Ulcerative colitis, or UC, has a way of turning ordinary workdays into obstacle courses. The meeting that runs long. The commute with no restroom stops. The supervisor who “jokes” about bathroom breaks. The body that looks fine on the outside while your gut is in an active inflammatory fight on the inside.
When UC is quiet, you can often work like anyone else. But when it flares, it can bring urgency, pain, fatigue, brain fog, and frequent bathroom needs that make a rigid schedule feel impossible.1
Knowing how to request workplace accommodations under the ADA is not about asking for special treatment. It’s about keeping your job, protecting your health, and reducing the chances that a manageable condition becomes a crisis.
What is Ulcerative Colitis?
Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). It causes ongoing inflammation and sores (ulcers) in the lining of the large intestine (the colon) and rectum.1
Common symptoms include diarrhea, blood in the stool, and belly pain. Symptoms can come and go, with periods of remission and periods of flare.1
UC is not the same as irritable bowel syndrome (IBS). IBS is a functional disorder (how the gut works). UC is inflammatory (the gut lining is actively inflamed and can bleed). That distinction matters for treatment, documentation, and workplace accommodations.1
What Happens as UC Progresses, And Why Work Becomes Harder
UC can range from mild to severe. Some people have symptoms mostly in the rectum while others have inflammation that spreads farther through the colon. During flares, inflammation can lead to severe urgency, frequent stools, bleeding, anemia (low red blood cells), dehydration, and exhaustion.2
Severe UC can also cause serious complications like toxic megacolon or perforation (a hole in the intestine), which require urgent medical care.2
Even when symptoms aren’t “severe,” UC can still affect work in ways that are easy for others to underestimate:
- Fatigue can be crushing, especially if you’re losing blood or not absorbing nutrients well.2
- Pain can make sitting, standing, or commuting miserable.2
- Urgency can make it risky to be stuck in meetings, on phones, or away from restrooms.2
- Medication side effects, infusion schedules, and frequent appointments can collide with strict attendance rules.2
This is why accommodations are often needed. They reduce the friction between your body’s reality and your job’s structure.
What The ADA Does, And What “Reasonable Accommodation” Means
Under Title I of the Americans with Disabilities Act (ADA), employers must provide “reasonable accommodations” to qualified employees with a disability, unless doing so would cause an “undue hardship” (significant difficulty or expense) for the business.3
If your health condition substantially limits a major life activity (like digestion, bowel function, or working), and you can do your job with some changes, you can ask for accommodations.3
UC often qualifies because it can substantially limit bowel function, eating, stamina, and other daily activities, especially during flares. The key is not the label “UC.” The key is the impact.3
One more important point: you do not need to use legal language to start this process. EEOC guidance says you can request accommodations in “plain English” and you don’t have to mention the ADA or say the phrase “reasonable accommodation”.3
What Accommodations For UC Can Look Like
Accommodations should match your job duties and your symptoms.3 For UC, common needs include:
- More flexible break access, including bathroom breaks without penalty.
- A workstation closer to a restroom, or permission to step away from meetings quickly.
- Remote or hybrid work options when symptoms flare.
- A flexible schedule or adjusted start time, especially after nights with frequent symptoms.
- Time off for treatment, infusions, colonoscopies, or urgent appointments.
- A private space to manage symptoms, medications, ostomy care (if applicable), or recovery after procedures.
- Modified travel expectations or the ability to decline travel during flares.
The Job Accommodation Network (JAN), a widely used resource for accommodation ideas, specifically notes that GI disorders like UC may require workplace adjustments and that written requests can help when symptoms feel hard to talk about.
Practical, Step-By-Step Guide to Request Accommodations for UC Under The ADA
This is the part to save. The goal is to be clear, specific, and calm. You’re not pleading. You’re proposing a workable plan.
Step 1: Identify the work problems UC is creating
Before you contact HR or your manager, write down what’s happening in plain language. Two columns helps: “Work barrier” and “Possible fix”.3
Examples:
- “I’m being penalized for bathroom breaks.”
- “I have early-morning urgency and need a later start time during flares.”
- “I have infusion appointments every 8 weeks and need schedule flexibility.”
- “My role requires long meetings where I can’t step out.”
This is important because the ADA process is about changing the work situation, not just naming a diagnosis.
Step 2: Decide what you are asking for, specifically
Vague requests get vague results. Instead of “I need understanding,” aim for “I need X change.”
A strong request sounds like: “I’m requesting flexibility to take restroom breaks as needed and to step out of meetings briefly without penalty,” or “I’m requesting a temporary hybrid schedule during flares with the expectation that I will meet core job duties.”
JAN and the Crohn’s & Colitis Foundation both encourage planning ahead and putting your request in writing as soon as possible.3
Step 3: Get simple medical documentation
Many employers will ask for documentation. You usually do not need your entire medical history.3 You typically need a note confirming:
- You have a medical condition that can affect major life activities.
- You need certain workplace adjustments.
- Whether the need is ongoing, episodic, or time-limited.
Ask your GI clinic for a short letter. If you need help phrasing the ask to your clinician, try using this script:
“Can you write a brief work accommodation letter that confirms I have ulcerative colitis and that symptoms can flare unpredictably, requiring urgent restroom access and schedule flexibility for treatment and appointments?”
Step 4: Make the request in writing (email is fine)
EEOC guidance is explicit: you can use plain language and you don’t need magic words.
Here is ready-to-use language you can adapt:
“Hi [Name], I’m reaching out because I have a medical condition that affects my gastrointestinal system and can flare unpredictably. I’m requesting workplace accommodations so I can continue performing my job effectively. Specifically, I’m requesting: [1–3 accommodations]. I’m happy to discuss options and provide medical documentation as needed.”
If you want to keep your diagnosis private in the first message, you can. You can say “a chronic GI condition” and share details with HR if required.
Step 5: Prepare for the “interactive process” conversation
Most workplaces will respond with questions and propose alternatives. This is normal. The goal is to land on accommodations that work for you and for the essential job duties.3
Here is some self-advocacy language to keep the conversation grounded:
- “I want to be proactive so my performance stays strong. These adjustments would help me meet my responsibilities without interruptions from symptoms.”
- “I’m open to options, but I do need reliable restroom access and flexibility during flares.”
- “If an accommodation isn’t possible, can you explain why and propose an alternative that still addresses the health barrier?”
Step 6: Confirm the plan, then document what happens
After the conversation, send a follow-up email summarizing what was agreed to:
“Thanks for meeting today. To confirm, starting [date], we agreed on [accommodation]. We’ll reassess on [date] to make sure it’s working.”
If accommodations are denied, ask for the reason in writing and request a different option. The ADA standard includes “undue hardship,” but that is not supposed to be a casual excuse.
More Self-Advocacy Scripts For Common UC Workplace Scenarios
When bathroom breaks are being monitored or criticized, say this:
“My condition can require urgent restroom access. I’m requesting that restroom breaks not be treated as misconduct and that I can step away briefly when needed so I can continue doing my job safely and effectively.”
When you need flexibility during flares:
“My condition is episodic. During flares, symptoms are more intense and unpredictable. I’m requesting a temporary adjustment for flare periods, such as [hybrid work / flexible start time / reassigned tasks], with the expectation that I’ll maintain essential job duties.”
When a supervisor wants details you don’t want to share:
“I’m comfortable discussing the functional impact and what I need at work. I’d prefer to keep medical specifics between me and HR.”
When HR asks for documentation and you want it narrow:
“I can provide a physician letter confirming the need for accommodations. I’m not comfortable sharing detailed medical records unless absolutely necessary.”
When you’re worried about retaliation:
“I’m requesting accommodations so I can perform my role. I’d like this request documented, and I’d like clarity on next steps and timelines.”
Call To Action for the NOWINCLUDED Community
If you live with UC, you should not have to choose between symptom control and job security.
This week in the NOWINCLUDED app, share one accommodation you wish workplaces understood better. It can be as simple as “bathroom breaks without questions,” or “flexibility on flare days,” or “time to attend infusions without penalty.” If you’ve already requested accommodations, share what helped the conversation go well, and what you wish you’d done earlier.
Someone else is reading this in the middle of a flare, afraid they’ll get written up again. Your clarity can be their next step.
References
- The Crohn’s & Colitis Foundation. (2026). Overview of Ulcerative Colitis. Retrieved from The Crohn’s & Colitis Foundation: https://www.crohnscolitisfoundation.org/patientsandcaregivers/what-is-ulcerative-colitis/overview
- Millar, H. (2025, September 5). What are the stages of ulcerative colitis? Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/stages-of-ulcerative-colitis
- The Crohn’s & Colitis Foundation. (2025). Employee and Employer Resources. Retrieved from The Crohn’s & Colitis Foundation: https://www.crohnscolitisfoundation.org/patientsandcaregivers/managing-the-cost-of-ibd/employee-and-employer-resources
- Borum, M. L. (2023). Racial and Ethnic Disparities in Inflammatory Bowel Disease. Gastroenterology & Hepatology. doi:37799459
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