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are covered employers may need to seek expert advice. In the UK this can be obtained from
Health and Safety Executives and the Employment Medical Advisory Service.

Pension schemes
Many employers may believe that new recruits to their pension schemes should have high
standards of health. This is not the case, however. If a person is suitable for employment then
they are suitable for a pension scheme. Large company schemes are usually based on a group
policy with no requirement for individual health criteria to be met.

Disclosure
Many people with epilepsy choose not to declare their epilepsy to their existing or prospective
employers. Those who are more likely to have seizures during the working day are more
likely to declare it than those whose epilepsy is in remission or occurs during sleep. The
Health and Safety at Work Act (1974) requires that both employers and employees declare
factors which might prejudice the safety of employees and epilepsy is regarded as a relevant
factor. A failure to declare can result in instant dismissal which would not be considered
unfair if brought before an industrial tribunal.

Overcoming employment disadvantages

Legislation
Some protection from discrimination in employment is afforded by legislation which
stipulates that people with disabilities are given equal rights to employment. In 1995, in line
with several other European countries, the Disabilities Discrimination Act was introduced in
the UK. It is too soon to judge what impact this will have on recruitment but similar
legislation in the US has been successfully tested in the courts by people with epilepsy.
Shortcomings of this legislation for people with epilepsy have recently been highlighted12.

Adequate assessment
When assessing employment prospects, many factors need to be considered. Too often, most
focus is placed on seizure-related factors. While the timing, frequency and nature of attacks
is important, these may actually not be the most relevant. A person’s skills, qualifications and
work experience will be crucial. In addition, some inquiry into a person’s understanding and
attitude toward his or her epilepsy may be helpful. A prospective employee’s ability to
present his or her own seizures in an appropriate and reassuring way can do much to allay the
employer’s concerns.

Difficulties obtaining relevant qualifications or maintaining employment may reflect an
underlying cognitive difficulty. A thorough neuropsychological assessment may help to
identify any problems that may be amenable to intervention, perhaps via a change in
medication, which should be taken into account when advising on career options.

Training, counselling and placement
Unrealistic employment aspirations can be prevented by accurate guidance concerning career
options. Counselling and training is vital to provide input on job presentation skills and the
role of psychosocial factors. Most people with epilepsy do not have access to specialist
epilepsy rehabilitation services and must rely on mainstream resources. Existing research
indicates that employment training schemes aimed specifically at people with epilepsy
generally achieve better results than more generic schemes. Components of these
programmes include neuropsychological assessment, vocational training, interview
techniques (including disclosure) and specialist placement and post-placement programmes.