How to Keep Working with Diabetes During COVID-19

People with diabetes are concerned about their risk of contracting COVID-19 at work. Many, including those in frontline jobs, have had to continue going to work despite the real threat of contracting and developing serious cases of COVID-19. Others, who have worked from home during business closures, are concerned about returning to workplaces as businesses across the United States reopen. Often, people with diabetes can’t choose between a paycheck (and their employer-based health insurance) and staying home to prevent the risk of becoming infected with COVID-19.
This dilemma affects all people with diabetes, but disproportionately impacts people with diabetes in low-income households as well as those who are Black, Indigenous, and People of Color, who, in turn, also have a higher prevalence of diabetes. According to a recent report from the Economic Policy Institute, Black workers are more likely to be classified as essential and, as a result, face a greater risk of COVID-19 exposure. The New York Times and Johns Hopkins Medicine reported that members of Latinx and Indigenous communities face similar challenges. This compounds existing health inequalities and adds additional risk for many BIPOC with diabetes.
So, what are people with diabetes to do? Current laws that protect workers with diabetes are not a cure-all, but as we collectively work towards systemic change, people with diabetes of all backgrounds can use certain laws during the COVID-19 pandemic to protect themselves. Under the Americans with Disabilities Act (“ADA”), most employers must provide reasonable accommodations to minimize the likelihood that employees with diabetes will contract COVID-19. In addition, workers with diabetes may be able to take legally-protected paid time off under the Emergency Paid Sick Leave Act and the Family and Medical Leave Expansion Act.
Here are a few ways in which people with diabetes can use these laws to protect themselves.

What can I do if I wish to continue working, but need my employer to make changes to my job to reduce my risk of catching COVID-19? If you need to continue working, you can request reasonable accommodations under the Americans with Disabilities Act.
An accommodation is a change or modification to a job, the way a job is done, or the work environment that allows you to care for diabetes and complete the most essential parts of your work. The Equal Employment Opportunity Commission (“EEOC”), a government organization that helps enforce anti-discrimination laws, recently explained that people with disabilities, such as diabetes, “must receive reasonable accommodations necessitated by pandemic conditions.” Diabetes puts people at a higher risk of developing serious complications from Coronavirus, so employers are legally required to provide accommodations to employees with diabetes to minimize the risk that they’ll contract COVID-19.
Is my employer required to provide reasonable accommodations? The Americans with Disabilities Act requires employers of 15 or more employees, except religious institutions, to provide reasonable accommodations to employees with diabetes. Some state civil rights laws require smaller employers to provide reasonable accommodations. In California, for example, the Fair Employment and Housing Act (“FEHA”), requires employers with five or more employees to provide accommodations.
How do I request an accommodation? You don’t have to use certain words or follow an exact formula to request a reasonable accommodation, but, the following tips can make requesting and actually getting accommodations easier.
Figure out whether your employer has a process for requesting reasonable accommodations. Some businesses provide specific policies and instructions for how you should request accommodation. Start with your employee handbook or your Human Resources Department. If you don’t have a handbook or an HR department, reach out to your supervisor.
If you haven’t already, tell your supervisor and HR department that you have diabetes. It can help to briefly describe diabetes so that your employer can better understand what you deal with. The American Diabetes Association provides this sample letter that you can use as a template.
Explain why diabetes puts you at a higher risk for COVID-19. You might say something to the effect of “The CDC has determined that people with diabetes are at greater risk for serious illness if they contract COVID-19.”
Explain how your job may put you at higher risk of contracting COVID-19. If you are a grocery store worker or someone who works in a factory, for example, you might explain that being close to people inside increases your risk of getting COVID-19.
Suggest solutions. If you provide suggestions as to how your employer can minimize your risk of contracting COVID-19, it can help them figure out accommodations that will work for you, allow you to keep doing the essential functions — basically the main parts — of your job, and stay safe.
According to the American Diabetes Association, the most common requests for accommodations for people with diabetes include working from home, temporarily changing certain job duties to physically distance from others, temporarily working in another open position, requesting personal protective equipment to wear at work, or taking time off.
If you are a frontline worker in a store, for example, you might request that you temporarily complete administrative work from home, rather than working in the building, or suggest that you work in the back and stock shelves alone to minimize contact with customers or employees. If you typically work in an office setting and have been asked to return to the office after teleworking, you can request that you continue to work from home. As we enter summer, more and more states are relaxing restrictions and workplaces follow suit — workers are increasingly being asked to return to work in the office. But if you’ve been allowed to telework during the pandemic, this is evidence of the reasonableness of a request to continue teleworking.
If you are having trouble coming up with a suggested solution, the Job Accommodation Network’s (“JAN”) searchable database of accommodations may be able to help you brainstorm the best fit for you and your job.
Provide supporting information from reputable sources. The American Diabetes Association has a helpful letter you can give your employer that explains the impacts of COVID-19 on people with diabetes, an employer’s responsibilities under the ADA, and COVID-19-related leave laws that you can attach to your request for accommodations. The CDC also provides helpful information on diabetes and COVID-19 on its website.
Be ready to give your employer a doctor’s note. You are not required to provide a doctor’s note when you request an accommodation, but it can make the process easier. The ADA allows employers to request a letter from your doctor, but they can only ask a doctor to confirm you have diabetes and need accommodations. The American Diabetes Association has a template letter that doctors can use to draft accommodations requests.
Put everything in writing and keep notes. If you request an accommodation in person or over the phone, follow up with an email. If you don’t have an email, send a letter via certified mail, and keep a copy. Ask your employer to put any responses to your request in writing. Keep notes, and include dates and the names of people involved. This way, you’ll have a record of what happened if you run into issues.
What does an employer have to do if I request an accommodation to minimize my risk of being exposed to COVID-19? If you request an accommodation, your employer is required by law to work with you to minimize your risk of COVID-19 exposure and perform the essential functions, or key parts, of your job. This is called the interactive process.
Your employer must carefully consider what you would like as an accommodation first, but if the accommodation causes an undue hardship — significant difficulty or cost — for their business, they can explore reasonable alternatives.
If you request an accommodation, it’s illegal for your employer to retaliate against you. They can’t demote you, remove job responsibilities, fire you, or take other negative actions against you because you exercised your legal rights.

Is there any way for me to take paid time off because of COVID-19? You may be able to use certain legally-protected types of leave, in addition to taking time off as an accommodation or taking existing paid time off that you’ve accrued. The American Diabetes Association created this chart to help workers determine how the new paid leave laws, discussed below, apply to them.
First, you may qualify for up to two weeks of paid leave under the Emergency Paid Sick Leave Act (“EPSLA”). EPSLA leave is available to people who work for businesses with less than 500 employees. It applies to workers in a number of situations, including those who can’t work because they are subject to a stay at home order or because they have been advised by a health care provider to self-quarantine. Because the CDC has advised people with diabetes to stay home, people with diabetes may qualify for paid EPSLA leave. Employers generally have to pay a worker taking EPSLA leave their regular salary during the leave, but payments are capped at $511 per day or $5,110 total.
Second, you can take up to 12 weeks of leave under the Emergency Family and Medical Leave Expansion Act (“EFMLEA”) to care for children who are unable to go to school or childcare because of COVID-19. EFMLEA leave is available to people who have worked at least 30 days for businesses with less than 500 employees. The first ten days of leave can be unpaid, or workers can use EPSLA leave. After the first ten days, an employer must pay two-thirds of an employee’s typical salary — up to $200 per day. This law does not specifically protect people with diabetes, but it can provide paid time off for parents with diabetes who qualify.
Both the EPSLA and EFMLEA have a few exceptions. If you are a health care provider or emergency responder, your employer does not have to provide EPSLA or EFMLEA leave. Some small businesses of less than 50 employees don’t have to provide leave, but they must meet certain criteria required by the federal government to avoid providing this benefit. Workers must use EPSLA and EFMLEA time off by December 31, 2020.
You are protected if you take EPSLA or EFMLEA leave. Your employer can’t reduce any time off you’ve already earned or retaliated against you.
How should I request leave under these laws? Some businesses have specific forms or procedures you should follow to request leave. Others don’t. Check with your Human Resources Department or your supervisor for information on how to submit a leave request. If they don’t have a procedure, tell your direct supervisor that you would like to take leave in writing. Explain the type of leave you are requesting and why you qualify. As with an accommodations request, it can help to attach information about the leave that you are requesting, such as the U.S. Department of Labor’s Families First Coronavirus Response Act: Employee Paid Leave Rights information page or the American Diabetes Association’s letter to employers.

Are there additional resources for workers with diabetes who are concerned about COVID-19? The American Diabetes Association provides great resources for people with diabetes regarding their rights during the COVID-19 crisis and on employment rights in general. For more information about people with diabetes’ rights and reasonable accommodations, please visit the EEOC’s Diabetes information pages. The Job Accommodation Network’s article on Engaging in the Interactive Process During the COVID-19 Pandemic can also be a helpful starting point on COVID-19 specific issues.
Where can I turn for help? Requesting an accommodation or leave can add stress to an already stressful time. It can also be particularly challenging for people with diabetes that face bias and discrimination at work based on race, gender, gender identity or expression, sexual orientationdisabilities other than diabetes, or other protected characteristics to make and receive leave or accommodations requests. People in marginalized groups are often subject to bias, scrutiny, or unfair treatment at work that make it difficult to ask for and get accommodations or leave.
Exercising your rights shouldn’t add stress to an already stressful time. If you’re concerned about making a request, if you face intersecting forms of discrimination, and/or if your employer pushes back, the right attorney or legal services organization can help reduce the anxiety and challenges that can come with taking a leave or accommodations request. If your employer refuses to provide accommodation or discriminates against you, you may also file a complaint with the EEOC.
If you need help finding a lawyer, the American Diabetes Association might be able to help connect you to a lawyer that specializes in issues faced by people with diabetes. Workers with diabetes can call 1–800-diabetes or email askada@diabetes.org to request help. The National Employment Lawyers Association also has a directory of lawyers that handle employment issues.
The good news is, as a person with diabetes, you’re likely to have experienced the need to advocate for yourself already, and thus are well prepared to stand up for your safety at work. We hope these tools will help arm you for the fight.

This article was a collaboration between Sarah Fech-Baughman, Director of Litigation for the American Diabetes Association, and Elise Cossart-Daly, Attorney at Cossart-Daly Law, A.P.C.
Sarah Fech-Baughman is the Director of Litigation for the American Diabetes Association, where she works to advance the rights of those with diabetes through impact litigation in employment, school, public accommodations, and jail and prison settings. When she’s not battling discrimination, you can usually find her in the kitchen, perfecting her guacamole recipe.
Elise Cossart-Daly is an anti-discrimination, civil rights, and environmental lawyer in Santa Barbara, California. She advocates for women, Black, Indigenous, and People of Color, people with disabilities and health conditions, and other marginalized community members on many issues, including employment, at Cossart-Daly Law, A.P.C. Elise has lived with type one diabetes since she was two years old and loves exploring the outdoors with her partner and two young children.
Portions of this article grew out of a piece originally drafted by Elise Cossart-Daly for Just a Little Suga’ in conjunction with their Invisible Identities: A Conversation on Diabetes and Disability Panel.
This article is not intended to serve as legal advice and is not an offer to represent you. It reflects current law as of June 22, 2020.