Almost one in five people have been disciplined at work because of their diabetes, according to a British survey. In addition to facing discipline for taking time off, about one in four people said they were unfairly questioned about time they had taken off, and some had been denied time off altogether.
There are occasions when employers can ask you about diabetes, and even occasions when they are legally allowed to deny a request for accommodation. But where exactly an employer’s behavior crosses the line into discrimination territory is not always clear, especially when an employee is nervous about keeping their job. But in the US, the Americans With Disabilities Act (ADA) is very detailed about what is and isn’t discrimination, so employers have no excuse for not knowing.
Below are five workplace situations that people with diabetes should be prepared for.
1. Can my employer ask me about diabetes during the interview process?
No. In the United States, employers are not allowed to ask about medical conditions during any part of the interview process. Employers cannot ask about past or present insulin or prescription drug use, and they may not ask about past medical leave.
Employers may ask questions relating to a candidate’s ability to do the job, such as ability to work long hours or use equipment. A job applicant may choose to disclose that they have diabetes, but employers may not ask follow-up questions unless they have a reason to think the person may require an accommodation, in which case employers can only ask about the type of accommodation needed, if any.
After a job offer is made, employers may ask questions about the applicants health, and even require a medical examination, so long as all applicants are treated in the same way.
2. What if I’m hassled about taking time off from work to care for myself?
Taking time off for diabetes care is often what causes employees to experience discrimination. They may be disciplined, passed up for promotions, or even denied time off. But the Family and Medical Leave Act (FMLA) requires private employers with 50 or more employees to provide up to 12 weeks of leave a year due to serious health conditions, and that leave can be taken in small blocks of time if needed for things like managing blood sugar and medical appointments.
Employees may still be discriminated against, and in such a case they can try educating their employers and HR departments. Diabetes discrimination is often due to ignorance about the condition and what it requires. If that doesn’t work, an employee may have grounds to file charges of discrimination.
3. What if coworkers make comments about my diabetes?
To be clear, it is never appropriate for an employer to disclose your medical information to another employee, even if you have to leave work because of a diabetic episode. If someone knows that you have diabetes and you haven’t told them yourself, there’s been a breach in confidentiality.
It’s not appropriate for coworkers to make rude or ignorant comments about diabetes, even if they don’t know you have it. The ADA says, “Although the law does not prohibit simple teasing, offhand comments, or isolated incidents… harassment is illegal when it is so frequent or severe that it creates a hostile or offensive work environment…” Any offensive comments should be addressed by either talking directly to the person in question or speaking with your HR department. If comments create a hostile work environment, they qualify as harassment.
Employers aren’t allowed to permit harassment, and most have an anti-harassment policy in place. Employees who violate the policy should be disciplined according to the policy.
4. What if I do need an accommodation? What counts as “reasonable?”
All you have to do to request a reasonable accommodation is tell your manager or employer that you need a certain adjustment because of your diabetes. Someone else, like a doctor or family member, may also make a request on your behalf.
Your employer may request medical documentation when a reasonable accommodation is requested, and employers are not required to meet a request for accommodation if it creates an “undue hardship.” An undue hardship might be eliminating an essential job function, tolerating poor job performance, or making an accommodation that is overly expensive. Something like needing an extra break, being allowed to have snacks, or even switching an employee to a different position with equal status may be considered a reasonable accommodation.
5. What if my employer thinks I’m a “direct threat?”
An employer may decide not to hire, to terminate, or to restrict the responsibilities of someone with diabetes only if that person poses “risk of substantial harm to the individual or others that cannot be eliminated or reduced through reasonable accommodation.” This determination has to consider medical evidence and the likelihood and severity of potential harm. A small or speculative risk does not count as a direct threat, and an employer must first try to overcome any threat through reasonable accommodation.
For example, if Frank the truck driver receives an offer of employment, but a post-offer medical examination (that is required of all potential employees), reveals that his diabetes is not well controlled and Frank has frequent hypoglycemic episodes, the doctor may determine that he would pose a risk to himself and others if hired to drive a commercial vehicle. Based on this medical evidence, the employer could rescind their job offer.
People who want to work as commercial truck drivers, firefighters, paramedics, school bus drivers, air traffic controllers, or police officers are required to meet certain health standards if they have diabetes. The United States severely restricts military enlistment for people with diabetes, though active duty members may be allowed to stay if diagnosed while serving.
In the past, the Federal Aviation Administration (FAA) prohibited those with insulin-dependent diabetes from receiving the first or second class medical certificate required to operate an aircraft, though it was possible to receive a third class medical certificate which would allow recreational flying. As of 2015, the FAA updated the policy to note it would consider first and second class certifications for those with insulin-dependent diabetes on a case by case basis.
In the United States, over 100 million people have diabetes or prediabetes, and they provide essential job functions throughout the workforce. If employers are not ready to make workplaces diabetes-friendly, then they’ll lose out on many talented employees, and they may end up with a lawsuit. It benefits everyone involved if workplaces welcome people with diabetes and educate themselves about appropriate accommodations.
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.