Diabetes May Require Special Accommodations

The incidence of diabetes is significant in the United States. According to the Centers for Disease Control and Prevention (CDC), more than 29 million Americans are living with diabetes, 86 million are living with pre-diabetes, a serious health condition that increases a person's risk of type 2 diabetes and other chronic diseases. Many of the people with diabetes and pre-diabetes don't know they have it, the CDC reports.

It is a disability under the Americans with Disabilities Act (ADA). Although diabetes can be treated, those with the disease are never fully "cured." Successfully managing the condition can require daily tasks like monitoring blood sugar, taking medication and snacking.

Also significant is the number of charges filed under the ADA alleging diabetes-based discrimination. The Equal Employment Opportunity Commission (EEOC) cites a jump in such cases in recent years.

The implications for diabetes in the workplace are significant so the EEOC has published guidance for employers. Here are the highlights:

Diabetes as a Disability

According to ADA guidelines, diabetes is a disability when it substantially limits one or more of a person's major life activities (such as getting in or out of bed or a chair, bathing, dressing or eating), or when it causes side effects or complications that substantially limit a major life activity.

These guidelines apply even if diabetes had these effects in the past, but is currently being controlled by medication, diet and other factors. Diabetes is also considered a disability when it does not significantly affect everyday activities, but when an employer treats the individual as if it does.

Information and Accommodation

The ADA strictly limits the circumstances where employers can question employees about medical conditions or require them to have medical examinations. These actions can only be taken if an employer has a legitimate reason to believe that diabetes, or another medical condition, is affecting an employee's ability to do the job. Generally, to obtain medical information from an employee, an employer must have a reason to believe there is a medical explanation for changes in the employee's job performance. Or, the employer must believe that the employee may present a safety hazard as a result of the condition.

Employees with diabetes may require special accommodations, such as:

• A private area to test blood sugar levels or to take insulin.
• A place to rest until blood sugar levels normalize.
• Breaks to eat, drink, take medication or test blood sugar levels.
• Leave for treatment, recuperation or training to manage diabetes.
• A modified work schedule or shift change.
• The use of a chair or stool for a person with diabetic neuropathy (a nerve disorder caused by diabetes).

Diabetes and Safety

An employer may question employees about diabetes or send them for medical exams only if there is reason to believe an individual poses a "direct threat" to himself or others that cannot be reduced or eliminated through reasonable accommodation. The EEOC emphasizes that safety concerns should be based on objective evidence, not general assumptions or myths.

With more than 29 million Americans living with diabetes, there's no question that paying attention to the disease makes good business sense. Working with diabetic employees can improve productivity, decrease absenteeism and promote healthy lifestyles. The key is to assess the ability of applicants and employees to perform a job with or without reasonable accommodation.