Work: At Work
For Additional Information, See Table Of Contents At The End Of This Article
This article provides an overview of the various ways your health condition relates to work. As you will see, the article covers a broad range of subjects. Which subject is important to you at any particular point depends on your individual situation. Our suggestion is to at least get an overview by skimming through the subjects or reading in chunks. You can return to particular subjects as needed or when you are ready.
If you are not up to reading through this article, ask a family member or trusted friend to read it for you. He or she can help determine what you should be doing and in order of priority. As noted elsewhere, family and friends are part of your team. The odds are they would be happy to help.
Even if you decide not to take any of the described steps, at least you will be making an informed decision with an understanding about what you are doing. That is a lot better position to be in than being surprised later simply because you were not aware.
Understand your legal protections at work.
- Employers are not allowed to discriminate against or harass a person who is "disabled" within the meaning of the Americans With Disabilities Act (ADA) and similar laws.
- It is difficult to prove discrimination or harassment. One way is to keep a work journal. Work journals are also useful if needed to help build a case that you are "disabled" when you want to stop work, even temporarily.
- A work journal is a diary that includes praise you receive at work; how your health condition impacts your ability to do your job; and events or conversations that seem to indicate discrimination relating to your health condition.
- To maximize usefulness, entries in the diary should be made within a few days of when the events occur. If you want to revise an entry at a later date, note the date of the change in your journal.
- As a general matter, as long as you can perform the essential functions of your job, the ADA requires that employers provide a reasonable accommodation if needed to help you do your job.
- If you are covered by the ADA you will have to negotiate for an accommodation that is reasonable with respect to your job and your employer. Rather than try to become a lawyer to figure out whether you are covered by the law, it is reasonable to assume you are covered and to negotiate for the accommodation you need. Even if you are protected by the law, you can be fired if you cannot perform the "essential functions" of your job. What is "reasonable" depends on the realities of the particular situation.
- In order to ask for an accommodation in a manner that is protected by law, you will have to disclose to your employer that you have a health condition. You do not have to disclose EVERY detail -- just enough to satisfy the law.
- Obviously, you can also ask for a change in your duties or work hours without disclosing anything about your condition. But, if you choose this route, you will not be protected under the law and will have to rely solely on your negotiating skills. Keep in mind that from the employer's point of view, the key is that he or she wants the job done -- and done well.
- NOTE: There is no protection if your health condition presents valid safety concerns. The Americans With Disabilities Act uses the words "direct threat." A "direct threat" is a significant risk of substantial harm to the individual or others that cannot be eliminated or reduced through a reasonable accommodation
- Employers are required to keep your health information confidential (even in a separate file) (ADA)
- If you work for a larger employer, you have the right to request unpaid leave [Family and Medical Leave Act (FMLA)]. You do not have to take all the leave at once. In fact, you can take it in hours, or minutes.
- You can continue your health coverage even after you leave work (COBRA). You can also obtain new health coverage because of the Affordable Care Act ("Obamacare.")
- You can change jobs despite a health condition. So-called "job lock" is no longer a problem.
- A prospective employer cannot ask about your current health or health history (ADA)
- Unless an employer's health insurance is self insured, you cannot be offered health insurance that's different from people who do not have a health condition. (ERISA).
- Health plans are prohibited from imposing new pre-existing condition exclusions. (HIPAA)
- As mentioned, you can also now obtain individual health insurance despite your health condition.
- Bankruptcy: Many people with a health condition file for bankruptcy, even people with health insurance. While an employer can discriminate against a prospective employee because of bankruptcy, such discrimination is prohibited by an employer against an existing employee.
- TIP: If you could be fired for downsizing or another reason that does not relate to your job performance, consider writing a letter disclosing your health condition and asking for an accommodation to enable you to do your job. While it will not likely protect you from being fired, it is likely to slow down the process to give you extra time to make plans. If you are fired -- and have NOT informed your employer about your health condition, you cannot later claim you were disabled and therefore entitled to disability benefits.
Look for an advisor - someone who is in a position to give advice about getting changes at work you may need to balance taking care of your health and work, who and what to disclose about your condition, and when to take different actions, such as going on disability. If your employer has an employee assistance (EAP) program, perhaps you can find an advisor in the EAP group. For a description of what to look for in an advisor and how to approach the person, click here.
Disclosure (telling) about your health condition Whether, when and how to tell your employer and co-workers about your health condition requires careful thought. As you consider whether to disclose, and if so to whom, when and how, please keep in mind that the greater the secret, the greater the stress on the immune system.:
- Employer: Disclosing Your Health Condition To Your Employer
- Disclosure is required in order to be protected by laws such as the Americans With Disabilities Act
- If history shows that an employer is not friendly to people with your health condition, think carefully before disclosing.
- Co-workers: Disclosing Your Condition To Co-Workers
- Generally co-workers are cooperative and considerate of a co-worker's health condition, particularly when going through treatment. Still, co-workers are burdened by time away from the job, fatigue or other symptoms, and an inability to do certain work. It is difficult for a co-worker to be sympathetic unless he or she knows about your health condition and/or treatment.
- For information about dealing with problems with co-workers, click here.
Examine All Your Benefits: What They Are And What They Could Be
- Benefits in general
- Check your benefits to know what they are, and whether they cover your foreseeable needs.
- You may be able to make your benefits better.
- Look for an "open enrollment" period during which changes are allowed without health questions. Typically, larger employers offer an open enrollment period once a year.
- Open enrollment periods frequently include the right to purchase life insurance without health questions In addition to increasing protection for your loved ones, you can sell a life insurance policy if you have a shortened life expectancy. See: How To Obtain Money From A Life Insurance Policy. TIP: Watch for open enrollment deadlines. You must act within them, or lose your rights.
- Consider taking Disability Income Insurance if offered. As you gmay gather from the name, it pays an income if you become unable to worki.
- If your employer does not have the benefits you need, consider changing jobs to get better benefits - particularly comprehensive health insurance. As noted above, "job lock" for people with a health condition is a thing of the past. Because of the Affordable Care Act you can also purchase health insurance on the open market despite your health condition.
- Health Insurance
- If you haven't done it before, now is the time to read your insurance policy to find out what is and what is not covered.
- Learn how to maximize your insurance so you get the most benefit at the least out of pocket cost. For information, click on the appropriate link.
- Original Medicare (Fee-for-service)
- Medicare Advantage: Medicare Advantage is private coverage that meets Medicare requirements. The policies are issued by private insurance carriers. The types of policies are the same as offered in the private market. See the policies listed after Medicaid for the type of Medicare Advantage policy you have.
- Private insurance
- Types Of Policies (to help you determine the type you have)
- Fee-for-service (Indemnity type policies)
- HMO And Other Managed Care policies
- PPO (Preferred Provider Organization)
- POS (Point Of Service)
- Coordination Of Benefits When You Are Covered Under More Than One Health Insurance Plan
- Employee assistance programs (EAPs)
- Employee assistance programs can provide a variety of helpful resources. Help can range from assistance navigating the health care system to mental health programs.
- Information an employer learns about you through an EAP must be treated with confidence.
- Wellness programs
- The healthier you are, the better able your body is to fight a medical condition.
- If offered by your employer, consider taking advantage of such wellness benefits such as:
- Exercise programs
- Discounts at fitness clubs. (For information about how to choose a gym, click here. For information about not getting infected in a gym, click here.)
- Smoking cessation classes and/or bonuses for stopping smoking. (For information about quitting smoking, click here.)
- Mental health assistance.
- Even if exercise is not an employee benefit, exercise is a good thing for a person with a serious health condition. To learn more, click here.
- NOTE: If a wellness program asks about your health and you have not disclosed your health condition to your employer, answering the questions does not act as a disclosure. The answers about your health are for a third party administrator and cannot be disclosed to an employer.
- Time off
- Whether you need a few hours off work to see a doctor, an entire day off occasionally because you can't get out of bed, or, you may need a period of weeks or months off work, there are alternative means of getting what you need. Knowing what benefits your employer provides and what your rights are under law will help. To learn how to get time off, and to maximize your benefits during time off, read Time Off Because Of Health.
- if you need more time off than allowed in your work place, find out if you can borrow the right to tme off from a co-worker.
- If your company doesn't have one, consider starting a pool of time that co-workers can contribute to and borrow from. See: Guidelines For Creating A Shared Pool Of Time Off.
- NOTE: You may be able to get time off as an accommodation under the ADA. See: Accommodation.
Treatment (Preparing For, In, Recovering From) Different treatments have different effects on work. While there is no way to predict what will happen to any person during or while recovering from a treatment, a general understanding of the effects of a particular treatment can help with planning. For information see:
- If you will be or are undergoing chemotherapy, click here.
- If you will be or are undergoing radiation treatment, click here.
Take Advantage Of Flexible Spending Accounts And Other Tax Related Health Savings Accounts
- Work related tax advantage health savings account are a great way to save money. The key is understanding the account(s) that may be available to you and learning how to maximize them. For an overview of these accounts, click here. For additional information, click on the type of account you have or could have:
Do What You Can To Prepare Financially For The Sunny Or Rainy Days Ahead
- In General
- Whether you need to stop working for a while or permanently, desire to retire one day, or keep working long into your senior years, while you are working is the time to focus on your finances. .
- If you can, create an Emergency+Fund to keep you going in case you have to stop working for a short or extended period of time or if you lose your job. Include money in case there's a drug or treatment you want that isn't covered by your insurance.
- If cash is tight and you are in a financial crunch, see Dealing With A Financial Crunch or Crisis.
- Outstanding Loans
- Pay all your loans on time. (On time payments help bolster your credit rating.)
- Consider not paying loans off early until it is clear that your health condition isn't likely to bring unexpected large medical expenses. Until that time, cash is king "just in case."
- If you have more than one loan: consolidate all your loans to the one with the lowest rate of interest. It is not advisable to consolidate Student Loans. Student loans are forgiven if you become disabled, but not if you redo them by consolidation or otherwise.
- Put as much money as you can into your retirement plan(s) -- especially if your employer matches your contributions. Advantages include postponement of taxes until a time when they might be lower than when you're working; money will be available if you become disabled, possibly without penalty; money in a retirement plan is exempt from creditors, and any contributions your employer matches serve as an increase in your compensation. For information about IRAs and your health condition, click here.
- If your finances aren't what you would like them to be, do what you can to increase your net income.
- See what you can do to increase your Real Earnings. Real Earnings is our way of describing what you actually make versus what you think you do. For instance, a calculation of real earnings includes expenses you would not have were it not for the job. For information about Real Earnings, click here.
- Consider changing jobs for your current employer or for another employer if you can make more money. For information, see below.
- If there is a possibility that you will want to or have to stop work, see:
- NOTE: While dealing with planning, if you haven't already, consider what would happen if you become unable to communicate and a health care decision has to be made. It is worth noting that this kind of planning can decrease stress. For information, see Advance Healthcare Directives and Estate Planning.
- Credit can be a life saving asset after a diagnosis.
- While you are working is the time to do what you can to get more credit and to improve your credit rating.
- A credit rating is important in unexpected ways. For instance, it can be a factor in setting the cost of your automobile and other insurance. It may also be important to a future employer. See New Uses Of Assets: Credit
- If you don't have credit, while you are working is the time to get it. You can even start getting credit if you have bad credit, for example, with a secured credit account. See: How To Get Credit When You Don't Have Any Or Your Credit History Is Bad
- If you have credit card debt, read: How To Pay Down Credit Card Debt As Quickly As Possible
- Consider accepting the credit offers you are likely to receive because you are working.
- To learn about credit, and how to improve your rating, click here.To learn about credit reports (and how to fix them), click here.
- If You Own A Home, Consider A Home Equity Line Of Credit
- Now, while you're working, is the perfect time to take out a Home Equity Line of Credit (HELOC.) You do not have to actually borrow any money, just keep the line in case you need it in the event your health condition takes an unexpected turn for the worse. If something happens and you become unable to work, it may be too late to then try to obtain a line of credit or a different loan.
- Look for a HELOC that has no closing costs so it doesn't cost you any money out-of-pocket to obtain.
- If the lender requires that you borrow some money, borrow the minimum amount of money you can for the minimum time period. Then pay it back. The amount you'll pay as interest for those days is a small premium for the security you'll have in case you need it. Plus, paying a loan on time can help your credit rating - leading to more credit in the future if needed.
- NOTE: For other ways of getting money from a home without selling it, click here. If you do have to sell, you can find selling tips by clicking here
Performance Reviews: A New Perspective
- Annual or semi-annual performance reviews are an opportunity to improve your pay or fulfillment.
- Prepare for the review.
- Think about everything you've done that benefited the company since your last review.
- In addition to the expected, look for how things you did for yourself can benefit your employer.
- Do not discriminate against yourself by thinking about your health condition or what could happen.
- If needed, reviews are a good time to ask for an accommodation -- or to start a discussion about ways to do your job differently..
When You Are Physically And Mentally Up To It, Consider Whether This Is A Time To Start Thinking About Changing Jobs Or Be Self Employed Or Start A Small Business
- Changing jobs
- By changing jobs, you may be able to get more money, better benefits, more job satisfaction, or perhaps a better balance between work and personal time.
- Prospective employers cannot ask about your health or health history before hiring you. For information about seeking work, click here.
- If health insurance is not available in a job of interest, it is available on the open market despite your health condition because of the The Affordable Care Act ("Obamacare").
- Do not let fear of what could happen because of your medical history be the deciding factor. No one can predict the future.
- If you cannot decide whether to change jobs and/or careers, consider the following:
- First look closely at your goals, your desires, your wishes.
- Then, consider: does the job you are in satisfy you and help achieve your goals? If not, are there parts of the job you could change now or in the foreseeable future?
- If you have a mentor or advisor at work, speak with him or her. If you do not have an advisor, this is a good time to look for one.
- If you do want to consider a job change, to what would it be? What kind of job would satisfy more of your goals?
- If you don't know the answer, speak with a job counselor or look at a book such as What Color is Your Parachute? by Richard Bolles. It is a classic in the area of helping people figure out work that best suits them.
- Read our article about Changing Jobs Or Careers to understand what will happen to the benefits you currently have from your employer, and about benefits from a new employer.
- If you're thinking of switching careers, think about which of your skills are transferable from one job to another and from one career to another. Everyone has transferable skills. Think of your skills in as broad a sense as possible. For instance:
- Perhaps your job taught you patience, or proved that you can manage people, or that you can sell to the public, or that you can actually function particularly well under heavy pressure.
- How do others categorize you? If you are a statistician who has analyzed data from clinical trials, you can consider yourself a "numbers person."
- If you may be interested in starting your own business see:
- If you are interested in becoming self employed, see:
Pay Attention To Your Mental health
- It's easy to feel like less of a person than you did before your diagnosis. However, you are still the same person. Your ability to do the job and your value to the employer are likely still there. You are a person living with a medical condition. You are not the medical condition.
- Don't bottle-up your emotions. See: Tips To Help Feel In Control Of Your Emotions. If a particular emotion shows up, such as anger, anxiety, depression or fear, there are practical steps for dealing with them.
- Do what you can to reduce stress.
- High levels of stress can affect your body's ability to function properly. Being diagnosed with a serious, possibly terminal or chronic, medical condition can be as stressful as losing a partner, family member or other major life event. For information about techniques for reducing stress, click here. For tips about coping with holiday stress, click here.
- Think about how work or the workplace can be less stressful. For instance:
- At least one company offers massages at work (www.massageatworkusa.com ). Massages can help reduce absenteeism as well as reduce stress.
- Think about taking a pet to work. Pets are good for your health. In the work place, pets can help to decrease immune damaging stress. They also provide an excuse to take at least one break during the day -- a break you may need for your physical condition, but which can be "blamed" on the pet. If pets are not allowed, you can argue that the pet isn't a pet at all -- but rather an emotional support animal needed because of your health condition. To learn how a pet can become an emotional support animal, click here. Once certified, you can request permission to bring the pet to work as a reasonable accommodation under the Americans With Disabilities Act (and not have to worry about changing the rule for everyone.) For information about pets, including travel and to be sure he/she is taken care of if you become unable to either temporarily or permanently, click here.
- Consider scheduling at least a few visits with a mental health professional to make sure you are dealing with your emotions and the changes you are going through in a manner that is as healthy as possible. If you ultimately decide to stop working, the visits can help build a case that you are "disabled" - unable to work. Disability does not have to be physical. It can also be mental (such as a diagnosis of clinical depression) or it can be a combination of the two.
- Keep in mind mental health coverage in your health insurance.
What If You Need To Stop Working?
- If you may need to stop work because of your health condition or due to the effects of a treatment, keep in mind that generally a health condition does not become disabling overnight. If disability occurs, it is generally more of a gradual process. It takes more and more effort to work, and performance gradually suffers. Rather than wait for disability to occur and then try to figure things out, it is better to start making preparations now. When a condition becomes disabling is not a time you want to start thinking about work and/or financial matters.
- If it appears that you could need to leave work for a while or for a long term, consider the following: Preparing To Stop Work: Long Term and Preparing To Stop Work: Short Term.
- If you are ready to stop work, see: Steps To Take To Prepare To Leave Work And Go On Disability, and Sample Timeline For Leaving Work
- TIP: Consider making a note on your calendar for every three months to see if it's time to start reading the article about short term. If it's not, the alert will give you a reminder to celebrate life. We can all get caught up in our problems of the moment, or the rush of day-to-day life, and forget how lucky we are for each day.
- If it would help, consider asking your doctor, social worker or patient navigator who specializes in your health condition to speak with your manager or human relations department about your treatment and health condition, and what to expect in relation to work.
- When you have contact with your employer about your health condition:
- Make notes when you are alone about the conversation. Include name of the person, dates, times and settings.. '(Do not store the notes on your office computer.)
- Keep a copy of all documents you provide your employer.
- Store the notes with your Work Journal.
- Watch what you say on line about your health condition. What you say or do may not remain private. Consider using a fake name or nickname except in the most private settings.
- If you decide not to disclose your health condition to your current employer, you may out yourself by what your do or say online.
- Even if your health condition or history doesn't matter to your current employer, it may matter to a future one.
NOTE: If you are considering stopping work, before you do, read about How To Prepare To File A Claim For Social Security Disability Insurance (SSDI) [and Supplemental Security Income (SSI)] and Disability Income Insurance Claims. Also read Preparing To Stop Work In The Short Term and Terminating Work.
Table of Contents:
- Americans With Disabilities Act
- An Advisor At Work
- Benefits At Work
- Business, Starting Your Own Business
- Chemotherapy And Work
- Disclosure (including what to say, how and when)
- Employer friendliness toward people with:
- Family And Medical Leave Act (FMLA)
- Financial Planning
- Home finance
- Legal Protections
- Life Insurance:
- Radiation Treatment And Work
- Self Employed
- Stopping Work (Preparing For)
- Tax Related Savings Accounts
- Time Off:
- Work At Home: Freelance Or Your Own Business