Silent Struggles: The Challenge of Requesting Workplace Accommodations

One of the primary reasons that neurodivergent (ND) individuals often remain silent at work is because the process of requesting accommodations can be arduous, frustrating, and emotionally draining. For many of us, the support we need simply isn't available - or when it is, it comes with red tape, resistance, and a lack of understanding.

In Canada, only 26% of working-age adults with neurodivergent conditions such as ADHD, dyslexia, autism, and intellectual disabilities are employed, compared to 80% of those without disabilities (Azrieli Foundation, 2025). This statistic highlights the urgent need for systemic change and better support for ND individuals in the workforce at large.

In March of 2025, I reached out to my employer for support after several workplace meltdowns indicated to me that I was on the brink of complete burnout. It is not easy for me to be vulnerable and ask for help, so this decision was not made lightly.

I quickly found the process to be frustrating, deeply invalidating, and leading to increased emotional distress. At the same time, it was a wake-up call. I began to see just how much the workplace environment, scheduling, and social dynamics were impacting me (more on that in a future post).

What I asked for (and why):

• 1:1 nursing assignment:

  To minimize cognitive load and stress of managing multiple patients with complex, competing needs

• No patients with a known history of aggression/violence:

  Unexpected or loud interpersonal conflict can cause sensory overload and dysregulation, impacting the ability to remain grounded and safe.

• No more than 3 shifts in a row OR breaking up of shifts:

  Adequate recovery time prevents cumulative fatigue and supports emotional regulation.

• Protected breaks and flexibility to take micro-breaks:

  Breaks allow time for sensory decompression, nourishment and emotional regulation - all of which are essential for maintaining focus, mood stability, and sustained attention. Breaks also reduce cumulative stress that can lead to exhaustion and burnout over time.

• Wearing LOOP buds at work:

  These reduce auditory overstimulation while allowing for awareness of alarms and team communication.

While many of these requests are aligned with basic principles of ethical care and labor law, I quickly hit a roadblock. The disability management team asked me to clarify: were these restrictions or recommendations? I hadn't expected to make that distinction, but it matters. A restriction must be followed by the employer at all times; it’s a non-negotiable. A recommendation, on the other hand, is something the employer should try to uphold—but isn’t legally required to.

This felt like a strange and disempowering question. I was also told my accommodations needed to be “generic” rather than specific to my unit which only added to the confusion as working in a setting such as the cardiac surgery intensive care unit (CSICU) comes with very specific demands.

The disability management team suggested that I undergo a neurocognitive assessment with a psychologist of their choosing. I declined because I knew from research—and instinct—that a standard assessment wouldn’t accurately reflect the sensory and communication challenges I face on the job. I was also concerned about misdiagnosis from a provider who lacked experience in adult autism. 

Instead, I conducted my own research and found an occupational therapy (OT) clinic specializing in Functional Capacity Assessments (FCA) for autistic adults. I brought this option forward to the team, explained my reasoning, and requested funding to proceed with this provider. While the disability management team agreed to support an FCA, they would only provide funding for a clinic who they were familiar with. A clinic which lacked what I felt was sufficient experience in adult neurodivergence. I agreed to go through with it, but it felt like my comfort and lived experience were being overlooked.

It is essential for employers to consider and respect their employees' individual comfort levels when placed in vulnerable situations. For many of us who are neurodivergent, safety comes from knowing we’re being assessed by people who get it. I’m someone who does a lot of research before stepping into unfamiliar situations—especially ones as sensitive as this. It helps me feel safe if the professional who will be scrutinizing my capacity is well versed in adult autism - as misinterpretations could significantly impact the trajectory of my career as an RN.

To have that kind of vulnerability dismissed in favor of “protocol” was disheartening.

While awaiting clarity on my accommodations, I have permission for my employer to treat my proposed accommodations as recommendations. What I did not expect, was that without warning or consultation, the employer also placed new restrictions on my hours. These included cancelling all overtime I had prebooked, placing me as supernumerary on the unit (although I took a patient assignment) and prohibiting me from picking up additional shifts outside of my baseline. These limitations directly impacted my financial stability. It was added stress on top of an already emotionally distressing process.

Honestly, although I could intellectualize their motivations for these restrictions —to protect me while accommodations were still being evaluated—it felt incredibly backwards. I felt deeply frustrated. The restrictions added stress, not relief. And with increased stress comes decreased tolerance, reduced performance, and ironically, more burnout.

It was the opposite of what I needed.

Despite my frustration, I remained committed to advocating for myself.

I expressed to my disability management team that I cannot afford to reduce my work hours. They held firm, and so I chose to practice acceptance of letting go of what I could not control and redirected that energy towards what I could control - requesting a medical leave from my medical doctor (MD).

This was a hard decision to make - but it turned out to be a lifeline. The leave allowed me to apply for short-term unemployment insurance - delivering a consistent bi-weekly income that would cover my monthly bills. More importantly - it has given me time to rest. Time to begin recovering from what had become chronic burnout.

I have been on a medical leave now since mid-May, and completed my FCA in late June (I'll share more on that soon). I'm currently waiting on a follow-up meeting with my MD and disability management team to determine what comes next. I suspect my leave will be extended while we work toward a sustainable long-term plan.

At one point, I was so frustrated I seriously considered withdrawing my application for workplace accommodations altogether. But I am an incredibly tenacious person and I remained committed to seeing this through. Meaningful change often doesn't come without resistance or risk. I refused to abandon my self-advocacy just because the road is hard. I knew that long-term, whatever the outcome, it would be worth the fight - not just for me, but for others, too.

There is nothing unreasonable about seeking support in the workplace. What is unreasonable is the expectation for neurodivergent individuals will continue conforming to a system that was not designed with us in mind.

Despite everything, I still believe this process matters. Advocacy isn’t just about getting personal needs met—it’s about making space for others. It’s about changing the culture. And I’m here for that.

However difficult this journey has been, I see it now as an opportunity—one that goes beyond me. Each step I take is part of a larger movement toward creating truly inclusive environments. Advocacy isn’t just about accommodations - It’s about changing the culture.

And I’m here for it.

 Sources:

Azrieli Foundation (2025). https://azrielifoundation.org/media/embracing-neurodiversity-will-build-a-more-prosperous-canada-but-the-onus-on-inclusivity-falls-upon-all-of-us/