Support an employee with 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 lifelong 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.

Time off work for illness & check-ups

To properly support your employee, you must 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.

ACAS: advice on disability leave

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, you must 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 for these appointments to be treated as disability-related sick leave, i.e. the individual is not penalised for needing to attend.

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; allow them time to recover and provide flexible working options as 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 diagnosis, 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: