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The incidence of diabetes is climbing in the United States. According to the National Diabetes Information Clearinghouse, about 1.9 million people ages 20 years or older were newly diagnosed with diabetes in 2010, (the most recent year for which statistics are available).

Two Relevant Cases

Case #1: Hospital Settles Case involving a Nurse. Hudson Valley Hospital Center, Inc., a community hospital bordering Peekskill, N.Y., agreed to pay $142,500 to a former nurse to settle a disability discrimination lawsuit brought by the EEOC.
    The EEOC's lawsuit (Civil Action No. 07-CV-83760), filed in the U.S. District Court for the Southern District of New York, charged that the hospital discriminated against the nurse on the basis of her disability, Type I diabetes, after she experienced a diabetic coma.  Specifically, the lawsuit charged that the hospital failed to grant a reasonable accommodation to permit the nurse to modify her part-time work schedule and:

  • Endangered her physical health.
  • Effectively terminated her employment by refusing to accommodate her modified schedule request.
  • Violated the Americans with Disabilities Act.

    The 2009 settlement included $142,500 in back pay and compensatory damages for the nurse, the payment of attorneys' fees to her attorney, a 26-month consent decree enjoining the hospital from engaging in further disability discrimination or retaliation and anti-discrimination training for employees, managers, and the human resources department.
    "Employers must recognize that the ADA requires them to provide adjustments or modifications to enable people with disabilities to enjoy equal employment opportunities, unless doing so would be an undue hardship, such as a significant difficulty or expense," said Spencer Lewis, district director of the EEOC New York Office.
    In the case of a diabetic employee, examples of accommodations that might be appropriate, according to Lewis, include: "Modified work schedules; a private area to test blood sugar levels or to take insulin; a place to rest until blood sugar levels become normal; breaks to eat drink, take medication, (and) leave for treatment or training on managing diabetes."

Case #2: Company Policy Prohibited Equipment Operation by Diabetic  The EEOC settled a lawsuit with an Arizona company after it was accused of firing an employee because he had diabetes.
    Facts of the case: An insulin-dependent diabetic with 30 years of experience as an industrial engineer was hired at Pimalco Inc. The employee was licensed to operate mobile equipment and successfully completed the company's class on operating equipment.
    Shortly after employment began, a Pimalco official told the employee that he was doing good work, but his medical exam disclosed that he had diabetes. The official "informed him that he was fired because he was diabetic and company policy prohibited him from operating mobile equipment," the EEOC stated. The employee never had a diabetic incident during his career.
    Under the 2004 settlement, the aircraft parts and equipment manufacturer agreed to pay $70,000 in back wages and compensatory damages, as well as make changes to its policies.

Click here for EEOC information about workplace diabetes.

Since the disease is a disability under the Americans with Disabilities Act (ADA), it is important to understand the potential impact in the workplace.

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 on the rise: The number of charges filed under the ADA alleging diabetes-based discrimination. The Equal Employment Opportunity Commission (EEOC) says the number of those cases is rising and the implications for diabetes in the workplace are so significant so that the federal agency has published guidance for employers. 

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 an increasing number of people in the U.S. living with diabetes, there's no question that paying attention to the disease makes good business sense.

Working to accommodate 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.

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