Employees with Hepatitis

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

The Job Accommodation Network (JAN) is a service of the Office of Disability 

Employment Policy of the U.S. Department of Labor. JAN makes documents 

available with the understanding that the information be used solely for 

educational purposes. The information is not intended to be legal or medical 

advice. If legal or medical advice is needed, appropriate legal or medical services 

should be contacted. 

JAN does not endorse or recommend any products or services mentioned in this 

publication. Although every effort is made to update resources, JAN encourages 

contacting product manufacturers/vendors and service providers directly to 

ensure that they meet the intended purposes. This guarantees that the most upto-date information is obtained. 

The following document is not copyrighted and reproduction is encouraged. 

Section 105 of the Copyright Law provides that no copyright protection is 

available for works created by the U.S. Government. Therefore, all works created 

by JAN fall under this provision. While individuals may use such work with 

impunity, individuals may not claim copyright in the original government work, 

only in the original material added. Individuals may access the full text of the law 

from the U.S. Copyright Office http://www.loc.gov/copyright. Please note that 

specific information cited by JAN may be copyrighted from other sources. Citing 

secondary sources from a JAN publication may violate another organization's or 

individual's copyright. Permission must be obtained from these sources on a 

case-by-case basis. When using JAN materials, JAN asks that the materials not 

be reproduced for profit, that the tone and substance of the information are not 

altered, and that proper credit is given to JAN as the source of the information. 

For further information regarding this or any other document provided by JAN, 

please contact JAN. 

Updated 03/22/10. 
Practical Solutions • Workplace Success 

3 

JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction 

JAN’s Accommodation and Compliance Series is designed to help employers 

determine effective accommodations and comply with Title I of the Americans 

with Disabilities Act (ADA). Each publication in the series addresses a specific 

medical condition and provides information about the condition, ADA information, 

accommodation ideas, and resources for additional information. 

The Accommodation and Compliance Series is a starting point in the 

accommodation process and may not address every situation. Accommodations 

should be made on a case by case basis, considering each employee’s individual 

limitations and accommodation needs. Employers are encouraged to contact 

JAN to discuss specific situations in more detail. 

For information on assistive technology and other accommodation ideas, visit 

JAN's Searchable Online Accommodation Resource (SOAR) at 

http://askjan.org/soar. 

Information about Hepatitis 

What is hepatitis? 

Hepatitis is an inflammation of the liver caused by a hepatitis virus. There are 

several types of hepatitis infections. The three most common in the U.S. are 

Hepatitis A, B, and C (Hepatitis Foundation International, n.d.). 

Knowing your ABCs – What types of hepatitis are there? 

Hepatitis A: Hepatitis A is the most common type of Hepatitis. It occurs when a 

person is infected by the Hepatitis A Virus (HAV). HAV is transmitted through a 

fecal-oral route either by person-to-person transmission between household 

contacts, by sex contact, or by ingesting contaminated food or water. Blood 

borne transmission is rare. Hepatitis A is highly contagious if you are in close 

personal contact with an infected individual. The Hepatitis A virus can be 

transmitted through food; no other type of hepatitis can be transmitted through 

the food supply. Hepatitis A is not a chronic condition and has an incubation 

period of 20-50 days and occasionally requires hospitalization. Most individuals 

infected begin recovery within three weeks while others may have recurring 

symptoms for up to six months. Symptoms include fatigue, nausea, jaundice, 

fever & abdominal pain. There is currently no treatment for HAV, but it can be 

prevented with the Hepatitis A vaccine. Good proper hygiene and sanitation help 

prevent Hepatitis A (Center for Disease Control and Prevention, 2008). 
4

Hepatitis B: Hepatitis B is a serious disease caused by a virus that attacks the 

liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong 

infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. 

HBV is transmitted by contact with the blood or body fluids of an infected person. 

It is NOT spread through food, water, or by casual contact. Symptoms include 

jaundice, fatigue, abdominal pain, loss of appetite, nausea and vomiting. There 

is no cure for Hepatitis B and that is why prevention is so important. The 

Hepatitis B vaccine is the best protection against HBV (CDC, 2008). 

Hepatitis C: Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). 

HCV is transmitted by direct contact with infected blood. Examples of how 

someone might contract Hepatitis C include the use of injected street drugs; 

receiving blood, blood products, or solid organs from contaminated blood; longterm kidney dialysis and unknowingly sharing contaminated supplies or 

equipment; frequent contact with blood on the job (e.g., healthcare workers and 

accidental needle-sticks); having sex with a person infected with HCV; and 

sharing items such as razors or toothbrushes with someone infected with HCV. 

HCV is NOT spread by sneezing, hugging, coughing, food or water, sharing 

eating utensils or drinking glasses, or causal contact. Symptoms include 

jaundice, fatigue, nausea, loss of appetite, abdominal pain and vomiting. Of 

every 100 persons infected with HCV about 85 may develop long-term infection, 

70 may develop chronic liver disease, 15 may develop cirrhosis, and 5 may die 

from the consequences of long term infection (CDC, 2008). 

How is Hepatitis treated? 

There is no treatment for Hepatitis A (HAV), but 99% of the time HAV will clear 

up over a period of a few weeks to months. Treatment for chronic Hepatitis B 

usually consists of Alpha interferon and lamivudine. These drugs are effective in 

up to 40% of patients. For Hepatitis C, interferon and ribavirin are the 

recommended drugs. Interferon can be taken alone or in combination with 

ribavirin. Combination therapy is currently the treatment of choice (CDC, 2008). 

Hepatitis and the Americans with Disabilities Act 

Is hepatitis a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must 

meet. Therefore, some people with hepatitis will have a disability under the ADA 

and some will not (EEOC, 2002). 

A person has a disability if he/she has a physical or mental impairment that 

substantially limits one or more major life activities, a record of such an 

impairment, or is regarded as having such an impairment. For more information 

about how to determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm. 
Practical Solutions • Workplace Success 

5 

Accommodating Employees with Hepatitis 

(Note: People with hepatitis may develop some of the limitations discussed 

below, but seldom develop all of them. Also, the degree of limitation will vary 

among individuals. Be aware that not all people with hepatitis will need 

accommodations to perform their jobs and many others may only need a few 

accommodations. The following is only a sample of the possibilities available. 

Numerous other accommodation solutions may exist.) 

Questions to Consider: 

1. What limitations is the employee with hepatitis experiencing? 

2. How do these limitations affect the employee and the employee’s job 

performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? 

Are all possible resources being used to determine possible accommodations? 

5. Has the employee with hepatitis been consulted regarding possible 

accommodations? 

6. Once accommodations are in place, would it be useful to meet with the 

employee with hepatitis to evaluate the effectiveness of the accommodations 

and to determine whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding hepatitis? 

Accommodation Ideas: 

Fatigue/Weakness: 

• Flexible leave. Consider time off of work as an accommodation if, for 

example, an individual is experiencing fatigue or needs to attend doctor 

appointments. An employer may allow the employee to use existing sick 

or annual leave. If all other leave has been exhausted, provide further 

unpaid. 

• Modified schedule. Types of accommodations may include adjusting the 

time of arrival or departure; provide intermittent breaks throughout the day; 

shorten the workday and extend the workweek; or provide a part-time 

schedule 

• Consider access to the facility (ramps, parking, etc.) 

• Frequent rest breaks 

• Reduce or eliminate strenuous activity 
6

• Flexibility to sit or stand (adjustable workstation) 

• Provide a rest area with cot 

• Job sharing 

Cognitive Complications: 

• Provide written job instructions and prioritize assignments 

• Increase job structure 

• Use of day planner or electronic organizer 

• Minimize distractions 

Psychological Implications (Difficulties adjusting to having a disability, stress, 

etc.): 

• Identify stressors and reduce stress 

• Educate coworkers, but keep person and his/her condition confidential 

• Allow telephone calls to emotional supports 

• Open door policy to supervisor 

• Time off for counseling or therapy 

• Provide praise and positive reinforcement

Other Considerations: 

• Work from home options 

• Reassignment. Reassignment is typically considered if the employee can 

no longer perform the essential functions of their job (either with or without 

accommodations). 

Situations and Solutions: 

A factory worker with Hepatitis C, receiving treatment for six months, was 

experiencing flu like symptoms with extreme fatigue. The employer provided a 

modified schedule so that the employee could attend doctor's visits and also 

leave when symptoms were exacerbated. 

An account representative was out of leave due to treatment for Hepatitis C. The 

employee wanted to return to work, but due to side effects of treatment, could not 

maintain the stamina needed to visit clients. The employer reassigned the 

employee to another account representative position that did not require travel. 

A computer programmer with Hepatitis B was experiencing fatigue and nausea, 

which resulted in problems commuting. The employer provided a modified 

schedule and gave the employee an option to work from home. 
Practical Solutions • Workplace Success 

7 

A food service worker disclosed Hepatitis C to her employer. The employer was 

concerned that the employee would risk transmission through the food supply. 

The employee provided a note from her doctor, indicating that Hepatitis C was 

"NOT transmitted through the food supply," and that the individual was "safe to 

perform the essential job functions." Note: Hepatitis A is a food borne illness, but 

Hepatitis C is not. 

Products: 

There are numerous products that can be used to accommodate people with 

limitations. JAN's Searchable Online Accommodation Resource at 

<http://askjan.org/soar> is designed to let users explore various accommodation 

options. Many product vendor lists are accessible through this system; however, 

JAN provides these lists and many more that are not available on the Web site 

upon request. Contact JAN directly if you have specific accommodation 

situations, are looking for products, need vendor information, or are seeking a 

referral. 
8

Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act 

(ADA), and the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase 

employment opportunities for adults and youth with disabilities while striving to 

eliminate barriers to employment. 

American Liver Foundation 

75 Maiden Lane, Suite 603 

New York, NY 10038-4810 

Toll Free: (800)465-4837 

Direct: (212)668-1000 

Fax: (212)483-8179 

Phone: (800)443-7872 

info@liverfoundation.org 

http://www.liverfoundation.org 

Provides education, transplant information, support group information, funds 

research, and maintains a Hepatitis Hotline. 
Practical Solutions • Workplace Success 

9 

CDC National Center for Infectious Disease 

Division of Viral Hepatitis 

1600 Clifton Rd. 

Atlanta, GA 30333 

Toll Free: (888)443-7232 

Direct: (404)639-3311 

Phone: (404)639-3534 

http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm 

The Centers for Disease Control and Prevention (CDC) is one of the 13 major 

operating components of the Department of Health and Human Services (HHS), 

which is the principal agency in the United States government for protecting the 

health and safety of all Americans and for providing essential human services, 

especially for those people who are least able to help themselves. 

Hepatitis Education Project 

The Maritime Building 

911 Western Ave #302 

Seattle, WA 98104 

Direct: (206)732-0311 

HEPInfo@HEPEducation.org 

http://www.hepeducation.org/ 

A non-profit corporation chartered in the state of Washington to provide 

educational materials and support groups for hepatitis patients and their families. 

Hepatitis Foundation International 

504 Blick Drive 

Silver Spring, MD 20904-2901 

Toll Free: (800)891-0707 

Direct: (301)622-4200 

Fax: (301)622-4702 

hfi@comcast.net 

http://www.hepfi.org/ 

The Hepatitis Foundation International (HFI) is dedicated to the eradication of 

viral hepatitis, a disease affecting over 500 million people around the world. We 

seek to raise awareness of this enormous worldwide problem and to motivate 

people to support this important and winnable battle. 
10

National Digestive Diseases Information Clearinghouse 

2 Information Way 

Bethesda, MD 20892-3570 

Toll Free: (800)891-5389 

Direct: (301)654-3810 

nddic@info.niddk.nih.gov 

http://digestive.niddk.nih.gov/index.htm 

NDDIC provides the following informational products and services: Response to 

inquiries about digestive diseases, publications about specific digestive diseases, 

referrals to health professionals through the National Library of Medicine's 

MEDLINEplus, maintains a database of health education materials produced by 

health-related agencies of the Federal Government, and presents exhibits at 

professional meetings specific to digestive diseases, as well as cross-cutting 

professional meetings. 
Practical Solutions • Workplace Success 

11 

References 

Center for Disease Control and Prevention. (2008). Viral hepatitis. Retrieved 

September 5, 2008, from 

http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm 

Equal Employment Opportunity Commission. (1992). A technical assistance 

manual on the employment provisions (title I) of the Americans with 

Disabilities Act. Retrieved September 5, 2008, from 

http://askjan.org/links/ADAtam1.html 

Hepatitis Foundation International. (n.d.). Frequently asked questions. Retrieved 

September 5, 2008, from http://www.hepfi.org/living/liv_questions.html 
12

This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability 

Employment Policy (DOL079RP20426). The opinions expressed herein do not 

necessarily reflect the position or policy of the U.S. Department of Labor. Nor 

does mention of trade names, commercial products, or organizations imply 

endorsement by the U.S. Department of Labor.