Article

Crohn's Disease and Ulcerative Colitis at Work: Your ADA and FMLA Rights

How the ADA and FMLA protect workers with Crohn's disease, ulcerative colitis, and other inflammatory bowel disease, including coverage based on digestive and bowel functions, flares and remission, why medication does not erase coverage, restroom breaks and schedule changes, leave for flares and treatment, medical questions and confidentiality, FMLA intermittent leave, retaliation, and deadlines.

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How Crohn's Disease and Ulcerative Colitis Can Qualify as a Disability

Title I of the Americans with Disabilities Act applies to private employers with 15 or more employees for 20 or more weeks in the current or preceding calendar year and to state and local government employers; federal workers are covered through the Rehabilitation Act, and many state laws reach smaller employers. MedlinePlus describes Crohn's disease as a chronic disease that causes inflammation in the digestive tract and ulcerative colitis as a disease that causes inflammation and sores in the lining of the rectum and colon; both are types of inflammatory bowel disease (IBD). Under 42 U.S.C. Section 12102 and 29 CFR 1630.2(i), major life activities include the operation of major bodily functions, and the regulation expressly lists digestive and bowel functions. Coverage is still decided individually rather than by diagnosis alone, but the ADA's definition of disability is meant to be construed broadly, and a person with a record of such an impairment or who is regarded as having one can also be protected under 29 CFR 1630.2(k) and (l).

Flares, Remission, and Medication

MedlinePlus notes that symptoms of Crohn's disease vary with where and how severe the inflammation is, and that some people with ulcerative colitis have long periods of remission when they are free of symptoms. Under 29 CFR 1630.2(j)(1)(vii), an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active, so an employer cannot deny coverage simply because you are between flares. Under 42 U.S.C. Section 12102(4)(E) and 29 CFR 1630.2(j)(1)(vi) and (j)(5), substantial limitation is judged without regard to the helpful effects of mitigating measures such as medication, and 1630.2(j)(4)(ii) says the negative side effects of medication or the burdens of following a treatment regimen may be considered. A person covered only because the employer regards them as impaired is not entitled to reasonable accommodation under 1630.2(o)(4).

Restroom Breaks and Schedule Changes

Under 42 U.S.C. Section 12111(9), reasonable accommodation may include job restructuring, part-time or modified work schedules, reassignment to a vacant position, and acquiring or modifying equipment. The EEOC's reasonable accommodation guidance says a modified schedule may involve adjusting arrival or departure times, providing periodic breaks, altering when certain functions are performed, using accrued paid leave, or providing additional unpaid leave, and that an employer must provide a modified or part-time schedule when required as a reasonable accommodation absent undue hardship, even if it does not offer such schedules to other employees. For a worker whose symptoms include urgent diarrhea or abdominal pain, that can mean breaks to use the restroom when needed or a start time adjusted around morning symptoms. If more than one accommodation would work, the EEOC says your preference should be given primary consideration, but the employer has the ultimate discretion to choose among effective options; undue hardship means significant difficulty or expense.

Leave for Flares, Treatment, and Surgery

The EEOC's reasonable accommodation guidance says permitting accrued paid leave or unpaid leave is a form of reasonable accommodation when needed because of a disability, and it lists obtaining medical treatment, including surgery, and recuperating from an illness or an episodic manifestation of the disability among the reasons. That can cover time off during a flare, for infusions or other treatment, or after bowel surgery. An employer does not have to provide more paid leave than it gives similarly situated employees, but it should let you use accrued paid leave first and then provide unpaid leave. The EEOC also says an employer should act promptly on a request, and unnecessary delays can violate the ADA. You do not need to use special words to ask; keep copies of each request and each response.

Medical Questions and Confidentiality

Under 42 U.S.C. Section 12112(d)(4)(A), an employer may not require a medical examination or ask a current employee whether they have a disability or about its nature or severity unless the examination or inquiry is job-related and consistent with business necessity, although it may ask about your ability to perform job-related functions. When you request an accommodation and the need is not obvious, an employer may ask for reasonable documentation about the disability and the functional limitations that make the accommodation necessary. Under Section 12112(d)(3) and (4), medical information the employer obtains must be kept on separate forms, in separate medical files, and treated as confidential, with limited exceptions such as informing supervisors about necessary work restrictions and accommodations.

FMLA Intermittent Leave for IBD

Under the Family and Medical Leave Act, 29 CFR 825.113 defines a serious health condition as an illness, injury, impairment, or physical or mental condition that involves inpatient care or continuing treatment by a health care provider. Under 29 CFR 825.115(c), continuing treatment includes a chronic condition that requires periodic visits for treatment at least twice a year, continues over an extended period including recurring episodes of a single underlying condition, and may cause episodic rather than continuing incapacity. Under 29 CFR 825.202, FMLA leave may be taken intermittently or on a reduced leave schedule when medically necessary for planned or unanticipated medical treatment or for recovery from treatment or from the condition. Under 29 CFR 825.110, an eligible employee has worked for the employer for at least 12 months, has at least 1,250 hours of service in the 12 months before leave starts, and works at a location where the employer has at least 50 employees within 75 miles.

Retaliation and Deadlines

Under 42 U.S.C. Section 12203, an employer may not retaliate against you for opposing disability discrimination or taking part in an ADA charge or investigation, or coerce, intimidate, threaten, or interfere with you for exercising ADA rights. Keep a written record of each accommodation or leave request, every response, and any discipline for breaks or absences, schedule cut, or termination that follows. A charge with the EEOC generally must be filed within 180 calendar days of the discriminatory act, extended to 300 days where a state or local agency enforces a law prohibiting the same kind of discrimination; federal employees generally must contact an agency EEO counselor within 45 days.

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