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Newly Diagnosed With Breast Cancer: At Work

Overview

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There are a variety of work subjects to think about after a diagnosis that may seem discouraging when grouped together in one place. However, reading about them can help you feel in control of the situation and get what you need when you need it - with the least effect on your pocket book, your work, and your career.

Consider reading through this summary, then returning to each subject as it works for you. You can go into more depth about a subject by clicking on the links as needed. Break subjects that relate to you into doable steps. When you are about to start treatment, read: In Treatment For Breast Cancer: Work Issues

  • If your employer offers assistance to employees with a serious health condition, take advantage of it. Keep in mind that what you tell employee assistance personnel must be kept confidential  Even if you use an emloyer's program,it is advisable to read the following information because it describes your rights and offers suggestions that may be helpful.
  • If you are a small business owner:  click here
  • If you are self employed: click here.

Impact of breast cancer in the workplace

  • Indications are that 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.
  • In the short term, work is likely to be affected by your treatment and/or condition. At the least, you are likely to need an accommodation to take time 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 full time or possibly even part time.
  • There are legal protections for people with breast cancer. As a practical matter, it is preferable to work things out on a friendly basis. Still, knowing about the law helps to empower you. 
  • For more information, see: Before Taking Any Action At Work, Find Out How Your Breast Cancer Or Treatments Are Likely To Impact Your Work.

Before taking any action, it is advisable to:

  • Take some time to think through your needs. If you can, consider taking a few days off to focus on your condition and what you need to do to accommodate it. The time will also help adjust emotionally to the diagnosis. (Please do not take this as a pass to procrastinate.) 
  • Ask your doctor how your cancer and/or treatments will impact your work. 
    • If he or she doesn't know, the doctor can likely point you to a person who can provide such information such as a member of the doctor's staff, a social worker or another person in a similar situation. 
    • For questions to consider asking, click here.
  • 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.
    • Also think about what work you need to temporarily pass on to others.
    • If you have not 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 can, look for an advisor at work - someone who knows the culture well enough to give advice about dealing with your work place and who will keep your information confidential.
    • If your employer has an employee assistance program (EAP), it may be a good place to start to look for an advisor.
    • Look for other women in your workplace who have had breast cancer. Ask them about their experiences at work. Remind them that you haven't told anyone yet and want to keep this confidential.
    • There may be a helpful social worker or navigator at the cancer center where you will receive your treatment. He or she may have some practical tips - including possibly knowing about experiences of other people who work for your particular employer.
    • In addition to discussing the general question of who, what and when to tell, you can discuss time off, other accommodations you may need to help you do your job before and during treatment, and other questions you may have.
  • If you belong to a union check with your union representative about your rights and suggestions about dealing with the workplace.
  • Learn about your legal rights. For current purposes, the two main legal protections for a person with a serious health condition are:
    • The Americans With Disabilities Act (ADA) and similar laws which provide protection against discrimination. The ADA also requires that you be given a reasonable accommodation to allow you to do your work. The ADA only applies to employers with 15 or more employees (your state's law may apply to more employers) and breast cancer as such may not be a protected "disability" because the condition must be substantially limiting. However, if your 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 (including through social media and sites that rate employers) that the employer discriminates against women with breast cancer. With respect to an accommodation, even if the law applies, you will have to negotiate for what you need. Since you will need the accommodation in order to do your work, the negotiation is the same whether it is protected by the ADA or not.  
    • The Family And Medical Leave Act (FMLA) provides unpaid time off for medical reasons.
  • Even if your employer is as supportive as possible, it is advisable to start keeping track of facts that seem like they could be relevant to a discrimination claim. Making notes as things happen becomes strong evidence in the event something happens and you want to file a claim in the future. For more information about why and how to keep track, click here. A few minutes of time as you go along can make a big difference if you need to file a claim some day.

Disclosure and the need for an accommodation to allow you to do your work while taking care of your medical needs

We group the subject of disclosure and accommodation together because it is difficult to ask for an accommodation without disclosing your health condition.

As a legal matter, you do not have to disclose your condition to your employer or to co-employees unless there is something about your situation that could cause harm. This is not generally the case wtih breast cancer or with any of the current treatments for breast cancer.

However,it is generally advisable to disclose your health condition unless there is an overriding reason not to. Keeping a secret is stressful. Stress lowers the immune system which in turn lowers your body's ability to fight disease. It is generally accepted that the greater the secret, the great the stress. You also need to disclose in order to obtain the support of your co-workers (including possibly borrowing some of their time off.) 

  • Your employer: 
    • The vast majority of employers try to be helpful when they learn about a new diagnosis. Still, when thinking about how your employer will react, look at How To Determine If An Employer Is Friendly To People With Cancer
    • 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.
    • Keep in mind that your employer may need to be educated about what your diagnosis and treatment may mean for you and for the effect on your work. Even in this day and age employers can fall into the mode: "Breast cancer? She’s going to die.” 
    • Employers are required to keep all information about your health condition confidential.
    • When disclosing to an employer, it is advisable to start with 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 information about disclosing to your employer, including what to tell, see: Disclosing Your Health Condition To Your Employer.
  • Co-workers
    • Co-workers tend to step to the plate and be helpful once they learn about a diagnosis. Not disclosing to them can cause negative feelings if you  an accommodation and/or some of your work is moved to them. 
    • Co-workers do not have an obligation to keep health information confidential. 
    • Co-workers may need to be educated. Some people are even afraid of catching cancer. Experience indicates that education and time relieve those concerns. 
    • Whatever the initial impact in the workplace, once the original crisis of the illness is over, any shock to your colleagues your cancer has caused seems to wear off.
    • For information about disclosing to your co-workers, including what to tell and how to deal with problems that may arise, see Disclosing Your Condition To Your Co-Workers
  • For ideas about accommodations and how to request them, see:
  • When you start discussions about your health condition and needs, it is advisable to 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.

Set medical appointments to fit with work to minimize interruption at work. 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. For other practical tips about chemotherapy, click here.
  • If you need surgery, 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 not to be fully staffed during weekends or on holidays.)

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

  • Think about how to take time off in a manner that least disrupts your income and benefits. 
  • 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 to make sure it is accurate. It helps to 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 information about working from 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. Click here.
  • Decide how to maximize time off with benefits. Click here for information.
  • 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 short term disability income. If finances will be tight, to learn about how to access money and/or lower expenses, see our article: How To Deal With A Financial Crunch Or Crisis.

When you have a chance, review employer benefits from the perspective of a person with breast cancer. For example, 

  • 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.
  • Consider buying 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. (The linked to articles tell you how.)
  • 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.

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 an advisor, review your situation with him or her, 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.

Steps to take now in case you ultimately feel you are being discriminated against

 "Just in case" it is advisable to start keeping notes about all discussions e mails etc about your condition and needs. It literally only takes a fwe minutes at a time. You may think you  would never file a discrimination claim at this point, but you may wish you had kept notes if you actually do feel the sting of discrimination. Include:

  • Name of person(s), date, what was discussed. Include your impressions and examples of facts which led to your impression
  • Good things that happen such as when you receive a pat on the back.
  • Anything that could be considered to be discrimination. Enough facts can create a pattern.

If you do ultimately believe you have a discrimination claim, the EEOC offsite link is there to help for free (in addition to private alternatives). For a sample EEOC complaint letter, click here.

While you are working, you are likely receiving credit card offers. Credit can come in handy to pay medical and other bills or to provide cash if you need it. It is advisable to take as many credit card offers as you can, but not to use the cards beyond what is necessary to keep them active and fee free. To learn more about credit, click here.

If you were diagnosed with Stage 3 or Stage 4 Breast Cancer 

  • Learn about the disability income sources to which you may be entitled.
    • Check benefits at work.
    • Look at the requirements for obtaining Social Security Disability Insurance (SSDI). You paid premiums from withholding. If you are going to apply for SSD): Only one third of applicants for SSDI are awarded an income. Our article about SSDI provides easy-to-use information for applying as an educated consumer that makes it more likely to get a "yes." 
    • See if you qualify for Supplemental Security Income (SSI). (See “To Learn More.”)
  • If you have health insurance through work, you will be entitled to continue it under laws generally known as COBRA. Before electing COBRA, check to see what coverage is available in your state. Because of the Affordable Care Act ("Obamacare"), you can purchase health insurance dspite your health condition. For information, see: Healthcare.gov offsite link
    • Since you will have to pay the premium, start thinking about how to pay for the coverage in case you become unable to work and have to pay the premium yourself.
    • If you can't afford the premium, and cannot be covered under a spouse or partner's coverage, look to see if you can qualify for Medicaid.
  • Do whatever you have to do to keep 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. See: How to Obtain Money From A Life Insurance Policy
  • There is the possibility that you may need to stop work at some point in the future. The operative word in the preceding sentence was "possibility."  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).

If you want more information about work: This article contains the basics needed at work after a new diagnosis of breast cancer. Additional helpful work subjects can be found in our article: Work: At Work


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