Making a Living with Diabetes: Job Problems

Two diabetes complications nobody talks about: unemployment and poverty. Diabetes costs money and makes earning a living harder. The disease and people’s reaction to it interfere with working many jobs.

Studies show that people with diabetes are more likely to be unemployed and to live in poverty than people without diabetes. Why is that and what can we do about it?

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Finding a job
Sometimes diabetes keeps employers from hiring you. Such discrimination is illegal, but it still happens. A study in the journal Health Affairs found that, “Employers may be less likely to hire people with diabetes, even in spite of nondiscrimination laws, because of concerns about productivity and health insurance costs.” The American Diabetes Association (ADA) can help you fight for your right to be hired, sometimes.

Legally, employers cannot refuse to hire because of diabetes, unless your condition would pose a significant threat to you or others. An example would be hypoglycemic episodes while operating heavy machinery.

Still, discrimination is common. According to the ADA, “For workers with diabetes, employment discrimination can take many forms, but typically includes a failure to hire or promote you because of your diabetes, termination due to your diabetes, or a failure to provide you with reasonable accommodations that help you do your job.”

Workplace issues
If you need to test or take insulin, some employers give breaks and some don’t want to. Some let you test or inject at your work area, and some want you to use a bathroom and count that as a break. Some want you to work overtime hours when you need to be eating or resting. Others don’t want to deal with diabetes at all. They may see your diabetes as making their job harder.

Under the Americans with Disabilities Act, employers with more than 15 employees are required to make “reasonable accommodations” to enable work by people with health issues. Accommodations for diabetes often include, among others:

• 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 or drink, take medication, or test blood sugar levels
• Leave for treatment, recuperation, or training on managing diabetes
• Modified work schedule or shift change
• Better lighting or larger-screen computers in case of visual problems

It can be scary and actually risky to ask for accommodations. You might wonder: Are you making yourself a target or being unreasonable? Please read some of this ADA webpage. It will answer a lot of questions.

If your employer has fewer than 15 employees, the Americans with Disabilities Act doesn’t apply, and a lot depends on your relationship with the company and the boss. Job performance and personal friendship help. Working with an employer to find accommodations that aren’t disruptive to the job may go a long way.

Some employers are more reasonable than others. Sondra commented on one of my blog entries, “My son…had a bad low blood sugar on the street outside of work…and had to be taken to the hospital… They now have him on ‘probation’ until he can get his ‘diabetes under control,’ even though his doctor cleared him.” How do you prove you’re “under control,” she asks.

And the reality is that, even without discrimination, a lifetime of diabetes can limit the amount and/or the type of work some people can do, because of fatigue, neuropathy, visual problems, or other issues.

You might have to consider changing to a less-demanding job, possibly including part-time work or work from home. We’ll have strategies for that in a couple of weeks.

Health insurance
Another limiting factor in job choices is the need for health insurance. People often feel stuck in a job they don’t like because the insurance is good or feel they can’t afford to give up Medicaid by going to work. The Health Affairs study of how diabetes can make people poor found that “People with diabetes may seek out jobs that pay less but make self-management easier, or stay at jobs to avoid disrupting their health insurance coverage when others might seek higher-paying employment.”

According to a blog entry in The New York Times, economists call this condition “job lock.” Job-locked people “stay in jobs they dislike, or don’t want, solely to keep their health coverage. A Harvard Business School study in 2008 estimated that 11 million workers are affected by this dilemma.” People with diabetes are no doubt heavily represented in that group.

If working at a physical workplace is hard for you, there may be other options, such as working from home or starting your own business. We’ll look at those possibilities in part two of this series next week. Part three will cover disability and other assistance, and part four will discuss other ways to make money.

  • RAWLCM

    It’s fairly easy for a sneaky boss to manufacture a pretext to get rid of you if they don’t want to deal with your medical issues. The ADA sounds very protective, but it’s full of loopholes. Employers are only required to provide accommodations if they aren’t “burdensome” -which means it doesn’t take much time, money, or effort- and if the accommodation makes it so you are able to perform at the level of a non-affected person. Even then, it’s easy to make duties more difficult, or skew a performance evaluation to make adequate performance impossible. In the end, it comes down to whether or not your company is committed to being supportive or not. If they’re not, and they know how to game the system, you really don’t have a chance.