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Multiple sclerosis (MS) is a progressive disorder of the central nervous system producing a varied range of symptoms affecting physical, cognitive, and sensory functioning. The variability and unpredictability of impairments, their duration and intensity on a day to day basis, and ongoing health impacts present formidable challenges to securing and maintaining employment. Research suggests, despite having recent and extensive work histories, as many as 70-80 percent of individuals with MS are unemployed after diagnosis. For women with MS, the challenge of negotiating paid and non-paid work responsibilities often leads to difficult choices about how to navigate these changing lifeworlds. For this reason, some women have explored non-standard work approaches such as self-employment, home-based work, and telework as alternatives to standard wage and salaried employment. This case study examines how women with MS navigate barriers to employment, strategies used to create alternative work options, and the ways in which intersecting social identities are renegotiated in the process. These work experiences are situated in the context of a changing new economy, state and economic restructuring processes, and the increasing privatization of public sector services. Understanding how the lives of women with MS are affected in alternative work contexts enables us to better identify how and if emerging employment strategies are empowering to women and whether they should be supported more vigorously at a policy level. Findings indicate alternative employment approaches offer increased flexibility, an opportunity for greater work-life balance, and the possibility for generating additional income that can be packaged with other income sources. However, these work strategies often place undue responsibility for success or failure on the woman with MS without accounting for complex social, economic, programmatic, and policy factors that equally impact the viability and sustainability of these options.