Life with T1D
Career Opportunities with Type 1 Diabetes
More and more professions are allowing individuals on insulin therapy to obtain medical certification through diabetes exemption programs. Technology and medical advancements make it easier to keep your time in range, proving your abilities are equal to others.
For many young people today, deciding what career path to choose can be daunting. With so many options, from health and science to computers, law, film, sales and writing—the choices are infinite.
What’s more, thanks to progressive thinkers, Americans with Disability Act (ADA) federal laws, and advancements in medicine and technology, there are far and few jobs off-limits to people with diabetes as it was 30 years ago.
Know Your Rights
You’re Protected
First, it’s important to know how the Americans with Disability Act protects T1Ds, and yes, diabetes is considered a disability under the third prong of the Act. This means employers are forbidden under federal law to refuse to hire or terminate an individual because of diabetes. Also, under Title 1 of the ADA, employers are prohibited from asking any questions relating to diabetes.
Full Disclosure - Or Not?
Most scenarios do not require employees to tell employers they have diabetes. However, in some professions, there are legalities to be aware of. Some jobs have physical qualifications that must be disclosed.
Do I Tell my Employer about my Diabetes?
Once employed, you should disclose your condition for your safety and those around you. Also, your co-workers and supervisor might need to know if you’re taking a break to eat a snack for a low blood sugar attack. And in extreme cases, if they need to call 911 due to an emergency.
Anti-Discrimination Laws
Also, if you want to be protected under any anti-discrimination laws, you must speak up and let your boss know your condition. Unless the employer has prior knowledge of your disability, you can't be protected from discrimination.
Type 1 Job Restrictions
Today, people with type 1 diabetes (T1D) needn’t let the condition restrict their professional choices in any way. However, there was a time when a type 1 diagnosis limited possibilities. Now, except for the armed forces, there is no vocation type 1 individuals can’t explore.
T1Ds have access to employment in most cases, with few exclusions where employers fear employees’ hypoglycemia might affect performance. These jobs are exempt from the ADA Act; however, any disqualification because of insulin therapy or diabetes must be determined case-by-case. Some professions require a person’s A1C to be below 8%.
Career Opportunities with Type 1 Diabetes
Armed Forces
The U.S. Armed Forces have a blanket ban on the employment of people with diabetes (type 1, 1.5 and 2). However, if a person in the military receives a diagnosis, they can undergo an individual assessment or Medical Evaluation Board (MEB) to determine if they can continue to meet medical standards.
Firefighters
The National Fire Protection Agency (NFPA) 1500 standard requires that an employee’s A1C below 8%. The American Diabetes Association (ADA) worked with NFPA to change the medical standard so diabetes is no longer considered an automatically disqualifying condition.
“The best thing someone can do is tell me I can’t do something, thanks for the coal. I’ll light the fire.”
Law Enforcement Officers
Once again, the American Diabetes Association joined the American College of Occupational and Environmental Medicine (ACOEM) to create a National Consensus Guideline for the Medical Evaluation of Law Enforcement Officers with diabetes. Now, each LEO with diabetes is evaluated on a case-by-case basis.
EMTs and Paramedics
Fortunately, you can be an EMT or paramedic if you control your diabetes. Since health and ambulance services treat patients with suspected hypoglycemia and administer emergency treatment such as glucagon, an individual with diabetes can get certified—and who better to treat a low blood sugar reaction than someone who’s experienced one?
Airline Pilots
New FAA guidelines allow T1Ds to become commercial pilots. They can apply for a medical certificate required to fly a U.S. airline and meet specific requirements, including regular doctor visits and A1C checkups. Other restrictions include testing a half hour before the flight. If the pilot’s blood sugar is less than 100 mg/dl, a glucose snack is required, then repeated if needed. If the level is between 100-300 mg/dl – no action is necessary. If greater than 300 mg/dl, they cannot fly. Pilots must also test one hour into the flight, and if their blood sugar level is over 300 mg/dl and won’t come down- they must land the plane at the nearest airport and not resume flight until the glucose levels are stabilized.
Federal Bureau of Investigation
Much debate has concerned the FBI’s blanket disqualification of people with insulin-dependent diabetes. In a court case in 2000, Davis v. Meese, the plaintiff, a T1D, who was already an accounting technician for the agency, applied for a job as a special agent, and the FBI rejected his application even though he met all essential requirements. The court upheld the FBI’s decision. However, today, thanks to advocacy efforts by the ADA, FBI agents and Foreign Service officers can undergo a medical evaluation to verify their diabetes management is in good standing. One special agent, Adam Roth, faced discrimination early in his career but fought through it and now encourages others not to let diabetes hold them back.
Allowances and Accommodations
Not only is it okay to ask for work breaks, but it’s also well within your rights. Your employer must be aware of your diabetes management needs. It’s essential that you be not only healthy at work but happy with your work conditions. This means fixed working hours, adequate pay for your job, and access to regular physical activity – getting up during the day to stretch, walk and test blood sugar levels.
Know Your Rights
If you’ve unjustly been fired or refused employment because of diabetes, you can seek legal advice and counsel. For general information about the Equal Employment Opportunity Commission (EEOC) laws or filing a discrimination charge, check out the EEOC Public Portal.
“Anytime someone tells me that I can’t do something, I want to do it more.” Taylor Swift
Health Insurance
When searching for a job today, it's important to secure a position with good insurance. Having the right health insurance lowers insulin and diabetes supply costs and protects you in case of an emergency.
Moreover, The Affordable Care Act (ACA) allows children to stay on their parents' health insurance plan until the end of the year they turn 26, regardless of their marital status. The U.S. Department of Labor states this applies to all employer plans and plans in the individual market.
Full-time positions generally offer health insurance. However, smaller companies may be exempt from this. You can learn more about job markets and health care options at Healthcare.gov.
Push Back
Just because a law is in effect doesn’t mean it’s right. There was a time in this country when slavery was legal, and women couldn’t vote. Things change only through grassroots efforts and a little pushback or a lot in some cases. Standing up to the status quo isn’t easy, but neither is diabetes.
Today, we have race car drivers, artists, athletes, health care professionals, entertainers, and even a United States Supreme Court Justice with type 1 diabetes. Chances are someone tried to sway their decision and tell them they couldn’t – but they did it anyway.
Good luck in your search!
For more information on type 1 career opportunities, check out these sites: