The legal perspective: is coeliac disease a disability?
Do you think coeliac disease is a disability?
There's SO MUCH to say about the matter...so here goes.
Why would we want coeliac disease to be classed as a disability?
I got asked this on Twitter and I can see why people don't want it to be a 'yes'. After all, there's a stigma around being disabled - as though there's something wrong with you - when in fact it ought to be reframed.
A disability should be seen as someone who has extenuating circumstances that prevents them from doing something that the majority of the population are able to do. No blame or judgement should come with it.
But disabilities are often considered ones we can see. But with an invisible illness like coeliac disease, it's arguably more difficult to prove you qualify.
That said, if there are people with coeliac disease who feel their lives are hindered by their condition, shouldn't we consider it a disability? (Especially when some sufferers are bed-bound for weeks if they eat gluten.)
The legal aspects of coeliac disease
Look up the definition of disability and you'll find it's got 2 criteria. The first is being classed as "a progressive condition that gets worse over time". Conditions include people who are automatically classed as having a disability - if they have cancer, HIV or the autoimmune condition MS. But the list doesn't include other autoimmune conditions like coeliac disease.
Conditions that meet the 2nd criteria need to be "substantial" (i.e. taking much longer to complete an ordinary daily task) or "long-term". Obviously, coeliac disease is for life, but for many of us on a strict gluten-free diet we could hardly claim it took us a lot longer to perform the task of eating. (That said, checking food labels and actually finding a gluten-free sandwich isn't exactly speedy.)
The government does not think it's a disability
A quick look at the Equality Impact Assessment issued by the government in 2018 states, "coeliac disease is not defined as a disability under the Equality Act 2010". They do add, "although it is a long term condition," clearly focusing on the criteria mentioned above where the words "long term" might be open to interpretation.
Here, however, I feel there should be some wiggle room. It can't just be a blanket statement for all people because there are coeliacs, particularly those who've suffered bone fractures, whose lives have been physically affected in a way that can't be reversed.
Only last week I attended a Harvard University coeliac bone lecture where it was revealed that 50% of hip fractures in coeliac patients don't fully heal, meaning patients are left with mobility issues. Perhaps the focus for disability should be on whether complications have occurred as a result of coeliac disease, and an assessment made accordingly.
Ability to work
But then again, disability isn't always about physical problems like not being able to climb stairs or operate machinery.
To my mind, if you're unable to do a job because of a medical condition, that should count as a disability. And there are jobs that coeliacs aren't able to have. These include:
being in the British army (the requirements state they'd refuse a "food allergy* requiring you to avoid some foods in your diet due to allergy or intolerance");
a baker (in an environment where airborne wheat flour would cause issues); and
a job involving a lot of travel/staying in hotels where gluten-free food couldn't be guaranteed.
* Let's assume coeliac disease is considered the same as an allergy, even though technically it's an autoimmune disease.
What about accommodations?
Surely, you might wonder, accommodations could be met if someone travels for work and needs gluten-free. What about a packed lunch? A specific accredited restaurant? A hotel chain that can be trusted?
But real life isn't always kind. I've had countless clients tell me their work place doesn't offer them appropriate safety measures and it can be really debilitating. One client travelled a lot and it was often to new places, meaning they were always anxious about their gluten-free needs getting lost in translation.
Also, there are plenty of coeliacs who don't get the help they need from their employer or school and end up either going hungry, missing out on opportunities or, worst of all, suffering the effects of gluten, especially with cross-contact.
The sliding scale
There are many who'd claim a condition can't count as a disability because it doesn't get as many "points" as another condition. Would it be fair to say there are illnesses and diseases that are milder than others and therefore coeliac disease shouldn't count because it's not as bad?
I fear we're getting into difficult territory. And if it's financial, then it's a tough one to argue because there's only so much money that can go round.
Are there people who'd be against labelling coeliac disease as a disability because they fear disability benefits would be awarded and others would miss out?
I'm not sure there's a definitive answer. But I do wonder if we need to look at individuals' needs rather than people as a whole.
The case of Mr Singh
This brings me to a pivotal court case. Despite the law declaring coeliac disease is not a disability, a lorry driver in 2018 managed to win a court case where they declared it was.
The lorry driver, Mr Singh, had been working for his employer for nearly a year before he discovered he had coeliac disease. The symptoms he experienced included diarrhoea, meaning he asked temporarily to be assigned a different role within the business so he wouldn't be out on the road where there were no toilet facilities immediately available.
But his employers weren't convinced he was sticking to a gluten-free diet and decided it was his own fault. They didn't pay him the appropriate sick pay rate and even questioned the validity of a sick note he'd obtained from the doctor.
Thankfully, Mr Singh was compensated in the courts after they determined "the unfavourable treatment that the claimant had suffered was in consequence of his disability" (the disability being coeliac disease).
Clearly, if a court case like Mr Singh's can be won then it may be changes are made in the future to the definition of coeliac disease and its relationship to the law on disability.
What do you think? Do you have coeliac disease and feel strongly about whether it should be classed as a disability? It'd be great to hear your thoughts below.