About Addison's Disease Employment and adrenal insufficiency Guidance for employers It can be difficult to know how you can best support an employee who has shared that they have a diagnosis of Addison's disease or adrenal insufficiency. Here we help you to understand the condition, the potential impact on someone in the workplace, and how you can follow best practice to support them. Understanding Addison's Disease and Adrenal Insufficiency Are Addison's and adrenal insufficiency disabilities? Adrenal insufficiency, of which Addison's disease is one type, is a rare condition and an invisible disability. Whilst everyone 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 they are life-long conditions that can seriously affect a person’s ability to do normal day-to-day activities and are fatal if left untreated. The Equality Act treats each person as an individual, and so Addison’s and adrenal insufficiency may not always be seen as a disability - ultimately, only a court or tribunal could decide. The important thing is that a person's individual needs are discussed with that person, reviewed regularly and taken into consideration in the workplace. The Equality and Human Rights Commission has guidance for employers on the Equality Act 2010. 'Guide for Employers' leaflet The best way to get informed about Addison's or adrenal insufficiency and how it might be affecting your colleague, team member or employee, is to ask them. They live with the condition every day and will be able to let you know how you can best support them at work. To support these discussions, we have produced a Guide for Employers: 'When an employee has Addison's or adrenal insufficiency'. It helps you to understand your employee's condition, how it might affect them at work, as well as best practice and reasonable adjustments. You can download our leaflet below or purchase a printed copy from our online shop. Download our Guide for Employers Time off work for illness & check-ups To properly support your employee, it is important that you understand when they may need time off work relating to their disability. Employers are legally required to make reasonable adjustments (e.g. allowing disability-related sick leave), to avoid disability discrimination and not treat people unfavourably for absences linked to disability. Someone with Addison’s disease or adrenal insufficiency can request disability leave for medical appointments, monitoring and treatment under the Equality Act 2010, It is important to understand the difference between sick leave and disability leave and how clear policies relating to them will enable both you and your employee to feel confident and secure. Employers are not required by law to offer paid disability leave; however, many employers have internal policies that define and allow paid disability leave as a reasonable adjustment. Advice on disability leave - ACAS website During diagnosis An employee with Addison’s or adrenal insufficiency is more likely to require time off work when they are first diagnosed, before their condition is fully stabilised and while their medication is being adjusted. Initially, regular hospital appointments and blood tests (including a blood test known as a ‘day curve’, which may require a whole day absent from work) will be required to monitor the condition. Ongoing health monitoring People with Addison's or adrenal insufficiency will need to go to several healthcare appointments a year. They’re an essential part of managing their condition and help reduce the risk of serious complications. If you manage someone with Addison’s or adrenal insufficiency, it’s vital you give them time off for these essential checks (see more under Disability Leave below). Check your policies on managing people with long-term health conditions and approving time off for medical appointments. It is best practice that these appointments are disability-related sick leave and the individual is not penalised for needing to attend these appointments. Managing illness Due to the body needing increased levels of cortisol during times of physical stress (like illness, injury or trauma), when people with Addison’s or adrenal insufficiency get illnesses like a cold, flu or stomach bug, they will need to change their medication regime (Sick Day Rules) and manage their body’s reaction carefully to avoid a life threatening adrenal crisis. They may need extra support from their healthcare team. So allow them time to get better and provide flexible working options if appropriate as they return to work. Stress can slow down their recovery even further and can affect their Addison’s or adrenal insufficiency too, so think about emotional wellbeing too. Emotional Wellbeing A diagnosis with a rare and lifelong condition has both physical and psychological implications. A diagnosis of Addison’s or adrenal insufficiency usually means a requirement to follow a time-critical medication regimen for the rest of an individual's life. It requires daily consideration and management and, particularly during the diagnosis period, or if someone has other conditions on top of their adrenal insufficiency, they are likely to have challenges and may need support at work. Stress at work Severe emotional stress is a potential trigger for adrenal crisis so it is important to understand your employee's response to stress, and to work with them to manage stress at work. Potentially stressful situations at work (things like interviews, increased workload, threat of redundancy) can make it harder for someone to manage their Addison’s or adrenal insufficiency. If you manage someone with Addison’s or adrenal insufficiency who might be struggling like this, discuss if any reasonable adjustments at work may help. Listen to them and work with them to help them manage their stress; for example offering flexible work hours, approving disability leave or offering a 'wellbeing' day to encourage them to do something to help manage their stress. You can read more about stress here on our website – take a look to make sure you’re in the know and can support your employee. If you feel that your employee needs professional help, they should speak first to their doctor. If you have an employee assistance programme or in-house counsellor, you could point them there too. Other potential supports to signpost to are: Managing Adrenal Crisis Life-threatening, time-critical emergency An adrenal crisis is a life-threatening health emergency that requires time-critical treatment. It is crucial that as an employer of someone with Addison's disease or adrenal insufficiency, you are aware of the signs and required emergency management of an adrenal crisis. 8% of people with Addison's disease will have an adrenal crisis every year. It is a treatable event, but efficient and effective management is crucial as it is life-threatening if left untreated. Learn more about adrenal crises This Adrenal Crisis Guidelines leaflet is a useful way of summarising an employee's personal medical needs in the event of an emergency, at work. Keeping a copy of it in the staff file is also helpful, so this guidance can be passed on to a medical professional should your colleague become unwell at work. Another alternative is our Medical Summary sheet. Our 'Guide for employers' leaflet also covers how to recognise and support an employee during an adrenal crisis. For further information about Addison's disease and adrenal insufficiency Addison's and adrenal insufficiency are complex conditions and even many years after diagnosis, your employee will still be learning about the condition and how they can optimally manage it, and their health and wellbeing. We would recommend that you also become well read about the condition and you may find these other resources useful to expand your understanding. Managing Your Addison's or 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 Confidentiality Each individual needs to decide for themselves, if and what they want to share about their diagnosis with their work colleagues, supervisor or employer. We believe that sharing a diagnosis and information about their condition can help ensure they receive the support they may need at work, and particularly in relation to the time-critical management of adrenal crisis. Please be aware of decisions around confidentiality and ensure that you have discussed with your employee, who they are happy to share their diagnosis with. If there is a first-aider at work, we would recommend that you encourage them to share their diagnosis, their low cortisol symptoms, and where their emergency injection kit is kept at work. Problem solving If you are struggling to find the best way forward to support your employee and their needs, try to resolve it informally by finding out more about Addison's and adrenal insufficiency and making sure you have listened to your employee to properly understand their individual requirements. Clear and empathetic communication, clear and fair policies in the workplace, and appropriate, reasonable adjustments will build trust and understanding. For information and support on dispute resolution, see the ACAS website: Dispute resolution | Acas Could Your Workplace Support the ADSHG? As a small charity, corporate support makes a huge difference to us. We rely on the generosity of individuals and organisations to support our vital work. That’s where your workplace can come in. Find out more Whether you're newly diagnosed or have lived with the condition for years - please join our community and support our cause! 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