Your health: If they ask, should you tell?

knitted pancreas, with suppliesThe state of your health is between you and your doctor and your family. Right?

Why should a government agency care? Why does your employer—current or future—need to know? What difference does it make?

I’ve been thinking about these questions lately because a few days ago I got a notice requesting information to be entered in a jury pool.

And about 6 months ago, I applied for a Maryland driver’s license. In both cases, one of the questions was “Do you have a health condition that would interfere with your ability to [drive/ serve on a jury]?”

What’s the answer?

In both cases, I answered No. After all I’m physically fit and mentally sharp. My hearing is excellent. My eyesight is good (after I put in my contact lenses), and I have no sign of eye diseases, such as retinopathy, macular degeneration, or glaucoma.

I do, however, have Type 2 diabetes.

Why that’s the right answer

You may be thinking, wait a minute! I remember that you yourself described Type 2 diabetes as a chronic, progressive disease. You said that chronic means that there’s no cure, and progressive means that it gets worse over time.

I did say that, and it does get worse over time—if it’s not well-managed. But mine is well managed.  I eat a healthful diet, exercise, monitor my blood glucose, and get regular medical check-ups.

Even with all that, though, I sometimes become hypoglycemic (meaning that I experience low blood glucose), especially between meals. When this happens I feel lightheaded, weak, and very hungry. Depending on how low my blood glucose goes, I may be sweaty and have what I call “fog-brain.”

I try hard to avoid hypoglycemia by checking my blood glucose, especially before a long drive or even a long walk. I keep energy bars in the house and in my car and in my fanny-pack when I go for a walk. I carry my cell-phone and a home-made medical card with relevant health information and contact information for my doctor and my BF. An Eagle Scout could not be better prepared.

What about job applications?

Employment questionnaires often ask a variant of the health question:  Do you have any condition which would interfere with your ability to do the job for which you’re applying?

I would answer No to that question too and for the same reasons.

What if you develop a health condition after you get the job? Should you tell anyone then?

Because Type 2 diabetes is common—even epidemic, in the U.S. and many other countries— it’s a good example of a health condition which could possibly interfere with your ability to do a particular job.

I think that there are compelling reasons to tell your supervisor and assorted co-workers, if you have Type 2 diabetes. If you have Type 1 diabetes, it’s essential. The reason is that people need to know what to do if something goes wrong while you’re at work.

Paula’s story

At my last job Paula, a woman with Type 1 diabetes, became dangerously hypoglycemic one afternoon. Her blood glucose went so low that she couldn’t speak. She was unable to respond to simple questions, such as “How old are your children?”

Because several of us knew that she had Type 1 diabetes, we quickly deduced what was wrong, summoned help, and told the emergency medical technicians what was happening. After treatment she recovered quickly and later that afternoon was able to drive herself home.

My story

I was on a telecon one day which went on much longer than I expected. I had not eaten lunch, and I became hypoglycemic. I rushed down to the cafeteria to get some food and brought it to the weekly staff meeting. My brain was feeling fairly foggy, when my supervisor (let’s call him George) turned to me and asked, “What do you think about that, Madeleine?”

What I thought about that was that I had no idea what he was talking about.

The brain is a real glucose-guzzler. It can’t make glucose or store it. It needs to get its supply from the blood vessels. When the supply runs low, the brain slows down. It gets foggy. It becomes challenging to answer simple questions.

If a person is dangerously hypoglycemic, as Paula was, she may be unable to speak. (Paula’s blood glucose levels had become extremely low due to a very unusual circumstance. It’s a long story.)

I was able to say that I was feeling a bit hypoglycemic, and George nodded understandingly. In short order, I was feeling fine again and able to join the discussion.

Should I just say No on a job application then?

Based on my experience, I’d suggest that you should not just say NO. If you don’t have a health condition which interferes with your ability to do the job for which you’re applying, you should say NO.

But if you do have such a condition, you should say so. Then you can describe what special accommodations you would need in order to perform the job.

If you have experience with a health condition which affects your ability to work or drive (even temporarily or from time to time) or any suggestions, I’d apreciate hearing from you.

Comments on this entry are closed.

  • Madeleine Kolb 10/09/2010, 5:24 pm

    Corrina, It’s hard for me to know, since I’m retired from that job. I’d like to think that my supervisor there was typical, but maybe he was exceptional.

    In another instance, one of my co-workers had breast cancer and was undergoing chemotherapy. She was anxious because she felt so awful and was missing a lot or work. She couldn’t get her work done. Our supervisor said, “Diane [not her real name], your job now is to take care of yourself. My job is to see that the work gets done.”

  • Corinna 10/09/2010, 4:25 pm

    “…perhaps all supervisors would not be so understanding. ”
    Perhaps I “grew up” in a very paternalistic corporate culture. My first supervisory position was in the phone company and we had it drilled into us that we are responsible for the safety of our workgroup.
    Later we were made aware of the legal responsibilities that supervisors have to not discriminate. The workers were unionized and the company was a lawsuit target because it was seen as having deep pockets.
    The up side of this was that as a supervisor I saw it as my responsibility to care about the folks in my workgroup and to pay attention to any sign that one of my people was having trouble.
    Of course these days, after going through multiple downsizings and the do-more-with-less mentality I’m sure the corporate culture is different.
    The idea that a worker must be careful what s/he reveals to a supervisor saddens me. Hmmm…

  • Madeleine Kolb 10/08/2010, 12:03 pm

    I really appreciate your thoughtful response and basically agree with the points you raise. Certainly, the need to protect legal rights and public safety trump other considerations.

    It’s quite true that “Asking the question on an employment application is a bit more complex.” For one thing, an employee may discriminate for other reasons, such as age or sex, in addition to disability. It is illegal, but–as you suggest–a legal challenge would take a long time, cost a lot of money, and is unlikely to prevail.

    “So why ask the question on a job application?” In addition to the reporting requirement that you mentioned, one reason may be that–if the applicant answers “Yes,” the next question is about reasonable accomodations. I’ve worked in buildings which had employees who were blind or deaf or in wheel chairs or morbidly obese, so I assume that making accomodations to such conditions is not uncommon.

    The aspect of disclosing a health condition which occurs after one has been hired is the most tricky part of this whole topic. Personally, I didn’t expect that there’d be any emergencies related to my having Type 2 diabetes. But since hypoglycemia could be mistaken for something more serious, such as a stroke, it made sense to me to tell people I worked with closely and my supervisor. He was very supportive, but perhaps all supervisors would not be so understanding.

  • Corinna 10/07/2010, 11:19 pm

    I guess my response to “Should you tell?” is a bit legalistic…

    First of all I read the question as asking what’s going on right now with my health, not at some hypothetical point in the future. After all being hung over one morning doesn’t make me an alcoholic. Is my Type 2 diabetes well controlled? Or do I experience extreme blood sugar highs and lows on a regular basis? If it’s well controlled then my answer is “No. I do not have a health condition that will interfere with my ability to do the job.”

    Asking the question on a jury pool application protects people’s rights. It protects the defendant’s right to a fair trial and society’s right to protection from criminal activity. I wouldn’t want someone convicted or a mistrial called because a juror who was too ill do the job.

    Asking the question on a driver’s license application protects people’s safety. If the driver’s medical condition is under control due to medication or lifestyle choices, then no problem. But if the driver blacks out while driving a vehicle, that is a problem.

    Asking the question on an employment application is a bit more complex. An employer cannot legally discriminate against a person with a disability. But the person with the disability must be able to “perform the job’s essential functions with reasonable accommodation.” Of course proving discrimination in a court of law can be very difficult. An employer cannot ask a job applicant about his/her disability in a job interview—no matter how obvious the disability is. The applicant can volunteer information about his disability if he chooses.

    So why ask the question on a job application? Because companies have to report employment and job recruitment statistics to the federal government. Most applications will say that the applicant can choose whether to answer the self-identifying question about race, gender, disability, veteran status, etc. ( There are a very small number of companies who have federal contracts where this exclusion does not apply.) In a bureaucratic irony companies have to report on the things that they cannot talk about in order to prove that they didn’t.

    What about saying something after being on the job? If there’s a possibility that I will need help or understanding, then I say “Yes, tell someone but not necessarily everyone.” It could save my life in an emergency, or at least reduce the stress of having to actively manage my health and do my job.
    .-= Corinna´s last blog ..Good Ideas- No Bun =-.

  • Madeleine Kolb 10/01/2010, 9:04 pm

    Andrea, It’s good to see you here.

    As you suggest, the key is knowing your own condition, doing as much as you can to manage it, and letting others know in case you need help sometime.

    “Feeling dizzy, fainting, or being disoriented can happen to anyone without having a known disease.” This is true, but if those symptoms (or other serious symptoms) recur a person should see a doctor.

    Type 1 diabetes is a very challenging illness to manage. Keeping blood glucose at the right levels takes a lot of care to avoid a mistake as my co-worker Paula learned. How tragic that your friend crashed while driving alone, probably from very low blood glucose.

  • Andrea DeBell - britetalk 10/01/2010, 5:35 pm

    Hi Madeleine! These are very relevant questions. I think this is case by case. We each know the severity of your illnesses and to which level they can affect our jobs.

    In the diabetes example, this disease doesn’t usually prevent a person from performing the job so I don’t think it needs to be disclosed. Only in special situations may the person need some assistance. The employee should let her co-workers know of her condition in case there is a need. Feeling dizzy, fainting, or being disoriented can happen to anyone without having a known disease.

    Thanks for making think about this important issue. Loving blessings!

    P.S. – Although, I do have a dear friend who had diabetes 1 and died in a car crash by hitting a wall all by himself on a freeway. Most everyone accounted the accident to him having a sugar crash while driving.
    .-= Andrea DeBell – britetalk´s last blog ..The Sexy Art of Touch =-.

  • Madeleine Kolb 09/29/2010, 8:35 am

    Hi Francoise,
    I really appreciate your comment. The simple question about interferring with one’s ability to work or drive is not so simple. So much depends on the individual situation.

    About 25% of the people with Type 2 diabetes don’t know that they have it, although they may be having symptoms of illness. Of those who have it and know that they have it, some are managing it well and some aren’t. Of those who are managing it well, some will seldom experience hypoglycemia, and some (like me) will experience it fairly often but deal with it quickly without assistance.

    The important thing is that all of these people need to think about what could go wrong at work and let co-workers know, so that they know how to help if they need to.

  • Françoise 09/29/2010, 7:38 am

    Hi Madelaine,

    you have a very interesting point there, I’m sure that I would have answered yes in such a situation. But I’m also sure that I could have done so by being over critical of myself and what I can do, I also would have said yes out of the wish to be as correct as possible.
    What I like about your approach is the fact that it aims at being responsible towards oneself too. Basically this isn’t a question of honesty but of position and perception. I simply don’t have enough knowledge about how it is to have diabetes type 2 making it difficult to know how manageable it is – so how should an employer know?
    And well, I’m not going to explain on such a document that it can happen that I’ll have such a headache that I might have a foggy brain …. (possibly even from the party the night before … )
    .-= Françoise´s last blog ..Emotional Competence =-.

  • Madeleine Kolb 09/25/2010, 4:11 pm

    Hi Alison, It’s great to see you here.

    Certainly, this question on a job application is not simple. On the other hand, most of us probably wouldn’t apply for a job that required lifting heavy things if we’d had back trouble in the past.

    Basically, I think–if you’re interested in a job and qualified for it and can answer No with a straight face to the question–that you should. The question applies to the present, and who knows what the future may bring?

  • Alison Kerr 09/24/2010, 5:48 pm

    “Do you have any condition which would interfere with your ability to do the job for which you’re applying.”

    I find this kind of loaded question very difficult. The question is, where is the dividing line between “would” interfere and “could” interfere? Obviously if you need to lift heavy weights in a job and have back problems the answer is “yes”, even though your back may not be having trouble right at the moment. Some other conditions are more of a judgment call.
    .-= Alison Kerr´s last blog ..Why Lettuce is Better Than Cabbage =-.