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  • Scott Adams
    Scott Adams

    A Critical Examination of the Inclusion of Celiac Disease in Disability Categories on Job Applications

    Reviewed and edited by a celiac disease expert.

    The primary argument against categorizing celiac disease as a standard disability is the fact that individuals with the condition can achieve a symptom-free state through dietary management.

    Celiac.com 06/15/2024 - In recent years, there has been a notable increase in the number of online job applications that include questions about disability status. At least 50% of these applications now inquire whether applicants have a disability, with celiac disease often listed as a potential disability. This trend raises important questions about the nature of celiac disease and whether it should be classified as a disability on a job application. While recognizing the challenges faced by individuals with celiac disease, it is crucial to critically examine whether it fits the standard definition of a disability, especially considering that adherence to a gluten-free diet typically leads to a symptom-free state.

    Understanding Celiac Disease

    Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Gluten is a protein found in wheat, barley, and rye. For individuals with celiac disease, even a small amount of gluten can trigger an immune response that damages the villi of the small intestine, leading to nutrient malabsorption and various symptoms, such as gastrointestinal issues, fatigue, and anemia.

    The Gluten-Free Diet as a Solution

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    The primary treatment for celiac disease is a strict, lifelong gluten-free diet. Adherence to this diet usually results in the healing of the intestinal lining and the resolution of symptoms. Most individuals with celiac disease who follow a gluten-free diet for several months to a couple of years can achieve a symptom-free state and lead normal, healthy lives—without any issues that would interfere with work—especially if the job is remote work (yes, even remote jobs where you would work from home are now asking this question).

    Celiac Disease and Disability: Definitions and Implications

    The Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more major life activities. This definition includes conditions that are episodic or in remission if they would substantially limit a major life activity when active. Understanding how the ADA applies to work and jobs is crucial for both employers and employees, as it ensures that individuals with disabilities have equal access to employment opportunities and workplace accommodations.

    The ADA prohibits discrimination against qualified individuals with disabilities in all aspects of employment, including hiring, firing, promotions, job assignments, training, benefits, and any other terms, conditions, and privileges of employment. It applies to private employers with 15 or more employees, as well as to state and local government employers, employment agencies, and labor unions. Under the ADA, employers are required to provide reasonable accommodations to qualified employees with disabilities, unless doing so would cause undue hardship to the business.

    Reasonable accommodations are modifications or adjustments to a job or work environment that enable a person with a disability to perform essential job functions. Examples of reasonable accommodations include:

    • Making existing facilities accessible
    • Restructuring a job
    • Modifying work schedules
    • Acquiring or modifying equipment
    • Providing qualified readers or interpreters

    For individuals with celiac disease, reasonable accommodations might include ensuring access to gluten-free food options in the workplace, providing flexibility in break times to allow for safe eating practices, or allowing remote work if gluten contamination in the workplace is a concern.

    The Case for Skepticism

    Symptom-Free State and Normal Functioning

    The primary argument against categorizing celiac disease as a standard disability is the fact that individuals with the condition can achieve a symptom-free state through dietary management. Once on a gluten-free diet, the majority of people with celiac disease do not experience limitations in their daily activities or work performance. They are not substantially limited in any major life activity, which is a key criterion for defining a disability under the ADA.

    If someone with celiac disease can bring their own food to work, of if they can work from home and fully control their food, it's very unlikely that a worker would ever be considered disabled to the point where it would affect their ability to perform their job.

    Comparisons with Other Disabilities

    Comparing celiac disease with other disabilities that inherently limit life activities can be illuminating. For example, conditions like multiple sclerosis, Parkinson's disease, or severe mental health disorders often have persistent symptoms and functional impairments despite treatment. In contrast, celiac disease, when managed with diet, does not typically present ongoing challenges or impairments that affect daily functioning.

    The Impact of Labeling Celiac Disease as a Disability

    Potential Benefits

    There are potential benefits to recognizing celiac disease as a disability. It can ensure that individuals with the condition receive necessary accommodations, such as access to gluten-free food options at work or understanding from employers regarding their dietary needs. It can also provide legal protections against discrimination.

    Potential Drawbacks

    However, labeling celiac disease as a disability can also have drawbacks. It may lead to unnecessary stigmatization or misconceptions about the capabilities of individuals with the condition. Employers might mistakenly believe that people with celiac disease require significant accommodations or are frequently ill, which is not the case for those adhering to a gluten-free diet. This could inadvertently affect hiring decisions and job opportunities.

    Navigating Job Applications

    Transparency and Honesty

    When faced with the question of disability status on job applications, individuals with celiac disease must navigate a complex landscape. Honesty is paramount, but so is understanding the implications of disclosing a condition that, when managed, does not cause substantial limitations. If someone with celiac disease has been symptom-free for a considerable period due to a strict gluten-free diet, they may not feel the need to disclose their condition as a disability.

    job_applicaiton_disability.webp
    Caption: An actual job applicationhow would you answer?

    Legal Considerations

    Legally, it can be permissible for individuals with well-managed celiac disease to answer "no" to the disability question if their condition does not currently limit any major life activities. The ADA defines a disability based on the presence of substantial limitations, and if those limitations are effectively mitigated through diet, an individual may reasonably determine that they do not meet this criteria. However, it's important to note that the ADA also considers conditions that are episodic or in remission, meaning that if the person were to consume gluten, their major life activities would be substantially limited. Thus, while saying "no" can be legally justifiable, it is crucial for individuals to consider their specific circumstances and the potential need for future accommodations when making this decision. Consulting with a legal or HR expert can provide additional clarity and ensure compliance with ADA guidelines.

    Rethinking Disability Categories

    Criteria for Disability

    The inclusion of celiac disease in disability categories invites a broader discussion about what constitutes a disability. The criteria should focus on the extent to which a condition limits major life activities despite management or treatment. If a condition can be effectively managed to the point where it no longer imposes substantial limitations, its classification as a disability should be reconsidered.

    Individualized Assessments

    Rather than blanket classifications, individualized assessments might offer a more nuanced approach. Evaluating the specific circumstances and needs of each person with celiac disease can ensure that those who genuinely require accommodations receive them, while those who do not are not unnecessarily labeled.

    Conclusion

    The increasing inclusion of celiac disease in disability categories on job applications warrants critical examination. While it is crucial to protect the rights and accommodate the needs of individuals with celiac disease, it is equally important to recognize that effective dietary management typically leads to a symptom-free and fully functional state. Classifying celiac disease as a disability for all individuals may not reflect the reality of those who have successfully managed their condition through a gluten-free diet. A more nuanced, individualized approach to disability classification and disclosure may better serve the interests of both job applicants and employers, fostering a more accurate understanding of celiac disease in the workplace.



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    Marish

    The article has good considerations.  I find myself favoring not considering Celiac as a “disability”, since, as the article points out, it is a condition that can be managed by proper food choices and it doesn’t impair one’s ability to do their job.  Many non-Celiac people have issues with various foods that can make them ill, food allergies, lactose intolerance, etc.   If improper foods are consumed, that person might get temporarily ill, or in the case of some allergies, like peanuts, critically ill.  The allergy or intolerance itself doesn’t equate to the person being disabled.  Perhaps a Celiac individual might have difficulties that make them temporarily disabled while they are adjusting to their Celiac diagnosis and their villi are still healing, However, like many illnesses and injuries, that would be a temporary situation. 

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    trents

    Another factor that needs to be developed here more thoroughly is the nature of job setting. Does the job require frequent attendance at lunch and/or dinner meetings and are these meetings generally "on campus" or off? 

    "The Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more major life activities." This would seem to squarely place celiac disease in the category of a disability since celiac disease always puts limits on us in social settings that involve food. So, unless you are a recluse, it limits a major life activity. Of course, I speak here in general terms and not in the context of this article which has to do with the work setting.

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    JoeBlow

    I would like to see a survey of experienced celiac patients (2 years on the diet or more) who are in a technical career where you create (like code, for instance) with a computer and collaborate with others and the situation you commonly experience is someone says “Let me drive” and grabs your keyboard and mouse. The question for the survey is “Would you like a guest keyboard and mouse.” I know I did. Yeah, we had docking stations for your laptop and there were a lot of extra keyboards and mice around in a shrinking company, but you might want to request such an accommodation. 

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    Betsy B
    Quote

    Celiac.com 06/19/2024 - For adults with celiac disease, managing their condition often means adhering to a strict gluten-free diet.  Research shows that is estimated that up to 50% of celiac disease patients have persistent symptoms while on the gluten-free diet.  The most common reason for persistent symptoms is continuing to ingest gluten.

    Avoiding gluten can be challenging in a shared work environment & often requires accommodation and support from the employer.

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    Scott Adams

    I agree that it can be challenging, but the vast majority of people with celiac disease do manage to maintain a gluten-free diet, even at work. I worked daily in offices for many years after being diagnosed, and was able to avoid gluten at work.

    Employers even ask this question on applications for remote jobs, where the work will be 100% from the employee's home. To me there is a fine line between your right to privacy, and the need for a company to know whether or not you have celiac disease.

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    JoeBlow

    Scott,

    Please pardon my brain damage. I absolutely agree that the question of Celiac status should not be on a job application or in a job interview. But it should be accommodated for after hiring. I do not see celiac genes as defective. Rather, I see reliance on wheat as defective, and here’s why: The “Ancestral Haplotype” contains the DQ 2.5 gene, and is known to be over 30,000 years old, and is the longest DNA sequence found in humans that has remained unchanged for that long. Agriculture is only 10,000-12,000 years old. There is an Italian haplotype that has the same DR and DQ genes. The vast majority of diagnosed and gene tested celiacs have the DQ 2.5 gene. The fact that there are other celiac genes and that there are 450 known gene loci that affect gluten sensitivity, and many doctors are recommending gluten-free diet for more conditions, I hope will one day turn the tide of systemic discrimination. I have read here and elsewhere of thee studies that show that the rate of celiac disease is 3%. Dr. Joseph Murray at Mayo Clinic has published that the rate is doubling every 15 years. Around a third of Americans have a celiac gene. Dr. Tom O’Bryan said that half of these have non-celiac gluten sensitivity and I know some of those people are as symptomatic as people with celiac.

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    trents

    Who is Dr. Tom O'Bryan and what is his specialty?

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    Scott Adams

    Dr. Tom O'Bryan is an early adopter of the idea of gluten sensitivity being the bigger picture, and although I believe he's a chiropractor, he's respected by many within the celiac community, and has written quite a few articles for Celiac.com over the years:

    https://www.celiac.com/profile/81264-dr-tom-obryan/

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    trents

    Scott, what do you mean by "gluten sensitivity being the bigger picture"? Do you mean in the sense of setting the stage for the development of full blown celiac disease?

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    Scott Adams

    There is that, but if you go back in time 15-20 years ago, it wasn't scientifically accepted that a much larger percentage of the population has gluten sensitivity than celiac disease. Dr. Tom O'Bryan was an early adopter of gluten sensitivity being more widespread, even though there wasn't any science at that time which showed that NCGS existed. 

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    dolson

    I am a Type 1 diabetic and that is a true disability. It is not inherited but caused from stress and I know where I got my diabetes from and the stress that caused it.

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    trents
    2 hours ago, dolson said:

    I am a Type 1 diabetic and that is a true disability. It is not inherited but caused from stress and I know where I got my diabetes from and the stress that caused it.

    Type 1 diabetes does have a genetic component: https://www.webmd.com/diabetes/diabetes-type-1-genetics

    You are more likely to develop Type 1 diabetes than the general population if one of your parents have it. As far at Type 1 being a disability, I see that the same as having celiac disease. If you are in a setting that allows you to do what you need to do to be safe (give yourself insulin, control diet, avoid gluten), it's not vocationally limiting and not a disability in that setting.

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  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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