Should You Tell Your Employer You Have Essential Tremor?

Involuntary hand tremors range from a minor nuisance to a full-on impairment, but they are a fact of life for millions who have a movement disorder called essential tremor (ET). Shaky hands affect all daily activities. Research suggests that ET is a progressive neurological condition, meaning it is expected to become more pronounced over time, and possibly begin to affect other parts of the body.

If you work outside of the house, you can’t leave “the shakes” at home when you head to your job. They accompany you no matter where you are. Although the onset of ET can occur at any age, its prevalence increases as people age. When you first entered the work force, possibly you had no sign of tremors. You were hired because you were the most qualified candidate. But most jobs involve hands.

When symptoms first appear, mild and sporadic tremors can often be disguised or compensated for. If they worsen, however, it becomes challenging to conceal them and the way they affect your performance. At what point do you reveal your diagnosis to your employer?

Considerations before full disclosure

It’s important to think twice before sharing personal or medical information with a boss. You can’t predict how you will be perceived, and once you share your diagnosis you can’t “unsay” it. Will you suddenly be under scrutiny to see how well you’re working? Will your confidentiality be honored? Will co-workers resent you if your boss makes extra allowances for you? Will it go on your record and affect your future employability? Will you lose your job? It is natural to worry about these and other potential scenarios, but there are very good reasons for opening up to your employer.

You are protected by law

You are safer than you may realize. Legally, ET is a disability that qualifies you for equal rights protection under the Americans for Disability Act (ADA) of 1990. Under this law, a disability is defined as “a physical or mental impairment that substantially limits one or more major life activities…”i If your ET reaches a stage in which it interferes with your responsibilities, the ADA guarantees your right to equal opportunity without being discriminated against. For companies with 15 or more workers, it requires employers to “…offer accommodations to qualified employees with physical or mental disabilities that allow them to perform essential job functions unless the accommodation would impose an ‘undue hardship.’”ii

When is the right time? Keep in mind that the decision to open up about ET is very personal, and if you never want to talk with your boss about it, you don’t have to. However, such privacy could come at the price of sacrificing your legal protection. If your work suffered to the point at which your boss took action against you—even going so far as to firing you—it will not serve you to explain your disability after the fact. The consequence will hold up against legal action on your part. Thus, consider disclosing well in advance of such situations as:

  • Experiencing work-related difficulties that could be handled by employer-provided assistive technologies and devices, which they would be obligated to provide, or
  • Compromised safety if your work involves using tools or machinery that could put you or someone else at risk

There is also another price in terms of your emotional energy. It is draining to hold a secret, and to put energy into camouflaging a disability no matter how small it is. Be confident that if you have consistently demonstrated that you bring value to the company, office, bank, factory—whatever—it’s in your boss’ best interest to keep you on the job. You may be surprised at the level of support, understanding, and logistical help you receive. It’s not just because the ADA says they have to, it’s because it will cost the boss more aggravation and lost work time to have to replace you.

Tips for sharing your ET with your employer

When the time is right, here are some tips:

  1. Before saying anything, familiarize yourself with the ADA and the employee handbook if there is one. Also, “…come up with a list of answers to questions—and before listing duties you don’t feel comfortable performing.”iii
  2. How you communicate about ET sets the tone and expectations. If you speak factually and without undue emotion, it’s easier to make the point that tremors might alter HOW you do the work, but they don’t lessen the fact that you DO the work, on time, and up to standards. Also, avoid saying more than is necessary. Keep it practical and professional.
  3. Offer concrete solutions that you know will help you. Don’t assume that your boss or the HR department knows what resources are available to help with tremors.

Bear in mind that in choosing to share your situation with your employer, you are creating an opportunity to also raise awareness, so being armed with correct information is important. The International Essential Tremor Foundation is a good place to start. Check out their “ET Awareness” button, and their “Coping with Essential Tremor” button on their homepage. Chances are they’ve already laid the groundwork for a constructive conversation and an improved job performance. Deciding to open up may be one of your best investments in career satisfaction.

ii Pompilio, Natalie. “Full Disclosure.” Brain & Life, Dec. 2019-Jan. 2020, 32-34.
iii Shumer, Lizz. “How to Disclose a Disability to Your Employer (and Whether You Should). The New York Times, July 10, 2019.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.

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