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Podcast #26A: You & Your Employer

  • Writer: Lynda Price
    Lynda Price
  • Jul 8, 2024
  • 28 min read

Updated: 3 hours ago



We've talked about almost everywhere else in your life, except the one place where you may spend most of your time--your job. What do employers need to know about invisible disabilities? What do you need to know as an employee with an invisible disability? Here's some ideas to get you started....


Who Are Employers?
Who Are Employers?

    Defining the term "employers" seems easy-peasy. As the folks from Ontop (2025) explain: "An employer is an individual or organization that hires employees and contracts them to work in exchange for wages or salary. The employer is responsible for providing a safe and fair working environment, paying wages, and providing other benefits such as health insurance and retirement plans."

    Sounds pretty uncomplicated, right? Wrong! In the 21st Century, employers and employment can be as complicated as trying to understand Egyptian hieroglyphs. It seems that no two employers are alike. For instance, one may be a single person who owns a small business. Another may run a multi-national corporation. A third may be a state or federal government agency. A company can run out of someone's garage and rely heavily on technology to function. A different company could be totally hands-on, using simple, traditional methods. Some have retail storefronts throughout the country. Another may function as a non-profit with a single office in a third-floor walk-up. Employers are found in urban, rural or suburban settings. You can also conduct business from a plane, a treehouse, under water, or on a mountain top. As an employer, you may have a single employee or thousands on your payroll. You may be a brand-new start-up or a family company that goes back generations. As you can see, you definitely can't put all employers into one box. However, they do share a number of characteristics in common. These include, but are not limited to: responsibilities, compensation, expectations, and legal obligations.

      

   First, let's talk about What are employer responsibilities to their employees? As either a new or current employee, we usually concentrate on what we owe the employer. But, that's a two-way street. An equally important question is: What should they give us in return? Basically, they must provide safety in a healthy job setting, comply with appropriate labor laws, pay fair wages, and make sure that you have the needed equipment and training to do your job. In addition, they should: comply with all OSHA laws*; support professional development, whenever possible; behave towards each employee in a fair, non-biased manner, especially when disputes arise; and pay each person accurately and on time (Indeed, 2025). An outstanding employer will often go one step further and provide this as well: a) encourage a work/life balance, b) let employees know they are valued and have job security through positive relationships, c) give employees responsibility and ways to grow on the job, d) provide benefits and bonuses to motivate employees and e) demonstrate transparency with information about the organization (Indeed, 2025). If you are able to work with an employer like that, consider yourself very lucky!


   Second, how do employers compensate their workers?  When most of us think of jobs, the first thing that comes to our mind is salary--and, the deal-breaker question: "How much am I making?" However, there's lots and lots of other critical factors to consider as well. For instance, ways to compensate employees besides salaries are: additional hourly wages; healthcare (physical and mental health, prescriptions, dental, vision benefits, etc.); paid overtime; on-site or credits for childcare; company car and/or mileage; on-site gyms or gym memberships; wellness offerings; scholarships or paid tuition for further education; professional development activities; vacation time; and maternity or paternity leave (Indeed, 2025). Additional perks include: pet insurance; retirement packages, including 401(K) and/or employer match; remote or hybrid work options; flexible schedules; paid time off (sick days, personal days, etc.); life insurance; disability insurance; stock options; relocation assistance; on-the-job training; and flexible spending accounts (Indeed, 2025). While this list can seem overwhelming, being a savy employee and figuring out exactly what you will need from your employer can be the difference between job success or failure. One size clearly does not fit all.

    Awareness of the complexity of compensation should not be underestimated. Professionals at Incentfit (2025) stress that: "In 2019, an organization surveyed 1000 UK employees regarding the importance of fringe benefits. A stark 66% rated their employee benefits as equal to or more important than their salary. In fact, 14% said they would like an increase in benefits over a pay rise. [Another] employee happiness study [showed] 92% of respondents reported fringe benefits as important to their job satisfaction."


Third, what do employers expect from their employees? Another pivotal component of the workplace is the overt--or often hidden--expectations that many employers have for their employees. These are the critical guidelines that can make or break you on the job. When thinking about expectations, most people focus on their Annual Evaluation. Nevertheless, the reality is that you will probably be judged everyday, not only by Human Resources, but also by: your direct line supervisor, your fellow team members, your customers, your clients, your patients, and especially your work friends and colleagues.

    Employer expectations are often based on personal characteristics as well as the necessary job requirements; a combination of both hard and soft skills. (For more information, see Podcast and Blog #5: How do I use Soft Skills?) For instance, these are six "must-haves" that many employers look for in their employees: initiative, positive attitude, entrepreneurial spirit, results-oriented, team player, dependable and/or responsible (Miller, 2025). Others include: reliability, effective communication skills, critical thinking, adaptability, motivation, honesty, and resourcefulness (Metric Group, 2023).

    The reverse side of the coin is what the employee expects of their employer.

Not only do they want to be fairly compensated for their work, they also desire: flexible work schedules, high quality tech assistance to do their job, autonomy and employee empowerment, a positive work culture, employer accountability, feedback and transparent expectations (Deskbird, 2022).

   Expectations are seen as key components for both employers and employees. Ironically, both assume that they will always be on the same page. But, what if that's not true? As Ali (2024) stresses: "In any workplace, there exists a delicate balance between employee and employer expectations. When these expectations align, productivity soars and the work environment thrives. However, when there is a disconnect between what employees expect from their employers and vice versa, it can lead to significant challenges, including distance, misunderstanding, lack of motivation, and a breakdown of trust".

    Such misunderstandings may be especially problematic when someone has an invisible disability. For example, an employer may not be clear in the initial interview that reading extensive how-to manuals and writing daily field reports are critical job requirements. This situation could be overwhelming to someone with severe dyslexia. Or perhaps, a new employee with ADHD has a customer service position but doesn't realize that they cannot leave the front desk for multiple breaks to refocus their attention as they did in their previous job.


    Fourth, what legal obligations do employers have to their employees?*  One area that should be crystal clear is the legal obligations that employers have for all of their employees, whether they have a disability or not. Examples are: statutory benefits (social security contributions, unemployment insurance, worker's compensation); withholding income tax; workplace safety; anti-discrimination laws; privacy and data protection; compliance with all labor laws; discrimination free workplace; and equal employment opportunities. Of special interest, such legal obligations must involve equal access and reasonable accommodations for all potential or current employees with disabilities (Ontop, 2025). This last point is significant, since such support is often the hidden, best solution to keeping or losing a job for employees with invisible disabilities. Legal support is illustrated in depth in the next section and related Scenarios.


*Please Note:  As usual, when I talk about employment, employer expectations, and legal considerations, it is through the lens of the United States. For folks in other countries, I strongly encourage you to explore these areas in your own location, as your situation may be unique.

     For instance , to understand German employment, you may need to a deep dive into federal legislation, case law, works council agreements, and so forth. You should look at the Behindertengleichstellungsgesetz (BGG) SGB IX and the Book IX of the Social Code for employees with disabilities (Federal Anti-Discrimination Agency, 2024). Australian employers and employees with disabilities are guided by the Disability Discrimination Act (DDA) of 1992 (Australian Human Rights Commission, 2025). The applicable law for people with disabilities in India is the Rights of Persons with Disabilities Act, 2016 (RPwD Act) (RoboBionics, 2025). Disability legal protection in the Russian Federation is through the Federal Law of Social Protection of Disabled People (Disability:IN, 2025). The list goes on and on.

     The take-away here is for you to do your homework. Read these laws and talk a lot to local employers, family or friends to see specifically what applies-- or does not apply-- to you. The more you explore, the more you will find your own path for advocacy and support needed to be an effective employee.


    

    

ComplianceConnecting Employers and Invisible Disabilities 


Employment and invisible disabilities go hand-in-hand. You won't see two topics more important to adults with LD, dyslexia, or ADHD, than finding and keeping a job. But the unemployment statistics here are not encouraging. For instance, the professionals at Creative Spirit (2024) state that: "The unemploy-ment rate for adults with dyslexia in the U.S. is around 45%, according to data from the Tremaine Foundation, the International Dyslexia Association, and the National Center for Learning Disabilities". Such high unemployment figures are also echoed by Mastermind (2025) who stress: "Approximately 58% of adults with dyslexia are employed, significantly lower than the 72% employment rate of the general population. . . In fact, dyslexia affects up to 20% of the workforce, illustrating how widespread this condition is." The trend is equally dark for people with ADHD: ""ADHD at work results in 1 out of 3 people with ADHD being unemployed at any time" (ADDA Editorial Team, 2023).

These grim statistics are a reflection of employment for people with all disabilities world-wide. Moser (2025) explains that: " . . . In most developed countries, the unemployment rate for individuals with disabilities who are of working age is at least twice as high as individuals without disabilities. If workers with disabilities reached the same employment rate as those without a disability, nearly 14 million more individuals would have been employed in 2021. These statistics support the ongoing notion that individuals with disabilities continue to not be hired, contributing to significant consequences of unemployment and poverty" (Moser, 2025).

   So, why are so many people with invisible disabilities either under-employed or unemployed? Time and time again, adults have told me that it is because they continue to face so many challenges in the workplace. If we want to understand the unfavorable statistics about employees and invisible disabilities, we should explore further the issues that they face everyday.

 

(A) Challenges in the workplace

   If you ask anybody about their job, probably the first thing that they reply is how challenging it is. Everyone faces hurdles, whether they run their own small business out of their basement or someone who is struggling not to be down-sized in a Fortune 500 company. However, adults with invisible disabilities have told me for years that they usually face an additonal layer of craziness. As an employee with a disability that is almost always hidden from others, there seems to be no end to the obstacles.

    It could be the people they work with or the person who supervises them or the job itself. These obstacles include, but are not limited to: a) Time management and organizational skills, especially when the job requires multi-step planning or strict deadlines; b) Writing problems, where spelling, grammar and writing involve frequent emails, reports, and/or presentations; c) Executive processing issues where you must follow complex instructions or process information quickly and efficiently; d) Social challenges like being part of a team or attending required social functions and meetings; and e) Constant fear of failure, along with anxiety, worry, and frustration (Ruth, 2024).

   Professionals at MHR (2025) elaborate further: "Exactly how dyslexia impacts any given employee can vary hugely. Typically, stress can make symptoms worse, as that often causes management strategies to fall to the wayside" These difficulties are echoed by Tomases (2023) who stresses:  "Anyone with a learning disability will tell you that they have to work twice as hard, are often ashamed of their learning style, can be overly focused on their shortcomings rather than their strengths, and can suffer from low self-esteem".

   But daily issues on the job are not the only hurdles that employees with invisible disabilities face. Many of the same problems that haunted them in school will come back again in force in the workplace. As Griggs (2022) has observed, ""In addition, traditional benchmarking tools [on the job] like standardized tests, psychometric tests, and recruitment filters disadvantage people with dyslexia. These tools typically measure dyslexic people against the very things which they find challenging (such as timed written tests) and can make them (and others) mistakenly believe they’re not as smart as their peers". That means such work-related tasks as: on the job training, informal/formal job evaluations, or reading/learning new technology can be embarrassing, and sometimes almost impossible for employees with LD, dyslexia, or ADHD.

    As Saw2193 (2025) discloses: "The worst advice I ever got was 'you can be anything you want to be if you put your mind to it.' No, I cannot. I failed in every normie job I tried and trust me I put my mind to it. I’m doing Land Planning now and I enjoy it and my coworkers haven’t realized I’m a weak link yet so things are going well. Just a matter of time though before my coworkers start realizing I’m “lazy” and “stupid.” Dyslexia and dyscalculia made me realize a “career” just isn’t in my cards. Survival is though".   

    Saw2193 underscores how these obstacles can make any new task or work transition a challenge, no matter whether you're just starting or been with a particular employer for a long time. No matter what obstacle you face, it can also mask for everyone the many assets that you bring to the table.

   (B) What people with invisible disabilities bring to the job

There's lots in the last section that describe the sometimes overwhelming difficulties for folks with LD, dyslexia, or ADHD in the workplace. Nonetheless, the other side of this picture is the unique qualities and gifts they can bring to employers if they are allowed to do so. For instance, employees with invisible disabilities are: good analytical and/or critical thinkers; great at solving complex problems; incredibly creative; and uniquely innovative. They can bring lots of empathy and sensitivity to the needs of others (e.g., clients, co-workers, and other team members). They are often wonderful leaders who show persistence, flexible thinking, and resilience in challenging or difficult situations (Tomases, 2023). They will work twice as hard and will stay twice as long as others to see a critical project through. Plus, they can be incredibly loyal emplyees who are highly motivated to learn from their mistakes and grow in their position. king

A surprising fact is that these positive characteristics are based in science. As Griggs (2022) explains: "Neuroscience and fMRI scanning show that dyslexic brains really are “wired” differently. The left parietal temporal area of their brains uses different neural pathways that help people with dyslexia to think

differently, creatively, and laterally. The axons linking the mini columns in dyslexic and non-dyslexic brains also differ in length, such that this difference has an impact on cognitive reasoning. While dyslexic brains tend to do well with 'big picture processing' they have trouble with 'fine-detail processing.' Conse-quetnly, dyslexic thinkers can solve problems and see patterns that others sometimes cannot — and that is incredibly valuable to employers."

Her conclusion came true when LinkedIn, a major networking platform used by professionals, businesses, and employees all over the world, added the ability for users to add Dyslexic Thinking to their Profiles. Thomases (2023) calls this a game-changer:"For those of us in the workforce, having a LinkedIn profile feels pretty typical. So when LinkedIn added Dyslexic Thinking in the spring of 2022 as one of many skills that users could select to describe their work attributes and reframe the narrative, it was a significant departure from the norm. What’s even more amazing is that once they began to promote this opportunity to their users, they had over 10,000 people apply this skill within the first hour. Polls suggest that 97% of people view dyslexia negatively. When LinkedIn added Dyslexic Thinking as a skill in the platform, positive sentiment toward dyslexia rose by 1,562% on social media".

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SCENARIOS


*Note: The focus of the two Scenarios in this Blog is a little different from previous blogs. Usually I've explored one primary disability. The following scenarios, however, look at the concept of comorbidity, or having two or more disabilities at one time. Examples given below look at LD, and dyslexia, coupled with anorexia nervosa or ADHD.



Scenario A:

Mindy loves her job--not just likes or tolerates it like most of her friends--but really loves it. As a lineman for the local power company, she has worked for the electrical company for over 10 years and has risen steadily throughout her career. The work pays well with great benefits. It's really interesting and she's busy everyday with new challenges. Since Mindy just loves puzzles anyway, she is constantly problem-solving in the field. She also really likes the customers and folks she works with, so coming to work is usually a pleasure.

That's the up-side. The down-side is that Mindy's company was just bought by a big conglomerate. Not only is everyone scared that they will get laid off, but if they do keep their jobs, they will probably be doing the job of two or three people. That's already happening to some linemen and Mindy is really afraid that she's next. She is especially concerned because of her LD and her ADHD. She knows herself well enough to know that she can't just jump from one job or location to another like other people. She needs pre-preparation, consistency and order, not confusion and more complexity. Also, job security is a big priority for Mindy, as she is the primary support for her elderly grandparents. But, what's going to happen to her job? Mindy can't even imagine......



Scenario B:

Tisha is a good nurse. Everywhere she works, she is always commended for her kindness, sensitivity, and up-dated knowledge in her field. Nobody is a better team player than Tisha. She is the one who is willing to work that extra shift or spend additional time with a patient. While she struggled academically to get her LPN and then her RN degrees due to her dyslexia, she absolutely would never think of using accommodations for tests or class assignments.

Tisha also never told anyone about her anorexia. She's always had issues around food, as she comes from a family of mostly single, overweight women. Tisha can't remember a time growing up with her mom, sisters, and aunties, where they weren't either going on or off the latest diet. Plus, since they were all excellent cooks, food was the constant topic of conversation.

Tisha swore she'd never gain weight--and she hasn't. But, maybe she's also gone a little over-board. For instance, she is constantly weighing herself and knows every calorie that goes into or out of her body. She always sees herself as overweight and is obsessed with how she looks. She copes with the stress and anxiety of her job as the Lead Supervisor at an up-scale nursing home with her abnormal eating habits. She is continually looking in mirrors, but what she sees makes her less and less happy. She can't control the craziness of her job, with its endless forms, constant crises, personel changes, family and patient issues, and budget cuts. But, she can always control what she eats.

Unfortunately, now the long term effects of her abnormal eating habits are finally catching up with her. It's always shaped her life, but now it's affecting her job as well. For instance, stress and Tisha's high visability job go hand-in-hand. She's used to juggling lots of agendas, problems, and people at the same time, but now she just feels very exhausted and overwhelmed all of the time.

She finds herself having trouble concentrating, especially during meetings or when people are trying to get her attention. She continually struggles to avoid situations where food is present and is irritated when her job keeps her from keeping up her rigorous exercise regime. Her bathroom breaks are becoming more and more frequent and she resents it when others constantly interrupt her with work problems or crises. Her paperwork is getting sloppy, as she just doesn't have the energy to complete all of the forms and jump through all of the hoops necessary for a big facility to run smoothly.

A few of her colleagues have gently commented on how thin she is and the dark circles under her eyes. But, Tisha just changes the subject. However, the owner unexpectedly dropped in recently and kept watching Tisha. His parting comment was, "We need to get together and talk....Soon....!" What does that mean? Tisha has enough problems in her life without dealing with him.

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Tips and Tricks



Tip #1: Goodness of Fit

Tip #1 focuses on a concept that you've probably never heard of, as it has traditionally been applied to statistical models--goodness of fit. That changed, however, when a group of creative early childhood educators used it to discover important insights into the temperament and development of very young children. As the educators at the Penn State Extension (2023) explain: "A common theory for supporting unique temperaments is 'goodness-of-fit.' The main rationale behind the goodness-of-fit theory is that all children's develop-ment is shaped by the interaction between their own characteristics and the environment and people around them".

So, how does this apply to adults with invisible disabilities? Goodness of fit is a major, but often unexplored, component of job success for all employees--both with and without disabilities (Reiff, Gerber, & Ginsberg; 1994). In other words, does your temperament fit where you work? Or, how compatible are you with the responsibilities, people or places where you go everyday to pick up your paycheck?

If you have great goodness of fit, you will probably thrive and grow in that environment. On the other hand, if you have poor goodness of fit (e.g.,constant issues, irritations, or minor conflicts), you're probably at the wrong job where your problems will only get worse. For example, what if someone works for a religious publishing house, but is an agnostic? Another person sells running shoes, but hates to exercise and spends her life eating chips and watching soap operas? Neither of these folks work in a compatible environment that fits their temperament. On the other hand, what if someone volunteered since they were a teenager at a local Legal Aid clinic? If they plan to be an immigration lawyer, they clearly are on the right track. What about a person who has a beautiful voice and has been singing as a soloist since they were a child? If they want to be a school choir director, they definitely have the experience and training for future success. Both of these are great examples of goodness of fit.

Gerber (2002) has repeatedly stressed that this is an especially critical component for people with learning disabilities. For instance, as part of his research, he interviewed 70 adults with LD to find out why they were successful employees. He discovered that they had a number of traits in common; one of which was goodness of fit. As Shellenbarger (2009) says: "Dr. Gerber urges workers [with invisible disabilities] to seek what he calls "goodness of fit" -- a job that suits their personality and abilities, at an employer with a proven ability to integrate workers with disabilities."

In other words, as an adult with invisible disabilities, you will always have extra homework to find or keep a job. You need to think carefully about the situation and how well it matches you--your unique strengths, along with the hidden ramifications of your disability. In other words, take time to carefully read the "work culture" (Dewar, 2025; Howington, 2025; Leather, & Kirwan, 2012). You should observe and explore the core values of the business, along with how it's reflected in the company leadership style. Also, try to get some clues about how the employers relate to their employees--and how the employees relate to each other. For instance, does the compan encourage innovation and collaboration? Do they want their employees to be engaged in the success of the company--or just show up for work on time and not steal the staplers? Do they believe in inclusive practices or are they only concerned about the bottom line? If you see any red flags, ask yourself how much you really want this job. Is there a true goodness of fit here for you?

A great example is Mindy in Scenario A. Mindy has been very successful at her job for over 10 years, but change is definitely on the horizon. Right now, she's has great goodness of fit. But, if her job description (e.g. essential job functions) radically change, she could have major problems. Mindy already knows pretty much what works and doesn't work for her. For example, her LD and ADHD require as much pre-preparation and consistency as possible. She knows that getting instructions at the last minute, going to places using equipment that she's never seen before, or increasing her workload significantly without warning could be a disaster.

After thinking this through, Mindy became proactive. She did her homework, before the firings and lay-offs actually happened, to explore the new company for goodness of fit. What she found online and talking to other people was encouraging. While there would be a totally new management structure, with new supervisors and colleagues, there could also be lots of benefits with a big corporation. For instance, the new company really seemed to encourage employees to grow in their positions with lots of on-the-job training, seminars, and money to go back to school. They supported a flexible work schedule and often promoted successful employees inside the company. They seemed to support inclusion, with paid pregnancy leaves, diversity training, employee support groups, and a dedicated Human Resources person for employees with disabilities. Since this sounded like the beginnings of goodness of fit for Mindy, she decided it was time to make her move to protect herself.

First, she started exploring a job that she had wanted for years--to be a Lineman Safety Inspector. She found out what type of training she would need to get her certificate and how much it would cost. Second, she thought long and hard how she would finally disclose her LD and ADHD. To help with this, she wrote a simple script that:


  • summarized the essential functions of her current job

  • specifically defined her LD & ADHD and

  • describe her job success with necessary reasonable accommodations


Third, she tried to match her current skills and successful experience with the requirements for the new job. For example, she listed the essential technical skills she already had, such as knowledge of: electrical safety protocols, hazard identification, OSHA regulations and (PPE) personal protective equipment. She also thought about the necessary soft skills that she brought to the table (e.g., great observation and problem-solving skills, attention to detail, communicates well with others, honesty, trustworthiness, motivation, great social skills, and lots of potential to train and lead others).

After she felt prepared to start this conversation, she made an appointment with her Supervisor as soon as possible. While not specifically referring to the upcoming changes in the company, she explained that she was ready to move forward in her job as a loyal, company employee. She already got great Performance Reviews, but she might need a few, simple accommodations if she was became a Lineman Safety Inspector (i.e. color-coding important manuals, emails, and memos; short breaks during important training sessions; written instructions whenever possible; and a task flow chart for her all of her new responsibilities). Mindy stressed that she could do all of this by herself and none of these things would cost the company a dime.

Her current supervisor told her frankly that he couldn't promise her anything right now with all of the upheaval coming with the new company. But, he would be glad to put notes about her request and a letter of recommendation in her personnel file. Mindy panicked for a minute. Did she make a big mistake by self-disclosing at exactly the wrong time? But, surprisingly, this conversation became one of the smartest things Mindy ever did.

Her old supervisor left before the new company made drastic cuts and changes. Her new supervisor liked what he saw in her personnel file and called her in for a meeting. He said that she would fit right in with the company's re-structuring plans and offered her grant money and time off to get her additional credentials and training. After that, Mindy was promoted to Crew Leader. With the new company's assistance and help from the College Disability Office, she went on to get a Bachelor's Degree in Occupational Health and Safety. When the second company drastically down-sized three years later, she became a partner in a successful consulting and training company with two former employees. With all of her job success and leadership training, she continued to support her grandparents and finally achieved her dream to be financially independant.


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Tip #2: Not Using Your Accommodations

Most of the stories in the various Blogs have illustrated what happens when you self-disclose, ask for, and then successfully use your accommodations. But, what happens if you don't? Maybe, for whatever reason, you think you don't need accommodations. Perhaps, you don't want to deal with the risks and potential embarrassment of using them in the workplace. That's your business. Nevertheless, in my opinion, that's also taking a real gamble. To be fair, each individual with invisible disabilities will have their own scenario and their own life--with or without support. For instance, in Tip #1, we talked alot about how reasonable accommodations and self-disclosure made a real difference for Mindy. Clearly, making those risky decisions changed her life for the better. But, many adults in Mindy's situation might have reacted in a very different way. For instance, just look at Tisha's decisions in Scenario #2.

Tisha was clearly in trouble at work. Her job just didn't seem to be a priority anymore, as she struggled to hold together the complex pieces of living as an independent, single woman--but one with rapidly deteriorating health. She couldn't concentrate anymore and focused on the only thing that worked for her; controlling what she ate and what she looks like. She felt irritated and distracted all of the time. That was when she wasn't too exhausted to get out of bed. Tisha really doesn't care about anyone else right now, especially when she starts feeling dizzy or has bad stomach aches.

Everything came to a head when she fainted at work. One of the other nurses rushed in to help and found out that Tisha had an irregular heartrhythm, with low blood pressure and severe dehydration. She also seemed to have a slightly yellowish tinge to her skin. She was sent home right away by the owner, Mr. Bridges, and given a few days off. He then met with her in his office and gently broached the subject of an eating disorder. Tisha vehemently denied this and asked to return to work right away. He told her firmly that she would first need a complete physical and time off to rest. She was also referred to a psychiatrist for more information.

The subsequent diagnosis of anorexia nervosia made Tisha madder than ever. She was fine; she just needed to stay on her diet and focus back on work. But, Mr. Bridges didn't feel that way. He informed her that she had a serious problem that was clearly interfering with her job performance. Through the company Employee Assistance Program, she could get free, personalized counseling, along with a leave of absence for in-patient treatment. If she refused, she would be demoted to another position.

What choice did Tisha have? With a great deal of shame and anger, Tisha packed up her stuff and went to treatment. She hated every minute of it, especially all the counseling stuff and everyone who forced her to eat and drastically decrease her exercise schedule. Tisha was convinced that she was gaining lots of weight, especially when her mom and sisters visited and told her so. In addition, she really disliked it when the therapist urged her to look at her control issues, along with her perfectionism and high stress levels. He even suggested that some of her anxiety, stress, and frustration might be due to her dyslexia. What a joke--she already got two college degrees without help from anyone. Why should she talk about this now?

After completing treatment, Tisha went back to work. At first, to keep her job, she tried using the techniques she learned earlier. However, after 2 months, she was back in her old pattern--lots of exercise, obsession with food, isolation from others, and denial that anything was wrong. Her job as a Lead Supervisor suffered and she was demoted by Mr. Bridges. Next, she started losing paper work and completing forms wrong, so she was fired.

She went on unemployment and moved back in with one of her sisters. It's then that she almost stopped eating altogether and fainted again.Hospitalization revealed that she had severe cardiovascular complications along with dehyd-ration and malnourishment. Tisha was forced to go through treatment again, this time to save her life. She approached this experience in a different way. She finally realized that she had to take it seriously, without anger or denial. It was time to make some difficult and painful choices--and start learning some new behaviors.

Unfortunately, Tisha is not alone. About 30 million Americans will have an eating disorder sometime in their lifetime, with eating disorders affecting 9% of the population worldwide. That's why it is seen as one of the deadliest forms of mental illness, with over 10,000 deaths per year in the United States (The Bulimia Project, 2025). In addition, people with invisible disabilities may be at risk for eating disorders. Reinblatt (2015) explains that: "There is preliminary evidence linking ADHD to [eating disorders] in both adults and children. The neurobiological mechanisms behind these associations are only beginning to emerge; however, they suggest that impulse control deficits may play a role in these eating disorders . . . . there is a growing association between ADHD, obesity, and binge-eating behavior in both children and adults". He adds that: "the prevalence of ADHD symptoms has been reported to be from 5 to 17% in samples of eating disorder patients" (Reinblatt, 2015).

You would think that such a prevalent, dangerous condition would encourage people to find help as soon as possible. However, the folks from the National Eating Disorders Collaboration (2025) identify social stigma as a critical hurdle to treatment. They say, "Research has consistently demonstrated that stigma is the most impactful barrier to people accessing eating disorder-specific treat-ment. People may experience stigma, feelings of shame and fear of judgement from family members/friends/health professionals regarding experiencing eating disorder symptoms or behaviours, thus presenting a challenge to help-seeking". This quote describes Tisha's situation perfectly.

Nothing made Tisha madder or more frustrated than people telling her she was wrong. Add embarassment, denial, and unhealthy ways to cope with stress and you have yourself quite a timebomb. Tisha had always been independent and never wanted help to do anything. Perhaps, that's why she resisted so strongly acknowledging her dyslexia in the past or using any type of accom-modations. She had struggled on her own for too long to admit that she might need assistance. Those attitudes and beliefs, in turn, influenced what she thought about her anorexia. Asking for help made her feel guilty and ashamed, like she was cheating. But now, she had no other choice.

Tisha had a long talk with her family and decided to return to treatment, but this time paying for it herself. As a result, she took advantage of everything; including available vocational counseling. She decided to be a Home Health Nurse. A rural agency desperately needed nurses and agreed to take her on part-time. As part of her out-patient treatment, she worked with an online support group to practice meal planning and find a healthy weight. She tried to set a regular eating schedule and consulted with a therapist about a realistic exercise schedule, along with how to cope with stress in a healthy way.

It was a hard, often discouraging process, but Tisha saw her life change in amazing ways. She went from part-time to full-time in 10 months and worked extra shifts as needed. When her boss left on medical leave, she became Lead RN in her area. This time, she saw her supervisory role differently. She now knew that her dyslexia could really impact her job success, so she used a Time Management App for deadlines and priorities, along with form-generating and screen-reading software for paperwork and organization.

She decided to specialize in oncology and went back to school for further training. This led to multiple job offers, including one as a travel oncology nurse. Tisha just returned from San Francisco and is packing to go to a hospital in Boston where she will have a 6 month stay. She's now making almost double her salary and has excellent benefits, along with travel to places she only dreamed of. However, she still struggles everyday to be healthy and avoid the trap of her anorexia. She meets with an online support group and checks in periodically with a therapist. While her family will never truly understand her challenges, they still love her and feed her whenever they can. Her life has been full of ups and downs, but she's decided that she likes this new life very much....

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RESOURCES



(B) Low Incidence Disabilities not normally addressed in the workplace --Example--Migraines


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Accommodating Employees with Migraines

People with migraines may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with migraines will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist."


JAN (2025)

"Questions to Consider:

  1. What limitations is the employee experiencing?

  2. How do these limitations affect the employee and the employee’s job performance?

  3. What specific job tasks are problematic as a result of these limitations?

  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?

  5. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?

  6. Do supervisory personnel and employees need training?"


    "The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA)."


    REFERENCES:



 
 
 

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