Job Accommodations and Job Loss From Unilateral Vocal Fold Paralysis

Objective: Unilateral vocal fold paralysis (UVFP) is a debilitating injury that affects a person's ability to communicate and swallow. Although clinical aspects are understood, how UVFP affects a person's employment and job security is poorly characterized. This study aims to elucidate how frequently patients request job accommodations or experience job loss related to UVFP. Study Design: Cross-sectional survey. Setting: Thirty-four US tertiary care voice centers. Methods: We analyzed data from a prospective cohort of patients with UVFP recruited from 34 vocal Cord Paralysis Experience (CoPE) collaborative voice centers. Sociodemographic information, clinical and treatment history, and patient-reported outcome measures were collected. Patients also provided employment information, whether they requested job accommodations, and if they experienced job loss due to UVFP. Results: In all, 613 participants (mean age 58 years, 65% women, 84% Caucasian) enrolled in CoPE. In total, 64 (10%) had requested job accommodations, and 46 (7.5%) reported job loss due to UVFP. Women (odds ratio [OR] 2.6, 95% CI: 1.4-5.0, P =.004) and participants with higher levels of education were more likely to request work accommodations (OR 4.5, 95% CI: 1.4-14.7, P =.01). Conclusion: UVFP has major impacts on employment with 1 in 10 patients requesting job accommodations and 1 in 13 experiencing job loss. Our results raise awareness of the importance of timely, effective treatment for UVFP and should alert treating clinicians to provide support to patients who may require job accommodations.