Insulin in Court

A few weeks ago, we wrote about an airline’s plans to bump plus-size passengers off full flights or require them to purchase two seats (“‘United’ in Discrimination?”) and received a record number of comments from readers. This week, another form of discrimination is in the news because — thanks to a court victory by the American Diabetes Association (ADA) — it has been declared illegal.


As the ADA’s Diabetes Forecast reports, a federal jury has ruled that the Federal Bureau of Investigation (FBI) illegally discriminated against Jeff Kapche, a Fort Bend County, Texas, Sheriff’s Department detective who applied to be an FBI Special Agent, by not hiring him because he takes insulin injections for his diabetes. The FBI policy had been to require Special Agents who need insulin to use an insulin pump because of “the unpredictable nature of the job.” Lawyers for the ADA argued that “each person with diabetes should be judged based on his or her merits,” and that the FBI’s policy ignored medical evidence regarding insulin injections as well as Kapche’s record of successful diabetes management.

What do you think — should people with diabetes celebrate this ruling? Was the FBI’s position on insulin unreasonable? Are there any jobs for which discrimination based on diabetes or insulin use should be allowed? Leave a comment below!

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  • Diane Bolduc

    I agree with the courts decision. No one should be denied unless they cannot do the job. Being diabetic does not keep you from doing a job. I have a family child care and work long hours with young children. I cannot imagine anyone telling me I cannot do the job I’ve been doing for 30 years because I inherited diabetes from my mother. My diabetes in no way hinders me from doing my job. Good for you Jeff

  • sherryl

    Truck drivers who take insulin lose their Class A CDL.
    This means that they lose their job and their career.
    If they take insulin they cannot even be considered for a CDL.

  • Amanda

    I agree with Jeff, and the dourts decision.
    Diabetes is a chronic disease, which changes your life in cariuos ways. Although I am type 1 diabetic and have been for 5 years since being diagnosed, yes, it has changed my life in many different ways… but has not restricted my abilities to perform on the job.

  • imdbestmom

    As a diabetic, I have mixed feelings about this one. I have had times that I have not eaten right or forgotten to take my insulin and meds and have gotten a little spacey but surely someone who has other people’s lives in their hands, as well as their own, would keep their sugar levels in check. I don’t like to see anyone discriminated against but this is a tricky disease and can change your whole outlook and reactions to things if your blood sugar is off. A pump would be an absolute for me to approve. We all have to take diabetes very seriously in order to do our best
    safely and in the right frame of mind.

  • Kimmie

    I’m in favor of the court’s ruling. I feel like the FBI Agency is being very bias towards diabetics which is ludicrous. The agent should hire Mr. Kapche because of his work record, and not based on his condition. I’m hoping that the agency will change their policy on not being bias towards a person because of diabetes. I had diabetes for 16 years, and I’m still able to function and go to work just like a non-diabetic.

  • Mark Schweim

    Actually, through FMCSA President Signed legislation several years ago, they CAN NOW qualify for Class A CDL, but ONLY IF they are willing to go through the hassle and added monitoring requirements to obtain and KEEP the FMCSA Diabetes Exception Certificate, which the Insulin using Diabetic needs to obtain BEFORE the DOT certified medical examiner will even look at the Insulin using Diabetic… At least 8 people received the FMCSA Diabetes Exemption certificate last year… Problem is most Diabetics will decide the added expense, paperwork, & hassle makes it NOT WORTH TRYING to get the exemption that would allow them to obtain the Class A CDL OR DOT Medical Certificate.

    Diabetes Discrimination is probably MUCH MORE RAMPANT than ANYBODY realizes… I was unemployed over 2 weeks 2 years ago when PPC discriminated against me, removed me from job I’d had for previous 3 years with fewer accidents than NON-DIABETIC CO-WORKERS!!! Took 2 weeks of EEOC and Labor Union fighting for me to get job back… Still have same job, since 2003… Still ONLY one on same job with ZERO ACCIDENTS ENTIRE 12 years at company (6 years on same job). Still fighting PPC to FOLLOW THROUGH with their promised Restoration of Vacation Time/Pay used to maintain income while they had me removed from job… May wind up in a Breach of Contract case…

  • Mark Schweim

    How can ANY employer, especially one going through BANKRUPTCY consider it WISE financial management to choose to pay an attorney an extra $3,000 – $9,000 to try getting out of paying the parson the $1,028 owed rather than simply paying the person the $1,028 owed, call CASE CLOSED, and SAVE the extra $2,000 – $8,000 the attorney would have charged to fight for company to get out of paying the original $1,028 amount owed and STILL possibly end up with judge saying they have to pay the person the claimed $1,028 IN ADDITION TO attorney fees paid to try fighting the case???

  • Mike Hammond

    I think it is wrong to be targeted by companies because of being diabeic and I am so glad that these particular cases were deemed illegal.
    I used to drive a 7 1/2 truck in the UK until I was placed on Insulin and told I can’t do that anymore, who has the right to say you can’t do anything I drove for years without an accident and now I live and work in the USA I am told I cannot drive a truck over here either.
    I hope these illegal decisions help all that are diabetic to get the goal in life that they seek and put a stop to these beuracrats that say NO YOU CAN’T DO THAT WORK all the time.

  • Kathy

    I have always been bothered by the diabetics who were being kept from doing a specific job. When you think about it, there are people who must take medications throughout the day to stay healthy; asthmatics, cardiac disease, HTN & all those people who THINK they are healthy & they really aren’t & SHOULD be on medications!
    I can see a diabetic needing to be stable on their treatment plan before being assigned high stress jobs, but NOT being totally banned from positions just because they are on insulin.

  • Jim Davis

    Been Type 1 for 57 years. Lots of stories, believe me.
    I am employed as a commercial business broker.
    I take 5-6 shots per day and test more than this amount. I believe common sense should not be forgotten in this question. For example, should I be dropped into a raging forest fire with no idea when I’d be anble to return? I think not. Is there any part of being a Special Agent for the FBI that could present similiar difficulties. Absolutely!
    This from a diabetic who has rebeled against, “You can’t because…”, all his diabetic life. Won often, but didn’t choose nonsensible conditions.
    If you can’t do a job without special considerations, find another job and excel at it.

  • W. Douglas Galloway

    I had a simular experiance, I was employed as a civilian by the Navy on an off shore island and after 29 years on the job they decided that I could no longer work there due to the lack of medical services. I had a letter from my doctor stating that I was not at any significant risk and a letter from me stating my responsibility to maintain an adaquite supply of medications and 5 years of graphs showing my glucose levels. I decided to retire rather than go to a “make work job” on the mainland.

  • Bea Atalig

    I also agree with the courts decision. Today’s climate for seeking allowances for many types of discrimination makes me see a similarity to the days of Germany and Hitler. They also went after particular groups–those with less than perfect health, heart problems,skin color,eye color, hair-that matched the “ideal”, loyalty, etc. So when will they come for You?
    The job should only be judged by qualifications and ability. Jeff’s diabetes is under successful management and not a hinderance. Much success Jeff!

  • James D.Taylor

    Like Mr.Davis in his earlier posting I too have been insulin dependent for a long time-45 years as of this year and have had to forego several options of employment that appealed to me.
    As a child, I was fascinated by my father’s lifetime career of flying (47 missions in a B-17 with the 8th AAF and 37 yrs.with United)but by my 9th birthday it had been made clear to me that my dream of “following in his footsteps” was not going to happen as no insulin dependent individual was ever going to be allowed to fly military or commercial aircraft.

    As I grew older, I became increasingly frustrated with the obvious discriminatory hiring practices in certain fields (Public safety and Transportation in particular)and the less obvious discriminatory practices in a much larger field. The most frustrating issue to me was why was I forced to “check a box” (Under penalty of perjury if I did not)on employment applications identifying myself as a diabetic, while individuals afflicted by HIV/AIDS were protected BY LAW from having to do so! This still makes no sense whatsoever to me and remains a strong point of contention for me. Just who warrants “protection from disease discrimination” and who doesn’t, seems to be an issue that courts and legislation should be addressing given the level of improvement in treatment and care over the years since I was first diagnosed.
    At my age, any changes on employment regulations come too late for me to benefit but I applaud Mr.Kapche’s gumption in fighting this battle and hope for all diabetics in the future that he perserveres.

  • Carol J. Thompson

    I absolutely agree that a person with diabetes should be able to persue any job that they want to regardless of their dependence in insulin.

  • DeLone F. Arthur

    I believe that the airlines should be able to seek additional monies for tickets because some persons are too big and infringe on the people assigned a space near them. Extra-wide seats would be a great idea too!

    All FBI field agents ( no exceptions) should be able to run fast, jump high, and run for prolonged time or to the office they go. However, an office job would be in order for folks on insulin!

  • Gail Kuula

    I agree with the court ruling. Each case should be based on the individual’s control and the job requirements. There should be no legal means of discrimination of all diabetics for whatever reason.

  • Bernard

    This makes me happy to see the courts backed up the young man with diabetes we need more of this in america buy the why i am aheavy set person and would be one of the air lines two seaters but i dont fly so tuff on them may GOD BLESS AMERICA

  • James D.Taylor

    RE The above posting. I for one turned my diagnosis with Type 1 at age 5 into a catalyst to work out both harder and longer than my “normal” competitors. In affect I channeled my adolescent angst over the whole situation into fuel for the fire and excelled at contact sports and went on to a D1 scholarship.
    I can guarantee you I could run faster and jump higher than roughly 98% of the agents currently serving until my late 30’s.
    While I have sustained peripheral vision loss in both eyes I remain highly proficient with a sidearm and see no reason why an individual couldn’t excel as an FBI agent should they be so inclined.
    James D.Taylor

  • Andy

    As long as the person can function properly in his or her job, they should be afforded the right to do so.
    I was in a similar problem with aml. I was given a 6 month leave and told if I didn’t return within the time period, I would be let go for failure to show up for work. It took 3 years to treat the problem and told I was cured. Now I had no job during the time frame and the government wouldn’t hire me back, saying they didn’t think I could now to the job.. This is the federal government for you.
    Being in law enforcement for thirty five years and now retired, I’ve seen alot of discrimination for many reasons. It’s about time to put and end to this.

  • RVold

    I think its a great victory. I’ve been type 1 for 23 years of 28. Its hindered me in a lot of ways, but also capable of doing alot of jobs I told I couldn’t (or doing tons of things I was told I couldn’t or beating all the “odds” Dr.s put on me)Its tough to swim against what everyone tells you, but its the only way TO do it. Airline pilots, bus drivers, active field military, things where public lives are at immediate risk there should be logical limitations. I am very glad to see this though, and I think it had been a LONG ignored disrimination that NO ONE had done anything about it seemed. Keep the tourch going!

  • Denise

    I have been a insulin dependent diabetic for 27 years. I have been on the pump for more that 8 years, with that said I must disagree with the court ruling. In being a special agent with the FBI there will be the time when a pump would be benificial, long chases, delayed meals just to name a few. The pump would give the diabetic/agent the flexibility to delay a meal or stop the pump during vigorus exercise. You can’t stop and eat a piece of fruit or drink some juice during a pursuit. I don’t think it would be safe for the agent on injections. This is not about discrimination it is about safety.

  • Florian

    Wait until the Presidents new nominee to the Supreme Court takes her seat on the bench. Things will change!!!

  • Chris M.

    Information on CNN about Supreme Court nominee Judge Sotomeyer, said that Judge Sotomyer wanted to be a police officer, but that she was told she couldn’t become a police officer when she was diagnosed with diabetes as a child. Instead she became a prosecutor and later a judge. If she is confirmed, it will be interesting to see what her personal experience as a diabetic presumably using insulin since childhood will bring to the Court.
    Even though judges base their decision on the law, I feel that how a person might see a law or constitutional ammendment is going to be affected by their experiences in some way.

    For example, look how people disagree about the 2nd ammendment. Someone who grew up hunting moose might interpert the 2nd ammendment differently than someone who lost a loved one to an armed robber.

  • Mary D. Richards

    I believe that a person’s diabetes management should be private. I don’t believe that any employer can dictate to any employee how to manage their health care unless there’s a serious issue. What I mean by a serious issue is the employee is a threat to themselves or others and it requires the supervisor and other employees to neglect or putoff important required duties.

  • Carrie

    You can drive a truck if you are insulin dependent, but it is very stressful keeping the paperwork up to date.

    The Federal Motor Carrier Safety Administration requires you to see a board certified endocrinologist every three months (only one available in the northern part of our state). My DH has to have a cdl for his job since on a rare occasion he has to be available to drive a big rig.

    Every three months he has to take off work for 3 visits to the dr (one locally for bloodwork, one locally to get the results and see his regular clinical endo, and the one 90 miles away to see a board certified endo). Between work, insurance and the FMCSA, I can see why so few people who are insulin dependent become truck drivers …

  • shinaye

    what about Pre. Obama’s choice to replace Justice Souter? She’s a type 1 diabetic. there are concerns about how long she’ll live as a supreme Court justice.

  • Cheryl Jordan

    The only time there should be ANY discrimination
    against diabetics is if their sugar is uncontrolled, such as A1c above 9, & this I would say would be jobs where you are driving, or operating dangerous machines.
    I’ve been harassed in several jobs due to the fact I had to use the bathroom frequently!

  • Al Fisicaro

    I applaud the decision for two reasons. First, the FBI’s position was discriminatory. But there’s something else they didn’t think of. What if an agent gets in a physical fight or a gun battle, and the insulin pump gets damaged or destroyed? Insulin pumps are really for people who either can’t control their blood sugar via injections, or who dislike the frequent injections. The applicant was not either of these. He was doing fine.

  • Mac

    I knew the FBI did lots of crazy things to employees but this takes the cake. I had two friends who roomed together while working for the FBI in Washington, DC and they had a squabble with each other and their employer got wind of it and fired both of them. One of them returned to home town and got a real job with the Goodyear Tire and Rubber Company and made a good living and has since retired with a good living and that was much better than the low pay as an FBI fingerprint technician.

  • Ed

    I drive trucks for a living and have done so since I was 20 yrs old,I am now 54 yrs old and have been dig.with type 2 diabetes but have been told if I progress to type 1 I will loose my DOT indorsment witch means no job.

  • Rose

    Realize that I am speaking from my own perspective. But I feel that a job that requires you to be physically superior in order to meet the demands of the job is entitled to expect that the hiree does not have physical challanges that could compromise the performance of that job. Diabetes is one of those challanges. Many factors influence the control of a diabetics blood sugar levels, such as stress, physical activity, conformance to your total medication regime etc. It would be horrible to be in a critical situation (where other people’s lives rely on your performance) and to have a low blood sugar episode that impacts your ability to think straight, or perform to your best abilities. You cannot be stopping to check your sugar levels, or administer injections when in a situation as this. Adhering to a strict diet schedule is also a challange in a job that can be unpredictable in its demands of your time. Normally, I would be more prone to defend the diabetic however in this instance I feel that the health of the diabetic would be at risk as well as the job compromised merely because of the danger of the job. I, myself am an insulin dependent diabetic for 10 years and have worked jobs requiring me to be “out in the field” and speak from experience in the challanges my diabetic condition has caused.

  • Derek

    I’m concerned the examples/comments supporting the discrimination decision have been from experiences which are not from life-threatening job situations.

    Sitting on the bench; working in the bank; teaching in a classroom; piloting an airliner; wielding a high rise–are jobs, like many others, in which injections can be taken at regulated times.

    I tend to agree with the FBI. They did NOT exclude Type-1, they only intended to eliminate instances where an agent could not be guaranteed the opportunity to give himself an injection during the performance of his job. The inability to stay 100% threatens the agent, his/her team members, and the citizens they are to defend.

  • Edie

    Hurray, I live with diabetes and it doesn’t affect my work ethick. Diabetics know when and how to control their diabetes. They know when they need their meds, I don’t think it should be anybodies business, if they can do their jobs well.

  • Freddy

    I worked in a factory for 35 years. I am 56 now. I have been on an insulin pump for about 7 years now. My last A1c came in at 6.3 and counting carbs and adjusting your pump for the carb intake in the only way to go. I recently wsa turned down for an armed security guard job. The interviewer expressed a “deep concern” about the diabetes.
    I agree with the courts and am glad that they made the decision that they did. This will open the door for more discrimination suits against employeers who do not hire good people just because they are diabetic.

  • Joe Martyn

    I’ve been diabetic almost 35 years (diagnosed in 1974 at the age of 13). It has never stopped me from doing anything and I recently had my life insurance reduced in price since the Underwriters said that I had normal — NORMAL!! — life-expectancy. Sure, I have to take more care than non-diabetics. But it is perfectly manageable.

    What is more sinister to me is the fact that the Agency said it was OK to use a pump but not to take injections. I moved to the USA about 15 years ago from Europe. Virtually no-one in Europe uses the pump; most people use pens which give all the flexibility of the pump, but without having a device strapped to one’s body day and night. I’m shocked at why diabetics in this country are pushed straight to pumps from syringes. I’ve met many diabetics who have never heard of pens. My suspicision — and it’s well-founded since I have worked in senior positions in drug companies in the US — is that it pumps which were developed and are pushed by pump manufacturers (most/all of whom are American). Pens, on the other hand, were developed and are mostly produced by European companies.

    Finally, when I was finishing my undergraduate degree in 1983 I was offered a job by a big insurance company. They subsequently withdrew the offer stating that since I was diabetic I could not participate in their pension scheme! Nowadays I could have sued the #%*# out of them. But I went back and did a Post-Graduate degree which has resulted in my having a much more successful career over the past 25 years. The worst thing was that the Careers advisor in my University told me at the time that I would have to “get used to the fact that I was handicapped”. Bull-s$%@! We’ve come a long way, and now we have a nominee for the highest court in the land who has been diabetic since the age of 8. There is nothing that we cannot do.

  • Amanda

    Re: Joe

    For the record, the pump offers WAY more managability for some people than pens. I was immediately put on pens, but decided in under 2 months that I would rather have a pump. I require twice as much insulin in the mornings as the afternoons, and my needs change literally hourly. On MDIs, I was constantly dangerously high at night, and dangerously low during the day — I couldn’t reduce the highs without increasing the lows and vice versa! I haven’t gotten my latest a1c from the pump, but I know my daily sugars are now in the 80-160 range, as opposed to the 40-350 range they were before. On MDIs, I couldn’t exercise, because I never knew what my numbers would be. Now I reduce my basal by 50% and keep going. Not to mention the horrible bruises from bleeders while I was injecting — my endo said that “just happens” to some people. It looked like my husband was beating me up!

    I’m not knocking MDIs, I know they work very well for some people — similarly, don’t knock pumps just because you yourself don’t want one!

    As to this case (just to keep this on topic!) I’m actually really conflicted. Part of me is outraged at ANY kind of discrimination against a diabetic who chooses to manage their conditioin their own way. OTOH, I agree that there may be times when the agent may have to work his body for extended periods, or miss meals on a stakeout, etc, and trying to arrange that around MDIs may not work out. If he can make it work, good for him! I think he should have a shot to do it — test it out in less stressful circumstances, and see if it works. If it can’t — then the pump may be necessary.

  • James

    I’ve been a diabetic for 21 years now. I take 4 shots a day and I check my suger level before and after each meal(6 times a day). I went to the doctor last month and my A1c was 6.2. I consider myself to be a responsible diabetic who takes my diabetes seriously. I was told by management in my department that I was not permitted to inject my insulin unless I was on my lunch break. I didn’t have a problem with that. I take my insulin right before my meal anyways. Now management has a problem with me checking my suger level during my shift. This would be my test after breakfast and lunch. It only takes a minute to check it and I have even put it off if we happened to be busy at the time. What pisses me off about this is that the women in my department are allowed the time to slap their make up on and do their hair during their shift with no problem. Well, I’ve had enough. I felt I had no choice but to go to Human Resorces. I just can’t see them in favor of the management. I hope it can be resolved with no further action. Wish me luck.

  • karen

    As an employee of a major airline, I agree that airlines should not remove large people. Any average person has a heck of a time fitting in the seats let alone a larger person. Traditionally, if we see a person who requires more space we quietly will find them 2 empty seats and offer the seats to them. I have never had anyone take offense, rather they are appreciative that we were sensitive to their needs without making a big deal out of it. Airlines know that this is discrimination but unfortunately in this economic climate the execs are trying to find any way to make more money. Pretty soon they will be putting coin slots in the lavatories!!!

    As far as the job restrictions go,I can understand both sides. Pilots work long erratic hours. However, they are highly educated, highly trained professionals. Many of them have been in the military and are used to even harder conditions. They are the most professional people I have ever met and I have never met a pilot that would take any chances with his or her passengers. It should be decided on a case by case basis looking at the history of the person’s diabetes management. If they have good control then I do not think they should be denied ANY position. I am very interested in this subject because my 8 year old has already encountered discrimination in her school. I have become an ADA Advocate because of it. I shutter to think of all of the discrimination she will encounter as an adult. Diabetics have enough to deal with in their lives, they should not have to deal with ignorance on top of it. Continue the fight!!!

  • Paige

    I am a diabetic who uses insulin injections and i want to be an FBI agent. I think it would be discrimination if they don’t let diabetics be in the FBI. If the diabetic can control their bloodsugar levels, they deserve a fair chance. If they are unhealthy, however, that is different. Give the diabetics a fair chance!

  • Jason

    I must agree that discrimination against diabetics in the work force is far more rampant than anyone could possibly know. I was just diagnosed with type 1 diabetes a year ago. i have been using an insulin pump for about the last 6 months. i can say honestly that since using the pump my blood sugars stay more normal than my non-diabetic mother, who tests herself regularly.
    I also had dreams of flying commercial jets for a career but that has also been smashed due to the discrimination of the FAA against diabetics. I think its wrong that a diabetic can be a doctor and surgeon and be trusted with someones life in that way but cannot fly a plane where there is atleast 1 other person capable of flying that plane at all time and the planes these days are practically completely automated.

  • Deana

    I’m just now getting to this posting and I’m SO glad I found it. It has been one year to the date that my 15 year old son was diagnosed with Type 1 diabetes. It ruined his world that the doctor’s told him he could never be in the military due to this illness. For 8 months he has been wondering what to do with his life. It put him in a great depression. Then he deceided that he will be an FBI agent. It is good to know that as long as he keeps his health in check they can NOT deny him of a job. This is his dream and it wasn’t his fault that he got this diease. Now we can plan for his future.

  • Hillary

    Hello. I am type one diabetic and have an insulin pump. I have always wanted to be a special agent in the FBI and I have researched it and they said that you could have NO medical disabilities. THANK YOU JEFF for fighting this. I can understand why they said you could not before, like if you are put into captivity or something, but I really think that if you have managed your diabetes right, you should be able to. Its frustrating. I hope this gets better soon.

  • zoe

    I’m a type 1. I’m all for “we’re equal, nothing can stop us!”
    But as I am looking more and more into the medical field for careers, I can understand why there are laws in place.
    I’m as disappointed as anyone that I can’t be a paramedic, etc., but the reality is, when there are other’s lives involved, I think that yes it is there right to put laws in place. No matter how well you are controlled, something can always happen.