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Draft: not yet reviewed by a clinician

Use this page to prepare questions for your care team. It does not replace their advice. Your own targets and doses come from your nephrologist, diabetes team and renal dietitian.

Working with kidney disease and diabetes

In short

Many people keep working with kidney disease and type 1 diabetes, and some keep working on dialysis. In the US, the Americans with Disabilities Act requires employers with 15 or more employees to make reasonable changes so you can do your job, such as breaks to check glucose and eat, or a schedule that fits dialysis (EEOC). The Family and Medical Leave Act (FMLA) can protect your job during up to 12 weeks of unpaid leave a year, which you can take in short blocks (US Department of Labor). Home and overnight dialysis can leave your working day free (NIDDK). If you cannot work, Social Security disability benefits may help (SSA). Laws differ outside the US; ask your kidney unit's social worker or national kidney charity.

Your numbers (US, 2026)

Rule The numbers Source
Americans with Disabilities Act: who must make accommodations Private employers with 15 or more employees, and state and local governments; some state laws also cover smaller employers EEOC
Time limit to file a discrimination charge 180 days from the event (300 days where a state or local agency also enforces a disability law); federal employees: contact an EEO counselor within 45 days EEOC
FMLA leave Up to 12 workweeks of unpaid, job-protected leave in 12 months; can be taken a day or a few hours at a time when medically needed; your group health cover continues Department of Labor
Who can use FMLA Employer with 50 or more employees within 75 miles; you have worked there 12 months and at least 1,250 hours in the last year Department of Labor
FMLA for family Also covers caring for a spouse, child or parent with a serious health condition Department of Labor
Social Security disability: dialysis Dialysis that has lasted, or is expected to last, at least 12 months meets the kidney listing SSA Blue Book 6.03
Social Security disability: transplant Counted as disabled for 1 year after a kidney transplant, then reassessed SSA Blue Book 6.04

Accommodations you can ask for

Examples from the EEOC and the Job Accommodation Network (EEOC; JAN):

  • Breaks to check glucose, eat, drink or take insulin.
  • A private place to check glucose or inject, and a place to rest until a low has passed.
  • A changed schedule or shift, so you can get to dialysis sessions or appointments.
  • Working from home on some days, or a laptop or tablet so you can work during dialysis.
  • For PD: a clean, private space and storage to do an exchange at work, and safe disposal of supplies.
  • Rest breaks when you are tired, or a move to a less physically demanding role.
  • Leave for treatment, recovery or diabetes training.

You do not need special words. Tell your employer that you need a change at work because of a medical condition. A family member, friend or health professional can also ask on your behalf (EEOC).

Telling your employer

  • It is your choice. You do not have to tell an employer that you have diabetes or kidney disease, unless you need an accommodation during hiring. You can ask for an accommodation during the hiring process or at any time after you start, even if you did not mention it before (EEOC).
  • To get an accommodation, you will need to say that you have a medical need. If the need is not obvious, your employer may ask for reasonable documentation, such as a note from your doctor (EEOC).
  • Your employer must keep medical information private, and may not tell coworkers you have diabetes (EEOC).
  • Before a job offer, employers may not ask about your health. After an offer, they may ask health questions only if they ask everyone offered the same kind of job (EEOC).

Treatments that fit around work

  • Home hemodialysis lets you choose your treatment times, which makes working easier (NIDDK). Overnight home hemodialysis runs while you sleep.
  • Automated PD runs overnight on a cycler, so your day is free (NIDDK).
  • In-center hemodialysis runs on a fixed schedule set by the unit. A US dialysis unit must give you information about scheduling options for working patients, including options it does not offer itself (42 CFR 494.70).
  • A transplant, especially before dialysis, gives the most freedom once you recover (Choosing a treatment).
  • US dialysis units must assess whether you want help to stay in or return to work, and refer you to vocational rehabilitation services if so (42 CFR 494.80 and 494.90).

What to do

  • Write down what you need at work: break times, a place to check glucose, time off for sessions or clinic.
  • Ask your doctor for a short letter that explains the accommodations you need.
  • Make the request to HR or your manager in writing and keep a copy.
  • Ask HR whether you qualify for FMLA, and ask for the forms before you need leave.
  • Tell one trusted coworker how to spot a low and where your glucose tablets and glucagon are. NIDDK suggests teaching coworkers when and how to give glucagon, and to call 911 after giving it (NIDDK).
  • Ask your kidney team whether home or overnight dialysis would suit your job.
  • If you are on dialysis, ask your social worker about vocational rehabilitation.
  • If you cannot work, apply for disability benefits early: ask your social worker to help (SSA).
  • For free, confidential advice on accommodations, contact the Job Accommodation Network (JAN).

Examples

An office worker starting in-center dialysis. You ask your employer to move your hours to start at 11 a.m. on Monday, Wednesday and Friday after morning sessions, and to work late on Tuesdays and Thursdays. You put the request in writing with a letter from your nephrologist. This is the kind of schedule change the EEOC lists (EEOC).

A low at work. Your CGM alarms during a meeting. You step out, take 4 glucose tablets and rest for 15 minutes in the quiet room your employer set aside (EEOC; Treating a low).

Surgery for a fistula. You need a day off for surgery and a few half-days for checks. Your HR team records them as FMLA leave taken in short blocks, so your job is protected (Department of Labor).

Ask your care team (and HR)

  1. Which treatment would let me keep working? Could I do home or overnight dialysis?
  2. Can you write a letter explaining the breaks and schedule changes I need?
  3. Does my unit have early or late sessions for people who work?
  4. (HR) Am I eligible for FMLA leave, and can I take it in short blocks?
  5. (Social worker) Can you help me with vocational rehabilitation or a disability application?

Get help now if…

Call 911 (or your local emergency number)

A coworker cannot wake you or you cannot treat a low yourself: they should give glucagon, turn you on your side and call 911. Also chest pain or severe breathlessness. Full list: Get help now.

Sources

Not yet reviewed by a clinician. Facts and sources last checked 2026-10-06. Prices and benefit amounts as of 2026-10-06.