EACH OF THESE SUBJECTS ARE DISCUSSED FURTHER IN OTHER SECTIONS OF THIS DOCUMENT

There are two issues to consider immediately:

• Whether to tell your employer and/or co-workers (and if so, what to tell)

• What accommodations you may need to enable you to do your job because of your health condition and/or treatment.

Before telling or taking any other action:

• Give emotions a chance to settle. (For information about dealing with emotions, click here.) If you can, take a day or two off.

• Think through the potential impact on work of your condition, diagnostic tests and treatment. If there is likely to be a substantial impact, you may not have a choice about telling -- at least about telling your employer. Ask your doctor how your cancer and/or treatments will impact your work. If he or she doesn't know, call the helpline at Colon Cancer Alliance 877.422.2030.

• Review your employer provided benefits to determine which are useful now and what you need to do to access those benefits. (For information about maximizing health insurance, click here.)

• Learn the basics about your legal rights at work. For example, the Americans With Disabilities Act (ADA) and similar laws provide protection against discrimination. The ADA also requires that you be given a reasonable accommodation to allow you to do your work. If you are a member of a union, learn about the rights you have through your union.

• Rather than rely solely on the law, be practical. Seek information about how your employer generally responds to health conditions and what is the best way to move forward. For instance, from an advisor at work who knows the culture well enough to give advice and who will keep your information confidential.

• "Just in case," start keeping a work journal. Include facts that would be relevant to a discrimination claim. Making notes as things happen becomes strong evidence in the event you want to file a claim in the future.

If you will take time off, think about how to do it in a manner that least disrupts your income and benefits.

• Call your time away from work whatever will maximize time off with benefits.

• Learn about protections such as the Family And Medical Leave Act (FMLA).

• Think about where income will come from during the time off.

When you have a chance, review employer benefits from the perspective of a person with colorectal cancer. For example, if your employer offers life insurance, take what you can or increase the death benefit for coverage you already have during an open enrollment period when no medical questions are asked. Likewise, consider signing up for disability and/or long term care insurance, or for increasing the benefits if you already have these coverages.

Accept the credit card offers you receive because you are employed. Credit can come in handy to pay medical and other bills or to provide cash if you need it. Do not use the cards beyond what is necessary to keep them active and fee free.

NOTE:

• Colorectal cancer does not have a negative long-term impact on the careers of most people. There may be difficulties in the work place in the short term, but they do not affect the long term.

• If you want more information about work than is contained in this document: Additional work subjects of interest to men and women with colorectal cancer can be found in our document: Work: At Work.

In the short term, work is likely to be affected by your treatment and/or condition, at least to accommodate the amount of time you need to take off for doctor appointments, tests and treatment. You may also need time off if you become fatigued.

If you will undergo major surgery, there will definitely be time off.

If you are going to have chemotherapy, many people fit treatment into their regular work schedule by scheduling chemotherapy for a Friday afternoon so they have the weekend to recover. Others need the time for their bodies and minds to rest.

If you are going to have radiation, it is generally possible to fit treatment into a regular work schedule by having the appointments before going to work, during lunch or after work. Fatigue is the biggest side effect. For some people, the disruption to their work lives was so minimal that no one at work even knew they went through radiation treatment. Others need time off.

Explain to your cancer doctor what you do at work, including what you do on a daily basis. Ask:

• Will I be able to work throughout my treatment?

• If I have to stay home to recover from surgery or other treatment, how long will I be away from my job?

• When I return to work:

  • Will any of my abilities to perform my job be impaired as a result of treatment?

  • Do I need to have a different work schedule?

  • How will I know if I am overdoing it at my job?

• What can help minimize the effect on work?

You do not have to reinvent the wheel of wondering what a person who works for your particular employer should know or do.

Look for an advisor at work who understands your situation, can help you make decisions, and who will keep your discussions confidential. The document in "To Learn More" describes what to look for in an advisor. In addition to discussing the general question of who to tell, also discuss how much to tell and requesting time off.

Look for other men and women in your workplace who have had colorectal cancer. Ask them about their experiences in the workplace. Remind them that you haven't told anyone yet and want to keep this confidential.

Speak with a social worker at the cancer center where you will receive your treatment. He or she may have some practical tips - including experiences they know about that happened to other people who work for your particular employer.

Employers

People have been known to be discriminated against because of their health condition. There are laws protecting against such discrimination, but it can still happen.

When thinking about how your employer will react, look at the Survivorship A to Z document in "To Learn More" about how to determine if your employer is cancer friendly.

Co-Workers

Your colorectal cancer may also cause coworkers to feel uncomfortable around you. On the other hand, there are many, many stories of co-workers who pitch in to help, including providing sick days and taking food to co-workers at home when needed.

There is no legal obligation to tell either employers or co-workers.

In General

If your work situation isn't a good place to discuss the details of your illness, perhaps your best option is to take time off and be discrete at work about what is wrong.

• Filing an insurance claim does not automatically trigger disclosure of what is wrong with you. In most situations, the insurer and the company's benefits department are specifically prohibited from such disclosure.

• Many companies also have a system under which you can send your claim directly to the insurer.

You don't have to make a decision before start of treatment about whether or not to disclose your health condition to your employer or co-workers -- but now is a good time to start thinking about it.

If you do decide to tell, think about:

• First consider who to tell. An employer must keep the information confidential. There is no similar restriction on co-workers.

To the extent that you can, schedule appointments for tests and treatments so the least amount of work is lost. For example:

• Schedule appointments in the morning before work begins, in the evening after work, or during lunch breaks.
• Schedule once-a-week chemotherapy for the day that means you will feel your worst on a day off. For example, if your worst day is the day after treatment, schedule treatment for Friday afternoon so you have the weekend to recuperate. If the worst days are 2 to 3 days after treatment, schedule your treatment for Wednesday or Thursday.
• If you need surgery that will require substantial time off, try to schedule it for a slow period at work. If you can, use sick leave or vacation time so you will continue to be paid and will also receive full benefits. (It is preferable to schedule surgery for early in the week and not just before a holiday in case there are complications. Hospitals tend to not be fully staffed during weekends or on holidays.)

Make a list of everything you do, and when you do it. Note when deadlines occur. Think about what part of your job can be handled by other people - and whose those people are.

• Review the list to determine what you will be able to do during treatment.

• Consider medical appointments and your likely capabilities during treatment.

• Think about accommodations you may need to permit you to take your treatment and to do your work.

• Also think about what work you need to temporarily pass on to others.

If you are going to take time off, start planning. It will help you and your co workers. For instance:

• Look at your benefits and think about how to maximize time off while minimizing disruption to your pay. (See How To Maximize Your Benefits If You Need Time Off For Health Reasons.)

• If your employer has forms to complete in order to take time off, get the forms and see what you need to do to complete them. If the form needs input from your doctor, send it on to the doctor. Ask the doctor to return the form to you rather than the employer (so you can check it over). Give the doctor a deadline by when you need the completed form.

• Talk with your boss about:

  • Working different hours, part time, or perhaps from home. (See "To Learn More" about working from home.)

  • Sharing work with other people.

  • Passing work on to other people.

• Make detailed lists of the work that will need to be done or followed up on while you are not working. Include deadlines and contact information for the people involved.

• Check to see if your employer or state required program provides short term disability income.

• Decide how to maximize time off with benefits.

• Learn about protections such as the Family And Medical Leave Act (FMLA). (See "To Learn More.")

• Think about where income will come from. Check for disability income from your employer, disability insurance, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI) or state disability income. (See "To Learn More.")

If you will need changes at work to permit you to do your job while undergoing treatment, before asking for changes:

• Make note of everything you do on a daily basis, including deadlines. It can be as simple as keeping a written log of what you do each day.

• Make a list of current projects and foreseeable next steps.

• Think about what could be postponed or given to other people.

• Note important dates when things have to be done.

Negotiate for what you need to permit you to work while going to medical appointments and receiving treatment.

• All accommodations involve a negotiation with your employer. Learn how to negotiate for what you need.

• Think about accommodations that would work, including alternatives. In addition to thinking about what would work for you, balance your employer's needs.

• Examples of reasonable requests to permit you to work while undergoing colorectal cancer treatment:

  • Leaving work early on Fridays for chemotherapy treatments.

  • Work from home all or part of the week. (See "To Learn More.")

  • Sharing work with someone else.

  • Extending deadlines.

• Keep notes in a Work Journal about what happens during every discussion with your employer about your condition and needs. Include name of person, date, what was discussed. Include your impressions and examples of facts which led to your impression.

The Americans With Disabilities Act (ADA) and similar laws provide protection against discrimination and require reasonable accommodations to allow people with a disability to do their work.

Colorectal cancer is not always considered to be a protected disability. In order to be considered to be a disability under the ADA, the condition must be substantially limiting.

It is not advisable to get into a legal battle if you can possibly avoid one. As a practical matter,

• If an employer says that the law doesn't apply, remind the employer of the effect on other employees and potential new employees if word gets out that the employer discriminates against men or women with colorectal cancer.

• With respect to an accommodation, negotiate for what you need. It is what you need to do whether you are protected under the law or not.

"Just in case:" start keeping a work journal to help keep track of facts that would be relevant if you ever want to file a discrimination claim. (You may think you would never do such a thing at this point, but you may wish you had kept notes if you actually do feel the sting of discrimination.)

• Include good things that happen such as when you receive a pat on the back.

• Include anything that could be considered to be discrimination. Enough facts can create a pattern.

If you believe you have a discrimination claim, the EEOC is there to help for free (in addition to private alternatives). See "To Learn More."

A diagnosis is a call to:

• Increase the amount of your life insurance death benefit if you can. If you cannot do it now, you may be able to during a period known as an "open enrollment" period. Open enrollment is when there are no medical questions asked.

• Buy the coverage if you become eligible for disability insurance and/or long term care insurance.

• If you have a tax advantaged savings account such as a Health Savings Account or other tax advantage health account, take full advantage of it. (See "To Learn More.")

• During open enrollment periods, don't just renew current health coverage. Look at all your health insurance options from the point of view of a person with colorectal cancer. Click here to learn how.

Check with your doctor to find out whether there will be periods during which you will not be able to do the physical effort you do now, or even at all.

It is likely that you will not be able to do a lot of physical labor immediately after surgery and perhaps during recovery. Radiation or systemic therapies such as chemotherapy may leave you fatigued.

If you won’t be able to physically do your job for a while, ask for an accommodation a work – a change which is not an undue hardship on your employer which permits you to do your work. Perhaps there is other work you could do on a temporary basis.

If you have an advisor, review your situation with him or her. Ask for help creating a plan that will work best for the company and for you.

If you are a member of a union, talk to the shop steward or another union official about your situation and how best to accommodate it at work.

For information about negotiating an accommodation at work, click here.

There is the possibility that you may need to stop work at some point in the future. The operative word in the preceding sentence is "possibility." The documents in "To Learn More" provide information about short and long term steps to take just in case. For instance:

Tell your doctor each time you visit about how your health condition and/or treatments are impacting your work.

• Be specific.

• Ask that the facts be noted in your medical record.

• These facts will be helpful if you ultimately decide to submit a claim for disability, such as for Social Security Disability Insurance (SSDI).

Do whatever you have to do to keep your health insurance and life insurance. In fact, if you can, increase the death benefit on your life insurance. Even if your beneficiaries don't need the money, you may be able to sell the policy while you are alive to get cash if needed.

If your employer offers them, explore what is needed to obtain disability insurance and long term care insurance.