How do I keep working with RSI or hand pain? (US)
Quick answer: Tell your manager what you need in plain words and ask for specific changes, such as different equipment, a lighter typing load or a modified schedule. In the US, the ADA can require employers with 15 or more employees to provide reasonable accommodations for a disability, and the Job Accommodation Network (JAN) gives free, confidential guidance. Get a doctor's view first if you can. This page is general information, not legal advice.
Health note: This page is general information, not medical advice. If you have numbness, weakness, night pain or symptoms after an injury, see a doctor first. When to see a doctor
Should I tell my manager?
It is your choice, but telling someone early usually gives you more options. CCOHS says the first signs of pain, numbness or tingling mean muscles and tendons need rest, and that early response matters because injuries can become long-lasting. A change made early is easier than a crisis later.
You do not have to share your full medical history. Say what hurts, what makes it worse and what would help. Keep it about the work: "Typing for long stretches makes my forearms hurt. I need to change how I do some tasks."
What can I ask for?
Ask for concrete things. A vague request is easy to postpone. Here are some options:
| Request | Example |
|---|---|
| Equipment | A different keyboard or mouse, a chair or desk that adjusts, a monitor at the right height |
| Setup help | An ergonomic assessment of your desk |
| Task changes | Less typing-heavy work for a while, or other tasks mixed in |
| Schedule | Shorter blocks of typing, more breaks, or a modified schedule |
| Voice input | Speech-to-text software for long documents |
| Time away | Leave for treatment or recovery |
Our pages on desk setup and typing breaks can help you decide what to ask for.
For elbow tendon pain in physical jobs, a review of occupational factors suggests changing the workload. This is about elbow tendon pain and manual work, not desk work.
"Workload modification should be considered, especially in manually strenuous jobs." — Rahman Shiri and Eira Viikari-Juntura, researchers, Lateral and medial epicondylitis: role of occupational factors, Best Practice & Research Clinical Rheumatology, February 2011
What does US law say?
The ADA is a US law. Its employment rules apply to employers with 15 or more employees, and federal employees are covered by the Rehabilitation Act instead. Under the ADA, an employer must provide a reasonable accommodation to a qualified employee with a disability, unless it would cause undue hardship. The EEOC says the definition of disability is construed broadly, in favor of extensive coverage, since the 2008 amendments. Some EEOC guidance pages, including the accommodation guidance linked below, were written in 2002 before those amendments, so they may describe coverage more narrowly than it works today.
The EEOC describes an accommodation as any change in the work environment or in the way things are customarily done. Examples include job restructuring, modified or part-time schedules, modified workplace policies and leave. Employers do not have to remove essential job functions.
Whether your condition counts as a disability depends on your facts, and this page cannot tell you that. A doctor, an employment lawyer or the EEOC can. State and local laws may add more protection.
How do I make the request?
You do not need special words. The EEOC says a request can be in plain English, spoken or written, and does not need to mention the ADA. A health professional or family member can make it for you. It starts an interactive process, in which you and your employer look for a solution together.
The employer can ask for documentation about the disability and the need for an accommodation when these are not obvious, but only what is necessary. Asking for your full medical records rarely meets that test. A short note from your doctor about what to avoid or change is often a useful start. Writing the request down helps you keep a record. JAN says an employer can try an accommodation for a trial period and should check that it works, so you can offer a trial and agree to review it.
JAN's own guidance describes its service as free, confidential technical assistance on accommodations and the ADA. You can ask JAN for ideas before you talk to your employer. JAN's sample forms are general guides, not legal advice.
What if I need time off?
Leave can be a reasonable accommodation. The EEOC guidance says an employee should use accrued paid leave first, then unpaid leave if needed. Leave also interacts with the FMLA, which is judged separately from the ADA. Ask HR which rules apply to you.
What if my employer says no?
The employer may choose among effective accommodations, but the EEOC says your preference gets primary consideration. If one option is refused, propose another. An employer can refuse if an accommodation would cause undue hardship, which means significant difficulty or expense judged for that employer. Delays can also be a problem, because employers must respond promptly.
If you hit a wall, you can read the EEOC's page or contact the EEOC or an employment lawyer. Keep your emails and notes.
Can dictation help me keep working?
Sometimes. If much of your work is writing, dictation can let you draft long text by voice and rest your hands. You still need to check and correct the text, and some tasks still need a keyboard and mouse.
Dictop is a dictation app for Mac, iPhone and iPad. Its speech models run on your device. It has a 30-day free trial, then costs US $6.99 once with no subscription (US App Store; regional prices vary). It is meant to help you type less and keep working while you recover. It does not treat or prevent pain. See Dictop for Mac, Dictop for iPhone and iPad and how to dictate on Mac.
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By Dictop · Reviewed