Guidance for employees Managing adrenal insufficiency, including Addison's disease, in the workplace requires understanding, communication, and appropriate support to meet your individual needs. Understanding the Condition To offer you appropriate support and reasonable adjustments in the workplace, it is important that your employer understands your condition and how it might affect you. Whilst you might not identify as having a disability, people with Addison's and adrenal insufficiency are covered by the definition of disability under the Equality Act 2010, or, if you live in Northern Ireland, the Disability Discrimination Act 1995. This is because adrenal insufficiency, including Addison's disease, is generally a lifelong condition, and it can seriously affect a person's ability to do normal day-to-day activities. It is fatal if left untreated. Why your diagnosis matters at work: You may experience varying energy levels You need to carefully manage stress (interviews, increased workload, threat of redundancy, etc) You may take longer to recover from illness or injury You are required to follow a time-critical medication regimen You are at risk of adrenal crisis You may find it difficult to cope with having a diagnosis of adrenal insufficiency and might need support with your emotional wellbeing. You are not under any obligation to share your diagnosis in the workplace, and you may not need or want adjustments, although this might change over time. Working with Your Employers to Manage Your Individual Needs Disclosing your condition It can be a difficult decision to share health information with your employer, and you may wish to define clear boundaries around the confidentiality of your information and who it should be shared with. Some workplaces have a first aider whom you may wish to inform, and let them know about your emergency injection kit. In other cases, you may prefer to share the information with a colleague. However, due to the risk of adrenal crisis, a life-threatening emergency, it is strongly recommended to share your diagnosis with someone in the workplace and help to build the appropriate support in the case of an emergency. You may need to provide medical evidence (e.g. a letter from your GP or Endocrine Team) confirming your diagnosis and ongoing care requirements.) Signpost your employer to more information about your condition: Discussing your individual needs The support you need will differ from the support someone else with Addison's or adrenal insufficiency might need. You may have other health conditions that need consideration. Your needs may also vary depending on how recently you have been diagnosed and how well-established and effective your medication regimen is. As such, your needs may not be constant, and you need to be able to review them regularly with your employer to explore whether there are reasonable adjustments that can be made at work to support you and allow you to work optimally. Reasonable adjustments Reasonable adjustments are changes an employer makes to remove or reduce a disadvantage related to someone's disability. They are specific to an individual, are for physical or mental health conditions and can cover any area of work. It's not enough for employers to provide a person with a disability with the same working conditions as non-disabled people. Employers must make reasonable adjustments by law. This means potentially: finding a different way to do something making changes to the workplace changing someone's working arrangements providing equipment, services or support Practical examples might include; Flexible working hours Time off for medical appointments Access to a quiet space for rest or medication Emergency protocols in case of adrenal crisis For more information on reasonable adjustments, please visit: Equality Act 2010: guidance Time off for medical appointments (& disability leave) You may require time off work when you are first diagnosed, before your condition is fully stabilised and while your medication is being adjusted. During the diagnosis stage, you are likely to have regular hospital appointments and blood tests, including a blood test known as a 'day curve', which may require a full day's absence from work, to monitor you. You will have several healthcare appointments per year as an essential part of monitoring and managing your condition, and you will need time off for these checks. It is best practice that these appointments are approved and recorded as disability leave and not as sick leave. This is because sick leave absence records are, in some situations, used as a performance indicator in annual reviews, in applications for promotions or job changes, and disciplinary actions. Although employers are not required by law to offer paid disability leave, treating all disability related absences as sickness could be considered discriminatory. Time off for illness Due to the body's requirement for increased cortisol when under physical or extreme psychological stress, when you are unwell with a cold, flu or stomach bug, you need to follow the Sick Day Rules and adjust your medication to avoid low cortisol symptoms and the risk of a life-threatening adrenal crisis. You may need additional support from your healthcare team and may require more recovery time or flexibility when returning to work. Your Employee Rights Under the Equality Act 2010 (or the Disability Discrimination Act 1995 in Northern Ireland), Addison's and adrenal insufficiency are considered disabilities because they significantly affect daily life and can be life-threatening if untreated. This means: Employees are entitled to reasonable adjustments Employers must avoid disability discrimination Absences related to the condition may be classified as disability-related leave, not standard sick leave If you feel you are being treated unfairly at work, it is important to share your concerns with your line manager or HR representative at the earliest opportunity so that communication channels stay open and you can both problem solve to find a way forward. You may want to: Check if there is a disability policy at work and whether it is being followed Keep a note of your absences and what they relate to Be clear about what your individual needs are in relation to your condition If an informal approach does not work, then as an employee, you will be able to submit a formal grievance under your employer's grievance procedure, stating the reasons why you feel you are being penalised due to your disability. We would advise you to seek support and advice from experts in this scenario - see options below. Next steps There are some straightforward ways that your employer can support you, by: Clear Communication An opportunity for you to share your needs, and for them to listen. Regular review of your needs. Respecting your wishes regarding confidentiality around your condition. A safe and inclusive environment Creating a culture that is inclusive and enabling, with suitable policies in place to give clarity (e.g. disability policy). Disability Leave Provision of disability leave for disability related absences. Emergency preparedness Discussion and planning around managing a potential adrenal crisis in the workplace. Awareness of, and access to your emergency injection kit. Understanding how to support you to prevent adrenal crisis, and an action plan to follow if you have an adrenal crisis. Where to Go for More Information ACAS: Information on reasonable adjustments, and what to expect in the workplace Citizens Advice Bureau: help with workplace rights and benefits advice Scope - Equality for Disabled People: free advice and helpline Turn2Us: benefits calculator and financial support resources Social Security Scotland: Adult Disability Payment For more detailed information on adrenal insufficiency, including Addison's disease, you may find the following resources useful: Managing Your Addison's & Adrenal Insufficiency A 20-page booklet with information on how someone can better understand and manage their condition. A practical guide providing a summary of the key points everyone with Addison's or adrenal insufficiency needs to know about to manage their health; to be aware, be prepared and be understood. Available to download or purchase via our online shop. Download booklet Living with Addison's Disease This unique book covers a wide range of aspects of Addison's from both a medical and patient perspective. From causes, diagnosis, treatment options, how to work with your doctors through to advice for navigating life's journey. The book is available in paperback and for Kindle at Amazon, globally. đź’¬ Final Thoughts Living and working with adrenal insufficiency is entirely possible with the right support. Open communication, informed adjustments, and mutual respect can ensure a safe and productive workplace for everyone. Whether you're newly diagnosed or have lived with the condition for years - please join our community and support our cause! You'll receive the latest expert advice, guidance and ADSHG news, whilst being part of our inspiring and supportive community. Become a member today! Join the ADSHG Connect on social media! Follow us on X/Twitter, Bluesky, Facebook, Instagram, LinkedIn, Threads, TikTok and YouTube. 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