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I have two medical conditions that are usually well controlled on medication. However, if I were to stop the medication, I would develop difficulty in coping with everyday life. Does this mean they qualify under the Disability Discrimination Act, even though they are normally well controlled? Do I have to declare them to employers or only to occupational health?

BMJ 2004; 329 doi: (Published 25 September 2004) Cite this as: BMJ 2004;329:s122
  1. Carl Gray, executive medical director
  1. Harrogate Health Care NHS Trust


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The Disability Discrimination Act 1995 essentially prohibits discrimination in employment against persons with a disability. See the Disability Rights Commission at

On applying for a job you must fill in the employer's application form. This will usually include a section on your health. The employer takes health into account when evaluating suitability but must not discriminate unfairly. Certain conditions, such as alcoholism, addiction to substances, and fire raising, are not included within the definition of “disability” under the act.

Applicants are under a duty to be truthful as false declarations can invalidate your contract of employment, resulting in dismissal.

In the case of a medical condition that could potentially interfere with fitness for work, then this fact should be mentioned briefly, with a request to have this matter considered confidentially by the occupational health department. The occupational health people are under a duty to preserve medical confidentiality while evaluating your fitness for employment. Disclosure of matters to do with substance misuse or addiction is especially important. Mental illness can be poorly understood by employers outside the field. It may be helpful to a have a current state of play letter prepared by your doctors. Certain bloodborne virus infections do disqualify applicants for work in exposure prone fields of medicine (and surgery).

The uncomfortable dilemma is that mention of a “problem” may discourage an employer from shortlisting the applicant, whereas not mentioning it could eventually lead to dismissal. No employer wants to take on an employee who may very soon become unfit for work. The employer has the right to appoint the person most likely to get their work done.

The best approach is probably to mention briefly “a well controlled medical problem” or “disability,” as appropriate, emphasising that this is stable and will not render you unfit for work. Suggest that you will happily disclose all details to the occupational health department.

You could consult occupational health physicians and your general practitioner in advance of applications for advice on how to present the issues. Each NHS trust will have some access to occupational health services.

At the same time, no one is owed a job. You must follow good practice in demonstrating your suitability for the post in every other way including mention of achievements, successful team working, marvellous experience, transferable skills, special sympathy with patients, qualifications, publications, teaching experience, etc.

The crux of this question is whether the medical condition is stable on medication. If not, will you be able to hold down a new and challenging job? The nature of the medication remains confidential. After taking up a post, in the case of potentially misunderstood medications such as regular injections or opiate substitution therapy, it might be wise to mention to your line managers what the medication is.

The NHS as a caring organisation should be able to accommodate employees' stable medical conditions with understanding and sympathy. However, seeking a new NHS job brings your health under a reasonable spotlight. Best of luck.


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  • Editor's note: Please note the extended Disability Discrimination Act, which comes into force on 1 October 2004, makes it illegal for employers to discriminate on grounds of disability.

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