If you have Crohn's disease or ulcerative colitis (collectively known as Inflammatory Bowel Disease or IBD), you may be concerned about the impact of your condition on your job and career prospects.

You may be seeking employment for the first time or planning a return to work after diagnosis, disease flare-up or surgery. If you have been diagnosed for some time, you may need advice on how to adapt your working environment to accommodate your condition better.

Despite living with a chronic condition, most people with Crohn's and colitis want to work and are able to have successful careers.

The good news is that with the appropriate support from your employer and your healthcare team, combined with proactive management, most people with |BD find that problems in the workplace can be successfully managed so that they remain in their jobs.

This information guide looks at some of the questions you may have about your employment situation and how you may be protected by law

IBD and how it may affect my work

The physical and emotional impact of living with Crohn's disease or colitis is something you will need to consider carefully when applying for a new job or planning a return to work.

Bearing in mind the physical symptoms of your Crohn's or colitis when in flare and not in flare, you will need to ask yourself.

Employers are often able to be flexible with some tasks required in your role. However, you still must be able to perform the essential duties of a role.

Perhaps less obvious, but equally important, is the emotional toll of Crohn's and colitis which is often underestimated when entering the workplace or planning a return to work. Stress is inevitable in any job so you will need to be realistic about the level of stress you feel able to manage. You will need to ask yourself.

Each case of IBD is individual so there are no right or wrong answers to these questions. You simply need to address them honestly and fairly - for your own benefit and that of your employer.

Do I have to tell my employer about my IBD?

Only you can decide if and when to tell your boss or colleagues about your Crohn's or colitis. It's understandable that you may have concerns about disclosing your condition to an employer.

Your decision will be influenced by the type of work you do, whether your condition affects the job and by how much.

You do have a duty to tell an employer about a health condition if it might present a health and safety risk to yourself or other work colleagues or if it may affect your ability to carry out your work.

If you're applying for a job:

You may be concerned that you will be at a disadvantage if you disclose your IBD, whether on an application form, CV or at an interview.

There is generally no legal requirement to disclose a medical condition to a prospective employer unless it will affect your ability to do the job for which you have applied.

If you do decide to mention your condition to a prospective employer, you may also find it helpful to show them our booklet Working with Crohn's and Colitis: a guide for employers - these resource is available on our website. 

In your current job:

If you are newly diagnosed, or if your condition becomes worse, you may wonder whether to tell your manager about it. There can be some advantages in sharing information about your condition sooner rather than later.

Firstly, symptoms can be a strain and it may be a relief to talk about your condition and not to have to try to hide it any longer.

Some employers may be willing to make necessary changes to assist with IBD challenges.

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 our Guide for Employers' on our website. 

Choosing whether to tell colleagues

The decision to tell your co-workers about your condition is again your own to make. There can be advantages in letting others know, especially your manager and immediate colleagues.

It can be quite stressful trying to hide your symptoms or the need to take medications, not to mention continually coming up with novel excuses for absences or late starts. If your fellow workers understand that you have a chronic medical condition, they're more likely to give you the support and assistance you need to create a better working environment.

If they don't know, they may jump to wrong conclusions or believe you're getting preferential treatment if your employer has made workplace adjustments for you.

Tips for Disclosing

What are my rights in the workplace?

As somebody with Crohn's disease or colitis, you may be particularly worried about missing time from work due to ill health. Employees have certain legal rights and you may have additional rights in your particular employment contract.

Unfortunately the legislation in Ireland is very narrow and from an employment/equality perspective, relates only to disability as opposed to chronic illness. However, all employees are protected by general employment law principles relating to maximum working hours and daily rest breaks etc. For further information on your rights under employment law, contact your local Citizens Advice Centre.

Sick leave

It is at the discretion of your employer to decide their own policy on sick pay and sick leave. By law, an employer must provide an employee with a written statement of terms of employment within two months of starting the job. This must include the terms or conditions relating to incapacity for work due to sickness.

An employer cannot require you to take annual leave for a certified period of illness. Workers in Ireland are allowed to accumulate statutory annual leave entitlement during a period of certified sick leave.

You may apply for illness benefit if you have enough social insurance contributions. If you do not have enough social insurance contributions, you should contact the Department of Social Protection's representative at your local health centre who will assess your situation. For further information, go to www.welfare.ie

If you have consistently been absent from work through illness or are no longer capable of continuing work, you are protected against termination in certain circumstances under the Unfair Dismissals legislation.

What adjustments can be made to help me at work?

Employers in Ireland are not obliged by law to make adjustments to the work environment of a worker with a chronic condition. Increasingly, though, employers are tailoring the workplace to their employees' needs through small but significant changes.

Helpful adjustments could include:

Tips for self-managing in the workplace

While there is currently no medical cure for either Crohn's disease or colitis, there are ways to help manage your disease to prevent flare-ups and complications. These are centred around diet, lifestyle and medication.

Diet

Eat smaller portions regularly throughout the working day every two to three hours if possible, rather than less frequent but larger portions

Avoid foods or situations that you know from experience can trigger a relapse and stick to the diet you have agreed with your doctor.

Drink plenty of water during the day, especially in warm weather, to avoid dehydration.

Exercise

Staying active is good for you psychologically as well as physically. Consider going for a brisk walk during your lunch break to get fresh air and sunlight as well as exercise.

Stress management

If stress is a problem for you, try a stress-reduction technique that fits your lifestyle e.g. exercise, yoga, meditation, reading, or professional counselling.

Avoid unhealthy habits such as smoking or excess alcohol.

Try to make sure you get a good night's sleep.

Share your concerns with a family member, friend, colleague or professional

Medication

Try to follow the treatment plan provided by your healthcare team (consultant, nurse specialist and GP) as closely as possible.

Remember - taking your maintenance treatment as prescribed helps prevent flare-ups.

Don't stop taking your medicine just because you feel well, discuss it with your healthcare team.

If you suspect a flare-up, start treatment or contact your nurse specialist, consultant or GP as soon as possible.

Travelling to work

You may find simply getting to work can be stressful and difficult, particularly if you travel by public transport.

It might be helpful where possible to:

Returning to work after long absence

If you've been off for several weeks or months because of your Crohn's disease 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 your employer during your absence can help. An occasional phone call or email to your manager or close colleague may be enough to make you feel like you're still 'in the loop! The level of contact can be increased as you get closer to a return.

It may also be helpful to try a phased return to work - starting with a few hours, and then increasing over time. Or perhaps you may want to ask for a reduced workload or lighter duties to begin with.

With a bit of knowledge about your condition and its impact on you, your co-workers will be more inclined to give you the support and encouragement you need to make a successful return to work.

I can't cope with my job and IBD

If your employer is unwilling to make adjustments at work or if changes have been made but you are still finding it difficult to cope, you may need to think about trying another career path that fits in better with your health needs.

Possible options

Entitlements/Statutory Support if I am unable to work

Your first step before applying for any benefit is to find out which payment you may be entitled to. This can depend on your social insurance record, your means and your circumstances.

There are two main types of cash payments:

The Department of Social Protection (DSP) publishes detailed information about each payment as well as general booklets. If you are not familiar with the system, the most useful of these booklets are the 'Guide to Social Welfare Services' and 'Rates of Payment" You can get information booklets and claim forms at your local social welfare office, online at www.welfare.ie or at www.citizensinformation.ie

Illness Benefit

Illness Benefit is a short-term payment made to insured people who are unable to work due to illness. You must apply for Illness Benefit within seven days of becoming ill. You must be aged under 66, unable to work because of illness and meet other criteria to be eligible for this benefit.

After 12 months on Illness Benefit, if you are permanently incapable of work and you satisfy the PRS| conditions, you may consider applying for Invalidity Pension. This is paid at a higher rate and opens the way to other benefits (see below).

For further information on Illness Benefit, contact the Department of Social Protection, PO Box 1650, Dublin 1.

Tel: (01) 679 7777 or go to www.welfare.ie

Invalidity Pension

This is a long-term payment made to insured people who are permanently incapable of work because of illness or disability.

Invalidity Pension opens the way to other benefits such as free travel, fuel allowance and the Household Benefits Package.

You must satisfy certain medical and social insurance (PRSI conditions to qualify for this payment.

Invalidity Pension is payable for as long as you are unable to work. At the age of 65, the personal rate of payment increases to the same rate as State Pension. At age 66 you transfer to the State Pension (Contributory). For more information, go to www.welfare.ie

Going back to education

If you are unemployed and are getting certain payments from the Department of Social Protection, you may be eligible to take part in a second or third-level education course and get a Back to Education Allowance (BTEA) Go to www.welfare.ie for further details

The Supplementary Welfare Allowance Scheme

The Supplementary Welfare Allowance Scheme is a means-tested payment which gives assistance to people who may not qualify for other benefits.

It consists of a basic payment, called Supplementary Welfare Allowance, and other financial supports which include rent and mortgage interest supplements, diet supplements, heating supplements, payments for emergencies and payments for urgent needs

This scheme is currently administered by the Health Service Executive's

(HSE) Community Welfare Officers on behalf of the Department of Social Protection (DSP). For more information, go to www.welfare.ie

Additional Supports and Resources

Citizens Information Board: Provides information, advice and advocacy on a broad range of public and social services. They provide free, confidential, independent and impartial information to all. You can log onto the Citizens Information Website at www.citizensinformation.ie, call in person to your nearest Citizens Information Centre or phone the Citizens Information Phone Service: 0761 07 4000, Monday to Friday, 9am to 8pm.

Department of Social Protection: For information on employment rights and supports like illness benefit go to www.welfare.ie or tel (01) 704 3300, LoCall 1890 928 400.

Gettingbacktowork.ie is provided by the Citizens Information Board. The website provides comprehensive information on the supports available to job seekers, the interaction between social welfare benefits and links to relevant websites.