Safety Issues

Employers who deny job opportunities because they think all people with diabetes are a safety risk do so based on misconceptions or a lack of current information about diabetes. 

The first step in evaluating safety concerns is to determine whether the concerns are reasonable in light of the job duties the individual must perform. For most types of employment (such as jobs in an office, retail or food service environment) there is no reason to believe that the individual’s diabetes will put employees or the public at risk. 

In other types of employment (such as jobs where the individual must carry a firearm or operate dangerous machinery) the safety concern is whether the employee will become suddenly disoriented or incapacitated. Such episodes, which are usually due to severely low blood sugar (hypoglycemia), occur only in people receiving certain treatments such as insulin or certain oral medications, and even then occur infrequently. 

To read the Association’s clinical practice recommendation on this issue, see the position statement Diabetes and Employment.

Can I be fired because my employer believes I am a safety risk?
Before your employer can fire you because it believes you pose a safety risk, it must conduct an individual assessment of your diabetes to see if you pose a ‘direct threat” and evaluate whether there are any reasonable accommodations that can eliminate safety problems. 

What does “direct threat” mean?
Direct threat is a term used in federal antidiscrimination law that means the person with a disability poses a significant risk of substantial harm to the health or safety of the person or other employees that cannot be eliminated by reasonable accommodation. It is a defense available to employers charged with discriminating against a worker because of a disability. 

Employers who claim that a worker with diabetes poses a direct threat must first conduct an individual assessment of that worker’s diabetes before taking any action that would harm the employee (like firing or transferring to a lower paying job). The employer must assess the worker’s present ability to safely perform the essential functions of the job, and the assessment must be based on reasonable medical judgment that relies on the most current medical knowledge or best available objective evidence. 

In determining whether a worker poses a direct threat, employers must consider:

  • the duration of the risk;
  • the nature and severity of the potential harm;
  • the likelihood that the harm will occur; and
  • the imminence of the potential harm.

Can I be disciplined or fired for having hypoglycemia on the job?
If your employer has workplace conduct rules that are applied uniformly to all employees, you can be disciplined if your conduct violates these rules—even if that conduct was because of diabetes, for example, your behavior was caused by hypoglycemia. 

If you have not violated any conduct rules, the most likely result from an episode of hypoglycemia on the job is that your employer may require a medical evaluation. You cannot be fired for having hypoglycemia without first conducting an individual assessment to determine safety risk, and without considering whether there are any reasonable accommodations that could eliminate the safety risk.