What is Brachial Plexus?
The brachial plexus is a collection of nerves that runs from your spinal cord to your shoulder, elbow, arm, hand, and fingers. These nerves send signals back and forth, which allows you to move your muscles and feel sensations like pain. The brachial plexus is made up of three parts. The upper part helps control the shoulder and the lower part mainly controls the hand and fingers. The middle part helps with function throughout the arm.
Brachial Plexus Injury
In a brachial plexus injury (BPI), the nerves are either pulled out of the spinal cord or are stretched too far. When this happens, the signals between your spinal cord and shoulder, elbow, arm, hand, and fingers no longer work. BPI injuries are usually closer to the neck or under the collarbone, but it is the shoulder, elbow, arm, and hand that lose function. The more nerves that are injured, the more numbness, pain or muscle loss you'll feel in your shoulder, arm, or hand.
A stretch injury happens when the nerve gets stretched or pulled apart. In stretch injuries, there is a chance that nerves can heal on their own. This can take many months or even years to get back to near- normal. Some stretch injuries can't heal on their own. In these cases, surgery can help improve function.
An avulsion injury happens when the nerve is pulled out of the spinal cord. With this type of injury, there is very little chance of the nerve healing itself. In this case, surgery can help improve function.
Both types of BPI (stretch and avulsion injuries) are hard to treat because we can’t see if the nerves are healing. This is different from broken bones or torn tendons, which we can see on an X-rays or MRIs. BPI injuries lead to muscle loss, numbness down the arm, and sometimes severe pain.
The pain from nerve injuries is different from the pain you get when you break a bone or sprain a joint. Some patients describe the pain from nerve injuries as sharp, the shooting pain that can last through the day and night, or start at random times. Every patient's experience with BPI will be different.
Introduction to BPI
How can BPI impact my general health?
BPI can affect all parts of your life. The loss of shoulder, elbow, arm, and hand function can make it hard or impossible to do everyday things. If the injury is severe, you may not be able to use your arm at all. In addition to not being able to use your arm, it may feel very heavy.
This can make it hard to sleep or exercise, which may affect your overall health and wellbeing. If you have been experiencing this, your surgery and therapy team may put limits on what you can do with your arm until your nerves heal.
How will this injury affect me?
A BPI may change many parts of your life. The good news is that you have many options in how you respond to those changes.
- Work: You may not be able to do your job the same way you used to. Your occupational therapist can help you figure out new or different ways to do your job, but you may also have to change jobs or apply for disability. This is different for everyone, based on your job and how bad your injury is.
- Self-care: It may take you longer to get dressed, to shower, or to fix your hair.
- Caregiving: The way you interact with your children or other family members may change due to your injury. You may need to accept help from others, and you may be less able to do things for others. For example, it may be harder to change a diaper, hold a child, or braid hair.
- Hobbies: Performance in sports, arts and crafts, gaming, and other activities can be impacted by your injury.
- Household chores: Chores like laundry, washing dishes, cooking dinner, and vacuuming may take more time or be harder to do after a BPI.
- Appearance: Your injury may change how your arm looks. You may have scarring, your muscles may shrink, and you may need to wear a sling.
- Mood: Many patients experience changes in their mood, including depression and anxiety, after their brachial plexus injury. Many people with BPI become frustrated with how their abilities change. They may feel loss, sadness, embarrassment, and a decrease in self-esteem at not being able to do the things they did before their injury. These are all normal responses to a life-changing injury. Just as occupational and physical therapists help you to rehab your arm, a pain psychologist can help you adjust to the changes in your appearance and functioning. Working with a psychologist does not mean there is anything wrong with you. It means that you are going through a life-changing event, and your BPI team wants to give you as many skills and tools as possible. A psychologist can help work through worries, concerns, new relationship dynamics, and changes to your daily life. If your injury was part of a traumatic event, a psychologist can also help you process any posttraumatic stress you may have.
What is the prognosis for BPI?
Every BPI is different. Some injuries involve more parts of the brachial plexus than others. Also, the nerves in the brachial plexus can be more severely affected in some injuries. There are three general types of brachial plexus injury. Let's talk about each one. ↓
Complete BPI (also called a “panplexus” injury)
In this type, all parts of the brachial plexus are involved in the injury. Some parts of the brachial plexus can be more severely hurt than others. The worst situation is when the nerve roots are pulled out from the spinal cord. You might hear your doctors call this an “avulsion” or “preganglionic” injury.
When this happens, the chances of recovery without surgery are close to zero. The other way that the nerves of the brachial plexus can be injured is through stretching. If the stretch injury to the nerve is severe enough, the nerve can break or rupture into two pieces. The nerves will try to grow and regenerate, but sometimes the stretch injury creates a lot of scarring that stops the nerve ends from growing towards each other.
The most common type of complete BPI is a combination of rupture (to the “upper” parts of the brachial plexus that control the shoulder and elbow) injury and avulsion injury (to the “lower” parts of the brachial plexus that control the hand and fingers). If this happens, it is hard to return normal fine-motor function of the hand. The priorities are usually to restore shoulder and elbow function, as well as focus on basic function of the hand, such as grabbing a large object. Even after very successful surgery, the hand is likely to become a helper hand with limited function. You may not have sensation in this arm again and the nerve pain can be very disruptive.
A less common, but more severe, form of complete BPI is where all parts of the brachial plexus are pulled out of the spinal cord. We call this a complete avulsion injury.
These are the hardest types of injuries to treat. Shoulder and elbow function is very limited and the hand is often unable to grip objects.
Partial BPI of the upper trunk
In this type of injury, the upper parts of the brachial plexus are injured. These nerves control function of the shoulder and elbow. The other parts of the brachial plexus that control the wrist, hand, and fingers still work.
When surgery is successful, patients regain much of the function of their hand. Yet, many patients still have trouble using their arm overhead and repetitive bending of the elbow is hard.
Partial BPI of the lower trunk
In this type of injury, the lower parts of the brachial plexus that control the hand and fingers are injured. The other parts of the brachial plexus that control the shoulder and elbow still work.
This injury can be more severe because the injured nerves are pulled out of the spinal cord (an avulsion injury). The nerves can’t make it to the muscles of the hand since it is a very long distance to travel. It is nearly impossible to restore the fine motor function of the hand, especially in the thumb.
Our goal when treating this type of injury is to help you at least be able to grab and release large objects. Sensation in the hand doesn’t return to normal and nerve pain is a problem for many patients. The hand may never go back to normal but it can become a useful helper hand with treatment.
How will I know what type of injury I have?
Your care team will use a combination of clinical examination and diagnostic tests (such as MRI, CT, and nerve studies) to determine which type of BPI you have.
Why is it so hard to improve after BPI?
There is a lot of variation in how many parts of the brachial plexus are injured and how severe those injuries are. Based on how severe the injury is, there may not be reliable options to restore function. Also, nerves heal very slowly so if the distance a nerve has to regrow is too long, it can be very challenging to see improvement even after surgery.
Sometimes there are delays in getting patients to BPI specialists, which can create challenges in getting the nerves to reach the target muscles in time. Lastly, pain can be a very big part of the experience after BPI. Pain is highly individual in terms of how severe it is and how much it affects your life. Sometimes, the pain cannot be reliably treated despite trying a number of different types of treatment.
Your Care Team
Although teams can be different, here are some of the other people that you might expect to meet with as part of your treatment:
Brachial Plexus Surgeon (Orthopaedic Surgeon, Plastic Surgeon or Neurosurgeon)
Brachial plexus injuries are often cared for by a surgeon with a special interest and background in brachial plexus injuries and nerve injuries in the arm. While surgery is not needed for all BPI patients, your surgeon will help you decide if surgery can help you. Surgeons who treat BPI patients may have backgrounds in specialties like orthopedic surgery, plastic surgery, or neurosurgery. However, not all orthopedic, plastic and neuro surgeons have a background or focus on treating brachial plexus injuries. This is why it is best to work with your local doctor and resources such as the United Brachial Plexus Network to find a brachial plexus specialist in your area. There are a lot factors involved in the care of a BPI, so brachial plexus surgeons often work with a team with various areas of expertise. Some of these people help diagnose your specific injury while others help you recover from the injury. There are also people who can help you understand how the injury will affect other aspects of your life like your job and relationships. Treating BPI is a team effort.
Physical Medicine and Rehabilitation Specialist (Physiatrist)
A physiatrist is a medical doctor who treats injuries to muscles, bones, and nerves without using surgery. For BPI patients, a physiatrist may be one of the people that help to diagnose which parts of your brachial plexus are injured. Physiatrists are often able to perform electrical nerve studies to see which nerves are injured. They may also use ultrasound to look at your nerves. These tests may also be performed by neurologists.
Psychologist or Mental Health Counselor
A psychologist will help you develop the best mindset for recovery. BPI patients often feel stress, anxiety, and uncertainty following their injury. Many patients experience a period of depression. These are completely normal responses to a BPI. While it may not make it easier at the time, it is important for you to know there are people who understand and can help. Many BPI patients say how important it is to have someone to talk to about the stress and emotions after the injury. A psychologist or mental health counselor can help you develop ways to work through and cope with the changes to your life.
Pain Management Specialist
A pain management specialist is a medical doctor that works in the treatment of pain. They may have a background in anesthesiology. BPI patients often experience pain from the injured nerves, known as “neuropathic pain.” You may also have pain from injuries to the bones and muscles that happened at the same time as your BPI. There are different kinds of medicine and methods used to treat pain. A pain management specialist will talk to you about your individual pain and help develop the best approach to treat your pain.
Radiologist
A radiologist is a medical doctor who uses images such as X-ray, CT scan, MRI, or ultrasound to diagnose an injury. You may have one or more of these tests when they diagnose or evaluate your injury. A radiologist will look at these tests with your surgeon and may also help perform the test.
Occupational Therapist (OT) or Physical Therapist (PT)
OTs and PTs will work with you to improve and maintain the ability of your joints to move, to strengthen weak muscles and to find ways to improve how you do daily activities after your injury. OTs and PTs use many methods, like stretching exercises, to prevent your shoulder, elbow, wrist, and fingers from becoming stiff as you recover from the injury. They can also make special splints to hold your joints in the best position while you recover. Since you work so closely with an OT or PT, they can also keep track and update your surgeon on your injury’s progress over time.
Social Worker
A social worker is a healthcare professional who helps you find resources after your injury. After a BPI, most patients have questions about work, finances, insurance, transportation to appointments and many other concerns. A social worker can help you understand what resources are available to you and how to apply for and use them.
BPI Diagnostic Tests
Ultrasound
- How does it work? An ultrasound uses sound waves to create a picture of your brachial plexus nerves. A wand is passed over your arm and neck to create this picture.
- How long does it take? About 20-30 minutes. It will take longer if paired with the EMG and NCS.
- What is it used for? Ultrasound is used to detect changes in the size and texture of your nerves from injuries and swelling.
- When will this happen? Likely to be done 6 or more weeks after your injury and to be paired with your EMG and NCS tests.
EMG and NCS (Electromyography [uh·lek·trow mai·aa·gruh·fee] and Nerve Conduction Studies)
- How does it work? Needles are placed into the muscles controlled by the brachial plexus. Pads are placed on the skin and small jolts of electricity are used to test your nerves.
- How long does it take? About 1 hour.
- What is it used for? The first EMG and NCS can tell your doctors which nerves are injured and how badly they are injured. Repeat tests can help track your recovery over time.
- When will this happen? The first test is done about 6 weeks after your injury to get a baseline, and it can be repeated at different times in your recovery.
Treatment and FAQs
Will I have pain after my brachial plexus injury
After a nerve injury, the nerve tries to heal itself. During this process, the nerve sends chemical signals and nutrients to the site of the injury.
In less severe injuries, these signals and nutrients are able to travel across the two ends of the injured nerve. In more severe injuries, the signals and nutrients are not able to travel across the injured nerve ends. When this happens, the nerve ends become very irritable and can cause severe pain. Each person experiences pain differently, but some patients describe that feeling as a sudden shooting pain that can “take your breath away” or can feel like an ice pick, electric shock, or a burning sensation. Some patients have described it like having a brief seizure in their arm. Pain after BPI can be highly variable and extremely individual. Be sure to let your BPI team know about what kind of pain you are having, what you have noticed makes it better, and what you have noticed makes it worse. Sometimes the pain can be treated through one of the ways listed below, but other times the cannot be reliably treated.
What are common approaches to treat pain after BPI?
Pain for BPI isn't always curable, but there are ways to treat it. Here are some ways your pain might be treated:
- Medication: There are also several medications that can help treat nerve pain. Medications that were originally used to treat depression and epilepsy can help patients with chronic nerve pain. Opioids are sometimes used to treat nerve pain, but they are usually used only if other treatments haven't worked.
- Nerve stimulators: Nerve simulators can be used to treat nerve pain by stopping the nerve impulses that lead you to feel pain. These devices try to stimulate nerve healing and reduce the irritability of the nerve ends.
- Cognitive behavioral therapy (CBT):CBT is a type of psychological treatment that can change how you experience pain and help you adjust to chronic pain (pain that has been present for a long time). This type of treatment may be recommended by a psychologist, psychiatrist, or other mental health professionals.
- Surgery:Surgery can be used to treat nerve pain, but it is not common with BPI. In some cases where the injured nerve is pinched or caught in scar tissue, surgery may be done to remove scar tissue (this is called neurolysis) or to release the pinch points (this is called decompression).
In severe BPI where nerve roots are pulled out of the spinal cord (an avulsion injury), the nerve pain can be even more debilitating. While the same treatments listed above are tried for patients with avulsion injuries, there are surgical treatments at the spinal cord that can be used if other treatments are not helpful.
What does a five-year recovery timeline look like?
Nerves take a very long time to regrow after an injury or after they have been repaired. Because nerves can take a long time to regenerate, it may take 9 to 12 months (or longer) to see some early recovery of function after surgery. The time will depend on where the nerve is repaired within the body and how far the nerve is from the target muscle.
The general approach to BPI treatment includes (1) Testing; (2) Surgery + Recovery; and (3) Therapy.
If a BPI is suspected, there will often be a period of observation to see if the nerve is likely to recover on its own without surgery. During this period of time, there may be some additional or repeat testing ordered. The amount of recovery and the results of these tests will help your team figure out whether surgery will be recommended.
At most medical centers, the initial surgery tries to get as many muscles reinnervated as possible. There is usually a waiting period of 1-2 years after the surgery to see how much recovery happens. Much of this time is spent focused on therapy exercises to improve recovery. If nerve transfers are used as part of the surgery strategy, there are specialized exercises that can help with retraining your brain to best use the nerve transfers.
After it looks like recovery from the first surgery has peaked, the BPI team will look at which functions are still difficult and what options remain. Sometimes, surgeries such as muscle transfers, tendon transfers, or selective joint fusions can be used to help patients get better function after the first surgery. The second round of surgeries may be done at the same time or the BPI team may choose to space them out over another 2-3 year period. The overall recovery after BPI can take 3-5 years.
How will this injury affect my daily life?
BPI will affect many aspects of your life. In the most severe cases of BPI, you may lose all function of your affected arm. In less severe cases, your shoulder and elbow may not work well but you may still be able to use your hand. In other cases, your shoulder and elbow work well but your hand doesn’t. Most patients with BPI struggle to do basic everyday tasks, like showering, dressing, and eating. Activities that require fine-motor skills, such as sewing or playing an instrument, are not possible for many BPI patients.
The ability to do both basic and fine tasks can improve over time with nerve regeneration. The limited arm function after BPI makes it hard for many patient to return to work, especially if their jobs involve manual labor. The nerve pain that can occur after BPI makes daily function even harder. The loss of function, nerve pain, and inability to work may make BPI patients rely on family and friends for physical, emotional, and financial support. Most BPI patients experience sadness and depression after their injury, but counseling and medication help many patients.
"Activities of daily living," or ADLs for short, are tasks you do on a daily basis. Some ADLs that may be hard to do after your injury include:
- Bathing and showering
- Personal hygiene and grooming (for example, brushing your hair)
- Dressing yourself and buttoning buttons
- Toilet hygiene
- Feeding yourself
- Walking or moving between chairs
Some other daily activities that may be hard to do include:
- Housekeeping and home chores
- Shopping for groceries and food preparation
- Holding a glass, opening a jar, or turning a doorknob
- Using a key to open a door
- Driving a car
Are there ways to make daily tasks easier after my injury?
You will likely work with an occupational therapist (OT) or physical therapist (PT) during your recovery to help you learn how to finish your daily tasks. Some OTs and PTs have additional training in hand therapy. These therapists can tell you ways to strengthen the injured arm and show you how to use the uninjured arm to help with daily activities. There are also devices that can make life easier for you, like belts and shoelaces that can be fastened with one hand.
Many brachial plexus patients find that they begin to rely on the uninjured arm and hand much more for tasks after their injury. At first you may feel very clumsy in using your non-dominant hand, but with practice you can become more comfortable doing things such as brushing your teeth or buttoning your clothes with the uninjured arm. A therapist can work with you to learn how to perform one-handed activities with your uninjured hand. Also, some patients find it helpful to use their uninjured hand to hold and position the hand on the injured side for certain activities.
Helpful equipment and assistive devices can help you better use the injured arm to perform certain tasks. You may have to get kitchen and household tools that are designed for one-handed use. There are also assistive devices that can help with tasks such as turning keys, opening jars, and even for holding the steering wheel of a car. There are some simple changes, or “hacks”, that can make everyday objects easier to use. For example, you can buy silverware or pens that have larger handles to help you hold onto them better if your grip is weak. You can place rubber bands around a glass can make it easier to hold onto. Placing a small loop keychain around a zipper can let you hook a finger into it and use the zipper without the need to pinch your fingers. These are just some of the changes that BPI patients find helpful to continue going about their day-to-day activities.
There will be trial and error involved in finding what strategies work best for you, so don’t be discouraged. A therapist can be a valuable partner in trying different strategies and equipment to give you the best use of your arm. Know that many patients have faced these challenges before, and their experience can help you find the best solutions for your needs.
How will this injury affect my friends and family?
Your friends and family may not know how to talk to you about your injury, especially if you are feeling stressed and irritable. They may be uncertain of what your abilities are, when to offer help, and what type of help to offer. You may find that you need to accept help from others, or that you are unable to do things for them the way that you used to. It is important to stay engaged with your family and friends and talk to them about any emotions you may feel. A psychologist can help you learn ways to better communicate and navigate these changes to your relationships.
How could this injury affect my finances?
BPIs can cause dramatic changes to your financial situation. This can occur due to the medical costs for treatment, loss of the ability to continue working in the same role as before the injury, loss of income if family members must take time off to help you recover, or a combination of the these. The following sections will help you better understand health insurance, disability benefits, and how your job might change after BPI.
Discussion Guide for Patients
During medical appointments, it is important to ask your BPI team about the type of injury you have, where the injury is located, and which functions are affected by the injury. The BPI team won’t be able to give you definite answers to these questions, but they can give you their opinion based on their assessment of your injury.
You should ask your team:
- What they expect for your recovery, such as the quality and type of function
- What issues you might have after successful treatment and surgery
- How long the whole process should take
- What the BPI’s team experience has been with patients who have similar injuries
- What changes you may have to make for your job or education
- Other areas that might be affected such as transportation, insurance coverage, and disability options
How to advocate for yourself as a patient
BPI is a complex topic that is hard for most patients (and even most health care professionals) to understand. BPI patients should do what they can to learn about BPI and its treatments. You can do this by asking your BPI team questions. You should also ask them what learning sources they suggest.
If you can, bring a family member or friend to your appointments so they can help you write down and remember what the BPI team says. You can also write down questions before your appointment so you remember to ask them. Most importantly, you should be comfortable asking your BPI team questions. Because BPI is so hard to treat, it is important that you and your BPI team are able to communicate openly and honestly.
How to remember what is discussed at your medical appointments
It is hard to remember all of the information discussed during an appointment. If you can, bring a friend or family member to your appointment. They can help you take notes and recall information afterward. If you have to go alone to an appointment, it might be helpful to reach out to somebody on the phone or online to discuss what was said. If you have questions or need help understanding what was said, you should reach out to your BPI team.
Health Insurance
A general overview of health insurance Some people may qualify for programs such as Medicare or Medicaid, which are medical insurance programs.
Health insurance typically pays for the medical, surgical, provided by the federal government and administered and prescription medication costs of the policyholder through state governments. Requirements for Medicaid and the policyholder's dependents. In the U.S., many are different for each state.
People get health insurance through their employer, but you can also buy an individual policy on the federal Health Insurance Marketplace (also known as Obamacare or ACA plans) or through a private insurance broker.
Important health insurance terms to know
Deductible: The amount you will pay for covered healthcare services before your health insurance begins to pay. Depending on your plan, the plan may pay part of the costs until you meet your deductible. Many plans have separate deductibles for medical services and for prescription medication benefits.
Coinsurance: Your share of the cost for a covered health service or medication. This is typically a percentage of the plan’s allowed amount for the service.
Premium: The amount you pay each month for your health insurance plan. If you receive insurance through an employer, it is typically deducted from your paycheck before you receive it.
Network: The doctors, hospitals, labs, and other health services your insurer has contracted with to deliver health care services to their policyholders.
Out-of-Network: This includes doctors, hospitals, labs, and other health service providers that your insurer does not have a contract with. Your insurer may or may not pay for services you receive from out-of-network providers. Some insurers will cover such services during an emergency, such as if you are taken to an out-of-network emergency department. In general, your insurer either will not pay for out-of-network care or they will pay a much smaller portion compared to in-person care.
Out-of-Pocket Costs: The amount you pay for health care services that aren't reimbursed, including deductibles copays, and coinsurance.
Out-of-Pocket Maximum: The maximum amount you will pay in a calendar year for out-of-pocket costs before your insurer begins paying 100% of charges for in-network, covered health care services. This amount varies by insurer and the exact plan you have. You may have separate out-of-pocket maximums for health care services and prescription medications.
Working After a Brachial Plexus Injury
Will BPI inpact my job?
It is very likely that a BPI injury will affect your ability to work, especially right after the injury and after any surgeries you may have. Depending on the severity of your BPI, the nature of your job, and your recovery progress, you may or may not be able to return to your previous job.
It is important you talk with your care team about your work tasks and what you do at work. It is especially important to have this talk with your surgeon and your occupational therapist. If you work in a high-stress or emotionally difficult job (for example, paramedics, firefighters, social workers, etc.), it may also be helpful to talk about a return to work with your pain psychologist. If you can, share any details that your employer has told you with your care team.
Some details to discuss might be:
- Will your position be held open for you and how long it can be held for?
- Have you talked to your employer about returning in a different capacity than your previous role?
- Has your employer has asked about adaptations they can make to help you return to work?
Returning to work
If you are able to return to work after your injury, it is likely that you will need a “Return to Work” prescription or instruction sheet. These forms typically include the following information:
Capabilities: These are activities you can do safely. Restrictions: These are activities that you should not do, due to the risk of hurting yourself or someone else. The most common example would be restrictions on driving or operating heavy machinery while taking pain medications which may slow down your reaction time.
Limitations: These are activities that you are not able to do.
Schedule modifications: These are changes to your work schedule. The most common example would be returning to work for shortened work days, or making sure you have enough time off for follow-up doctor appointments and OT visits.
Duration: This is the length of time for which the “Return to Work” instructions are expected to last. This might include temporary limits while you are recovering, or permanent limits on your work activities.
If you are unable to return to your previous job, and your employer is not able to put you in a different role, then you may need help finding a new job. Vocational Rehabilitation is a government program that provides job and education counseling, skill testing, and job skills training. This program is managed by each state, so the exact services and resources available will vary by location.
Workers' Compensation Programs
If you are injured on the job, your employer is responsible for the costs of your medical care, private disability payments, and potentially for costs related to vocational rehabilitation, such as tuition for education-related retraining. Employers are prohibited from discriminating or retaliating against employees who file workers' comp claims.
Disability and Social Security Benefits
If you are not able to return to full-time employment during or after your recovery, you may need to look into disability benefits to protect your finances. Both require you to be considered disabled under their criteria, which is that you are unable to work because of a medical condition that is expected to last 12 or more months. There are two types of government-funded disability programs:
Social Security Disability Insurance Program (SSDI)
- Cash benefits under this program are calculated based on your work and salary history.
- Individuals who receive SSDI are also eligible for Medicare.
- Individuals can receive SSDI until they reach the full retirement age.
Supplemental Security Income Program (SSI)
- This program requires applicants to have limited income and resources. The exact requirements are updated yearly.
- Individuals who receive SSI are also eligible for Medicaid.
- Individuals can receive SSI throughout their entire life.
- Many states offer supplemental funds to SSI recipients.
You may be eligible for one or both programs. Applying for disability is often a long, involved, and frustrating process. It can take years and multiple appeals for it to be granted. If you are considering applying, detailed current application guides are available on the Social Security Administration’s website. We encourage you to speak to your BPI team about this, and to ask about resources available through the medical system to help you navigate this process.
The Americans with Disabilities Act (ADA)
The ADA is a set of federal regulations which require reasonable accommodations to be made to facilitate daily life. For employment, ADA standards apply to all public employers and all private employers with more than 15 employees.
The ADA protects qualified individuals with disabilities from discrimination in the job application process, hiring, firing, advancement, compensation, and other aspects of employment. If reasonable accommodations can be made, such as providing a chair for employees who would otherwise be required to stand for their full work shift, the ADA dictates that they should be made. There are limitations on what accommodations can be made.
For example, an individual with uncontrolled epilepsy would not be allowed to work as a pilot due to the high risk of endangering others and themselves. If you feel you have been discriminated against by a past, present, or potential employer, you can file a complaint with the Equal Employment Opportunity Commission, who will evaluate and investigate your complaint.