Type1. Lack of understanding from Employers

Hi @jay1989 was there a HR representative at the meeting? Did they reference any internal guidelines or policies when putting in place the requirement for a doctors note for any further absences? Did the put this requirement in writing?

I'm not sure it really is the diabetes causing absence, you've just been unlucky with two major illnesses (DKA then norovirus, anyone would be off with norovirus I hope they wouldn't come into my office anyway) soon after starting a new job. In the usual course of things it wouldn't be standard/expected for diabetes to cause a lot of absence.

Type 1 is a disability under the equality act, so employers need to consider reasonable adjustments to accommodate the disability. If your needing more time off due to diabetes you might need to ask the to consider being flexible with application of their absence policy. You might want to have a chat with the hr representative to find out I'd your disability was considered when imposing the requirement.

But is there any reason to go in strong with it at this point? Is there any reason to anticipate more sickness absence?

Your company should have a policy on illness and absences. Maybe you should ask to speak to a manager if you are not happy with supervisor

jay1989 said:

The point I'm making is should they require all this documentation after this amount of absence?

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I dunno, a doctors not isn't an unusual request for a sickness absence. You need to find out what you employers ansence policy actually says.

If you've constantly got high blood sugar obviously you are prone to illnesses and hit hard by them. While you are waiting for DAFNE have a look at the Bertie online course to learn about carb counting and insulin adjustment. There's no reason you should be running high often if you can learn how to manage your diabetes. Have a look at the book think like a pancreas for tips on managing diabetes.

Many GPS will not give a fit certificate if you have not already been off work for 7 days. No GP would want you in a surgery for norovirus

From Wikipedia

Disability rights legislation
The British Disability Discrimination Act 1995 and 2005 (DDA), (replaced by the Equality Act 2010) creates a duty on employers to tailor their actions to the individual circumstances of disabled employees. As certain disabilities may lead to a greater likelihood of short-duration absences or to a higher total of days of absence, caution is needed in taking action as a consequence of the data generated from the application of the Bradford Factor. The DDA allows disabled employees to request 'reasonable adjustments' in situations where they are disadvantaged by generic processes. Failure to provide these reasonable adjustments, or to adequately justify why they cannot be provided, may leave the employer open to civil action for breach of the DDA in an Employment Tribunal. Reasonable adjustments in the case of the Bradford Factor might include recording Disability-Related Absence separately from Sickness Absence, or individually tailoring targets. Reasonable adjustments may also be requested by disabled employees for relief from any negative consequences of application of the Bradford Factor, such as disciplinary action or reduced salary awards.

You need to speak to HR

jay1989 said:

All I want is some help. Everyone else seems to get satisfactory diabetes care why shouldn't I. Thank you, I shall take a look. I just feel like giving up though sometimes.

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I'm in USA so we have different rules here but I feel for you-it is difficult to deal with diabetes appointments and working as well-please do not let it get you down. You are worth taking care of.

This page shows you how the Bradford factor is calculated:-
http://employmentlawclinic.com/attendance-and-performance/bradford-factor/

You might like to show your employer this, regarding type 1 diabetes:-

The Bradford system is used to ensure that everybody is treated fairly in Companies. There are many other illnesses that would get exactly the same treatment-epilepsy, fibromyalgia, coeliac etc...

They are not being discriminatory by having a bradford system
In place. Good for them that they have. I know. I'm T1 and used it when I was a Manager.

I am concerned that you think the NHS is responsible for keeping you well with diabetes. If you are waiting for a dafne course then you could be getting agead of the game by checking out the bdec course online. You could get the book "thinking like a pancreas" by John Walsh.

I have to mention that diabetes is your control and your responsibility long term. Yes, you should be given the instruction and tools like a safne course nowadays but you do nowadays also have online information. T1's existed for way before dafne and internet and we were not given blood strips etc or meters etc or carb counting books/courses.

I know this sounds harsh but the NHS will give you ;I think) it averages about 2 hoyrs a year to manage your diabetes after you have had your course and you are bedded in. The rest of the time it will be down to you.

Now, your employers will have a policy in place if they use the Bradford system. You should have been given some sort of staff handbook or guidance on their policies when you joined them. Details should be displayed or available somewhere for you to get yourself accustomed to the rules.

I had staff that played the bradford system to their advantage!! They weren't sick, they knew they could have so many occasions in so many minths and took advantage! I even had one union rep phone me up at home saying he was playing golf and wouldn't be in!! I had to treat him fairly along with the braford absentee format and policies!!

DKA is avoidable under normal circumstances and with the correct knowledge you should not be having high levels let alone dka.

Please take this instance as an opportunity to learn and to manage. Checkout bournemouth diabetes education centre online..get some books like I suggested. The NHS can do more to help you to learn to luve and gain control of your diabetes... they should give you help and if they know its affecting your ability to work etc then they should push to help you quicker.

You will find though that the bradford system can faurly lead to cerbal warnings, written warnings and dismissal, even if you have any disabling critical illness as it is not your employers responsibility to actually make sure you take your insulin and food correctly.

The Bradford system can be weighted in favour of someone with a disability.... it is not actually set in stone... however.. it is used fairly by most employers. I know my hubby is certainly fair in his management of persons ysing the bradford way...

jay1989 said:

All I want is some help. Everyone else seems to get satisfactory diabetes care why shouldn't I. Thank you, I shall take a look. I just feel like giving up though sometimes.

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What do you think everyone else diabetic care is that makes it different to yours? If you have diabetic consultant you should have access to their diabetic nurses. If you are struggling, call your diabetic nurse to ask for their advice.

jay1989 said:

They do have a policy. They use the Bradford score to determine if any disciplinary action should be taken. The manager is more useless than supervisor in all honesty. I've had to cancel a medical appointment on 12th Dec as they have stated the needs of the business come first and too many people are off. I spoke to her (manager) and the attitude was "not my problem". This is why I've asked advice as I don't want to go straight to HR all guns blazing.

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That is wrong, you need to attend medical appointments and your employer should make allowances for you to attend them.

Diabetes UK have an Advocacy Service that helps people like yourself with employment issues, why don't you contact them and see if they can assist in any way:

https://www.diabetes.org.uk/How_we_help/Helpline/Your-rights/

jay1989 said:

I am hoping now I'm in Kent the care may be slightly better and things start to improve. I guess work my insulin as had no help what so ever and hope to go on a DAFNE course.

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Until then why don't you register with the following, it's an on-line carb counting course which is similar to what is taught on the DAFNE course:

http://www.bertieonline.org.uk/

Good luck and hope it all works out well.

It strikes me that there are two issues going on here @jay1989 .

The first is the lack of care that you feel you are receiving from the NHS. WHilst it might seem that you're not getting that much, you are sadly getting as much as anyone else, and by joining up on here, we can hopefully provide you with some help to fill the gaps that you are struggling with.

As many have mentioned, take a look at www.bertieonline.org.uk which is a great course to take you through the process of learning about dose adjustment, dealing with high glucose levels and a host of other things.

Secondly, go and have a look at www.t1resources.uk - a website built by T1s and Healthcare professionals to provide a really useful set of reviewed links to a huge variety of resources. Going away and looking at all of these will help you to get your head around T1.

Secondly, your employer. A back to work process and use of the Bradford score are, in their own right, normal processes, and as others have said, you aren't being treated unfairly in that respect. I'd agree that the Doctor's certificate statement seems a little odd, so I would certainly double check your employee handbook/processes, which the company has to provide for you.

As has been mentioned, under the disability discrimination act, your employer has to make reasonable adjustments, but this doesn't mean that you can do whatever you like in respect of your diabetes and expect them to just deal with it. It's a two way thing and you also have to be making a reasonable attempt to manage yourself, so extreme highs and swinging lows that result in time off could be considered by the company as unacceptable. To deal with this, go through the links I provided earlier, which will give you some tools to manage.

With regard to the appointment on the 12th December, what's it for, and how much notice did you give your company? Have you explained to them the importance of it? Whilst you should be reasonably allowed to attend, if there are a lot of people off and the company will be understaffed, and the notice provided was short (less than two weeks say), again, they are within their rights to say "We're really sorry, but we just can't manage without you, would you mind re-arranging it?".

I think the most important thing to bear in mind when dealing with your supervisor and management is that they probably have never encountered Type 1 before and have no idea what it means for you. Their view on Diabetes will be driven by the T2 propaganda, so somewhere, it's likely that one or two of them will be thinking that you brought it on yourself, however wrongheaded that might be.

One thing you might consider, especially if it is a small company, is providing your management and fellow employees a type of "Lunch and Learn" session where you take them through what T1 is and what you have to do to manage it. That will help them understand what you have to deal with and provide you with an opportunity to help them understand what assistance you might need. My take is that you should be proactive on educating them and assume they know nothing as that's often the case.

Where I work (big company) everyone is taken on with a probationary period, during which sickness attendance is particularly scrutinised. The managers are required to precisely follow a set procedure, and that sickness attendance is factored in at the end of the probationary period, when it is decided whether to keep the employee, terminate, or extend the probation. This applies to everyone, T1 or not.

There is a certain number of sickness days at which that is grounds for extending the probation, and another number that is grounds for not keeping the employee. Discussing making allowances for T1 (or other conditions) would be factored in after those numbers had been hit.

jay1989 said:

All I want is some help. Everyone else seems to get satisfactory diabetes care why shouldn't I. Thank you, I shall take a look. I just feel like giving up though sometimes.

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I haven't seen a diabetes doctor or nurse since 2013. As many know on here know it hasn't been lack of action on my side. Every time GP refers me it gets knocked back.

jay1989 said:

Hi all,

I am brand new to the forum and relatively new to Diabetes, only having been diagnosed a short while.

I wanted to get your opinion on a topic that's really got to me lately. I recently started a new job back at the start of October 2016 and through no fault of my own have had 5.5 days sickness, as I ended up with Ketoacidosis, and ended up being hospitalised, and Norovirus on another occasion. Today I had a back to work meeting and my manager questioned me on every little detail of my norovirus not believing it affected my t1. I was unable to eat and drink so of course it affected me more than an able bodied person. I have now been told if I have any more absences I must produce a doctors note. My understanding is that you can self certify for up to 7 days? I am apparently racking up the points ( Bradford factor) and is now making me worry. I said outright to them I'm not making any illness up, I need to be in work.. unfortunately diabetes is unpredictable.., they did not seem to care one bit. Now I'm stressing as if I'm ill again I will have to drag my self in to work.. or be faced with meetings. Any advice would be greatly received

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My workplace also uses the Bradford factor and any time off as a direct result of an ongoing long term illness does not count. Only unrelated illnesses e.g. A cold, migraine etc. I would ask for an appointment with the occupational therapist if they have one, HR if they don't. Getting you medical condition recognised and having the Bradford factor explained should help.

I think you've received some pretty wonderful advice here, so I won't recapitulate what you've been told.
BUT...
Please remember the role stress plays in managing your diabetes. Stress raises blood sugar significantly without reason. I'm a T1 for almost 50 years. When I worked, my BG was a rollercoaster: High high high and then way too low for no apparent reason - until I started taking stress into consideration.
It's unfair, really. You worry about your levels and up goes your sugar. You take extra insulin to compensate and get your BG down and the stress goes away and now you're bottoming out.
My way of dealing with it when I had a manager who listened was to let them know about stress as a factor. Good managers helped me get the lunches and breaks I needed and didn't punish me for times I couldn't control. They partnered with me and for that, they got me there at work being very productive.
Stay strong and don't let this stress you out.