Accommodating Employees with Tonic‑Clonic Seizures at Work

When a colleague experiences a tonic-clonic seizure on the job, it can feel shocking-but with the right plan, it doesn’t have to derail productivity or morale. This guide walks HR professionals, managers, and team members through what a tonic‑clonic seizure is, the legal framework that protects workers, and practical steps to keep everyone safe and supported.

What Exactly Is a Tonic‑Clonic Seizure?

Tonic‑clonic seizure is a type of generalized seizure that involves a loss of consciousness followed by rhythmic muscle stiffening (tonic phase) and then rapid jerking (clonic phase). It typically lasts one to three minutes, after which the person enters a post‑ictal state that may involve confusion or fatigue. Tonic‑clonic seizures are the most recognizable form of epilepsy, affecting roughly 1 in 100 people worldwide.

Legal Landscape: Rights and Responsibilities

In the United States, the Americans with Disabilities Act (ADA) requires employers to provide reasonable accommodations for employees with epilepsy, provided the work essential functions can still be performed. In the UK, the Equality Act 2010 serves a similar purpose. Both statutes obligate employers to engage in an interactive process-meaning you must talk openly with the employee to figure out what works.

The Occupational Safety and Health Administration (OSHA) also expects workplaces to maintain a safe environment for all staff, which includes developing emergency response procedures for medical events.

Step‑by‑Step: Building a Seizure‑Ready Workplace

1. Gather Information: Ask the employee to share a brief medical summary (with consent) that outlines seizure frequency, triggers, and any prescribed medication. A neurologist’s note can help clarify the level of risk.
2. Conduct a Risk Assessment: Walk through the employee’s typical duties and identify high‑risk tasks (e.g., operating heavy machinery, climbing ladders). Note any locations where a seizure could pose a danger to the individual or others.
3. Develop a Seizure Action Plan: Create a concise document that lists:

• Who to alert (supervisor, designated first‑aid responder)
• Preferred positioning (side‑lying if possible)
• Medication timing (e.g., rescue benzodiazepine)
• Any required post‑seizure rest period

Store the plan in an easily accessible digital folder and give a printed copy to the employee’s direct manager.

4. Train Staff: Conduct a short, 15‑minute training session for coworkers on how to recognize a tonic‑clonic seizure and what to do. Emphasize that the person should not be restrained and that mouth‑to‑mouth breathing is not required.
5. Adjust the Physical Environment: Keep pathways clear, provide adequate lighting, and consider a safe, low‑stimulation work area if bright lights or loud noises are known triggers.
6. Offer Flexible Scheduling: Allow for medication breaks, a brief recovery period after a seizure, or the option to work remotely on days when seizure frequency is higher.
7. Leverage Employee Assistance Programs (EAP): Ensure the worker knows how to access counseling, stress‑management resources, or medication‑adherence support through the company’s EAP.
8. Document Everything: Keep written records of accommodations offered, training completed, and any incident reports. This protects both the employee and the organization.

Accommodation Options at a Glance

Communicating with the Employee

Respectful dialogue is the cornerstone of a successful accommodation plan. Ask open‑ended questions like, “What changes make you feel safest while you’re on the job?” and avoid assuming you know the best solution. Confidentiality matters-keep medical details between HR, the employee, and any direct supervisors who need to know for safety reasons.

Encourage the employee to update the team if seizure frequency changes. A dynamic approach prevents misunderstandings and ensures that accommodations stay relevant.

Handling a Seizure in Real Time

Even with precautions, a seizure can happen. Here’s a concise checklist for coworkers:

1. Stay calm and clear the area of sharp objects.
2. Note the time the seizure started.
3. Gently turn the person onto their side (recovery position) if safe to do so.
4. Do not restrain the individual or place anything in their mouth.
5. Call emergency services if the seizure lasts longer than five minutes, if it’s the first seizure, or if the person does not regain consciousness after the episode.
6. Notify the employee’s designated contact (manager or safety officer) as soon as the seizure ends.

Afterward, offer reassurance, a glass of water, and a quiet space to recover. Document the incident in the seizure log and review the action plan with the employee to see if any tweaks are needed.

Returning to Full Duties: What to Expect

Most people with well‑controlled seizures can perform their regular duties after a short recovery period. However, the timeline can vary:

• Minutes to hours: Post‑ictal fatigue may require a brief rest.
• Days: If a medication adjustment is needed, a temporary reduction in workload might be appropriate.
• Weeks: In rare cases where seizure frequency spikes, a gradual return‑to‑work plan with reduced hours can help the employee regain confidence.

Keep the lines of communication open, and involve occupational health professionals if you’re unsure about the employee’s readiness.

Key Takeaways

Accommodating employees who experience tonic‑clonic seizures isn’t about special treatment-it’s about creating a safe, inclusive environment where everyone can thrive. By understanding the medical basics, complying with legal standards, crafting a clear action plan, and fostering open communication, businesses can protect their staff while maintaining productivity.