I be fired for having seizures? You can’t be lawfully fired just for having epilepsy. Discipline must be tied to essential functions and applied consistently. If a real safety risk exists, the employer must consider accommodations before any job change.
• Can they ask about my medications? They can’t demand full medical details. If you ask for accommodations, they can ask for info related to functional limits and what helps you do your job. Keep it job-focused.
• What if a seizure happens at work? Follow your plan. After, note the time, any injury, and how long recovery took. Use that data to tune your accommodations.
• Should I bring up epilepsy in an interview? You don’t have to. If you need an accommodation for the interview itself (like breaks), you can ask for it without sharing full medical info.
• What about driving? Commercial driving often has strict rules. For non-driving roles, commuting is usually your responsibility; ask about remote days after an event or flexible start times.
• Can I ask for leave as an accommodation? Yes. Intermittent or block leave can be reasonable when it helps you manage treatment or recovery.

Tools you can copy‑paste

Accommodation request subject line: “ADA Accommodation Request - [Your Name]”

Opening paragraph: “I’m requesting reasonable accommodations to perform the essential functions of my job. Based on my clinician’s guidance, I’m asking for [two or three concrete adjustments]. I propose a 60-day trial and a brief check-in at day 30.”

Safety plan header: “Seizure First Aid at Work - [Your Name], Emergency Contact: [Name/number]”

When to involve HR: the moment you need job changes, time off beyond ordinary sick days, or anyone asks medical questions. HR is the keeper of process and confidentiality.

Why this works

• It aligns with EEOC guidance on the interactive process.
• It uses CDC-backed first aid steps, which are simple and actionable.
• It references JAN’s cost data, easing budget concerns.

Pro tips

• Use numbers in your trial plan: “two breaks up to 15 minutes,” “remote on day-after-event.” Numbers beat vague promises.
• Pair each requested accommodation with the business benefit: fewer errors, steady output, better safety metrics.
• If you have auras, add a line to your plan: “If I say ‘pause for a sec,’ I’m stepping away to prevent a larger episode.”
• Keep your safety plan on your badge holder or pinned in your team’s private channel.

Common pitfalls to avoid

• Over-sharing medical details. Stick to functional limits and supports.
• Waiting until a crisis. Plan before you need it.
• Accepting a flat “no” without alternatives. Ask, “What would make this workable?”
• Ignoring recovery time. Ten minutes now can save a day later.

Next steps and troubleshooting

• If you’re job hunting: refine your essentials list for the roles you want; prep one sentence about how you succeed with simple adjustments; line up a clinician letter template.
• If your employer resists: ask for their reasoning in writing; propose a trial; consult a local disability rights group; know the EEOC filing window (often 180-300 days).
• If you’re a manager: schedule a 15-minute first aid teach-in; set a recurring 10-minute check-in for the trial period; document wins (reduced errors, stable attendance).
• If you work around hazards: request a targeted risk assessment; reassign only the hazardous slice of the job; propose a buddy system and emergency stop protocols.
• If your seizures change: update your clinician letter and plan. More control? Scale back. Less control? Add supports or adjust duties temporarily.

Credibility corner (what I’m drawing from): EEOC ADA guidance and technical assistance (latest updates through 2024), CDC epilepsy first aid and prevalence data (2024), Job Accommodation Network cost and effectiveness reports (2025), and national equality laws like the UK Equality Act 2010. These sources align on the big points: legal protection, low-cost accommodations, and practical first aid. That’s why this approach works.

One last nudge: ask for what you need, clearly and early. When people understand the plan, fear drops and support rises. That’s true in boardrooms and break rooms-and yes, in homes where a cat named Miso learns not to play with light cords at 3 a.m.

Mark this one phrase in your notes: epilepsy at work. That’s what this is about-your right to do your job, safely and with dignity, today.