Information for Employees
The ADA strictly limits the circumstances under which an employer may ask questions about an employee's medical condition or require the employee to have a medical examination. Generally, to obtain medical information from an employee, an employer must have a reason to believe that there is a medical explanation for changes in the employee's job performance or must believe that the employee may pose a direct threat to safety because of a medical condition. (See Question 3 for other instances when an employer may obtain medical information.)
1. When may an employer ask an employee if diabetes, or some other medical condition, may be causing her performance problems?
If an employer has a legitimate reason to believe that diabetes, or some other medical condition, may be affecting an employee's ability to do her job, the employer may ask questions or require the employee to have a medical examination.
Example: Several times a day for the past month, a receptionist has missed numerous phone calls and has not been at her desk to greet clients. The supervisor overhears the receptionist tell a co-worker that she feels tired much of the time, is always thirsty, and constantly has to go to the bathroom. The supervisor may ask the receptionist whether she has diabetes or send her for a medical examination because he has a reason to believe that diabetes may be affecting the receptionist's ability to perform one of her essential duties sitting at the front desk for long periods of time.
2. May an employer obtain medical information from an employee known to have diabetes whenever he has performance problems?
No. Poor job performance often is unrelated to a medical condition and should be handled in accordance with an employer's existing policies concerning performance. Medical information can be sought only 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.
Example: A normally reliable secretary with diabetes has been coming to work late and missing deadlines. The supervisor observed these changes soon after the secretary started going to law school in the evenings. The supervisor can ask the secretary why his performance has declined but may not ask him about his diabetes unless there is objective evidence that his poor performance is related to his medical condition.
3. Are there any other instances when an employer may ask an employee about diabetes?
An employer also may ask an employee about diabetes when an employee:
- Has asked for a reasonable accommodation because of his diabetes
- Is participating in a voluntary wellness program that focuses on early detection, screening, and management of diseases such as diabetes
- In addition, an employer may require an employee with diabetes to provide a doctor's note or other explanation to justify his use of sick leave, as long as it has a policy or practice of requiring all employees who use sick leave to do so.
With limited exceptions, an employer must keep confidential any medical information it learns about an applicant or employee. An employer, however, may disclose that an employee has diabetes under the following circumstances:
- 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 would need emergency treatment or require some other assistance because, for example, her blood sugar levels are too low
- To individuals investigating compliance with the ADA and similar state and local laws
- Where needed for workers' compensation or insurance purposes (for example, to process a claim)
4. May an employer explain to other employees that their co-worker is allowed to do something that generally is not permitted (such as eat at his desk or take more breaks) because he has diabetes?
No. An employer may not disclose that an employee has diabetes. However, an employer certainly may respond to a question about why a co-worker is receiving what is perceived as "different" or "special" treatment by emphasizing that it tries to assist any employee who experiences difficulties in the workplace. The employer also may find it helpful to point out that many of the workplace issues encountered by employees are personal and, that in these circumstances, it is the employer's policy to respect employee privacy. An employer may be able to make this point effectively by reassuring the employee asking the question that her privacy similarly would be respected if she ever had to ask the employer for some kind of workplace change for personal reasons.
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."
Excerpted and Adapted from the EEOC Fact Sheet: The Americans with Disabilities Act and Diabetes by the U.S. Equal Employment Opportunity Commission.
Reviewed by Francine Kaufman, MD. 4/08
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I had a work dinner last night with some leadership from my office. I always find diabetes etiquette at these things to be kind of tricky. It was a four course meal, with salad, soup, entree' and dessert and coffee. There was also a selection of gluten free and non-gluten free dinner rolls. I felt way too full of questions for waitress... "Could I get my dressing on the side? How much sugar is in it?" A course later...