Difficult decision around disclosure - new job

As some of you may know from my posting in social, I started a new job yesterday. It's an entry level position but with a great organization that offers great benefits, pension, room for advancement, and wellness perks.

There is however one downside. Occupational Health questionnaire Form B. Form A is standard for all hospitals and deals with making sure your immunizations are up to date - fair enough. Form B goes into your complete health history. It asks for a complete list of all medications that you're on, a bunch of different medical history conditions, including seizures, motor vehicle accidents, bone or joint injuries, mental illness, and specifically anxiety & depression. It also asks if you're under a Dr's care for anything and if you require accomodation.

I've consulted my lawyer, a friend who knows a lot about privacy legislation, a patients rights representative at my psych hospital, an HR professional who I know who ran it by a labour lawyer, and my addictions Dr. The overwhelming consensus is that the questions are a clear violation of privacy legislation and that I am within my rights to refuse to fill out the form. This however will get me branded as a S*** disturber, and I'm pretty sure ensure that I don't make it out of the probationary period. If I fill in the form honestly one look at my meds will tell you that I'm an alcoholic psych patient. I've had 2 withdrawal seizures and been hospitalized 4 times in the past 4 years - twice for addiction and twice for mental health. In theory the information is kept confidential within occupational health, but I don't trust that 100%.

The ironic part is I don't particularly care who knows that I'm in recovery or that I'm in ongoing treatment. My attitude is stigma will never go away unless we're willing to talk about it, yet I have a real fear of discrimination. There's a big difference between who I choose to tell and being forced to disclose to my employer.

I have until my occupational health appointment at 2:15 tomorrow to decide if I'm going to refuse to fill out the form, or if I'm going to answer it honestly.

I really don't know what I'm going to do.

--splitimage

Hello, splitimage. Do you have an employment contract? If so, is there a provision that specifies grounds for dismissal? If there is, is a failure to completely fill out the questionnaire grounds for termination?

Even if a failure to complete the questionnaire is not grounds for termination by contract, some contracts provide the contract is conditional and does not fully vest until the period of probation is over. In effect, the contract confers at-will* employment until probation is over.

Should you have a right to privacy, you likely will have to sue the hospital for reinstatement. A lawsuit is expensive, stressful and comes with no guaranty of success. If you win and get damages for unlawful termination, reinstatement does not assure you will not be ostracized and isolated.

If you do not have a contract and would be an at-will employee, the hospital may not need to have a reason to terminate you, depending on the law in your jurisdiction.

I know you are running out of time. I hope you are able to talk to your attorney about some of my concerns before you have to decide.

I certainly understand how you can feel you are between a rock and a hard place. I will conclude by asking you, what if there comes a day you require an accommodation?

*At-will: Under common-law, this phrase describes the relationship between employer and employee that exists without a written contract or other agreement guaranteeing job security. An at-will employee may be terminated at the will of the employer without reason or cause.

Good luck. I spent years as the employees with disabilities rep where I work - and was "out" as they say. Things got rough though, and in later years I sometimes wished that I hadn't put myself out there. On the whole, though - I think I did more good than not by doing it, but have to say I think it affected my career growth.

Regarding accommodation - you can always request an accommodation at the time needed. It's not all or nothing. Your advantage is that you are not worried about the stigma thing - second guessing yourself is always tricky. And 95% of folks are good about rolling with all sorts of things. The 5 percent... just be polite and steer clear once you get a sense of them. (OR.... invoke mediation for understanding). Love K

Hi - I'm a recovering alcoholic myself. What i've done in the past is been honest with them. I figure that somewhere along the line there is always the possibility that they might hear about my alcoholism somehow, somewhere - so it's better that I tell them outright.

If I end up NOT making it thru the probationary period - and I feel I've done my job up to par, and have not had any write ups - and I try to make copies of my personnel file (which are supposed to be open to us) and there are good reports in the file, then I have reason to sue for unfair firing. This happened to me once and I sued and WON. I do NOT like to sue, but when something like this happens and it's definitely NOT FAIR, I'm going to use my rights. God bless. Hugs, Lee

Splitimage, what did you decide to do? How did it go?

I'm having a similar dilemma where I work. I've been there for years. We fill out a similar questionaire. In the last year the agency decided to start randomly drug testing employees. We can be fired if we fail the drug test. Because I beleive it's none of my employer's business what meds I'm on I did not report any of my psych meds on the questionaire. Now I'm worried what will happen if they drug test me because one of my psych meds is a "controlled substance."

Based on your timeline I suppose you have already decided what to do but I thought I would give my 2 cents anyways. One of the things I do for a living is write HR policy so I have some familiarity with the subject.

It is a violation of privacy but as you say refusal may not be recieved well. It is also true that you can be dismissed within your probationary period without cause. Your employment contract likely sets out in the terms that it is subject to successful completion of the probationary period. This means they can hide discrimination because they don't need to give a reason for releasing you before your probation is up. It's a catch 22.

Were I in your shoes I would likely go ahead and disclose and take the risk. If they dismiss me because of my disclosure then perhaps it isn't a good fit for me. If I do need accommodation I want to know my organization will actually come through for me. Their response to my disclosure will be a good early indicator.

Being willing to battle stigma is a worthy cause and more of us need to be willing to do the work and take the risks that that involves. It isn't easy but the more people are exposed to people with mental illness functioning the more likely the stigmas can be torn down.

If you refuse to sign, when your probationary period is over and if you find yourself in need of accommodation you can still get it based on the current need without having disclosed any related history. Accommodation is legislated by our Canadian labour law and they would be hard pressed to refuse you.

Curious to hear what you decided.

This reminds me of something. I was the director of student services for a college and we were interviewing to hire a new student advisor. The candidate we choose had actually disclosed his battle with PTSD in the interview. To our credit (I include myself because I was still in denial about my own illness and if asked at the time would probably say mental illness was a personality weakness to be overcome) we didn't hold that against him. Based on the rest of the interview and his resume we picking him for the job. Some on the committee actually thought his experience with PTSD would be an asset because many of our students had suffered significant trauma in their lives and he would be well equipped to relate.

Interestingly there were times when we did need to make accommodation to manage the stressfulness of a situation for him. The work environment at times could be very stressful and the pressure to deal with conflict was constant. Because he had disclosed early it was made easier for him to ask for accommodation when things started to get a little overwhelming for him. In fact in my orientation with him we had discussed possible scenerios where he thought he might need accommodation that our collaborative model of operation might not already be accommodating enough. As such I was able to describe his job in a way that would allow us to transfer cases or to increase the involvement of others to assist him with cases without it being preceived as him not performing his job.

I find that often times what is considered an accommodation for someone with a specified need is in fact an accommodation that should be made for all employees. Rather then it being preceived as an accommodation it should be seen as normal operating procedure. Accommodation for me says healthy work environment.

I am a strong advocate of 'wellness days' and 'wellness policies' that accommodate good mental health practices in general. Workplaces should not be pressure cookers that are inflexible to the needs of its workers. The more an organization views its employees as partners and human assets instead of worker-bees and machines the healthier the organization and the more productive, effective and profitable the organization can be.

So, I was advised by multiple people that I had the right to refuse to answer the questions, and that my refusal could not be grounds for dismissal. I am however a realist, and starting out a new job by pointing out to your employer that a form they insist all employees complete is illegal would likely get me branded as a s**** disturber and pretty much guarnnatee that I wouldn't make it out of my probationary period. ok so maybe I'm cynical. but I got fired from my last job because the new managing director didn't like the fact that I worked flex time - they had to give me a good package but still.

So I decided to be honest. I listed all my meds. I checked off that I have a history of seizures, hospitalizations, been in car accidents, been treated for anxiety & depression, that I'm under a Dr's care currently and require accomodation.

The interview was interesting. I could tell from the nurses face that she was thinking "problem" but she handled the interview pretty well. She asked about my seizure history, which I do consider legitimate because if I had epilepsy that would be a real workplace issue. I told her that I had 2 seizures and both were caused by alcohol withdrawal. She asked me how long I'd been sober. I fudged there and said I'd completed rehab in summer 09. I didn't mention the relapses and figured it sounded better if I was sober for a year and a half rather than 6 months. She didn't ask about my hospitalizations (thank God). She asked about the anxiety and depression and if it was both or more one than the other. I said mine was purely depression. She asked how I was doing on my meds. I said I was completely in remission from depression (I am). She asked me if I was still attending any groups for addiction treatment. I told her I was in aftercare 1 morning a week at my hospital, and that I was active in AA. I told her that I had already negotiated taking Tues. mornings off as part of my offer, and that I hadn't specified what it was for, beyond that it was for ongoing medical treatment. She said that if I ever started getting pushback from my boss or the department about the flex time, to come to occupational health and they'd confirm that I needed flex time as a disability accomodation without revealing what it was for. So at this point I'm feeling pretty good about the whole thing.

Then things started to go downhill. She then produced a medical release form, for me to sign authorizing occupational health to tell my manager about any medical conditions that could affect my position. There was an option to refuse to sign the release - you had to give an explanation, but again I figured I'm not going to do anything to create waves. So now I just have to hope they keep my info confidential.

The part that really pisses me off is that the hospital is flat out lying to their employees. The nurse gave me a form to take home and read that outlined their policies around confidentiality. It also "explained" why the hospital was collecting the data. It said it was collecting the data in order to be compliant with workplace health and safety legislation. That's BS. I know this is BS as I was responsibile for workplace health and safety and all reporting at my last job. I also talked to a patient's right's advocate at my psych hospital who had run the form by her hospitals occupational health and safety department. According to her there was no way her hospital would dare collect the info my hospital is collecting due to privacy legislation and becuase there's no way it would get past the union. She also told me that the hospital I'm working for has all kinds of strange HR policies, because they're one of the few non-unionized hospitals in town. Their vacation policy is really screwy, and seriously messes with employees.

So for better or for worse, my MH and addictions history is out there.

--splitimage

I'm impressed. It was the best choice in a tough situation.

I second that reply. I hope everything works out well and that your new job is a great success. Congrats!

Your experience really turns my stomach. I had to apply for hospital priviledges last year and had a similar form. I felt I had no choice but to fill it out accurately. I got the job, but it is kind of strange because I don't know what my boss knows about me. Maybe that's fair, all I know about him is that he sends me picky emails.

Back in my intern year I told my chief residents about my illness and it got real awkward with them. I told my mentor and I felt she was always grading me through a colored lens. I've adopted the policy that my illness is my business, not my employers, and that the people in my life are on a need to know basis. Isn't hiding healthy?

I'm new to this website so please bear with me if I do something wrong. I wanted to reply to your consideration of whether you should answer all those medical questions at your new job. I work for a place that sounds like where you are going to work. My reply is more for anyone who finds him- or herself in this situation in the future. Ideally I would try to find someone who works there who could tell you whether there has ever been an instance where that information, or similar confidential stuff, was used against someone. I work for a big organization, and like any big place, there are friendly, honest, caring, cooperative people, and some who are not--shockingly not. I think the major downfall of the place is that the organization refuses to acknowledge that there are some employees with a bad attitude and it leads to abuse -- including such things as revealing information that should be confidential. I've seen employees mistreat each other, supervisors verbally abuse employees, and heard supervisors disclose information that they had no business disclosing. There's been at least one shooting (resulting in deaths). So I write not just to encourage people to find out about the place with the view to getting hired; but also to find out as much as possible from one or more current employees, to see whether it is a good situation for continued employment. For me where I am working is a horrible place, because I feel as though I am being forced to ignore abuse. I hope what I have replied makes sense; your comment about it being the only place that had such HR policies made me think of my own situation.

I'm so screwed but good for you Split Image! I work at a group home for mentally and physically handicapped. I manage meds, appointments. personal care. I did not disclose I was BP when i got the job in June. I was perfectly stable in June, but since then I have gone through both Mania and depression and have a hard time with thing. I had to call work and call them because I was so manic. Actually, I made my counselor call cause I was so strung out and they questioned my ability to work their. They had been questioning my job performance lately (but as I've said I've been manic and depressed the past few month) My 90 day eval was supposed to be in Dec. but it hasn't happened yet. I'm scared to death to lose my job, I like parts of it. it is overwhelming and probably caused my Mania in the first place. Got any ideas what I should do. I think I should have disclosed and next time I might. Congrats and Lots of Love and Luck! Mildred

Midred... I wonder if it is necessary to disclose your history or if you can just focus on the health concerns you are having now. It is tricky since you haven't made it through your probation yet so you won't qualify for any extended group health benefits your organization has set up. You are entitled to a certain amount of sick days either way, in Canada it is 15 per year with pay and then sick leave can be requested without pay. Long term paid sick benefits vary and are provided through optional group health plans available only after successful completion of probation.

I would recommend, if you feel up to it, to try to get your probation review done asap so you can get on group benefits (usually including long term sick leave) if they are available. Meanwhile work with your doctor and therapist to try to stabilize your symptoms as best you can. If you can't work at all right now due to symptoms then max out your sick days and go from there.

It is tough when our illness effects our employment. I lost my job due to my denial of my illness which meant I didn't take sick leave or get any help but just walked away to get away from the pressure. It was not the best way to manage things considering our org did have a very cushy benefits package. Had I not been afraid of the stigma I might very well be back there working again.

I hope things get better for you soon Midred. Wishing you well.

Is anyone else kind of shocked or at least dismayed with the level of ignorance in these hospitals about people with mental illness? I mean of all places that one might expect greater awareness and understanding and where someone would not be subjected to the effects of stigma it would be a hospital. Wouldn't it? One would think wouldn't they? Most disturbing!

very little surprises me any more. I particularly enjoyed the mandatory on-line diversity training that I had to complete. It dealt with accomodations and dealing with people with different disabilities. Overall, I'd say it was mediocre - I've seen better in the private sector. But I almost choked on my coffee when I got to the part about dealing with people with mental ilnesses. I'm not making this up. It said "Maintain eye contact, and don't make any sudden gestures." WTF. It also said allow any directions or instructions to be communicated by the person's caregiver, and finished with "When necessary call for back-up from Psychiatry."

On the plus side I'm getting assigned to work with all the interesting departments, including psychology and telepsychiatry. When I expressed that I thought that would be interesting - he said that's right you're interested in addictions and mental health. I had put on my resume a number of mental health related volunteer activities.

So I guess even if I'm no officially personally out, I'm out.

--splitimage

SplitImage,

I have every confidence that you will do well.

Mildred, it might be advisable to tell your employers that at the time you were hired that your condition was not an issue as it was controlled and that right now what is happening is basically a bad reaction to stress. That is more or less the truth. With proper management of stress at work it will probably calm down again. What does your counselor suggest?
I find that the stress explanation tends to normalize the bipolar thing a great deal for people who otherwise don't understand it very well.