Diabetes and Employment

diabetes-at-work

Surviving Diabetes at Work: Keeping yourself healthy while at work

It was once common practice to restrict individuals with diabetes from certain jobs or classes of employment solely because of the diagnosis of diabetes or the use of insulin, without regard to an individual’s abilities or circumstances.

Employment decisions should not be based on generalizations or stereotypes regarding the effects of diabetes. The impact of diabetes and its management varies widely among individuals.

Questions are sometimes raised by employers about the safety and effectiveness of individuals with diabetes in a given job.

When such questions are legitimately raised, a person with diabetes should be individually assessed to determine whether or not that person can safely and effectively perform the particular duties of the job in question.

Application of blanket policies to individuals with diabetes results in people with diabetes being denied employment for which they are well qualified and fully capable of performing effectively and safely.

The word “diabetes” can lead employers to concerns about reliability and productivity, thereby influencing their willingness to hire, continue to employ or promote an individual living with diabetes.

Also, coworkers who lack information about diabetes can feel uncertain about how to treat their colleagues with diabetes who are testing their blood glucose, administering insulin and treating hypoglycemia throughout the workday.

Therefore, it is not uncommon for people living with diabetes to conceal their disease from their employers and colleagues in order to avoid negative reactions or discrimination.

As a result, an insulin injection may be missed, a blood glucose test forgotten or a meal postponed, consequently jeopardizing an individual’s overall health and perhaps his or her safety on the job.

An individual with well managed diabetes, and whose employer encourages his or her diabetes management in the workplace, does not pose any more threat to his or her colleagues or to the efficient operation of a business.

It is important that everyone in the workplace has accurate information about diabetes and how it is managed.

Communication, cooperation and accurate information will encourage a healthier and more productive environment.

 1.EVAULATING SAFETY RISK OF EMPLOYEES WITH DIABETES

Employers who deny job opportunities because they perceive all people with diabetes to be a safety risk do so based on misconceptions, misinformation, or a lack of current information about diabetes.

The following guidelines provides information for evaluating an individual with diabetes who works or seeks to work in what may be considered a safety-sensitive position.

1A.Safety Concerns

sakety-at-work

Safety at Work

The first step in evaluating safety concerns is to determine whether the concerns are reasonable in light of the job duties the individual must perform.

For most types of employment (such as jobs in an office, retail, or food service environment) there is no reason to believe that the individual’s diabetes will put employees or the public at risk.

In other types of employment (such as jobs where the individual must carry a firearm,work with chemicals or operate dangerous machinery) the safety concern is whether the employee will become suddenly disoriented or incapacitated.

Such episodes, which are usually due to severely low blood glucose (hypoglycemia), occur only in people receiving certain treatments such as insulin or  sulfonylureas and even then can occur infrequently depending on the individual.

Workplace accommodations can be made that are effective in helping the individual to manage his or her diabetes on the job and avoid severe hypoglycemia.

1B.What Should I Do If Someone Experiences Hypoglycemia Attack At Work?

does-and-donts-of-hypoglycaemia

DO S DON TS OF HYPOGLYCEMIA

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1C. Hyperglycemia

 

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In contrast to hypoglycemia, high blood glucose levels (hyperglycemia) can cause long-term complications over years or decades but does not normally lead to any adverse effect on job performance.

The symptoms of hyperglycemia generally develop over hours or days and do not occur suddenly. Therefore, hyperglycemia does not pose an immediate risk of sudden incapacitation.

While over years or decades, high blood glucose may cause long-term complications to the nerves (neuropathy), eyes (retinopathy), kidneys (nephropathy), or heart, not all individuals with diabetes develop these long-term complications.

Such complications become relevant in employment decisions only when they are established and interfere with the performance of the actual job being considered.

Evaluations should not be based on speculation as to what might occur in the future.

Job evaluations should take high blood glucose levels into account only if they have already caused long-term complications such as visual impairment that interfere with performance of the specific job.

Prevention of hyperglycemia for people with a diabetes is a matter of good self-monitoring and management of blood glucose levels.

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1D. Employment Safety Risk Assessment For Diabetics 

When an individual with diabetes is assessed for safety risk there are several aspects that must be considered.

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 2.ACCOMMODATING EMPLOYEES WITH DIABETES

 

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Individuals with diabetes may need certain changes or accommodations on the job in order to perform their work responsibilities effectively and safely.

Employment laws require the provision of “reasonable accommodations” to help an employee with diabetes to perform the essential functions of the job .

Although there are some typical accommodations that many people with diabetes use, the need for accommodations must be assessed on an individualized basis .

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3.May an employer ask a job applicant whether she has or had diabetes or about her treatment related to diabetes before making a job offer?

No. An employer may not ask questions about an applicant’s medical condition or require an applicant to have a medical examination before it makes a conditional job offer. This means that an employer cannot legally ask an applicant questions such as:

whether she has diabetes or has been diagnosed with diabetes (for example, gestational diabetes) in the past;

whether she uses insulin or other prescription drugs or has ever done so in the past; or,

whether she ever has taken leave for medical treatment, or how much sick leave she has taken in the past year.

Of course, an employer may ask questions pertaining to the qualifications for, or performance of, the job, such as:

whether the applicant has a commercial driver’s license; or

whether she can work rotating shifts.

4.What may an employer do when it learns that an applicant has or had diabetes after she has been offered a job but before she starts working?

When an applicant discloses after receiving a conditional job offer that she has diabetes, an employer may ask the applicant additional questions such as how long she has had diabetes; whether she uses insulin or oral medication; whether and how often she experiences hypoglycemic episodes; and/or whether she will need assistance if her blood sugar level drops while at work.

The employer also may send the applicant for a follow-up medical examination or ask her to submit documentation from her doctor answering questions specifically designed to assess her ability to perform the job’s functions safely.

Permissible follow-up questions at this stage differ from those at the pre-offer stage when an employer only may ask an applicant who voluntarily discloses a disability whether she needs an accommodation to perform the job and what type.

An employer may not withdraw an offer from an applicant with diabetes if the applicant is able to perform the essential functions of the job, with or without reasonable accommodation, without posing a direct threat (that is, a significant risk of substantial harm) to the health or safety of himself/herself or others that cannot be eliminated or reduced through reasonable accommodation.

5.Are there any instances when an employer may ask an employee with diabetes about his/her condition?

Yes. An employer also may ask an employee about diabetes when it has a reasonable belief that the employee will be unable to safely perform the essential functions of his job because of diabetes. In addition, an employer may ask an employee about his diabetes to the extent the information is necessary:

To support the employee’s request for a reasonable accommodation needed because of his/her diabetes.

To verify the employee’s use of sick leave related to his/her diabetes if the employer requires all employees to submit a doctor’s note to justify their use of sick leave.

To enable the employee to participate in a voluntary wellness program.

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6.Keeping Medical Information Confidential


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With limited exceptions, an employer must keep confidential any medical information it learns about an applicant or employee. Under the following circumstances, however, an employer may disclose that an employee has diabetes:

To supervisors and managers in order to provide a reasonable accommodation or to meet an employee’s work restrictions.

To first aid and safety personnel if an employee may need emergency treatment or require some other assistance because, for example, her blood sugar level is too low.

Where needed for workers’ compensation or insurance purposes (for example, to process a claim)

7. May an employer tell employees who ask why their co-worker is allowed to do something that generally is not permitted (such as eat at his/her desk or take more breaks) that he/she is receiving a reasonable accommodation?

No. Telling co-workers that an employee is receiving a reasonable accommodation amounts to a disclosure that the employee has a disability.

Rather than disclosing that the employee is receiving a reasonable accommodation, the employer should focus on the importance of maintaining the privacy of all employees and emphasize that its policy is to refrain from discussing the work situation of any employee with co-workers.

Employers may be able to avoid many of these kinds of questions by training all employees on the requirements of equal employment opportunity laws.

Additionally, an employer will benefit from providing information about reasonable accommodations to all of its employees.

This can be done in a number of ways, such as through written reasonable accommodation procedures, employee handbooks, staff meetings, and periodic training.

This kind of proactive approach may lead to fewer questions from employees who misperceive co-worker accommodations as “special treatment.”

8. If an employee experiences an insulin reaction at work, may an employer explain to other employees or managers that the employee has diabetes?

No. Although the employee’s co-workers and others in the workplace who witness the reaction naturally may be concerned, an employer may not reveal that the employee has diabetes.

Rather, the employer should assure everyone present that the situation is under control.

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An employee, however, may voluntarily choose to tell her co-workers that she has diabetes and provide them with helpful information, such as how to recognize when her blood sugar may be low, what to do if she faints or seems shaky or confused (for example, offer sweets or a sugary drink), or where to find her glucose monitoring kit.

However, even when an employee voluntarily discloses that she has diabetes, the employer must keep this information confidential.

An employer also may not explain to other employees why an employee with diabetes has been absent from work if the absence is related to her diabetes or another disability.

9.What kinds of discrimination have people with diabetes reported in the workplace?

 

Discrimination and the Law

Direct and indirect discrimination under the Anti-Discrimination Act.

Direct discrimination is when someone is treated less favourably because of their diabetes.

Examples of direct discrimination include if an employer:

1. Refuses to employ you after an employment medical identifies diabetes, or fires you.

2. Limits your job responsibilities.

3.Refuses promotions and training.

Indirect discrimination occurs when a workplace has requirements or practices that may appear fair but in fact discriminate against people on the basis of a particular characteristic.

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Examples of indirect discrimination include if an employer is unwilling to:

1. Accommodate your need for regular meal or snack breaks.

2. Provide a private location where you can check blood glucose levels.

3.Provide a private location where you can administer insulin.

4.Allow Installation of emergency ‘hypo’ prevention and treatment provisions at your work station .

Often, discrimination in the workplace occurs because employers and co-workers do not understand diabetes and how it is managed.

10.Do I have a responsibility to disclose my diabetes if my work involves driving?

Yes.If you drive a company car or bus,truck or lorry whether you have type 1 or type 2 diabetes, all  drivers, including learner drivers with diabetes, have a legal responsibility to  disclose your diabetes to your employer.

11.How does an employee with diabetes request a reasonable accommodation?

There are no “magic words” that a person has to use when requesting a reasonable accommodation.

A person simply has to tell the employer that she needs an adjustment or change at work because of her diabetes.

Consider proposing a trial period so your employer can get a better sense of how a specific accommodation will work.

A request for a reasonable accommodation also can come from a family member, friend, health professional, or other representative on behalf of a person with diabetes.

Individuals with diabetes can and do serve as highly productive members of the workforce.

While not every individual with diabetes will be qualified for, nor can perform, every available job, reasonable accommodations can readily be made that allow the vast majority of people with diabetes to effectively perform the vast majority of jobs.

The therapies for, and effects of, diabetes vary greatly from person to person, so employers must consider each person’s capacities and needs on an individual basis.

People with diabetes should always be evaluated individually with the assistance of experienced diabetes health care professionals.

The requirements of the specific job and the individual’s ability to perform that job, with or without reasonable accommodations, always need to be considered.

For information on ENTITLEMENTS & SOCIAL WELFARE INFORMATION FOR DIABETICS IN IRELAND refer to Diabetes Ireland Website.

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For more great Health and Nutrition Tips refer to the website positivehealthwellness.com.

If you have any information,questions, or feedback you would like to include in this webpage.

Please email momo19@diabetessupportsite.com or leave your comments below.

 

 

 


4 Comments

s a h

March 23, 2016 at 8:05 pm

Hey there what a great site. I know a few people who suffer from diabetes and I reckon this website would be great for them due to there long hours at work. I read through and found that there was a lot of helpful content and there is a great amount of advice.

    momo19

    March 24, 2016 at 11:25 am

    HI sah,

    Thanks for the positive feedback on this site.

    Please let your co-workers and employer know about this website as this diabetes resource can be easily accessed at work through their mobile phones or computers-knowing how to treat a hypoglycaemic attack could save a life!

Louise

March 23, 2016 at 8:08 pm

Great article, very informative. I had virtually no idea about diabetes before and would certainly not known what to do if someone had a hypoglycaemia attack. It is shocking that people can have career prospects affected by diabetes when it is not a risk for employers as long as simple measures are kept. Interesting about assessing diabetes, if you think you could be affected is the best option to visit the doctor?
Thanks
Louise

    momo19

    March 24, 2016 at 10:54 am

    Hi Louise,

    Thanks for taking the time to read this article and leaving a comment.

    To answer your question,if your diabetes makes you prone to suffering from hypoglycemia, its well advised to let your colleagues know and make sure they understand what steps need to be taken.

    Make sure your employer knows that it is important that you need to be able to test if you feel your blood sugar levels are low.

    If hypoglycaemia is starting to significantly affect your ability to do your job as well as you would like, it may be worth speaking with an Occupational Therapist or your endocrinologist who will be able to consider your case and make recommendations which your employer should take into account.

    If the nature of your work, such as working differing shifts or needing to forgo lunch, is increasing the chance of hypos,your endocrinologist or a occupational health professional may be able to work with you and your employer to suggest changes to your working regime.

    It makes sense for colleagues and first-aiders to know about a co-worker’s diabetes and what to do in the event of a hypo, and for health and safety professionals to make sure needles are disposed of safely.

    Diabetic workers should always be encouraged to perform self-monitoring of blood glucose by testing their blood sugar levels using a glucometer regularly throughout their working day..

    Because all workplaces are different, there’s no set advice given on where to do tests and insulin jabs. Recommendations say it should be done close to their workstation, in a safe working environment where the person feels most comfortable, and the toilet is less than ideal for hygiene reasons.

    How frequent these readings should be taken will depend on the persons medication and their glycemic control and the safety sensitivity of the work involved.

    Also a diabetic worker who has embarked on increased physical activity (either at work or at leisure) or a change in dietary habits will need to perform more self-monitoring.

    As the number of people who are being diagnosed with type 1 and type 2 diabetes is rising it is necessary to implement diabetes awareness courses into training schedules at work.

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