Required Accommodations for Employees with Diabetes

The Americans with Disabilities Act (“ADA”) prohibits discrimination against employees with disabilities by state and local governmental entities and by private employers with fifteen (15) or more employees. The ADA was amended in 2008 to make it easier for an employee seeking protection under the ADA to establish that he or she has a disability.  American with Disabilities Act Amendments Act of 2008 (“ADAAA”), 42 U.S.C. § 12102. The Equal Employment Opportunity Commission (“EEOC”) enforces the provisions of the ADA and the ADAAA.  

Diabetes is a Disability 

As diabetes becomes more common in the United States, it is important for employees and employers to understand the application of the ADA as it pertains to employees with diabetes. Diabetes is a disability under the ADA when it “substantially limits one or more of a person’s major life activities.”  42 U.S.C. § 12102. The amendments and the EEOC’s final regulations have made it clear that diabetes is among several listed impairments that “virtually always” substantially limit a major life activity. 29 C.F.R. §§ 1630.2(j)(3)(iii) and (j)(4)(iv). In other words, diabetes is almost always considered a disability under the ADA.  

Employers must tread carefully when diabetes is suspected or where an employee has indicated directly that they have diabetes.  

Asking the Employee About Diabetes or Requiring a Medical Exam 

For various reasons, employers may suspect that an employee has diabetes and want confirmation. However, the ADA strictly limits the circumstances in which an employer can ask about an employee’s medical condition or require an employee to submit to a medical exam.  

The circumstances in which an employer can ASK about suspected diabetes include:

  • (A) where the employer has reason to believe that there is a medical explanation for changes in an employee’s job performance;

  • (B) where the employer believes that an employee poses a direct threat to safety of themselves or others because of the medical condition;

  • (C) where an employee has asked the employer directly for a reasonable job accommodation; or

  • (D) where the employee is participating in a voluntary wellness program focused on early detection, screening and management of diseases like diabetes.

The circumstances in which an employer can require an employee submit to a medical exam are limited to (A) and (B) above, in that an employer:

  • (A) must have reason to believe that there is a medical explanation for changes in the employee’s job performance; or

  • (B) must believe that the employee poses a direct threat to the safety of themselves or others because of the medical condition.

An employer may also ask an employee for a doctor’s note or some explanation for the absence where the employee has taken sick leave, but only where the employer maintains a policy or practice of requiring all employees using sick leave to provide a doctor’s note or some explanation.  

Under (A), employers must be careful not to ask an employee for medical information simply because job performance is poor. Medical information can only be sought where an employer has a reasonable belief, based on objective evidence, that a medical condition may be the cause of the employee’s performance problems.  

Under (B), employers should not act based on myths fears, or stereotypes about diabetes. The employer should evaluate each individual based on their skills and how diabetes affects them. Only then can an employer can make an unbiased determination of whether an employee does in-fact pose a threat to themselves or others because of the medical condition.  Once all information about the employee is gathered and viewed objectively, the employer must determine whether a reasonable accommodation can be made that would eliminate or alleviate the safety concerns, as discussed more fully below.  

Privacy of Obtained Information

An employer must keep confidential any medical information that it learns about an employee, except in specified situations. An employer may disclose the information to supervisors and managers in order to provide a reasonable accommodation, to first aid and safety personnel for emergency treatment, or where needed for workers’ compensation or insurance purposes.  

Even where other employees are asking why the employee with diabetes receives special treatment (e.g., more breaks), the medical condition cannot be disclosed.  Instead, employers should emphasize that they try to assist all employees with difficulties in the workplace and that such information is private.  Inquiring employees should be reminded that their privacy would be equally respected.  

Reasonable Accommodations 

An employer is required to offer a reasonable accommodation to an employee with diabetes, as long as the accommodation does not pose an undue hardship on the employer. An undue hardship means that providing any reasonable accommodation would result in significant difficulty or expense. If one proposed accommodation is too difficult or expensive, an employer still would be required to determine whether there is another easier or less costly accommodation that would meet the needs of the employee.  

Proposed accommodations should be considered on a case-by-case basis, but some common accommodations for employees with diabetes include:

  • (A) a private area to test blood sugar levels or to take insulin;

  • (B) a place to rest to stabilize blood sugar;

  • (C) breaks to eat/drink, take medications, test blood sugar, or take insulin;

  • (D) leave for treatment, recuperation, or training on diabetes management;

  • (E) a modified work schedule or shift change; or

  • (F) modifications to physical aspects of the job (e.g., allowing use of a stool, chair).

Employers may ask an employee requesting an accommodation what the employee needs to help perform the job. Employees often request accommodations that are less burdensome or expensive than the employer anticipated.  

Employers should also consider whether an employee with diabetes is entitled to leave under the Family Medical and Leave Act (FMLA), which provides up to twelve (12) weeks of unpaid leave for a serious health condition.  

For questions about the ADA, ADAAA, FMLA, disability discrimination, or reasonable accommodations, contact us at 614.745.2001