Breast Cancer: Recurrence: At Work
With a recurrence, 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 and tests. You may need time off if you become fatigued. During treatment, you may or may not be able to work.
Just as when you were first diagnosed, there are two issues to consider immediately:
- If you haven’t already told your employer and/or co-workers, think about whether to tell. If you do tell, what to tell and to whom.
- What accommodations you may need, if any, to enable you to do your job because of your health condition and/or treatment.
Before taking any action:
- Give emotions a chance to settle. If you can, take a few days off.
- Take time to think through your needs.
- Whether you can, or should, work straight through treatment or take limited or extended time off, is purely an individual decision to be made after discussion with your doctor. Some people can work through a treatment and recovery period. Others need the time for their bodies and minds to rest.
- Explain to your cancer doctor what you do at work, including what you do on a daily basis. Ask questions such as:
- 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?
- If I do 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?
- Look for an advisor at work who understands your situation, can help you make decisions, and who will keep your discussions confidential. For information about what to look for in an advisor, click here.
- In addition to discussing the general question of who to tell, also discuss how much to tell and requesting time off.
- If you are going to have radiation, keep in mind that many women fit it into their regular schedule before going to work, during lunch or after work. Fatigue is the biggest side effect. For some women, the disruption to their work lives was so minimal that no one at work even knew they went through radiation treatment.
- Look for other women in your workplace who have had breast 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,
- If your work involves a lot of physical effort, 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, or possibly during recovery. Radiation or systemic therapies such as chemotherapy may leave you fatigued. If you have one, review your situation with your advisor, and 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.
- 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.
While secrets can be stressful, it is advisable to be cautious before telling about your situation.
- Breast cancer may cause co-workers to feel uncomfortable around you. On the other hand, there are many, many stories of co-workers who pitched in to help, including providing sick days and taking food to women at home when needed.
- There is no legal obligation to tell either employers or co-workers. Consider taking some time to focus on your condition first.
- 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.
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.
- If you will need time off beyond what you are entitled to as vacation time, or you need an accommodation at work to permit you to do your job while undergoing treatment, you will have to disclose your condition at least to your employer, and likely to your co-workers.
- It may help determine whether to tell if you think about whether your employer is cancer friendly or not. To learn how, click here. If you need to disclose your condition, tell a supervisor in human resources. (Supervisors are more likely to know about and honor the confidentiality requirement than low level clerks). Remind him or her that you expect this information to remain confidential -- at least until you have a chance to decide who you want to tell and when. Keep in mind that what you tell co-workers is not confidential information. (As a practical matter, it will be difficult not to tell co-workers if part of your work will be shifted to them).
Schedule appointments for 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 chemotherapy for Friday afternoon so you have the weekend to recuperate.
- If you need surgery, try to schedule it for a slow period at work.
- For more information, see: Work: Time Off Because Of Health. What To Expect After Breast Surgery
Review your work schedule.
- 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 have been thinking of training someone to take over some or all of your duties and responsibilities, now is a good time to start in case you need someone to take over parts of your job temporarily.
- If you will need to take a period of time off, see Taking Days Or Weeks Off and How To Plan Before You Take Days Or Weeks Off
If you need to request an accommodation, it is advisable to first read: Work How To Request And Negotiate An Accommodation At Work
When you have a chance, review employer benefits from the perspective of a pesron with breast cancer. For example:
- If your employer offers life insurance, take what you can or increase the amount you already have during an open enrollment period when no medical questions are asked. Likewise, consider disability and/or long term care insurance. 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.
- 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. To learn how, see: Tax Advantaged Health Savings Plans.
- During open enrollment periods, look at health insurance alternatives from the point of view of a woman with breast cancer. Click here to learn how.
Accept the credit card offers you receive because you work. 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.
If you don't already know, learn about your legal rights. 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.
- Breast cancer is not always considered to be a protected disability under the ADA. 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 women with breast 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 track in a work journal 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).
If you want more information about work: This document contains the basics needed at work after a recurrence of breast cancer. Additional work subjects of interest to women with breast cancer can be found in Work: At Work.