The Impact of Governmental and Workplace Measures on the Employment Sustainability of Chronically Ill Individuals

Mona-Elisa Eberharter ^*

1. Privatuniversität Schloss Seeburg, Faculty of Business Administration, Seeburgstraße 8, 5201 Seekirchen am Wallersee, Austria

* Correspondence: Mona-Elisa Eberharter

Academic Editor: Fabrizio Stasolla

Received: November 03, 2025 | Accepted: February 09, 2026 | Published: February 12, 2026

OBM Neurobiology 2026, Volume 10, Issue 1, doi:10.21926/obm.neurobiol.2601324

Recommended citation: Eberharter ME. The Impact of Governmental and Workplace Measures on the Employment Sustainability of Chronically Ill Individuals. OBM Neurobiology 2026; 10(1): 324; doi:10.21926/obm.neurobiol.2601324.

© 2026 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

1. Introduction

Multiple sclerosis (MS) is a disease that causes chronic inflammation in the central nervous system, which can result in physical as well as cognitive deficits [1]. The number of people with MS is stated worldwide at 2.8 million [2], with an average prevalence of 36 per 100,000 population. Furthermore, in the number of MS cases, a divide in North-South is clearly visible [3]. MS primarily affects people in their working age (20 to 40 years), resulting in individual burden and economic costs associated with the effects on human capital in society. Fatigue is the most frequently cited physical symptoms that lead to early retirement, followed by visual problems and emotional aspects (demographic characteristics, work environment, or financial dependence). Generally, patients characterise physical and cognitive symptoms as crucial in determining whether they can remain in the workforce [4].

In Germany, MS is a major driver of the financial burden on pension, long-term care, and health insurance. This can be justified by early disease diagnosis and the risk of progressive disease [5]. 11.5% of patients with MS who suffer from a milder form of the disease (Expanded Disability Status Scale of 0-3) request disability retirement in Austria, which has a significant impact on the socio-economic effect on the health insurance and early retirement [6]. Additionally, nearly half of the costs associated with MS are attributable to reduced work productivity. Another study estimates the indirect costs of MS at $1.5 million per patient, which is four times those of a healthy counterpart [4]. For patients with multiple sclerosis, long-term absence due to invalidity or early retirement results in annual costs of €6,735 for those with a mild disease course (EDSS 0-3), €14,924 for a moderate course (EDSS 4-6.5), and €18,676 for a severe course (EDSS 7-9) [6]. These figures can be compared with data on indirect costs in Germany, which are estimated at approximately €4,500 to €19,000 per MS patient per year, depending on disease severity [7].

In Austria, various government measures of support are available for individuals with multiple sclerosis (MS) and other chronic illnesses. However, there is insufficient data on their effectiveness in helping patients maintain their work capacity. A study involving experts in social and health services who work with affected individuals highlighted the importance of tailoring job classifications to meet patients' specific needs. Furthermore, it is essential to promote the implementation of strategies to reduce workplace fatigue [8].

The objective of this study is to analyse support measures from the government and companies, aimed at preserving the work capacity of individuals with multiple sclerosis. The emphasis is on evaluating existing governmental and workplace support offerings in Austria and identifying potential approaches to improvement and expansion, to effectively assist as many affected individuals as possible and providing them with appropriate measures. Given the qualitative design, this study does not estimate causal effects. Rather, it synthesizes stakeholder perspectives on needs, gaps, and feasible improvements. The study results should serve as a first step for other European countries and other chronic diseases to help maintain the long-term ability to work of those affected.

2. Methodology

2.1 Study Design

A two-stage qualitative interview study was conducted. In the first stage, problem-centered qualitative interviews were held with experts from the health and social care sectors who work with individuals affected by multiple sclerosis (MS). The second stage involved qualitative biographical interviews with patients [9]. A purposive sampling approach was employed to capture the greatest possible diversity between both the experts and individuals with multiple sclerosis.

2.2 Participants and Sampling

2.2.1 Expert Sample (Stage 1)

For the expert group, diversity was ensured by considering: experience working with people with MS, gender, urban versus rural settings, and a variety of professional backgrounds and institutions. These included medical and rehabilitation services, employee protection and labour law, financial support and insurance, scientific research, and associations and self-help groups.

Expert professions: Department of a federal ministry; regional self-help group; local office of the Chamber of Labour; local office of the Pension Insurance Institution; nursing care center; physiotherapist specializing in MS; rehabilitation center A; Multiple Sclerosis Society; MS Center.

2.2.2 MS Sample (Stage 2)

The group of individuals with MS varied based on gender, age, place of residence, industry, level of education, work activity, age at diagnosis, current employment status, medical treatment (medication), progression of symptoms and disease, and years of work completed. The primary criterion for inclusion was that participants were currently employed or had previously been employed, enabling them to provide a realistic assessment of the work situation for individuals with MS. To address work history explicitly, participants were required to have been employed and to have a diagnosis of MS.

Participant characteristics are summarized in Table 1.

Table 1 Participant characteristics.

A total of 43 experts from various institutions were identified and contacted multiple times via phone and email. Among these, eight experts declined to participate, citing insufficient knowledge about support programs for individuals with multiple sclerosis (MS). Despite several follow-ups, 21 experts did not respond. Ultimately, 14 experts agreed to take part in the study; however, four were unable or chose not to comment on specific topics. With 10 experts fully participating, the study successfully achieved its diversity goals.

Participants with MS were recruited via a social media platform, yielding 42 volunteers. After reviewing the demographic data, 20 individuals were selected for inclusion in the study, and telephone interviews were subsequently conducted with them.

2.3 Data Collection and Interviewer Effects

The studies were conducted using qualitative content analysis as described by Mayring [10], with a particular emphasis on summary content analysis [10]. Utilizing software MAXQDA for data analysis, data from both studies were compared to extract key findings from the interviews. All interviews (expert and MS participants) were carried out by the same researcher to ensure consistency; thus, there was no unequal distribution of interviews across interviewers. To uphold rigor, the primary author coded and analysed all data [11]. Individual participants' information was anonymized to protect confidentiality. Potential bias due to single-researcher interviewing and coding was mitigated by using a structured interview guide and transparent category development; nevertheless, interviewer and coder subjectivity remains a qualitative study limitation.

3. Results

The results of these two qualitative studies were compared and summarized. The focus was placed on both state and workplace support measures. The key results are summarized in Table 2:

Table 2 Overview of governmental and workplace support measures.

To reduce repetition, detailed illustrative examples are summarized here and referred to in the Discussion rather than repeated across sections. Key themes included: (1) easier access and clearer navigation of governmental support; (2) rehabilitation and MS-specialist capacity building (occupational therapy; MS specialist nurses); (3) fatigue-sensitive work design; (4) structured return-to-work processes; and (5) psychosocial workplace factors such as disclosure, stigma, and mental health support.

4. Discussion

4.1 Contribution to Organizational and Health Research

The results of this two-stage study contribute to the international research literature on maintaining the work ability of people with MS by synthesizing perspectives from both system-level stakeholders (experts) and affected employees. The study extends prior work on work retention and employment status in MS by detailing how Austrian stakeholders perceive the fit and feasibility of governmental and workplace measures [12,13,14].

4.2 Addressing the “Impact” Versus Qualitative Inference

Because the present study is qualitative, the findings should be interpreted as stakeholder-derived evidence on perceived needs, barriers, and promising measures rather than as causal estimates of effects. This distinction is important when translating the results into policy or organizational interventions.

4.3 Role of Healthcare Providers and Occupational Physicians

A key cross-cutting implication is the stronger integration of healthcare providers – particularly occupational physicians/occupational health services – into return-to-work planning and job accommodation. Occupational physicians can (i) assess functional limitations and fatigue patterns, (ii) advise on reasonable accommodations, (iii) coordinate graded return-to-work plans and reintegration agreements, and (iv) provide a trusted confidential interface between employee and employer – especially relevant when disclosure is difficult.

4.4 Disclosure, Stigma, and Mental Health as Gaps in “Classic” Measures

Respondents described that many workplace measures target physical work design (hours, tasks, workplace adjustments) but less often address psychosocial barriers. Concerns about stigma and uncertainty about when/how to disclose a diagnosis may delay support until symptoms become more visible, which can reduce the feasibility of early accommodations. In addition, mental health strain (e.g., stress related to unpredictability, fear of job loss, or workplace conflict) emerged as a relevant contextual factor that is not sufficiently covered by standard adjustment measures. Therefore, workplace interventions should be complemented by: stigma-sensitive communication, manager training, confidential counselling pathways, and clear guidance on disclosure options and employee rights.

4.5 Reducing Fragmentation via Navigation Support

Consistent with the reported lack of knowledge about support options, the study supports the need for a central contact point to reduce fragmentation and improve access to vocational rehabilitation and financial support. This complements the broader evidence base indicating that employment retention in MS is influenced by both individual symptoms and environmental/contextual factors [12,14].

4.6 Contribution to Practice

Practically, the findings suggest that maintaining work capacity in MS requires bundled interventions rather than isolated measures. The most actionable directions include: (1) improving access and navigation of governmental programs; (2) scaling rehabilitation resources and MS-specialist roles; (3) implementing fatigue‑sensitive work organization; (4) formalizing return-to-work processes (e.g., reintegration agreements); and (5) embedding occupational health and psychosocial supports (disclosure guidance, anti-stigma approaches, mental health pathways). This responds directly to the reviewers’ observation that not all patient demands are covered by the measures described.

4.7 Limitations and Future Research

The study is limited by its qualitative design, country context (Austria), and sample size; therefore, transferability should be assessed on a case-by-case basis. Future research should evaluate implementation outcomes (uptake, feasibility, satisfaction) and, where appropriate, quantitatively assess associations between specific measures and employment outcomes.

5. Conclusion

Integrating existing governmental and workplace support measures with the proposed optimizations and additions from both MS patients and experts could substantially reduce disease-related absences and limitations, ultimately aiding individuals with MS in maintaining their work capacity. Participants advocated for less stringent criteria for state assistance approval, the centralization of facilities for individuals with disabilities, and a transfer of disability support responsibilities to the federal government.

A crucial element of this support framework is the establishment of a central counselling service, accessible to individuals with MS for any inquiries they may have. Moreover, implementing a system with specialized nurses for MS as primary contact points—either in place of or alongside MS physicians-could provide valuable information and support post-diagnosis, particularly concerning work-related activities and care.

Maintaining work capacity also depends on targeted funding for rehabilitation programs and financial support for both rehabilitation and personalized therapies. Increasing the use of occupational therapies and providing outpatient rehabilitation could improve access to health-promoting exercise sessions for MS patients.

Furthermore, both experts and MS patients highlighted the importance of strong collaboration between healthcare providers, labour market services, and employers, including occupational physicians/occupational health services, to create suitable job opportunities. Specific training for staff involved in vocational rehabilitation was also recognized as beneficial for patients with MS. The discussion examined the German "partial pension" system for potential adaptation in Austria, along with other interview recommendations that warrant further investigation.

In summary, the combination of current governmental and workplace support measures and the proposed enhancements from MS patients and experts offers significant potential for reducing disease-related absences and limitations, thereby preserving work capacity. The approaches identified in this study require further research for effective implementation.

Author Contributions

The author did all the research work of this study.

Competing Interests

The author has declared that no competing interests exist.