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.

Comments on this blog are closed. If you have questions about hepatitis B or this blog post, please email info@hepb.org or call 215-489-4900.

64 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.

  14. Hi,? I have a hepa b, and i work in a cruise line, and now im in vacation, and have my med exam, they see on my med that i have hepa b, am i still fit to work on a cruise ship as a cabin staward,?

    1. Hello: In most countries you would be, it all depends on what country the cruise line is registered in, and what guidelines they follow. You pose absolutely no infection risk, I hope the cruise line is educated and up-to-date with information. If you need documentation that you do not pose a health or safety risk, I will be happy to email you some materials from the CDC. Please email me at chris.kukka@hepb.org if you need them. Good luck.

  15. Hello… I am indonesian. Sometime I’m join recruitment in aviation industry MRO in Indonesia. I have completed all test selection. But I’m failed in medical examination because I’m carrier hepatitis b….previously worked in mining contractors 5 years and I’m health with my carrier hepatitis b…..would you like to recommended me fit to work…. Thanks!!

    1. Hello: I am so sorry you face job discrimination because of your hepatitis B. In the U.S., employers of all kinds are prohibited from discriminating against people with hepatitis B. I’m not sure how we can help. Good luck.

  16. Hey. I was diagnosed with acute hepatitis b. I bartend and they won’t let me go back to work unless I get a doctor’s note saying I don’t pose a threat to my co-workers and customers. It’s there any documentation I can show them that they’re in the wrong?

    1. Hello: That is outrageous, unnecessary and if you live in the United States, it is blatantly illegal and a violation of civil rights.
      This is an excerpt from a letter that our organization has sent on behalf of people facing similar discrimination, please use what you can to help your cause:
      “Hepatitis B is a liver infection, that in most cases does not cause liver damage or disability or lost work days due to illness. The majority of people with hepatitis B live long and productive lives.
      Hepatitis B is not spread through casual physical contact, especially in a workplace, and there is a safe and effective vaccine that prevents hepatitis B.
      In the United States, the Centers for Disease Control and Prevention (CDC) studied whether hepatitis B-infected doctors and nurses posed a risk to patients and coworkers.
      Despite the high risk of needle sticks and close contact with blood and body fluids, the CDC found hepatitis B-infected healthcare workers posed no infection risk. For more information on this, please visit: https://www.cdc.gov/mmwr/pdf/rr/rr6103.pdf
      In summary, if hepatitis B-infected doctors and nurses can perform their jobs, we are confident this employee can.
      It is unfortunate, that some countries continue to discriminate against people with hepatitis B, though there is no clinical evidence to justify this employment discrimination. In the United States, it is a violation of the Americans with Disabilities Act to discriminate in this manner.”
      I hope this helps, show this to your doctor and your potential employer. Good luck.

  17. Hi my bestfriend has hepatitis b

    i want to know which which country has no objection for employment visa.

    Please help.

    1. Hello: Most North American and European countries do not restrict work visas based one one’s hepatitis B status. Figure out where he wants to work and then investigate the country’s immigration or work visa requirements. Good luck!

  18. Hi, I have chronic hepatitis B and I’ve been taking antiviral pills for 2 years. I’ve seen doctor every 6 months and check my viral load. My liver function is still good. I want to go to school for dental assistant. But my school requires Shots record and hep b declination letter. Should I tell them I have Hep B and quit? Or should I just quit without telling them reason? With my condition, what kind of jobs I can get? I’m so ashamed to apply for any jobs and so scared to be asking about my health. I need help please. Thank you

    1. Hello, Can you please tell me where you live? In the United States, there are strict laws prohibiting discrimination against anyone with hepatitis B. The CDC has issued clear guidelines that healthcare providers, including dentists and dental assistants, cannot be discriminated against because there is no scientific proof that providers put patients or coworkers at risk of hepatitis B.
      If you email me at chris.kukka@hepb.org, I will email you a .pdf file of their guidelines for you to show your school/employer. If all they require is a hepatitis B immunization, without confirmation of antibody status afterwards, you can under go that.
      I am sorry you are facing such concerns. Good luck.

  19. Hi
    I am a nurse and wanted to work in UK or in Austria but I’m afraid that I might fail in medical exam. Because I am a hepatitis b carrier. Would It be possible to work on my dream country as a nurse even I still have this medical condition?

    1. Hello: Europe and North America generally do not restrict work visas or immigration based on hepatitis B status. They will ask about your overall health, but as long as you are not suffering serious liver damage, it should not limit your job prospects. In the U.S., the CDC has issued guidelines about this topic at: https://www.cdc.gov/mmwr/pdf/rr/rr6103.pdf
      Good luck to you.

  20. Dear Hep B Foundation,

    Does the Medical personnel like Physician, Physician assistant and Medical Assistant in California, United States can not get job at Hospital or clinic even if they have Chronic hepatitis B without any severe signs or symbols?
    What does the Law in United States or California law says ?
    Is it true such persons were refused for job at hospital or clinic with other reason because of law?


    1. Hello: In the U.S. (and California), the CDC and other agencies found that doctors/nurses/dentists etc. do not pose a risk to coworkers or patients if they have hepatitis B. Their findings can be found at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6103a1.htm?s_cid=rr6103a1_w in the event you ever need to use this as ammunition to fight for your right to practice.
      A board that regulates surgeons etc. in the U.S. did recommend that surgeons and dentists who perform surgeries that carry high risk of needle or surgical tool cuts use antivirals to lower their viral load if they had high viral loads, but that’s the only restriction we know of.
      Good luck.

  21. Hello,
    I am a dentist who has to move to perform in Switzerland.
    i have a chronic hbv with about 8000 iu/ml virus load. Do i hv to inform my status already ahead? And do i have to be treated? Coz my previous doctor in my country did not recommend me to as my liver function is normal.
    Do u know if there’s restriction in europian country for me ro work.

    1. Btw. It is a bit unclear what is Epp. (And i am specialized not for oral surgery. But in some definition performing an injection can count as EPP already.

      Thank you

    2. Hello: Excellent question. Every country is different and I don’t know what Switzerland requires in terms of disclosure ahead of time. However, in the U.S., the CDC and other agencies addressed this question and found that doctors/nurses/dentists etc. do not pose a risk to coworkers or patients. Their findings are at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6103a1.htm?s_cid=rr6103a1_w in the event you ever need to use this as ammunition to fight for your right to practice in Switzerland.
      A board that regulates surgeons etc. in the U.S. did recommend that surgeons and dentists who perform surgeries that carry high risk of needle or surgical tool cuts use antivirals to lower their viral load if they had high viral loads, but that’s the only restriction we know of.
      Good luck, let us know what happens.
      Good luck

  22. Hi! I am from the Philipines. I was directly hired by a university in the Middle East and was never required medical certificate prior to the issuance of my visa. I was given medical clearance by a clinic here in the Philippines since i “undetectable” viral load. When I arrived in the Arab country and about to obtain a work permit, i was required to present a letter from employer that they take responsibility of me. Unfortunately, my employer refused and cancelled my visa. Is there any international forum or organization that we can lodge our complaint against discrimination, especially if it caused one financial hardship and embarassment?

    1. Hello: I am so sorry to hear about your situation. Unfortunately, it is not an unusual one. Some Middle Eastern countries have treated people with hepatitis B horribly, truly violating their civil rights and demanding that they immediately leave the country.
      Unfortunately, there is no international commission or organization working to protect the rights of people in your situation.
      However, in the Philippines, there is an organization working to protect the civil rights of people with hepatitis B. Below is their contact information:
      Yellow Warriors Society of the Philippines
      Good luck!

    1. Hello: There are many people in Taiwan who are infected with hepatitis B, so I hope it will not be a barrier for you in obtaining a work visa. I know the Middle Eastern countries are very discriminatory and prohibit people with hepatitis B from gaining work visas. Please do more research and let us know what your findings are. Good luck.

      1. Im just worried for my medical here in the philippines..they are very strict about medical..in taiwan its ok with them..

        1. Hello: Good luck, I know the Philippines can be arbitrary and difficult when it comes to issuing work visas. Good luck.

  23. Hi. I’d like to study and work especially in New Zealand/Australia/Canada. Are these countries strict on people with Hepatitis b specifically for employment? Thanks

    1. Hello: As long as you are not experiencing severe liver damage, most of those countries do not discriminate against people with hepatitis B. It’s mainly the Middle Eastern countries that practice this unethical and unnecessary discrimination. Good luck.

  24. Hi! I just knew that I have hepa b so I took hepa profile and my HbeAg is reactive as well as HbsAg, Anti-hbe is non reactive and my SGPT/ALT result is 20.0U/L, reference ranges 12-78 U/L, I really dont have any idea what these results mean. My question is Do I still have the chance to work in Japan base on my results? I already have my visa buut I’m worried about my medical exam. I hope someone will answer this, Thank you!

    1. Hello: I do not think that Japan discriminates against visa applicants with hepatitis B. Most countries simply want to make sure that an applicant is not suffering a serious medical condition that will require immediate treatment.
      Your liver enzyme (20 ALT/SGPT) is within the healthy range (which is up to 19 for women and 30 for men), which shows you are not experiencing any liver damage, which should assure the Japanese officials that you are a healthy work candidate.
      Good luck.

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