You might not feel disabled if you have type 1 diabetes, but if you live in the United States, you officially have a disability. The good news is that this designation may grant you extra rights in the workplace, including reasonable accommodations to perform your work while managing your condition.
“‘Workplace rights’ encompasses all the rights that a person with diabetes might have in the workplace,” says Jennifer Sherman, a staff attorney with the American Diabetes Association based in Washington, DC. “Getting a reasonable accommodation at work is one of the ways to get those rights, but there are many things that [people with diabetes] are protected in: hiring, firing, discipline, pay, promotion, job training, and fringe benefits.”
The Americans with Disabilities Act (ADA) requires employers to make adjustments to the job application process and work environment that enable you to enjoy the same benefits and privileges that your coworkers without diabetes enjoy. The ADA doesn’t necessarily guarantee workplace rights, but it guarantees you the opportunity to negotiate with your employer, and requires them to make an effort to satisfy your reasonable requests.
It’s up to you to advocate for yourself: “It’s the worker’s responsibility to ask for the accommodation. That request triggers an interactive process, which means that the individual with diabetes and the employer have to work together to come up with ways that they can do their job. And the employer has to give primary consideration to the preference of the person with diabetes on what that reasonable accommodation is,” says Sherman.
While not every accommodation you receive may perfectly match your preference, you have recourse if an employer refuses to negotiate or only offers unacceptable accommodations. You may be able to appeal internally to human resources or get your union involved. You can also contact a lawyer or a free protection and advocacy program. If you’re not sure what to do, Sherman recommends reaching out to the American Diabetes Association at 800-DIABETES for guidance and resources.
1. Testing and Treatment Breaks
Type 1 diabetes means you have an absolute necessity to tend regularly to your condition while you’re on the clock. Whether it’s testing your blood sugar, administering a dose of insulin, or having a snack to treat low blood sugar, you can request additional breaks from work to perform these vital checks. These breaks can be random or scheduled, depending on what you and your employer agree to.
2. The Right to Treat Yourself Privately or Publicly
Some people with diabetes don’t want to administer insulin or perform fingerstick tests in front of coworkers. If you prefer to test and treat your diabetes in private, you can request a private space for doing it.
“I think checking blood glucose levels in that private space if they want, or wherever they want, is a great example of an accommodation for people with diabetes,” Sherman says.
On the other hand, if you would find it more convenient to test and treat your diabetes at your desk or in your work area, you can request an accommodation to do this, even if it would normally go against your employer’s rules.
3. Access to Hypo Snacks and Beverages
Low blood sugar (hypoglycemia) can be dangerous without prompt treatment. If you work far from your locker room or storage area, it may be necessary to carry your glucose gels, candy, juice boxes, or other hypo snacks with you.
In cases where employers don’t allow employees to keep snacks or beverages in their work environment, you can request an accommodation to do so.
4. Access to Refrigeration
In an office setting, you can request a small refrigerator to keep near your desk to store insulin or perishable snacks. If you work in a field setting, you might request a high-quality cooler or portable refrigerator to keep your insulin at a safe temperature, especially outdoors during summer. While many insulins can be stored at room temperature for a period of time, you may want to keep several extra vials on hand at work, and these require refrigeration to ensure their effectiveness.
Sherman says that you can also negotiate for backup supplies like a cooler and ice pack. It may be a good idea, she says, to “keep backup supplies on you in case the technology that you’re using fails and you don’t have a way to replace that.”
5. Extra Breaks for Blood Sugar Fluctuations
Both high and low blood sugar involve symptoms that can make your job performance suffer, and it may be in everyone’s interest to let you take a little time away from your responsibilities to recover.
If you sometimes need extra time to recover, you can request extra break time to go to the bathroom or to rest until your glucose levels return to normal.
6. Confidentiality
Employers are bound to medical confidentiality by the ADA. They cannot disclose your diabetes status to coworkers, except in limited circumstances, such as when discussing your accommodations with a supervisor, telling first responders about it in the event of a medical emergency, or processing workers’ compensation claims. Crucially, employers may not disclose your health status to coworkers who may ask why you are receiving an accommodation.
7. Access to Your Devices
If you need your smartphone to manage your continuous glucose monitor (CGM) or insulin pump, you probably need an exemption from any “no cellphone” rules at your job.
“Something we’re seeing more and more across various settings in a lot of jobs is that you’re not allowed to be on your cellphone,” says Sherman. “But a lot of people use their cellphone to check what their CGM is reading or what’s going on with their pump, so permission to have that cellphone on you for those tasks is important.”
8. Excused Absences and Unpaid Leave for Diabetes Care
People with diabetes may need more frequent medical care than the average employee. If you have regular checkups with physicians, diabetes nurse educators, and other healthcare professionals, you can request an accommodation for additional excused absences to attend medical appointments.
If you’ve already exhausted your paid time off and still need to miss work for medical care related to your diabetes, your employer must consider granting you unpaid leave. This is considered a reasonable accommodation, as long as it doesn’t create an undue burden for the business. Unpaid leave shouldn’t affect your responsibilities or standing in the company: When you return, your employer is not permitted to penalize you or retaliate in any way.
9. Privacy During the Interview Process
“Employers are not allowed to ask questions that are likely to reveal disabilities, such as whether you have diabetes, before they make the job offer,” Sherman says. Furthermore, employers cannot withdraw an offer of employment based solely on learning you have type 1 diabetes. An employer can ask you to take a pre-employment medical examination, which may reveal that you have diabetes, but only if they require a medical exam for every new employee.
10. Assistive Devices for Complications
Sherman says that if your diabetes causes a complication like the eye condition retinopathy, you can request accommodations like large computer monitors, better lighting, or other changes that allow you to see better to perform your work. Likewise, if diabetes causes neuropathy in the legs and feet, you can request permission to use a chair or stool, even in an environment that typically requires standing, such as a grocery store checkout station.
11. Time and Equipment for Movement
Many people with type 1 diabetes engage in post-meal movement as a glucose management tool, and you can request extra time to take a walk after meal breaks. You could even ask for a treadmill to use in your workspace for this purpose, Sherman says.
“It’s important to note that these reasonable accommodations can happen if you’re a remote worker, too. It doesn’t have to be that you’re physically at the office,” she says.
12. Task Reallocation or Job Reassignment
If your type 1 diabetes and associated complications have made it difficult for you to fulfill your job responsibilities, you still have options.
If you can still perform your core job functions but struggle with marginal tasks, your employer could accommodate this by reallocating those tasks to another employee. An example of this might be a facilities maintenance worker who had a lower limb amputated due to T1D: Perhaps they can still perform their primary daily job functions, but have difficulty climbing a ladder to change lightbulbs a few times a year.
Even if you become unable to fulfill the core functions of your job due to type 1 diabetes or its complications, you still have some protection: You can request to fill a vacant position of equivalent pay and status that you are able to perform. An employer does not have to create a new position for you, but they should consider you for vacancies that arise.
13. Permission to Possess, Use, and Dispose of Syringes
Some employment environments, from corrections to aviation, may restrict the possession or use of objects that can be used as a weapon, and syringes could fall into that category. In that case, you can request an accommodation to possess, use, and dispose of syringes to manage your diabetes. You may need an additional accommodation to carry a needle-clipping tool or to keep containers for collecting needles until you can dispose of them properly.
The Takeaway
- Type 1 diabetes is officially considered a disability in the United States. Employers must make reasonable accommodations for their employees with the condition.
- Potentially helpful workplace adjustments might include additional breaks for blood sugar testing and treatment, continuous access to refrigeration and medical devices, longer breaks for meals, and a guarantee of confidentiality if you prefer to keep your medical status private.
- Be prepared to advocate for yourself: You will probably have to negotiate with your employer to secure new accommodations to help you manage your diabetes more effectively while on the job.
Read the full article here
