How to Keep Your Job When You Become Ill

by Monica Steinisch

Many employees would say that, even under the best of circumstances, showing up on time every day and giving 110% to a job can be a challenge. For employees living with chronic illnesses such as multiple sclerosis, persistent back pain, HIV, arthritis, diabetes, chronic fatigue syndrome, and cancer, the average workday is made even more difficult by the demands of managing their condition.

According to the Partnership for Solutions, an initiative to improve the quality of life for those who live with chronic illness, 41% of working-age adults (20 to 65 years) have at least one chronic condition, which the Partnership defines as a medical problem that lasts a year or longer, limits what a person can do, and requires ongoing care. With that number predicted to grow, employees who need--or want--to work have to wonder: If I were diagnosed with a chronic illness, how would I hang on to my job?

The law is on your side

That's exactly what Margaret, a marketing assistant for a 75-employee accounting firm in Newark, N.J., asked herself when she was diagnosed with cancer about three years ago. As a single mother, she feared the worst. Anxiety turned to relief when Margaret learned about the various laws and benefits that, together, would help her keep her job while receiving treatments over the course of the coming year.

First, the federal Americans with Disabilities Act (ADA) requires employers with 15 or more employees to make a "reasonable accommodation" for a disabled worker as long as it does not present an "undue hardship" to the company and the employee can perform the job's essential functions. Reasonable accommodation can cover everything from allowing an employee time off for medical appointments and providing a private room where one can inject medication to scheduling more frequent breaks during the day or arranging for work to be done at home. Not all people and all conditions will be protected by the ADA. The Equal Employment Opportunity Commission can provide more details.

Under the Family and Medical Leave Act (FMLA), companies with 50 or more workers must provide eligible employees up to 12 weeks of unpaid leave during any 12-month period to deal with the birth or adoption of a child, their own illness, or that of a family member (child, spouse, or parents) without fear of losing their job or medical insurance.

In addition to protection under the ADA and FMLA, workers may have rights and benefits under state and local family leave laws. A few states even offer temporary disability insurance. Visit your state's labor office Web site for information.

Individual employers may offer such benefits as short-term or long-term disability coverage, paid time off, or flexible working arrangements.

In Margaret's case, FMLA allowed her the extended time off she needed to deal with her illness at its most critical point. While she was on unpaid leave, she continued to receive some income in the form of New Jersey state temporary disability insurance payments. After returning to work, Margaret was allowed to work from home two days per week, giving her the opportunity to replace a long commute with some extra rest on those days. After a full recovery--and a victory celebration with friends, family, and co-workers--Margaret returned to the office full time.

Should you reveal your illness?

To tell or not to tell: That is the question for employees weighing the pros and cons of disclosing their illness to their employer and co-workers. On the one hand, you may fear that disclosing a chronic illness will be bad for your career, assuming that your employer will favor healthy workers over ill ones when it comes to promotions and other recognition. You also may be concerned that co-workers and supervisors will, accurately or not, perceive you as less able to do your job well, or may pity you.

On the other hand, by not disclosing your illness you lose out on any protection, accommodation, and time off provided under the ADA and FMLA. And co-workers left in the dark about your condition may resent being asked to pick up extra work during your unexplained absences.

"[Whether or not employees should disclose an illness] will really depend upon their work environment," says Rebecca Hastings, manager of the Society for Human Resource Management information center, Alexandria, Va., which answers around 400 questions a day on workplace issues. "Some cultures encourage close employee relationships--and in such an environment someone would probably feel very comfortable being open about [his or her] situation. In others, however, [employees] may feel they need to really watch what they say and do."

Thinking back to a job she held years ago, Hastings recalls a co-worker who began having mild epileptic seizures at work and eventually disclosed her illness to co-workers and filled them in on what to expect.

"By educating those around her, she alleviated fears and provided guidance on what to do if [she has a seizure]," recalled Hastings. "That choice worked well for her at the time given the work environment we were in. But that may not be the best choice for everyone."

In her article titled "7 Habits for Regaining Power in the Workplace with Chronic Illness," Rosalind Joffe, who as founder of Boston-based CIcoach.com, coaches people with chronic illnesses on how to survive and thrive in the workplace, encourages chronically ill workers to "come out of the closet." Joffe, who herself has lived and worked with chronic illness for 25 years, advises being "as public as you need to be and as private as you want to be."

If you do decide to tell, experts recommend approaching the conversation with your boss with as much professionalism as you would bring to any work-related discussion: Wait until you know what kind of accommodation you will need (time off, more frequent breaks, permission to work at home, a more ergonomic work station, and so forth) so that you can talk specifics.

Making it work

According to Hastings, the best organizations will have well-developed human resource functions and will consider employees valuable assets that they want to keep happy and productive for as long as possible under all circumstances.

Nevertheless, even an exceptionally supportive supervisor will face some challenges in trying to balance the needs of a sick employee with those of the company and co-workers. There are things you can do to help make the adjustment go more smoothly for everyone:

Do your best to schedule absences in advance. Have a project or two with you that you can work on even when you can't make it to the office. Recognize co-workers who step in for you in an emergency. Learn how to manage your symptoms and reduce aches and pains to a level where you can make it through the average workday. Request accommodation that will allow you to perform better. Update your supervisor as your condition and needs change. Make the most of your strengths and talents. Know your rights and benefits. Provide required forms and follow personnel procedures.

There was a time when the diagnosis of a chronic illness would mean an end to full-time employment. Thanks to improved medicines and treatments as well as supportive laws and a more enlightened attitude, it's very possible for employees with long-term ailments to adapt and succeed in the workplace. Examine your situation and, if your goal is to keep your job, create a plan that will allow you to do just that.

As Joffe points out in her article, you may not be able to control the course of your illness, but you can control the direction you take and the choices you make regarding that illness in the workplace.

August 22, 2005