Medicolegal Aspects of Disability in Narcolepsy

Narcolepsy is a severe, chronic, disabling disease affecting almost all personal and social activities. Sleep disorder specialists deal with the disabling burden of narcolepsy since their first approach to the patient. The disease continues to be a burden throughout the patient’s life as pharmacological and behavioral treatments only seldom control the variety of symptoms. Empirical data showed that from one fourth to half of people with narcolepsy are forced to modify or leave a job due to the disease, which may also cause higher absenteeism due to disability and accidents, as well as being more likely subjected to unemployment and early retirement with high social and economic costs. Excessive daytime sleepiness seems to be the main symptom associated with work disability, but cataplexy may be even more disabling in cases with many cataplectic attacks. Since people with narcolepsy experience a wide range of occupational problems, both clinicians and researchers are interested in how to help their patients to hold down a job, return to work, and, if necessary, receive benefits for work disability. This chapter considers the medicolegal aspects of work disability in narcolepsy, summarizing essential issues clinicians and researchers have to address in providing medical information to assist disability determination in people with narcolepsy.