Life with IBD
Crohn's disease and a career are not mutually exclusive, but navigating work while managing unpredictable flares, infusion appointments, and chronic fatigue requires more than willpower. It requires knowing your rights. Research shows that one in three people with inflammatory bowel disease (IBD) lose their jobs because of their condition, and those who remain employed miss nearly twice as many workdays as their peers without IBD. Much of this job loss is preventable. Federal protections like the Americans with Disabilities Act (ADA), the Family and Medical Leave Act (FMLA), and Social Security Disability Insurance (SSDI) exist specifically for situations like yours. The challenge is that most Crohn's patients don't learn about these tools until they're already in crisis. This guide walks through the full employment journey, from deciding whether to tell your boss, to requesting specific accommodations, to understanding when disability benefits become the right move.
Deciding Whether to Disclose Your Diagnosis
You have no legal obligation to tell your employer about your Crohn's disease. The ADA actually prohibits employers from asking about medical conditions during the hiring process, and you can choose to keep your diagnosis private indefinitely. But privacy comes with a tradeoff: you can't request formal accommodations without disclosing at least some information about your condition.
The question isn't really whether to disclose. It's when and how much. If your symptoms are well-controlled and rarely affect your work, staying private may make sense. But if you're dealing with frequent flares, regular infusion appointments, or fatigue that affects your performance, disclosure opens the door to protections that can save your job.
When you do decide to share, you control the conversation. You don't need to provide a full medical history. A simple statement like "I have a chronic medical condition that can flare unpredictably" gives your employer enough context without oversharing. Direct the conversation toward your direct supervisor and HR, and frame it around solutions rather than limitations. Come prepared with specific accommodation requests and, if possible, a letter from your gastroenterologist supporting those requests.
Timing matters too. Many patients find that disclosing after receiving a job offer, but before starting, sets the right tone. Others wait until they've established themselves and then disclose when accommodations become necessary. There's no single right answer, but planning the conversation in advance consistently leads to better outcomes than being forced to explain during a flare.
Crohn's Disease and the ADA: What Qualifies and What You Can Request
The ADA protects employees with disabilities from workplace discrimination and applies to employers with 15 or more workers. Crohn's disease qualifies as a disability under the ADA when it substantially limits one or more major life activities, which includes eating, digestion, bowel function, and immune system function. During active flares, this threshold is almost always met. Even during remission, the ADA Amendments Act of 2008 broadened protections so that conditions in remission still qualify if they would be substantially limiting when active.
Once you're covered, your employer must provide "reasonable accommodations" unless doing so would create an "undue hardship" for the business. For Crohn's patients, the most effective accommodations tend to be straightforward. The Job Accommodation Network (JAN), a free consulting service funded by the U.S. Department of Labor, maintains a detailed list of accommodations for gastrointestinal disorders. Common requests that Crohn's patients find helpful include:
A workstation located near restroom facilities, or guaranteed quick access to a private restroom
Flexible scheduling for infusion appointments, which can take 30 minutes to several hours and recur every four to eight weeks
Permission to work from home during flares or on high-symptom days
To request accommodations, you don't need to submit anything in writing, although documenting your request is smart. The process starts an "interactive dialogue" between you and your employer where you work together to find solutions that address your needs without fundamentally altering your role. Your employer can ask for medical documentation confirming your condition and the need for accommodation, but they cannot demand your full medical records.
Using FMLA for Flares and Medical Appointments
The Family and Medical Leave Act provides up to 12 weeks of unpaid, job-protected leave per year for employees with a serious health condition. Crohn's disease clearly qualifies. What many patients don't realize is that FMLA leave doesn't have to be taken as one continuous block. Intermittent FMLA allows you to take leave in separate increments, whether that's a few hours for an infusion appointment, a day or two during a flare, or a modified schedule during a rough stretch.
To qualify, you must have worked for your employer for at least 12 months and logged at least 1,250 hours in the past year. Your employer must also have at least 50 employees within a 75-mile radius. If you meet these criteria, your employer cannot penalize you for taking FMLA leave or count those absences against you in attendance policies.
The paperwork involves a medical certification form that your gastroenterologist completes. For intermittent leave, the form should specify the frequency and duration of flares you typically experience, as well as the schedule for recurring treatments like infusions. Getting this certification in place before you need it is critical. Once approved, you don't need to re-explain each absence to your manager. You simply notify HR that you're using FMLA time.
One practical tip: if your Crohn's symptoms follow any pattern at all, note it. Employers can request recertification periodically, and having consistent documentation of your symptom frequency strengthens your position. Tracking your symptoms over time creates a record that supports your FMLA claims with objective data rather than subjective reports.
When Disability Benefits Become the Right Decision
For some Crohn's patients, the disease reaches a point where working full-time is no longer sustainable. SSDI provides monthly income to people whose medical conditions prevent them from maintaining substantial gainful activity, which the Social Security Administration (SSA) defines as earning more than $1,690 per month in 2026.
The SSA evaluates Crohn's disease under Listing 5.06, Inflammatory Bowel Disease. To meet this listing, you need a confirmed Crohn's diagnosis plus at least one of the following, documented at least twice within a six-month period and at least 60 days apart: bowel obstruction requiring hospitalization or surgery, perineal disease with a draining abscess not controlled by medication, involuntary weight loss of 10% or more from baseline, or the need for supplemental nutrition via a feeding tube or central venous catheter.
If your condition doesn't meet Listing 5.06 exactly, you may still qualify under Listing 5.08 for weight loss due to a digestive disorder, or through a residual functional capacity assessment that evaluates how your symptoms limit your ability to perform any work. The SSA gives particular weight to opinions from gastroenterologists, so specialist documentation matters.
The application process is notoriously slow, and initial denial rates are high. Building a strong case means gathering endoscopy and imaging reports, lab work showing inflammatory markers, detailed notes from your GI documenting flare frequency and severity, and records of hospitalizations or surgeries. The more objective evidence you can provide, the better your chances on initial review or appeal.
Choosing Work That Works With Your Body
Whether you're re-entering the workforce after a flare or evaluating a career change, certain job characteristics align better with Crohn's management. Flexible scheduling and remote work options rank at the top. Roles that let you control your pace, take breaks without permission, and access a restroom without delay reduce the daily friction that makes work with Crohn's so exhausting.
Fields like consulting, writing, software development, accounting, and other knowledge-work roles often offer this flexibility. Roles in occupational therapy and social work also tend to provide more schedule autonomy. On the other hand, positions with rigid schedules, extended time away from restrooms, heavy manual labor, or frequent travel may create unnecessary conflict with your symptoms.
That said, no career is automatically off-limits. With the right accommodations in place, many Crohn's patients thrive in demanding roles. The key is honestly evaluating what your body needs right now, not what you think you should be able to handle, and matching your work environment accordingly.
Building Your Documentation Strategy
Every protection discussed in this article depends on one thing: documentation. ADA accommodation requests need medical evidence. FMLA certifications require a physician's confirmation of your condition and its impact. SSDI applications live or die by the strength of your medical records.
Start building your documentation habit now, even if you don't anticipate needing formal accommodations soon. Keep records of your flare frequency, symptom severity, missed workdays, and how your condition affects your daily functioning. Track when you have infusions, how long recovery takes, and any side effects that affect your work performance. This kind of longitudinal data transforms vague claims into compelling evidence.
When you do need to make a formal request or file an application, you'll have months or years of tracked patterns to support your case. Objective symptom data is more persuasive than recalling from memory, whether you're sitting across from an HR director or submitting records to the SSA. Tools that help you log symptoms consistently give you a concrete advantage when the time comes to advocate for yourself.