In my years as a hiring manager, I interviewed hundreds of candidates and oversaw the hiring of thousands. Before the accident that left me a quadriplegic, it rarely occurred to me that a candidate who appeared sluggish or unmotivated might be living with a serious health condition. I now realize that my own judgments – sometimes harsh, often uninformed – may have dismissed people coping with degenerative illnesses.
Degenerative neurological conditions like Parkinson’s disease, multiple sclerosis (MS), ALS, and early-onset dementia are often assumed to affect only the elderly – people considered to be in “old age”. But millions of younger adults – many under the age of 60 – live with these diagnoses. MS alone affects over a million people in the U.S. under 50. Unless someone is a celebrity like Michael J. Fox or Lady Gaga, their illness often goes unnoticed.
People with these conditions face a range of barriers in the workplace that affect their ability to obtain, retain, or advance in employment. These include:
Cognitive issues such as memory loss, slower processing, or difficulty concentrating (common in early-onset dementia or MS) can affect task performance and productivity. Motor symptoms like tremors, weakness, or poor coordination (seen in Parkinson’s and ALS) can make physical tasks challenging. Fatigue, especially in MS and ALS, can be unpredictable and disabling.
Fear of being treated differently may lead individuals to hide their diagnosis – a survey found that 88% of people with an invisible disability had negative views of disclosing their disability to employers. This can lead colleagues and supervisors to misunderstand the conditions or assume incompetence. These conditions may cause career instability because the progression of symptoms can lead to frequent absences, demotions, or forced leaves of absence. There’s a cascade effect – people have difficulty in finding new employment due to bias during interviews or concerns about longevity in the role.
Many employers lack ergonomic tools, assistive technology, or even basic awareness of ADA-compliant accommodations. Few companies have inclusive policies that address progressive or invisible disabilities. Remote or flexible work options – which can be game-changers – are often discouraged.
Most companies don’t have disability-inclusive policies that specifically address invisible or progressive disabilities. HR departments frequently lack training in how to support employees with neurodegenerative conditions. Employees may lack access to peer support or mental health resources to help manage the emotional toll of working with a chronic illness.
Accommodations
Some companies have made an effort to hire and be inclusive of people with degenerative conditions. A few of these are:
Supporting Neurodivergent Employees
The Costs of Accommodation
Hiring people with degenerative conditions is often straightforward – but supporting them well may require thoughtful accommodations. These changes aren’t always cheap or easy, especially for small businesses. But the long-term return on investment – in the form of loyalty, reduced turnover, and increased productivity – can be substantial.
What I failed to see in those early interviews may have unfairly cost some candidates their chance. I can’t undo those decisions, but I can speak openly about the biases I held. If sharing my experience helps another hiring manager pause, reconsider, and recognize the barriers that people with invisible disabilities face – then maybe something good can come from my past mistakes.
