I am worried about my employer finding out about my treatment. How can I prevent his or her finding out?

All employees need to know that they are under no obligation to disclose medical information, whether they are seeking employment or are currently employed. Many job application forms request information about mental illness. The employers may request information about a gap in employment, and because many employers pay the medical bills, employers frequently feel that they have a right to know an employee's medical history. If treatment requires time away from work, some medical information may need to be released in order to justify the time off.

The information given to an employer is strictly at the employee's discretion. If a health care professional or health care institution shares information with the employer without permission, legal sanctions may be invoked that will penalize the provider. The threat of legal sanctions should prevent the employer from finding out about your health status. The legal sanctions are described Question 92.

American Disabilities Act title I of the Americans with Disabilities Act of 1990 took effect July 26,1992.

It prohibits private employers, state and local governments, employment agencies, and labor unions from discriminating against people who have physical or mental disabilities in job application procedures, hiring, firing, advancement, compensation, job training, and other terms, conditions, and privileges of employment.

Many patients fear that they will be fired if an employer finds out about their history of alcoholism or drug addiction. The American Disabilities Act is a federal law that was passed to protect patients with disabilities from being fired because of a specific disability. The American Disabilities Act of 1990 makes it unlawful to discriminate against an employee if he or she is a qualified individual with a disability. A disability is defined as "a person who has a physical or mental impairment that substantially limits one or more major life activities, has a record of such impairment or is regarded as having such impairment" (U.S. Equal Employment Opportunity Commission, 1991). This law also applies to people with mental disorders, including addictions. If the disabled person is the most qualified person among all of the applicants, then accommodations must be made, such as job restructuring, modifying work schedules, and acquiring or modifying equipment. According to the American Disabilities Act, employers cannot discriminate in their hiring and firing practices based on medical information. The law specifically prohibits an employer from asking questions about a person's disability during an employee's job interview unless the questions are directly related to job requirements. The same principle remains true after the prospective employee is hired.

Current laws protect employees from unwanted disclosures to employers, which should prevent the employer from finding out about your alcoholism or drug addiction. In this case, the law prevents your employer from finding out about your medical status.

My employer ordered me into treatment or risk getting fired? What are my rights?

Employees need to know that disciplinary actions may occur, including dismissal, if the employee's job performance has been compromised as a result of alcohol or drug abuse. Employers may offer time off to seek treatment and a return-to-work agreement. The Family Medical Leave Act (FMLA) may also cover the employee's ability to take a temporary leave of absence to seek treatment for alcohol and drug addiction. You are eligible to take time off without pay to get treatment under these circumstances:

1. Your employer has 50 or more employees.

2. You have been employed at least 12 months or worked in excess of 1,250 hours.

Family Medical Leave Act (FMIA) the U.S. Congress passed this act in 1993 with the goal of providing employees with a balanced life between family and work.

The Family Medical Leave Act (FMLA) may also cover the employee's ability to take a temporary leave of absence to seek treatment for alcohol and drug addiction.

3. Your employer must continue your health insurance coverage, but you must pay your share of the premium.

4. You may or may not return to the same job, but it should be an equivalent position.

5. You must give notice 30 days in advance of your intention to go on medical leave.

6. You do not have to reveal a great deal of confidential information, but the employer has the right to know enough of the facts in order to discern that your reason is covered by FMLA.

7. The health condition must be serious enough to warrant inpatient care in a hospital, hospice, or residential medical facility or continuous treatment by a health care provider.

8. You may be required to provide a physicians certification that you are in need of continuous treatment, with the date on which the condition began, its probable duration, and the pertinent medical facts.

If written notification has been given to the employee, the employer also has the right to require a fitness-for-duty exam before the employee returns to work. If your employer ordered you to get treatment or be fired, you have the following rights:

• The right to not be unfairly dismissed

• The right to refuse treatment

• The right to privacy

• The right to be absent from your job, while seeking treatment, under the FMLA guidelines, if you and your employer qualify

It is also your right not to tell your employer whether you are receiving treatment and still remain on the job. Your job performance, however, must meet the required standards.

If your addiction is interfering with your job performance, take your employer's offer to seek treatment rather than be fired. Employers have the right to take disciplinary action based on job performance problems that result from an employee's alcohol or drug abuse. Negotiate with the employer on the amount of time away that you will need to get the required treatment. Determine what you must change in order to meet his or her expectations regarding your job performance. Take the offer: Save your job, and save your life!

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