In Treatment for Breast Cancer: At Work
Breast cancer does not have a negative long-term impact on the careers of most women. There may be problems in the work place in the short term, but they do not affect the long term.
The Americans With Disabilities Act (ADA) and similar laws provide protection against discrimination and require reasonable accommodations to allow you to do your work. However, if your treatment is interfering with your job and you have not disclosed your condition, the ADA does not provide any protection.
- Breast 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 women with breast cancer.
- With respect to an accommodation, negotiate for what you need. Whether you are protected by the law or not, you have to negotiate for an accommodation. It is not granted automatically. See: Work: How To Request And Negotiate An Accommodation.
- "Just in case," start keeping track of facts that would be relevant to a discrimination claim. A good way is to keep a Work Journal.
- 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).
Impact of Breast Cancer In The Workplace
- Employers and co-workers can fall into the mode: “Breast cancer? She’s going to die.” Some people are even afraid of catching cancer. Education and time relieve those concerns.
- The more common reaction to telling people about breast cancer is that employers and co-workers step to the plate to offer support.
- Whatever the initial impact in the workplace, once the original crisis of the illness is over, over the long term the question becomes your ability to do your job. Indications are that breast cancer as such does not have a negative long-term impact on the careers of most women.
If You Don't Already Have One, Look For An Advisor
- Someone at work at work who knows how your employer operates can help guide you through practical questions such as telling about your condition or treatments, and how to maximize your benefits.
- A good person to look for is one who has been with the company long enough to know how it reacts to women with breast cancer and who knows the ins and outs of the company’s benefits. Of course, you want to find a person who will keep your discussions confidential.
- The steps to take for finding an advisor and advice about the continuing relationship are contained in our article: An Advisor At Work
If You Haven't Told About Your Condition At Work
- If you have not told your employer or co-workers about your condition yet, think about whether to continue to keep it a secret. The greater the secret and the longer you keep it, the greater the stress. It may be very difficult to keep the secret if you need time off to take your treatment or if you suffer from side effects.
- While we encourage disclosure, it is wise to be cautious about telling.
- 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 co-workers at home.
- There is no legal obligation to tell as long as your condition does not endanger other people.
- Keep in mind that stress can be harmful to your immune system. The greater the secret, the greater the stress can be.
- 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 have a system under which you can send your claim directly to the insurer.
- It may help determine whether to tell if you think about whether your employer is cancer friendly or not. See How To Determine If An Employer Is Friendly To People With Cancer
If You Do Decide To Tell, Think About:
- First consider who to tell.
- An employer must keep the information confidential. 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. For more information, click here.
- There is no similar restriction on co-workers so what you tell co-workers is not confidential information. For information about telling co-workers, click here.
- You may need to tell your employer and likely your co-workers if:
- You will need time off beyond what you are entitled to as vacation or personal time, or you need an accommodation at work to permit you to do your job while undergoing treatment.
- You need an accomodation such as moving closer to the bathroom or shifting some of your work to co-workers for a while.
If You Need To Take Hours, Days Or Weeks Off From Work
You may need hours or even days away from work because of your treatment, or you may need an accommodation at work because of treatment side effects. For instance, if you have fatigue, you may need rest time. If you have diarrhea, you may need to work near a bathroom. If you are undergoing chemotherapy and get what is commonly referred to as "Chemo Brain" you may need to have deadlines extended.
- If you need to take time off work because of your treatment or side effects, you may be entitled to the time under any of the following concepts
- As an employer based benefit such as sick time, vacation time or personal time.
- As a matter of right under such laws as the Family and Medical Leave Act (FMLA) and laws such as the Americans Disabilities Act under which the time may be considered to be an accommodation to which you are legally entitled.
- If you will need time off:
- Look at benefits from your workplace and think about how to maximize your time off while minimizing disruption in your pay. (See How To Maximize Your Benefits If You Need Time Off For Health Reasons)
- Check to see if your employer has forms to complete in order to take time off. If so, 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 for all or at least part of the day. (For information about working at home, click here).
- 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.
- Learn about protections such as those provided by the Americans With Disabilities Act (ADA) and the Family And Medical Leave Act (FMLA).
- Think about where income will come from. Check for disability income from your employer, disability insurancefrom work or individually, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI)
If You Need Changes At Work To Permit You To Do Your Job
- You will need to negotiate for what you need. If you do not ask for an accommodation, and your work suffers, you can be fired. For example,
- Before you ask for changes, it is advisable to do the following:
- 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 as you go through the day so you don't forget anything.
- 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.
- If you haven’t disclosed your cancer to your employer, talk to your boss or a supervisor in human resources as soon as possible. Even if you are protected under the Americans With Disabilities Act and similar laws, there is no protection until your employer is informed of your situation.
- Think about specific accommodations that would work for your needs, 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 breast cancer treatment:
- Leaving work early on Fridays for chemo treatments.
- Work from home all or part of the week. (See Work: At Home)
- Sharing work with someone else.
- Extending deadlines.
- All accommodations involve a negotiation with your employer. Learn how to negotiate for what you need. (See: Work: How To Request And Negotiate An Accommodation)
- Keep notes of 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. (You may need this information in case you later need to file a discrimination claim under laws such as the Americans With Disabilities Act
- If you have chemotherapy, you may experience a fogginess and forgetfulness due to what is commonly referred to as "chemo brain."
- Chemo brain may even start after treatment is complete. The odds are that chemo brain will lessen over time and then disappear.
- For techniques to help deal with chemo brain, click here.
Review Employer Benefits In Light Of Your Diagnosis Benefits may look differently to you as a person who has been diagnosed. For instance:
- If you have a tax advantaged savings account such as a Health Savings Account take full advantage of it.
- Increase the amount of your life insurance if you can.
- Even if your beneficiaries do not need the money, you can get money froma life insurance policy while alive if your life expectancy becomes shortened. A sale is through a process known as a Viatical Settlement or a Life Settlement.
- You can purchase life insurance during open enrollment periods when no health questions are asked.
- Buy the coverage if you become eligible for disability insurance and/or long term care insurance. Your health condition makes it more likely that something else may happen.
- During open enrollment periods, look at health insurance alternatives from the point of view of a woman with breast cancer. Our Health Insurance Evdaluator helps you compare policies from such a point of view.
- NOTE: If finances are a problem, look at our information from the point of view of a person living after a diagnosis: How To Deal With A Financial Crunch Or Crisis for. It provides information from the point of view of a person living after a diagnosis.
If Your Work Requires A Lot Of Physical Effort
If you are having difficulty doing your job because of your condition or because of treatment:
- Ask your advisor to help create 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.
- Negotiate with your employer to get an accommodation to let you do work that requires less physical effort - at least while undergoing treatment and immediately after until you get your strength back. You may even be legally entitled to the accommodation under laws such as the Americans With Disabilities Act. To learn how to negotiate an accommodation, and about your legal rights, see Work: How To Request And Negotiate An Accommodation,
If You Were Diagnosed With Stage 3 or Stage 4 Breast Cancer
- It is wise to start planning in case in the future you want to stop work, or have to. For example, let your doctor know how your breast cancer or treatment affects your job. Be specific. Ask him or her to note the facts in your medical record.
- Learn about the steps to take to prepare long term in case you eventually want or have to stop work, as well as short term steps to take. They are listed in Preparing In Case Of Disability: Long Term and Work: Preparing For Disability -- Short Term
- If you may need to stop work:
- Learn about the disability income sources to which you may be entitled.
- Check benefits at work. If you don't have an employee handbook, ask a supervisor in human resources about your benefits.
- Speak with your advisor to find out if your employer has any informal policies about disability.
- Look at the requirements for obtaining Social Security Disability Insurance (SSDI). You paid premiums from withholding for SSDI.
- If you are going to apply for Social Security Disability Insurance (SSDI), keep in mind that only one third of applicants for SSDI are awarded an income. We provide easy-to-use information for applying as an educated consumer that makes it more likely to get a "yes." See: SSDI: Guidelines For Applying For Benefits
- See if you qualify for Supplemental Security Income (SSI).
- If you have health insurance through work, you will be entitled to continue it under laws generally known as COBRA. Before applying for COBRA, check the availability of health insurance in your state through www.healthcare.gov. (Becuse of the Affordable Care Act, insurance companies cannot impose a pre-existing condition exclusion.) Since you will have to pay the premium under COBRA, start thinking about how to pay for the coverage.
- If you can't afford the premium:
- Learn how to continue your life insurance coverage. Even if your beneficiaries don't need it, you may be able to sell it while you are alive under a process known as a Viatical Settlement or Senior Settlement.
- Learn about the disability income sources to which you may be entitled.
- This article only covers subjects of general immediate concern to women in treatment for breast cancer. Additional work subjects are contained in Work: At Work.
- Information for small business owners and self employed people is covered in separate articles.