If you have Crohn’s Disease or Ulcerative Colitis (the two main forms of Inflammatory Bowel Disease - IBD) you may be concerned about your employment position. You may be employed or looking for a new job. You may be on benefits and are thinking about returning to work. While Crohn's and Colitis are chronic (ongoing) conditions, with appropriate treatment it is often possible to remain well for long periods. Many people with Crohn's or Colitis are able to work and have successful careers.
This information sheet looks at some of the questions you may have about your possible options and how you may be protected by law. Some of the quotes included are from people with Crohn's or Colitis who responded to a 2011 Crohn’s & Colitis UK survey on Crohn's and Colitis and employment. Others are responses provided by people with Crohn's or Colitis during the review process of this information sheet.
Some of the quotes included are from people with Crohn's Disease or Ulcerative Colitis who responded to a 2011 Crohn’s & Colitis UK survey on Crohn's and Colitis and employment. Others are responses provided by people with Crohn's or Colitis during the review process of this information sheet.
This information sheet also covers the Equality Act 2010, which applies to England, Wales and Scotland. The Act does not apply to Northern Ireland. If you live in Northern Ireland, you may wish to visit nidirect for further information on employment rights: www.nidirect.gov.uk
...during the recruitment process
You may be concerned that you will be at a disadvantage if you declare your Crohn's or Colitis, whether on an application form, CV or at an interview.
The Equality Act 2010 makes it unlawful for employers to ask intrusive questions about your health - including previous sickness absence - before making a job offer. This applies to questions on an application form as well as questions asked during an interview.
This is to encourage employers to consider whether or not you can do the job rather than ruling you out early on in the process because of your health condition.
There are a few exceptions to this. For details of these, see the disability discrimination guidance on the Acas (Advisory, Conciliation and Arbitration Service) website.
...once you’ve been offered the job
Some job offers may be conditional on a medical examination or on satisfactory completion of a medical questionnaire after the job offer stage. A conditional offer should only be withdrawn on medical grounds at this stage if it can be shown that you would not be able to do the job once reasonable adjustments have been made (See the section What are reasonable adjustments? below). If you deliberately withhold information at this stage and it comes out later, you could risk being dismissed.
In deciding whether to disclose your IBD to a prospective employer, you might find it helpful to speak to a Careers Adviser. The National Careers Service can provide advice on job-hunting and applications for people of any age (see Other Organisations).
If you do decide to mention your IBD to a prospective employer you may also find it helpful to show them our leaflet Employment and IBD: a guide for employers.
...in your current job
If your diagnosis comes once you are already working, or if your condition becomes worse, you may wonder whether to tell your manager about it. There is generally no legal requirement to disclose a medical condition – unless it is required in your own personal contract of employment.
While some people with IBD decide that they do not wish to disclose their IBD to their employer, there can be some advantages in sharing information about your condition. Firstly, hiding symptoms can be a strain and it may be a relief to talk about your IBD. In a study into IBD and employment in 2015, the employees with IBD who had disclosed their condition to their employer said they felt that their employer was grateful. Once you have made your employer aware of your needs, they can consider reasonable adjustments for you.
That said, if you do decide to disclose your condition, you may find that some employers show a lack of understanding, at least initially. If you want some support when you tell your employer, you could ask someone else to accompany you, such as a colleague, an occupational health worker or a trade union representative.
You may also find it helpful to show your employer Employment and IBD: a guide for employers.
I have told my employer about my Crohn’s. It has allowed me to be open about going to appointments and getting the time I need to go to hospital. It helps to know I have the support of my manager.
If you do decide to tell an employer or prospective employer about your Crohn's or Colitis, you may not wish it to become public knowledge. You also need to decide if and what you are going to tell your co-workers. Again, there can be advantages in letting others know about your Crohn's or Colitis. If fellow staff know that you have a long term condition and what it means, they are more likely to give you the support and assistance you need, helping to create a better working environment.
If they don’t know, they may draw the wrong conclusions or believe you are getting preferential treatment if your employer makes adjustments for you. Being more open could also mean that you wouldn’t, for example, have to hide taking your medication, that you have painful stomach cramps or that you are struggling to cope with fatigue.
It is common for people to feel embarrassed when talking about bowel movements, so you may find it difficult to explain your symptoms, especially urgency and the frequent need to rush to the toilet.
Using our information may help. As well as this leaflet, we also have a number of other information sheets and booklets, such as All about Crohn's and Colitis and Living with Crohn's or Colitis that you could think about giving to your manager and/or your colleagues. Explaining that IBD is not infectious is often particularly helpful, as this may be a concern. It may also be useful to make it clear that Crohn's and Colitis are different from Irritable Bowel Syndrome (IBS).
In a survey we carried out into Crohn's and Colitis and employment, it was found that eight out of 10 employees had told their employer or HR department about their Crohn's or Colitis, and nearly as many had told their co-workers. However just under half of the respondents reported worrying that their colleagues might think that they do not pull their weight at work because of their Crohn's or Colitis symptoms. A quarter also said that they worried about being discriminated against in the workplace as a result of their Crohn's or Colitis.
I have told the colleagues I thought needed to know about my Crohn’s. They have been really supportive and it has been such a fantastic help in coping with my diagnosis, appointments and any absences I have had to take.
Employees have certain legal rights and you may have additional rights in your particular employment contract. You can get further information about general employment rights from several sources including the government website: gov.uk, ACAS, Citizens Advice and trade union representatives.
As someone with Crohn's or Colitis, you may be particularly worried about whether your employer can dismiss you for ill health. The law does give some protection here but the level of protection will depend on whether you qualify as disabled under the Equality Act 2010 (see below When is Crohn's or Colitis a disability?).
Many people with Crohn's or Colitis do not consider themselves to have a disability, however, anyone with an ongoing illness may qualify for protection against discrimination. When asked whether or not they consider themselves to have a disability, just over half of respondents to our Employment Survey answered yes.
The Equality Act 2010 defines disability as a physical or mental impairment which has an effect on a person’s ability to carry out normal day-to-day activities. This includes ‘hidden’ impairments or disabilities such as incontinence. The effect must be substantial, adverse and long-term. For example, the loss of bowel control is considered substantial and adverse if it is unpredictable and leads to immediate major soiling, even if it is infrequent. Minor but frequent loss of bowel control may also qualify as substantial and adverse. Long-term is generally taken to mean the effect has lasted, or is likely to last, at least a year.
The fact that your Crohn's or Colitis is a variable condition, generally with good days and bad days, does not affect your rights. The main point is that the overall effect is long-term.
Importantly, in most cases, treatment for a health condition is not considered when deciding if someone is disabled under the law. This means that you may still benefit from the protection of the Equality Act even if your symptoms are controlled by medication.
If you think you fit the criteria of disabled under the Equality Act and you feel able to speak to your employer, it may be worth talking to them to see how they can support you.
The Equality Act is in place to protect people against discrimination at work, including people who may consider themselves not covered by the Act, even those who are:
• working on a casual basis
• on zero hours contracts
• trainees, or
• in some situations, self-employed.
See Citizens Advice for further information.
The Equality Act covers all aspects of employment from recruitment, selection, pay, training, promotion, dismissal and redundancy.
Your employer has a legal duty to make ‘reasonable adjustments’. They should also look at any alternatives to your current position, such as other duties or different employment. Under the Equality Act, discrimination means either treating a disabled person less favourably than others because of their disability, or failing to make reasonable adjustments to the workplace or working arrangements.
Dismissal because of a disability may be unlawful discrimination and you may have grounds for bringing a claim for disability discrimination.
Under the Equality Act, an employer can take positive action to help employees or job applicants who are disabled. This may be represented by a ‘Disability Confident’ symbol on a job advertisement, which means that an employer has made a commitment to employ, keep and develop the abilities of disabled staff. This would apply to you if your condition means that you are defined as disabled under the Equality Act (see When is Crohn's or Colitis a disability?).
You may wish to refer to www.gov.uk for further information on the ‘Disability Confident’ policy. A Careers Adviser may also be able to discuss this policy with you and how it can help in relation to applying for a particular job.
You can ask your employer for reasonable adjustments when any aspect of your working arrangements, including the building or place of work or your working hours, puts you at a substantial disadvantage compared to a non-disabled person doing your job. Employers have a legal duty to consider making reasonable adjustments and to involve the disabled employee or successful job applicant in the discussion about what can be done to support them, if the employer:
- becomes aware of their disability
- could reasonably be expected to know they have a disability
- has been asked by the employee for adjustments to be made
- the disabled employee is having difficulty with any part of their job
- either the employee’s sickness record, or delay in returning to work, is linked to their disability.
However, there is no exact definition about what is or is not ‘reasonable,’ and factors such as the cost and difficulty in making the adjustment and the size of the employer will be taken into account. Generally, an adjustment is likely to be considered reasonable if it is not too expensive considering the resources of the employer and the type of business.
Helpful adjustments that would not generally be too expensive could include:
- allowing time for medical appointments or treatment,
- flexible working arrangements, such as shorter or different hours,
- unlimited toilet breaks,
- moving your work station close to a toilet,
- providing a car parking space close to the entrance into work,
- allocating some of your duties to someone else,
- offering another place of work,
- providing you with relevant training, for example if some of your duties have been reallocated and you take on new tasks that are more suitable to your needs.
In talking to your employer, it may be useful to have some suggestions ready of changes that would help you.
Where adjustments are expensive, such as installing separate toilet facilities, a scheme called Access to Work may be able to help (see below).
If you have discussed adjustments with your employer and you find that an agreement cannot be reached, you could raise a formal written grievance. (See What can I do if I feel I have been treated unfairly?) For more detailed guidance on your rights, contact EASS - the Equality Advisory and Support Service.
During previous times when I have had flare-ups and, most recently, after I had surgery, I was offered the opportunity to work reduced and flexible hours. This really helped me with coping with my Crohn’s and the pressures of work and daily life.
Access to Work is a government funded scheme to help people with a disability overcome practical difficulties that may stop them from working. It is available for part-time or full-time workers and for those who are self-employed or unemployed and looking for work. It also applies whether you are on a permanent or a temporary contract, but does not cover voluntary work.
Besides possible help towards installation of toilet facilities, Access to Work can help in a number of ways such as with the additional costs of travel to work if you are unable to use public transport.
You can apply for an Access to Work grant online at gov.uk. Alternatively you can contact Access to Work to apply.
A stoma is an opening in the skin of the abdomen that diverts the contents of the bowel out of the body (ostomy). A bag (pouch) attached to the stoma collects the faeces.
If you have a stoma, you may be finding it difficult to manage at work, or when travelling to and from work. There are organisations that provide information and support on living with a stoma, including the Ileostomy and Internal Pouch Association and the Colostomy UK. You may also find our information on Surgery for Crohn’s Disease and Surgery for Ulcerative Colitis helpful.
Many people with Crohn's or Colitis tell us that travelling to work or jobs that require travelling are particularly difficult. You may find it helpful to obtain a Radar key for public toilets for disabled people from the Disability Rights UK Online Store. The Disability Rights UK Store can also provide a Region List of National Key Scheme (NKS) toilets in your area for a small additional donation to the purchase cost of the key. You may also be able to purchase a Radar key from your local council.
You may get help with travel costs from Access to Work, as mentioned above.
Online resources such as the Great British Toilet Map can be useful in locating your nearest public toilet on your journey to work. It covers most of London including toilets in tube and rail stations.
If you have had a conditional job offer withdrawn on medical grounds but feel that you would have been able to do the job with reasonable adjustments, you can make a complaint to an Employment Tribunal. When you make a discrimination claim, you need to provide the employment tribunal with evidence from which it could decide that discrimination has happened. Only then is the employer required to show that discrimination has not happened. The obligation on you to provide this evidence is called the initial burden of proof. When you’ve done so, the burden of proof shifts to your employer. There is more information about this on the Equality and Human Rights Commission website.
You may also face difficulties because of your Crohn's or Colitis when you are in work. Your employer may be able to help if you feel you are being treated unfairly by colleagues. As a first step, it is usually a good idea to talk informally to your employer or manager about your concerns relating to how you are being treated. Often things can be resolved by talking them through. It can also be useful to keep notes of conversations or meetings just in case you need to take the matter further.
If you find the situation does not improve, you could make a formal complaint through your employer’s internal grievance procedure. A written grievance has to be submitted within three months (minus one day) after the discrimination took place. Your employer then has to arrange a meeting with you to discuss the problem. You have a legal right to take a colleague or trade union representative with you if you ask your employer beforehand. Alternatively you could ask a family member to accompany you. This is not allowed by all employers. You may find out if it is allowed from your employment contract, company handbook or human resources intranet site. If you are not happy with the result of this meeting you can make an appeal to your employer.
If you find it difficult to make a complaint or if, having made it, you are still not satisfied with the outcome, you might want to contact the Equality Advisory and Support Service (EASS), Acas or other similar organisations to explore your options (see list under Other Organisations). You may be referred to a caseworker to help you to negotiate adjustments with your employer or if necessary, to help you make a complaint to an Employment Tribunal.
If you have been off work for several weeks or longer because of your Crohn's or Colitis, you may feel anxious about returning to work. It is common for people to lose confidence about being able to return to work even after a relatively short time away. Keeping in touch with an employer can help. It may be worth agreeing in advance about how your employer will maintain contact with you if you are absent. This could specify a timescale - for example, suggest contact once you are absent for more than two weeks. It might also specify the method by which you would prefer to be contacted, for example, phone, email or personal visit. You may prefer contact from a co-worker, close colleague or union representative rather than your direct line manager.
In England or Wales, if you have been off sick from work for four weeks or more, you can get advice and support from government funded initiative called Fit for Work. It is designed to support people in work with health conditions and help with sickness absence. For more information, visit: fitforwork.org
If you live in Scotland or Northern Ireland, the rules may be different. For Scotland, visit: fitforworkscotland.scot. For Northern Ireland, visit nidirect: nidirect.gov.uk
It is important not to feel pressured into returning to work too soon when you have been unwell. If you are absent for more than a week, you will need to obtain a ‘fit note’ (‘statement of fitness for work’) from your doctor. This is the form your doctor will use to advise your employer that you may be fit for work. It also allows your doctor to suggest that you would benefit from additional support or adjustments, such as a phased return to work or amended duties. You will need to discuss with your employer what this might mean for you.
For example you might want to start working only a few hours each day and gradually increase your hours over time. Or perhaps you may want to ask for a reduced work load or lighter duties to begin with. Generally the more open you are about your needs, the more likely it is for your employer to be willing to make reasonable adjustments to help you back to work. (See What are reasonable adjustments?).
If you have to remain away from work until reasonable adjustments are in place (for example, moving your work station close to a toilet), arguably this should not be recorded as ‘sick leave’.
If you are absent from work because of a disability-related sickness, it is important that this is recorded separately from other sickness absences, such as having a cold. This is to make sure that you are not discriminated against if, for example, decisions about promotion or bonuses take other sickness absences into account.
My employer was very understanding during a long period of absence and recovery from surgery. I was referred to Occupational Health and I was pleasantly surprised by the amount of knowledge of IBD the team had and how supportive they were.
You may find that having tried changes to your current employment, your condition still makes it difficult to continue. In this case, it is not unusual to feel angry or upset at the impact of Crohn's or Colitis on your working life or career.
There are various options you could consider, including:
- Self-employment – you may feel daunted at the prospect of setting up your own business or worry that you would miss socialising at work. But you can often work the hours to suit your energy levels and, if you can work from home, reduce the fear or possibility of having an ‘accident’ in public. You can get help and advice about self-employment from several organisations including the Citizens Advice Bureau, Leonard Cheshire Disability, the Northern Pinetree Trust, the National Careers Service and from government schemes such as Access to Work, as mentioned earlier in this information.
- Re-training – you may find that another kind of job makes it possible for you to work more comfortably. There are a number of organisations that offer training such as the Shaw Trust, AbilityNet, Leonard Cheshire Disability, and SHARE Community.
- Early retirement – you can check your pension position and get information about pensions from the Pensions Advisory Service. It may be helpful to get financial advice, including information on how your pension could affect entitlement to other benefits should you need to claim them.
- Volunteering – if income is not crucial, this could provide a challenge while allowing you to give something to others. You can contact national volunteering organisations listed at the end for ideas and opportunities. They each provide an online database of volunteer jobs. Crohn’s & Colitis UK also has volunteering opportunities. For further information contact our Volunteering Team on 01727 734472 or email: firstname.lastname@example.org
If you have care or mobility needs arising from your Crohn's or Colitis you may be eligible for disability benefits, such as the new Personal Independence Payment (PIP), whether or not you are working. We have a Disability Benefits Service that can provide information about claiming these benefits and is contactable through our helpline. More details are also given on our website.
If you are in employment, your employer should pay Statutory Sick Pay if you are too ill to work. This starts after you have been off sick for 4 days and can be paid for up to 28 weeks. If you are not well enough to return to work after this time, or if your employment is terminated, you may qualify for Employment and Support Allowance (ESA). Some employers may make additional payments through their own sick pay scheme. This will depend on your terms and conditions of employment.
If you are well enough to look for work you may be eligible for Jobseeker’s Allowance. You may also get help and support through schemes available to help people get back into work. For more information contact Jobcentre Plus or see gov.uk.
We offer more than 50 publications on many aspects of Crohn’s Disease, Ulcerative Colitis and other forms of Inflammatory Bowel Disease. You may be interested in our comprehensive booklets on each disease, as well as the following publications:
• Living with Crohn's or Colitis
• Taking Medicines
• Managing Bowel Incontinence
• Living With a Stoma
Health professionals can order some publications in bulk by using our online ordering system. If you would like a printed copy of a booklet or information sheet, please contact our helpline.
Our helpline is a confidential service providing information and support to anyone affected by Crohn's or Colitis. Our team can:
• help you understand more about Crohn's or Colitis, diagnosis and treatment options
• provide information to help you to live well with your condition
• help you understand and access disability benefits
• be there to listen if you need someone to talk to
• put you in touch with a trained support volunteer who has a personal experience of Crohn's or Colitis
Crohn’s & Colitis UK Forum
This closed-group community on Facebook is for everyone affected by Crohn's or Colitis. You can share your experiences and receive support from others.
Crohn’s & Colitis UK Patient Panels
IBD Patient Panels, which are supported by Crohn’s & Colitis UK, are groups of people with Crohn's or Colitis who use their perspective as a patient to work with their IBD healthcare team to help improve their hospital services. For more information on patient panels, please read our information leaflet or contact our Patient Engagement Team.
Crohn’s & Colitis UK Local Networks
Our Local Networks of volunteers across the UK organise events and provide opportunities to get to know other people in an informal setting, as well as to get involved with educational, awareness-raising and fundraising activities. You may find just being with other people and realising that you are not alone can be reassuring. Families and relatives may also find it useful to meet other people with Crohn's or Colitis. All events are open to members of Crohn’s & Colitis UK
Enterprise House, 95 London Street, Reading, Berkshire, RG1 4QA
Helpline: 0800 328 4257
IA - Ileostomy and Internal Pouch Association
Danehurst Court, 35-37 West Street, Rochford, Essex, SS4 1BE
Helpline: 0800 018 4724
I found the Crohn’s and Colitis UK Guide for Employers very useful in explaining my condition to my employer. It took the embarrassment out of talking about my bowels!
Advice helpline: 0800 269 545 or
01926 312 847
A national charity helping disabled adults and children use computers and the
internet by adapting and adjusting their technology.
Acas (Advisory, Conciliation and Arbitration Service)
Helpline: 0300 123 1100
Free, impartial, confidential advice about any kind of dispute or query about
relationship issues within the workplace.
Citizens Advice deliver advice services from over 2,900 community locations in England and Wales. You can find details of your nearest office at on their website. There is also specific information on the website for people living in Scotland, Wales or Northern Ireland.
Civil Legal Advice (CLA)
Helpline: 0845 345 4 345
Offers free legal information if you qualify for Legal Aid and live in England and Wales.
For information about services in Scotland contact:
Scottish Legal Aid Board
Legal Aid Information Line: 0845 122 8686
For information about services in Northern Ireland contact:
Legal Services Agency Northern Ireland (LSANI)
General enquiries: 028 9040 8888
Department for Transport
Great Minster House, 33 Horseferry Road
London, SW1P 4DR
Switchboard: 0300 330 3000
Disability Law Service
39-45 Cavell Street, London, E1 2BP
Telephone: 020 7791 9800
The DLS offers free advice and representation for disabled people, their families and
carers, on specific areas of law, including disability discrimination, employment and
Disability Rights UK
Disability Rights UK, 12 City Forum,
250 City Road, London EC1V 8AF
020 7250 3222
Organisation leading change for disabled people.
Equality Advisory and Support Service (EASS)
Advice Line: 0808 800 0082. Monday - Friday 9am - 7pm and Saturday 10am - 2pm.
Provides information, advice and support on discrimination and human rights issues to individuals in England, Scotland and Wales.
Equality and Human Rights Commission (EHRC)
Promoting equality and help for people who have been discriminated against.
Informative UK government website covering a range of issues including all aspects
of employment and disability.
A government agency which is part of the DWP, set up to help more people into work and to give people of working age the help and support they are entitled to if they cannot work. To find your local office, look in your phone directory or visit the or visit the website: www.gov.uk/contact-jobcentre-plus
Law Centres Network
Floor 1, Tavis House, 1-6 Tavistock Square, London, WC1H 9NA
Office Line: 020 3637 1330
Law Centres is a membership organisation for not-for-profit legal practices providing free legal advice and representation to disadvantaged people.
National Careers Service
Telephone: 0800 100 900
National Careers Service advisers can provide you with information, advice and guidance on skills, learning and work.
Pensions Advisory Service
11 Belgrave Road, London SW1V 1RB
Pensions Helpline: 0300 123 1047
Helpline for self-employed: 0345 602 7021
Or you can submit your query using the online form.
An independent non-profit organisation providing free information and advice on pensions including State, company, personal and stakeholder schemes.
Every employee has the right to join a trade union. For further information contact
the Trades Union Congress (TUC):
England and Wales: 020 7636 4030 Website: tuc.org.uk
Scotland: 0141 337 8100 Website: stuc.org.uk
Northern Ireland: 028 9024 7940 Website: ictuni.org
Unit 9, Cefn Coed Parc, Nantgarw, Cardiff CF15 7QQ.
Helpline: 0808 802 2000
Organisation helping people in financial need gain access to welfare benefits, charitable grants and other financial help.
402 Metro Central Heights, London, SE1 6DX
Telephone: 0845 658 5717
A not-for-profit social enterprise formed to help disabled jobseekers find work with employers who are inclusive and will value their skills.
Leonard Cheshire Disability
66 South Lambeth Road, London, SW8 1RL
Telephone: 0300 303 0074
Charity supporting disabled people in the UK and around the world to fulfil their potential and live the lives they choose.
64 Altenburg Gardens, London SW11 1JL
Telephone: 020 7924 2949
Provides training for people with disabilities or long-term health problems in London and the surrounding area.
Shaw House, Epsom Square, White Horse Business Park, Trowbridge, Wiltshire,
Enquiry Line: 0345 234 9675
Supports disabled and disadvantaged people to prepare for work, find jobs and live more independently.
Various offices across Northern Ireland
028 9023 2020
Lead organisation which works to promote, develop and support volunteering across Northern Ireland.
Jubilee House, Forthside Way, Stirling, FK8 1QZ
Society Building, 8 All Saints Street, London N1 9RL
General Enquiries: 020 7713 6161
Organisation committed to supporting, enabling and celebrating volunteering in all
Information Service: 0800 169 0022
Membership organisation for Scotland’s charities, voluntary organisations and social enterprises.
WCVA Helpdesk: 0800 2888 329
For information about volunteering opportunities throughout the UK visit do-it.org.
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Last reviewed: May 2017