Employment and Type 1 Diabetes


Note: This article is part of our Daily Life library of resources. To learn more about the many things that affect your health and daily management of type 1, visit here.

The Dos and Don’ts of Employers

As a person with type 1, you are protected under several laws in the United States from discrimination on the job. It is important to get a clear overview of how you are protected so that you can make sure you are being treated fairly and equally. Here is a breakdown of how you are protected:

An employer is not allowed to do the following actions:

  • Fail to hire or promote you because of your type 1
  • Terminate you because of your type 1 (unless you pose a “direct threat”)

An employer must to the following actions:

  • Provide you with reasonable accommodations that help you perform the essential functions of your job
  • Not discriminate with regard to employer-provided health insurance

Interviews: Is it better to disclose?

There’s no law that requires you to disclose your diabetes, and employers aren’t allowed to ask about your medical background before offering you a job. Even if you choose to disclose your diabetes to your employer, your employer is required to keep that information confidential. Some job offers may depend on your ability to pass a medical evaluation after the initial offer, such as police officers or firefighters. However, these results will only affect your offer if they prevent you from doing your job or put your coworkers at risk.

Whether or not you talk about your diabetes is up to you. However, if your employer doesn’t know about your diabetes, you may have a hard time proving discrimination based on your condition in the future. Let them know about hypoglycemia, hyperglycemia and other complications that can arise.

Check out Julia’s experience with employment and type 1 here!

Reasonable Accommodations

A reasonable accommodation is any change to a work environment that enables a person with a disability to do the job.

According to the ADA, employers are required to make these accommodations if requested, unless the accommodation would cause an “undue hardship” on the employer. You are entitled to reasonable accommodations even if you did not disclose your diabetes prior to being hired. Generally, accommodations for those with type 1 are easy, inexpensive and helpful. This is another conversation that is helpful to have with your employer to make sure that they are aware of your daily routine.

These accommodations include:

  • Daily diabetes management needs, (such as managing blood sugar levels)
  • Taking the necessary insulin
  • Treating any hypoglycemic or hyperglycemic episodes

Medical Leave

You have a right to medical leave to take care of your type 1. The Family and Medical Leave Act requires most private employers with over 50 employees and most government employers to provide up to 12 weeks of leave per year because of the worker’s, or an immediate family member’s serious health condition.

This leave can be flexible. You can take this leave in small blocks of time to deal with short-term problems such as managing blood glucose levels or doctor’s appointments.

Employer’s Rights

In certain situations, employers are permitted to ask about your diabetes and can require that you undergo a medical examination.

These situations are generally limited to employment physicals, requests for reasonable accommodation, when you return from work following an extended medical leave, or when you have experienced a medical problem on the job that raises safety issues for the employer.

A common problem in diabetes discrimination cases is that the employer claims that the person with diabetes causes a safety risk to other employees. Sometimes this refers to an employee experiencing hypoglycemia on the job, or it is based on an employer’s misconceptions about diabetes. It is important that you educate your employer about your ability to be a safe, responsible and effective worker with type 1.

Health Insurance

Depending on your job, you may be offered into a job-based group health plan. These job-based plans are not allowed to exclude coverage for pre-existing conditions, so you will be covered as a person with type 1. 

Before you accept a position, consider the health insurance coverage and benefits that will be given to you. Job-based health plans will have a Summary of Benefits and Coverage (SBC) that will include information on the plan’s coverage and cost (such as deductibles and out-of-pocket limits).  Your health insurance should give you an SBC when you first enroll and at the beginning of each year. Different employers, depending on size and preference in insurance plans, will cover you in separate but similar ways. Comparing different SBC’s can be a helpful way to compare various health plans.

COBRA, or the “Consolidated Omnibus Budget Reconciliation Act,” is a federal law that enables an employee and his/her family to maintain health coverage for 18-36 months on the employer-based group plan after certain major life events (such as the employee’s death or firing). COBRA can, but not always, allow for cheaper coverage than purchasing individual health insurance plans.

For further information on rights and protections in employer-sponsored health insurance, visit the following information from the U.S. Department of Labor.

What laws are protecting you?

If you ever feel uncomfortable, discriminated, or wrongfully terminated because of diabetes, you have a variety of options to stand up for yourself. You are protected from workplace discrimination under both federal and state laws.

Both federal and state laws in the U.S. offer protection from workplace discrimination.

  • The Americans with Disabilities Act applies to private employers, labor unions, and employment agencies with 15 or more employees, and to state and local government.
  • The Rehabilitation Act of 1973 generally covers employees who work for the executive branch of the federal government, or for any employer that receives federal money.
  • The Congressional Accountability Act covers employees of Congress and most legislative branch agencies.
  • All states have their own anti-discrimination laws and agencies responsible for enforcing those laws. Some state anti-discrimination laws provide more comprehensive protection than do the federal laws.

Termination because of Type 1

If you are fired from your job because of your diabetes, you have a right to file a charge of discrimination with the Equal Employment Opportunity Commission (EEOC) or your state fair employment agency.

ADA is a great resource for this and offers pro bono legal advice if you have been discriminated against for having type 1.

Depending on your circumstance, you may have other options available. These can include filing a union grievance or negotiating a return to work with your employer.

  • Steps to file a complaint

If you want to file a complaint with a government agency, human rights commission, or file a lawsuit in the court, there are deadlines and details about the process to be aware of before you take action.

  • Be aware of dates

Many complaint processes have strict deadlines for filing a complaint.  In some cases, complaints must be filed quickly in order to preserve legal rights. The deadline for filing a complaint will be based on a number of factors, so make sure you are aware. It is best to consult a knowledgeable attorney so that you don’t miss any deadlines.

  • File it ASAP

Filing a complaint, regardless of your intentions to pursue the discrimination, is an important way to preserve your legal options. Filing an administrative complaint is a prerequisite to filing a lawsuit in court, so it is necessary to be completed as soon as possible.

Employment Claims: What to file, Where to file and When to file by…

  • Federal government employees
    • Must file complaints with agency’s equal employment opportunity (EEO) office within 45 days of the alleged discriminatory action.
    • Read more about the federal sector complaint process here.
  • Private sector employees
    • Must file complains with the Equal Employment Opportunity Commission (EEOC) or with their state fair employment agency within 180 days of alleged discriminatory action (or with an extension of 300 days)
    • All but five states (Alabama, Arkansas, Georgia, Mississippi, and North Carolina) extend the time to file complaints from 180 days to 300 days
    • Read more about filing a complaint of discrimination with EEOC
  • Lawsuits
    • Must be filed in state or federal court within 90 days of receipt of the notice of the right to sue

Do Your Research and Communicate

Having type 1 should not prevent you from entering the workforce or pursuing a career you love. Sometimes it might take educating your employers about your condition and explaining your needs. This, of course, is up to your discretion. Try communicating with your employer about reasonable accommodations, take advantage of your rights to take medical leave and be aware of any discrimination.

Read Life After College Graduation by Julia Flaherty.

WRITTEN BY BT1 Editorial Team, POSTED 09/16/16, UPDATED 04/15/23

This piece was authored collaboratively by the Beyond Type 1 Editorial Team.