Health Discrimination at Work: Rights, Accommodations, and Deadlines

Health discrimination at work is illegal under several overlapping federal laws that bar employers from making job decisions based on a disability, a serious medical condition, a pregnancy, or your genetic information. The protections are real, but using them means knowing which law applies to your situation, what your employer can and cannot do, and how to move quickly enough to preserve your right to sue.

The Federal Laws That Apply

Four statutes carry most of the weight.

The Americans with Disabilities Act is the broadest. It applies to employers with 15 or more employees and prohibits discrimination against qualified individuals with disabilities in every aspect of employment, from hiring through termination. It also requires employers to provide reasonable accommodations unless doing so would create an undue hardship.¹²

The Genetic Information Nondiscrimination Act bars employers from using your genetic information for any employment decision. Genetic information under GINA includes results from genetic tests, family medical history, and participation in genetic research or counseling. GINA also restricts employers from requesting or purchasing that information in the first place.³⁴

The Family and Medical Leave Act provides up to 12 weeks of unpaid, job-protected leave per year for qualifying medical and family reasons, and requires your employer to maintain your group health benefits during that leave.⁵ Eligibility is narrower than most people expect. You have to have worked for the employer for at least 12 months, logged at least 1,250 hours in the previous 12 months, and work at a location where the employer has at least 50 employees within a 75-mile radius.⁶ Workers at smaller companies or those who haven’t hit the hours threshold aren’t covered.

The Pregnant Workers Fairness Act took effect in 2023 and fills a gap the ADA leaves open. Pregnancy itself isn’t a disability under the ADA, and many pregnancy-related conditions are too minor or temporary to qualify. The PWFA requires employers with 15 or more employees to provide reasonable accommodations for known limitations related to pregnancy, childbirth, or related medical conditions, no matter how minor or short-term.⁷ It also differs from the ADA in a key way: you can still receive an accommodation under the PWFA even if you temporarily cannot perform an essential function, as long as that inability is temporary and can be reasonably accommodated.⁸ Typical PWFA accommodations include more frequent breaks, schedule flexibility, temporary reassignment, light duty, telework, and leave to recover.

What Counts as a Protected Health Condition

Under the ADA, you’re covered if you have a physical or mental impairment that substantially limits a major life activity, if you have a history of such an impairment, or if your employer treats you as though you have one.¹

Major life activities include hearing, seeing, speaking, breathing, walking, caring for yourself, learning, and working.¹ A chronic back condition that limits lifting, a mental health condition that affects concentration, or diabetes that affects blood sugar regulation can all qualify. The condition doesn’t need to be permanent. Conditions that are episodic or in remission are covered if they would substantially limit a major life activity when active.

The “regarded as” piece is worth understanding. If your employer refuses to promote you because they assume a visible health condition makes you less capable, you’re protected even if the condition doesn’t actually limit you. What matters is the employer’s perception.

What Your Employer Cannot Do

An employer cannot refuse to hire you, fire you, deny you a promotion, cut your pay, or reassign you to a less desirable position because of a health condition or disability. Every employment decision has to rest on your qualifications and performance.

Offensive remarks about a health condition or disability become unlawful harassment when they are severe or frequent enough to create a work environment a reasonable person would find intimidating, hostile, or abusive.⁹ A single offhand comment probably doesn’t meet that bar. A pattern of mocking a condition, repeated health-related jokes at your expense, or exclusion from meetings and assignments because of your disability likely does.

The ADA also places strict limits on medical questions and exams, and those limits shift as you move through the hiring process:

Before a job offer, an employer cannot ask any disability-related questions or require a medical exam, even if the questions are directly related to the job.
After a conditional offer but before you start work, the employer can require a medical exam or ask health-related questions, but only if it does so for every applicant in the same job category.
Once you’re employed, medical inquiries and exams are allowed only when they are job-related and consistent with business necessity.

These come from EEOC enforcement guidance interpreting the ADA’s three-stage framework. Any medical information an employer does obtain has to be kept confidential and stored separately from your general personnel file.¹⁰

Retaliation is its own violation. An employer cannot fire, demote, harass, or otherwise punish you for filing a discrimination complaint, participating in an investigation, or pushing back against practices you believe are discriminatory.¹¹ The legal standard asks whether the employer’s response would deter a reasonable person from opposing discrimination.

Asking for a Reasonable Accommodation

If you have a disability, you’re entitled to changes in your job or work environment that let you perform the essential functions of your position. Accommodations can take many forms: a modified workstation, a flexible schedule for medical appointments, screen-reading software, reassignment to a vacant position, or additional unpaid leave.²

It starts with a request, which triggers what the EEOC calls the interactive process, a back-and-forth conversation between you and your employer to figure out what you need and what works for the business. Your employer should respond promptly. Unnecessary delays can themselves violate the ADA, and refusing to engage in the process can create liability for failing to accommodate.¹²

An employer doesn’t have to provide an accommodation that would impose an undue hardship, meaning significant difficulty or expense given the employer’s size, financial resources, and the nature of its operations.² The employer also doesn’t have to eliminate an essential function of the job or provide personal-use items like eyeglasses or hearing aids. That said, the bar for proving undue hardship is higher than many employers assume, especially at larger companies.

What to Do If You Suspect Discrimination

Start keeping a written record the moment you notice a pattern. For each incident, note the date, time, location, what was said or done, and who witnessed it. Save copies of performance reviews, emails, text messages, and any written communications tied to the issue. Keep the file somewhere your employer cannot reach, like a personal email account or a folder at home. Detailed records are what separate strong claims from ones that stall.

Then report internally. Most companies have a complaint process, usually through HR or a designated manager. Following it creates a paper trail showing you gave the company a chance to fix the problem, and the internal report itself becomes evidence. Skip this step and an employer’s defense will often be that they didn’t know.

If internal reporting doesn’t resolve it, file a formal charge of discrimination with the U.S. Equal Employment Opportunity Commission. This isn’t optional. For claims under the ADA, GINA, or the PWFA, filing an EEOC charge is required before you can bring a federal lawsuit. You can start through the EEOC’s online public portal, which walks you through an inquiry and interview before you formally file.¹³ There is no fee.

Deadlines You Cannot Miss

This is where people lose cases they would otherwise win. Your window to file an EEOC charge starts running from the date the discriminatory act occurred, not the date you realized it was discrimination.

In states without a state or local anti-discrimination agency, you have 180 days to file. In states that do have such an agency, the deadline extends to 300 days.¹⁴ Most states have their own agencies, and through worksharing agreements, a charge filed with the state agency is automatically dual-filed with the EEOC.¹⁵ Don’t assume you have the longer deadline without confirming your state qualifies.

When the EEOC finishes processing your charge, it issues a Notice of Right to Sue. Once you receive it, you have exactly 90 days to file a lawsuit in federal court. Miss that window and you may lose the right to go to court at all.¹⁶

What You Can Recover

Winning a discrimination case can produce several types of relief. Back pay covers wages and benefits you lost. Front pay compensates for future lost earnings when returning to your old job isn’t realistic. Reinstatement is also possible. Courts can award compensatory damages for emotional harm and out-of-pocket costs, and punitive damages when the employer acted with malice or reckless disregard for your rights.

Federal law caps the combined amount of compensatory and punitive damages based on employer size:¹⁷

15 to 100 employees: $50,000
101 to 200 employees: $100,000
201 to 500 employees: $200,000
More than 500 employees: $300,000

Back pay and front pay are not subject to these caps. A prevailing plaintiff can also recover reasonable attorney fees and court costs from the employer. Many employment attorneys work on contingency, typically taking between 25% and 40% of the final recovery, so upfront cost isn’t always a barrier to filing suit.

Federal Employees Follow a Different Track

If you work for a federal agency, the process is different. You’re covered by the Rehabilitation Act rather than the ADA, and you must contact your agency’s Equal Employment Opportunity counselor within 45 days of the discriminatory act. If informal counseling doesn’t resolve the issue, you then have 15 days to file a formal complaint with the agency itself. The agency has 180 days to investigate, after which you can request a hearing before an EEOC administrative judge or file a federal lawsuit.¹⁸ The 45-day initial deadline is much shorter than the private-sector window, and federal employees who miss it often find themselves with no recourse.

1
U.S. Equal Employment Opportunity Commission. The ADA: Your Responsibilities as an Employer
2
U.S. Equal Employment Opportunity Commission. Small Employers and Reasonable Accommodation
3
U.S. Equal Employment Opportunity Commission. Genetic Information Discrimination
4
U.S. Department of Labor. The Genetic Information Nondiscrimination Act of 2008
5
U.S. Department of Labor. FMLA Frequently Asked Questions
6
U.S. Department of Labor. Fact Sheet #28 – The Family and Medical Leave Act
7
U.S. Equal Employment Opportunity Commission. What You Should Know About the Pregnant Workers Fairness Act
8
U.S. Equal Employment Opportunity Commission. Pregnant Workers Fairness Act
9
U.S. Equal Employment Opportunity Commission. Harassment
10
U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees Under the ADA
11
U.S. Equal Employment Opportunity Commission. Retaliation – Making It Personal
12
U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the ADA
13
U.S. Equal Employment Opportunity Commission. Filing a Charge of Discrimination
14
U.S. Equal Employment Opportunity Commission. Time Limits for Filing a Complaint
15
U.S. Equal Employment Opportunity Commission. State and Local Programs
16
U.S. Equal Employment Opportunity Commission. Filing a Lawsuit
17
Office of the Law Revision Counsel. 42 USC 1981a – Damages in Cases of Intentional Discrimination
18
U.S. Equal Employment Opportunity Commission. Overview of Federal Sector EEO Complaint Process