Hep B Blog

Do You Have to Tell Your Employer About Your Hepatitis B?

Image courtesy of Ambro at FreeDigitalPhotos.net
Image courtesy of Ambro at FreeDigitalPhotos.net

“Do I have to tell my new employer about my hepatitis B?”

After years of cautiously completing medical forms for schools, camps and college, my daughter’s question took me by surprise. It shouldn’t have. Many jobs—even when they don’t involve direct medical care—require a physical exam and confirmation of hepatitis B immunization.

There may be a safe and effective vaccine and new treatments for hepatitis B, but ignorance and stigma remain stubbornly entrenched in many HR departments. So here is what every job applicant, employee and employer should know about hepatitis B and employment.

During the application process or job interview, can an employer ask about my health?No. The Americans with Disabilities Act (ADA) strictly limits what can be asked during an interview. According to federal law, an employer can’t ask if you have a disability (such as hepatitis B) or require you to undergo a medical exam before offering you a job.

They CAN ask if you can perform the job (can you lift 50 pounds if you’re applying for a warehouse job) or how you would perform a job, but they can’t ask about your health.

Can an employer require a medical exam or ask medical questions after an offer is made?

Yes. After the offer is made, employers can require you to answer certain medical questions (such as immunization coverage) and undergo a medical exam—as long as everyone who performs that job has to undergo the same exam.

If the medical exam reveals a disability that prevents you from doing the job, even after a “reasonable accommodation” is made, then the employer can withdraw the job offer.

Can an employer withdraw a job offer after they learn I have hepatitis B? No, because the majority of people with hepatitis B are healthy, productive and able to perform their jobs. Unless you have severe liver disease, hepatitis B does not impair your ability to be a teacher, nurse, doctor or home health aide.

If your hepatitis B status is made known as a result of a blood test or exam, that information should go no farther than the human resources department. Federal law requires employers to keep all medical records and information confidential and in separate files.

What if they say my hepatitis B poses a threat to clients, coworkers or patients?

There is no medical basis for that fear. The U.S. Department of Justice and the U.S. Centers for Disease Control and Prevention have determined that hepatitis B-infected nurses, doctors, dentists and other providers do not pose a threat to patients. If they say it does, send them these reports (see below). Call or email us if you need help.

The U.S. Department of Justice’s warning letter to medical, dental, nursing and other allied health programs to stop discrimination against applicants with hepatitis B. The letter can also be found online at: http://www.hhs.gov/ocr/office/hep-b-letter.pdf

And Updated CDC Recommendations for the Management of Hepatitis B Virus–Infected Health-Care Providers and Students is found at: http://www.cdc.gov/mmwr/pdf/rr/rr6103.pdf

What can I do if I feel I’ve been discriminated against?

You can file an ADA complaint against a state or local government or any business by mail or e-mail. For more information click here.  You can also file a complaint by email and if you have questions about filing an ADA complaint, call the ADA Information Line at 800-514-0301.

37 thoughts on “Do You Have to Tell Your Employer About Your Hepatitis B?”

  1. i have hepatitis b for about a year now and i only seems to experienc minor stomach pain at my rightside

    1. Hello:
      Because there are so few nerve endings around the liver, it is rare that hepatitis B causes any physical pain or side effects. Does your doctor run tests regularly to assess your liver health? It is important to see your doctor to determine if there are any other medical conditions, such as fatty liver or a gall bladder, that may be contributing to your discomfort. Good luck.

    2. Hello: Because there are so few nerve endings around the liver, it is rare that hepatitis B causes any physical pain or side effects. Does your doctor run tests regularly to assess your liver health? It is important to see your doctor to determine if there are any other medical conditions, such as fatty liver or a gall bladder, that may be contributing to your discomfort. Good luck.

  2. Hi i am hepatitis b carrier for 7 years but i been work in different hotels and country and also because i am healthy carrier. i prove this to all doctors that i been check before. i have a problem right now cause i apply one of the Hotel in Saipan which dominated by the United States.i already passed the interview and all but the medical that is my problem the employer said If there are no immigration restraints to consider my case we would love to have me in there hotel. please help me what should i do?

    1. Hello: What agency or individual is saying you cannot go and work in Saipan? Unfortunately, some Central Asian and Middle Eastern countries will not issue work visas to people with hepatitis B. This is discriminatory as hepatitis B does not prevent people from working and they do not pose an infection risk to others. Good luck.

  3. Hi sir,
    I am having hepatitis b from past five years but I am healthy. My quantity DNA test is normal. Can I go USA or such foreign countrys for job.

    1. Hello: Yes, countries in North America and Europe do not restrict immigration or work visas based on your hepatitis B status if you are healthy. Unfortunately, some countries in the Middle East will not issue work or student visas if one is positive for hepatitis B, which is unfortunate and unwarranted. Good luck.

  4. Hi sir.i am selected the sub inspector of police and next week medical check up but I have hbs b positive so am unfit or fit?

    1. Hello: You are very fit to work. Hepatitis B does not impair your abilities at all! In nearly all countries, having hepatitis B does not disqualify you for any job. Unfortunately, some countries still unfairly discriminate against people with hepatitis B. Please do all you can to fight this discrimination, it is the only way we can change these unjust policies and remove the stigma around hepatitis B. In the event this is helpful, this link https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6103a1.htm?s_cid=rr6103a1_w is to the CDC policy on hepatitis B-infected healthcare workers. Basically, it demonstrates there is no reason to discriminate against workers with hepatitis B. Good luck, I am sorry for what you are facing.

  5. hi my boss offered me to come with them in the US as a nanny,but i am a hepa b carrier for 3 years. i need to undergo for amedical and hapa test. im scared that they cant bring me to US because im hepa b carrier. any help?

    1. Hello: The U.S. does not discriminate against people who have hepatitis B. There are countries that do, unfortunately, primarily in the Middle East, but the U.S. does not. They will ask about your overall health, but will not prohibit you from coming. Good luck.

      1. thank you im worried that my diplomat boss will withraw the job offer and might loss my job after knowing im a hepa b carrier. or should i tell them now? or should i wait the medical exam?

        1. Hello: In the U.S., medical information is private and is never shared with anyone else. Will your boss have access to this information eventually? If you test positive during the medical exam, will those results be shared with him? If they aren’t shared, there is no reason to tell him. It does not affect the performance of your job at all.
          If they will be shared with him, you know him best and can judge if telling him ahead of time is advisable. I am sorry you have to endure this, it is necessary and inhumane. Good luck.

          1. hi thanks for your response so i found out that the medical and laboratory where required by one of the government ageny to find out if im fit to work. does my medical exam will varies if hepa b carrier is allowed to work n the US? would i expect them to give me fit to work med clearance?/certifivate?

          2. Hello: Currently, you will be allowed to work in the U.S. even if you test positive for hepatitis B (HBsAg) unless there is some other serious medical condition. Good luck!

    1. Hello: Hepatitis B should never, ever bar you from a profession. It is not spread through casual contact. Unfortunately, some countries continue to discriminate and pose restrictions against people with hepatitis B. Try to find out if there are organizations in your country working to overturn these discriminatory laws. The CDC report explains that hepatitis B-infected healthcare workers pose no threat to patients or coworkers, if that is helpful to you: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6103a1.htm?s_cid=rr6103a1_w
      Good luck, I am sorry for what you are facing.

  6. Hello. I’m offered a position to deal with the data from hospitals. So may I ask if this kind of position belongs to the medical jobs that require Hep B tests? Thank you.

    1. Hello: It depends on where you live and the hospital’s policies. First of all, no one should be screened for hepatitis B to qualify for any jobs. In the U.S., there are very few restriction on healthcare workers who have hepatitis B unless they perform surgeries with a high risk of sharp injuries. I would hope the hospital does not require a hepatitis B test for your position. Good luck!!! I hope this discrimination ends soon.

  7. Hello .. thanx for the help
    I am also a hep b ,, i have a job offer in hongkong ,,, do you think i have a chance getting a work permit there …?
    I know in the Gulf its not possible .. china also restricts people tested positive Hbv ..
    Any one has an idea to where we can work as normal people .. which country other then US and Europe dose not screen except workers for the hep virus …??
    God bless you all for the help

    Stand tall and face it with dignity ….

    1. Hello: I’m sorry you are facing discrimination in the workplace. China is gradually changing and becoming less discriminatory. Perhaps because the job is in Hong Kong, a hepatitis B test will not be required? It also depends on the type of job you hold. Canada also does not discriminate against people with hepatitis B. Good luck to you!

  8. Hi sir,
    I am planning to apply for casino cashier in cruise ship I am a hep b carrier but my liver is normal but I am worried do I have a chance to work in cruise if they found out that I am a hepa b carrier?

    1. Hello: Hepatitis B in no way should ever prevent anyone from any profession. Hepatitis B is not casually transmitted. However, some countries in the Middle East and the Philippines restrict employment based on hepatitis B, which is very unfortunate and a violation of civil rights. I hope the cruise line is not based in any of those countries. I would recommend you apply for the job and see what happens. The important thing is you are healthy and able to work. Good luck.

  9. Hi.
    I got job as an embryologist in pakistan 6 months back by a ivf centre. Ivf center is in collaboration with a hospital. The hospital is wanted to recruit me as an permanent employe but due to my hep b positive hosptle is not hiring me and asking ivf center to discontinue my job. I am healthy and got normal ALT and low HBV dna.
    Need your help sir.
    Is there any legal document to face this situation in pakistan.?

    1. Hello: I am very sorry to hear about the unwarranted discrimination you are facing. The U.S. CDC has issued guidelines making clear that there is no reason to discriminate against or restrict healthcare workers with hepatitis B. The document can be found at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6103a1.htm?s_cid=rr6103a1_w
      If you want a .pdf version of this, please email me directly at chris.kukka@hepb.org and I will email it to you as an attachment.
      Have courage, the only way to change this is to fight it and educate the hospital and lab where you work.
      Good luck, you are in our thoughts.

  10. Hello,

    I have been looking for information on this topic for some time. I am a nurse, recently offered a job in hospital. During the physical, I went ahead and told them I have chronic hepatitis B. After my physical exam, I was asked to have my doctor fill out a form stating that I am stable, meaning I need to have a viral load of 00. But how is this possible? Given that I am positive for the disease I do have a viral load, not just high enough to warrant the start of therapy. If this is used to withdraw the job offer do you think it can be considered discrimination?
    Thank you for your help.

      1. Hope you have the information you need. Let us know if not. Rules definitely differ from country to country.

    1. A hospital is going to likely going to check for anti-HBs titers anyway, but I do understand your concern with disclosure. Are you being monitored by a liver specialist? Hepatitis B is covered under the ADA, but depending on your duties and the status of your HBV, you might need to be treated with an antiviral to ensure there is no transmission to patients. This would suppress the virus and make your viral load undetectable or below 10^3. If you are challenged because of your status, please point your hospital to the following: Updated CDC Recommendations for the management of hepatitis B virus infected Health care providers and students http://www.cdc.gov/mmwr/pdf/rr/rr6103.pdf and DOJ Announces First Settlement of an ADA Case Involving Hepatitis B: http://ohsonline.com/articles/2013/03/07/doj-settles-ada-case.aspx?admgarea=news http://www.justice.gov/opa/pr/2013/March/13-crt-271.html Hope this helps. Please email us at info@hepb.org if you have other questions since we can’t send attachments etc.

    2. Hello: Where do you live? In the U.S., it is illegal to discriminate against anyone with hepatitis B, even in the healthcare field.
      If you live outside of the U.S., please share this document with them, issued by the U.S. CDC, which explains why there should be no restrictions imposed on healthcare workers with hepatitis B. It is at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6103a1.htm?s_cid=rr6103a1_w
      Unfortunately, we all still must fight discrimination and do our best to change policies that violate basic civil rights.
      There is no reason for you to achieve undetectable viral load in order to perform your nursing duties. You do not pose an infection risk to your patients or coworkers. Good luck.

    1. Hello: Here is one opinion: “Blood tests for both the hepatitis B virus (HBV) and HIV remain part of the standard health examinations for people starting new jobs on China’s mainland, and individual health authorities retain the right to refuse hepatitis B carriers at their discretion.
      Still, so long as your liver functions are normal, the chances are slim that your visa application will be denied on the basis of your being a hepatitis B carrier. If you know that you carry hepatitis B, you can ask the hospital performing the check to also check your liver function, though this will come at an extra charge.” Source: http://onestop.globaltimes.cn/can-i-get-a-chinese-work-visa-if-i-have-hepatitis-b/
      Good luck.

  11. hi i have sone question.me and my husband work in uae right now.and my husband also work but after two years whe he renew his visa the medical result was hepa b positive.he can still work in dubai for this result.thanks for your reply.

    1. Hello: I am not sure how strict authorities are in Dubai. No one should ever be discriminated against because of their hepatitis B, I hope he can continue to work in Dubai. Good luck.

  12. Good day! does anyone with hepatitis b can work in Palau.is Palau strict on their medical.? I am a Filipina wishing, hoping, planning to work abroad.

  13. Hi, I am a hepatitis b carrier from India. I wish to know whether I can apply for a job in any of the cruise ships of USA( royal carribean or carnival) into food and beverage services department? And also which countries apart from gulf will issue me a working visa despite having hepatitis b? Thanks

    1. Hello: The U.S. Americans with Disabilities Act prohibit American companies from discriminating against people with hepatitis B. However, these cruise lines may have their corporate headquarters outside of the U.S. and may follow different guidelines. Good luck in your application.

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