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Summary

There are more people with a medical condition or a history of a medical condition in the workplace today than ever before. However, deciding whether or not to disclose your health condition to a current or prospective employer can still be a difficult decision to make. While more and more companies are enlightened and welcome people with a health condition into the workforce, there are still some instances in which ignorance and fear still remain.

Whether or not to disclose your health condition to your employer is a decision that is yours and yours alone. There is no legal obligation to disclose your health status unless you are in a situation where your health condition is a risk to the people you work with or that you come into contact with.

We encourage disclosure. If for no other reason, the greater the secret, the greater the stress. Likewise, disclosure may occur from a simple phone call or message from your doctor's office or if side effects occur such as weight loss or other physical changes, or fatigue.

At the same time, there may be reasons not to disclose which should be considered. For instance, you may not want to tell your employer if your employer has not been sympathetic to people with a condition like yours. 

Fight any urge you may have to make a hasty decision. Once you disclose your condition, there is no turning back. Human Resource personnel indicate that disclosure often occurs as a result of an office crisis. Careful planning can help prevent this.

When considering whether to disclose, keep in mind that, in most situations, if you disclose your situation to your boss and to the people who handle Human Resources:

  • Your condition must be kept confidential.The information must even be kept  in a separate file.
  • You cannot be discriminated against because of your health condition..
  • You can be eligible for up to 12 weeks off work under the Family and Medical Leave Act and similar laws.
  • You can obtain a reasonable accommodation to fit your needs if you can perform the essential functions of your job. To learn more, see Americans With Disabilities Act
  • On a human level, your supervisor or employer may be influenced by an anger at not having been told about your health condition..

Laws do not change the basic fact that employers will generally do what is good for business, not necessarily what is good for you. Even if you have a right within the law, you do not want to have to sue.

Find out what you can about your new boss's attitude. Is your boss sensitive to health problems?

Until you are ready to disclose your medical condition:

  • Do not keep your medical appointments on your work calendar.
  • Do not send or receive e-mails on your work account that refer to your health condition.
  • Create a credible story for the times you are away from work for medical appointments or treatments.
  • Think about aspects of your life outside work that could disclose your health condition. For example:
    • Your Facebook page and othe social media. Do you mention your health condition? Organizations at which you volunteer that relate to your health condition?
    • Social media of your friends and family. Do they mention your health condition?

Before disclosing, practice what to say before hand. This is one of the few areas that a patient has control over. The surest way to get into difficulty is by not practising what you say in advance.

If you do disclose, keep in mind that is important to manage an employer's expectations. Be sure to let your employer know that a diagnosis is fluid. What you know and share today is not necessarily what will be true in a month, or six months or a year from now. A discussion of a health condition is not like talking about leave to have a baby where there are usually clear dates and an understanding of what will happen. It is not possible to predict what will happen to any particular person with a major health condition. Let your employer know that you will keep him/her to date as things progress.

The other sections of this article provide information about:

NOTE: 

  • Whether you tell or not, it is advisable to start keeping a work journal about events at work that either show how well you are doing your job or that could seem to be discrimination or harassment. Keeping a journal does not take much time.
  • For information about disclosing to co-workers, click here

3 Steps To Take To Help Decide Whether To Disclose Your Medical Condition

To answer this question, take the following 3 steps:

Step 1. Think about the possible reasons to disclos

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e and not to disclose. A list of reasons that may help jog your thinking is in the next section of this document.

Step 2. Make a list of your reasons. 

Step 3. Put your list away for a day or so and then look at it again. Things will probably look different. You may even find that you have items to add.

If you decide to disclose, consider:

  • The timing of your disclosure
  • The appropriate method for disclosing
  • How much to disclose
  • To whom to disclose

If you decide not to disclose, then read: If I Choose Not To Disclose: How Can I Handle Workplace Issues?

Reasons to Disclose And Reasons Not To Disclose A Health Condition

As you make a decision, the following reasons to disclose or not to disclose your health condition to your employer may help you. Add your own reasons to the list.

Possible Reasons to Disclose

  • Avoid the stress that comes with keeping a secret, especially when it seems that the more important the secret, the greater the stress in keeping it.
  • Unless you disclose your health condition, you cannot get the legal protections described in the next section -- such as the right to a reasonable accommodation to perform the essential functions of your job, or to unpaid leave if it becomes necessary. (To learn more, see Protections Under The Law.)
  • You may gain support from a surprisingly supportive employer. If you aren't familiar with your employer's attitude, look for a person you can trust who has been with your company long enough to advise you about this subject. Since there are no legal requirements for co-workers to keep medical information confidential, be sure anyone you choose as an advisor is someone you have reason to trust. (To learn more, see Advisor.)
  • You may be able to speak more openly to your employer about any issues that arise for you, including any changes in your health.
  • You will not have to worry about your employer finding out about your diagnosis such as from a phone call from your doctor's office or a change in your physical appearance.  For instance, rapid weight loss or gain accompanied by clothes that are too tight or too loose.
  • As a general matter, what you disclose to your employer must be kept confidential. (To learn more, see: Your Employer Must Keep Your Health Condition Confidential.)
  • You can take your drugs and other treatments without having to hide them.

Possible reasons not to disclose

  • If your employer reacts poorly to your medical condition, you may find that there are subtle or not so subtle changes in your relationship.
  • Secrecy is often confused with toughness, and some of us see toughness as a virtue.
  • An employer that is initially supportive may change.
  • You may feel that you are being treated differently, or that you are no longer being judged on your performance, but by your diagnosis.
  • You don't want to feel pity or be treated "differently."
  • If your employer isn't friendly to people with your medical condition, you may encounter discrimination from your employer despite the law. This might include anything from being passed over for a raise or a promotion to having your employment terminated.

As you will see in the other sections of this document: how, when and what you disclose to your employer about your condition will likely be closely linked to the reason for your disclosure.

If you choose not to disclose your health condition, be sure to look at: If I Chose Not To Disclose: How Can I Handle Workplace Issues?

If I Choose Not To Disclose, How Can I Handle Workplace Issues?

If you decide that you would rather not disclose your diagnosis to your employer, consider the following tips for handling various workplace issues:

Communication With Your Health Care Team (or others abouthealth issues)

Any e-mail sent through your employer's computer network can be read by your employer - including messages in your work e-mail account and in your personal e-mail accounts if you use your employer's network to send or receive them. This includes messages on your own personal laptop, tablet computer or smartphone.  

Employers also have a right to read text and e-mail messages sent from company-owned cell phones, smart phones and laptops, even if those messages are sent through personal e-mail accounts from outside the work place.  

If you must send a private e mail or text form the work place, try to use your own mobile computer or cell phone. If the device can operate over both Wi-Fi and a cellular network, confirm that it is accessing the cellular network rather than the workplace Wi-Fi.  If you must use a company cell phone to send a private message, call the person instead of texting or e-mailing.

Also watch your online activity. Employers can monitor your internet use when you are in the office.

Health Insurance

If you need more detailed information about what your group health insurance does or does not cover, consider contacting the insurance company directly. You do not have to provide your name for this type of inquiry, only your group number and/or plan information. This should allow you to find out additional information without disclosing your name.

There are some companies, however, that will refuse to talk to you without your Social Security number. If that is the case, you may try to reach a supervisor at the insurance company. Explain that you have a general question but it concerns a medical issue you're not yet comfortable talking about.

  • Stress that you just want general information and that you understand they can't guarantee whatever they tell you since they don't know the entire situation.
  • Keep detailed notes of any conversation that you have and be sure to note the name and title of the person with whom you speak.
  • Be aware that if you rely on information you receive this way, and a claim is denied, your only argument will be that you had an anonymous conversation with someone at the insurance company. It is always best to confirm information about insurance benefits in writing.

Ask if the information you are inquiring about can be faxed to you, or if it can be found in the benefits handbook or summary plan description.

  • If the information will be faxed, use a friend's fax machine or a commercial center such as FEDEX Kinkos.
  • If you need to obtain a copy of the handbook or description of benefits, don't give your mailing information or you'll disclose your identity. Ask for the documentation in a separate phone call from some one else's phone when there is no connection between your question and your request for the document. Mail can be addressed to a trusted friend.

If you are unable to obtain the information you need in this manner, and if your employer has an Employee Assistance Program (EAP), perhaps one of the people in the EAP can obtain this information for you without disclosing your identity.

Reasonable Accommodation

You can legally ask for an accommodation at work to help you do your job without giving a reason. However, there are few employers who would consider changing the way they do business without a reason. 

Making up a reason doesn't work. If you lie, you can be fired for lying.

You may request a reasonable accommodation from your employer by indicating only that you are a person with a disability, as defined by the Americans With Disabilities Act, without disclosing your actual diagnosis. 

  • It would likely be very helpful in this scenario to ask your doctor to write a letter detailing your need for an accommodation or indicating any functional limitations you may have. You can ask that your doctor keep this correspondence general, without divulging your specific diagnosis. For example, your doctor may indicate "Anne suffers from fatigue due to a chronic illness, and thus needs to be able to take her lunch break at a regularly scheduled time." This may provide your employer with enough information for granting an accommodation.
  • If your employer wants more information, it has a right to request additional information about your "disability" that you must provide if asked. By making the request, your employer triggers the legal obligation to maintain the information confidentially. In this instance, it is advisable to note in your work journal that the employer specifically requested additional information.

For additional information on this topic, see: Requesting An Accommodation.

Leave of Absence

Similar to requesting an accommodation, you may request a leave of absence by providing your employer only with general information indicating that you suffer from a medical condition, without disclosing the exact diagnosis. As with the request for an accommodation, your doctor should be consulted about providing a letter for your employer. Again, your employer has the right to request additional information.

Disability Income

If you are filing for short or long term disability, you can arrange to have your doctor communicate directly with your employer's insurance carrier regarding your diagnosis. Ask your doctor to specifically request that the disability carrier not discuss any specific medical information with your employer.

If I Choose To Disclose My Medical Condition To My Employer, When Should I Disclose?

The best timing for disclosure generally depends on why you are disclosing. If you are in need of an immediate medical leave of absence or a job accommodation, you have no choice about when to tell your employer of your condition.

If you can avoid it, don't disclose your condition just prior to an expected raise, bonus, performance evaluation or opportunity for promotion.

On the other hand, it is advisable not to wait until your job is in jeopardy before disclosing your diagnosis. While you can't be fired because of your medical condition, you can be fired if you're not doing your job. If, for example, you are having difficulty getting to work on time due to nausea, diarrhea, or other side effects of medications: do not wait to disclose your condition or to ask for an accommodation until your employer is about to fire you as a result of tardiness.

How Should I Disclose My Health Condition?

While there is no one single way to handle disclosure, the following is one possible method to consider. It is merely an example to give you ideas for how to create the scenario that works best for you.

  • Set up a meeting with the appropriate HR person in your company. Go as high up in the chain of command as you are comfortable going.
  • Before the meeting, prepare a letter which states your desire that both the meeting and the contents of the letter be kept confidential. Consider asking your doctor to write a letter identifying your diagnosis and stating that it does not affect your ability to do your job, or, if applicable, that you will need an accommodation to do your job, or that you will need medical leave.
  • At the start of the meeting, hand whatever letters you have to the individual with whom you meet.
  • Indicate your reason for the meeting. For example, "I would like to talk to you about an accommodation," "I may need some time off for treatment," or "I wanted to discuss this with you before talking to my supervisor."
    • Concentrate on the impact your treatments may have on your work. For instance, how much work time do you think you will miss?What accommodation do you need? Why?
    • Is it possible to reduce your hours, work from home or take some time off?
  • During the meeting, keep in mind that you want your employer on your side. Try not to create a situation where you become adversaries. Do not make threats.
  • Depending on your reason for disclosure, discuss what information, if any, might need to be relayed to others, such as an immediate supervisor. You and your employer should reach a mutual agreement on this matter.
  • It may also be helpful to tactfully let your employer know that you are aware of your rights under the law. This can be done both verbally and in your letter. For example, "I would really appreciate it if this information remain confidential as required by the Americans with Disabilities Act (ADA)." This type of statement will remind your employer of the law if they already know about it, or prompt them to find out about your rights in case they don't know the law. On the other hand, "If anyone else finds out about this information, I'll sue you," is the type of statement that likely won't sit well with an employer.
  • If things do not go well during the meeting, do your best to prevent it from getting out of control. If all else fails, suggest that the meeting be continued at another time after both of you have a chance to think things over.
  • If the meeting goes well, at the end, thank the individual for his or her assistance.

At the very least:

Follow-up any oral disclosure with a letter. An employer will often be more attentive to written information as opposed to verbal information, and a letter or follow-up letter creates an important "paper trail" if needed. In the letter:

  • Confirm your understanding of the conversation.
  • Indicate your desire that your medical information remain confidential as required by law.

While the law does not specify how disclosure should be made, there is at least one case where disclosure resulted in the termination of an employee. The employee disclosed her cancer diagnosis to her immediate supervisor as a "friend." Unfortunately she was fired soon after. The employee filed a discrimination suit. The employer claimed that the employee was not entitled to legal protection because disclosure was not made in the context of requesting a job accommodation or medical leave of absence. While we hope that this type of scenario is rare, disclosing your diagnosis in writing can help to prevent this from happening to you.

If I Disclose My Medical Condition, What Should I Disclose?

There is a difference between disclosing and sharing everything.

  • How much to disclose depends primarily on your reason for disclosing. For example, if you have decided to disclose so that you do not have the burden of keeping a secret, it may not be sufficient for you to indicate that you are a person with a disability without indicating your diagnosis. You would meet the legal requirement, but you would still be keeping your diagnosis a secret.
  • Even if you are disclosing in order to request an accommodation or a leave of absence and you do not want your employer to be aware of too much information, you may consider simply indicating that you are a person with a disability, and describe the need you have. Understand that if your employer requires evidence of your condition (which it has a right to do), the evidence such as a letter from your doctor will likely include mention of your health condition.

 

If I Disclose My Health Condition To My Employer, To Whom Should I Disclose?

If you disclose any information about your diagnosis, do it to the highest level person with whom you are comfortable, preferably someone in your company's Human Resources department.

Generally speaking, Human Resources personnel are more likely than the average executive to understand the laws about confidentiality and the consequences to the company if an employee's medical information is not kept confidential.

The higher you go, the more likely it is the person will be aware of the responsibilities that the company has with respect to your disclosure. Additionally, information in a company usually flows upward. For example, if you decide to go the Manager of Human Resources and she reports directly to the Vice President of Personnel, you likely will have eliminated the information being passed through all of those individuals between your immediate supervisor and the Manager that you went to directly.

If you work for a small company that does not have a human resources department, disclosure should be made to an individual who is at least in a supervisory position in the company

Keep in mind that your immediate supervisor will likely be the person most impacted by your diagnosis. Think about your relationship with your supervisor, and how he or she has acted in the past, before deciding whether to tell him or her yourself, or to ask Human Resources to do it.  If you tell your supervisor and not your co-workers, consider reminding him or her of the obligation to keep your information confidential.

Is There Anything I Should Do After Disclosure?

After disclosing your diagnosis, summarize in writing any conversations you had with your employer as soon as possible after the conversation. 

Carefully note any specifics that were agreed to. For example: "it was agreed that our meeting will remain confidential, that no one else needs to know about this." This can be done without indicating your diagnosis so there will be one less piece of paper with the diagnosis on it.

We recommend that everyone keep a work journal. If you haven't been keeping one, it should definitely move into the "must do" category from the moment that you disclose your diagnosis to your employer, or if you suspect that your employer and/or co-worker(s) may think that you have a medical condition.

  • While you may never need the information that you compile, it could become critical in the event that you believe your employer discriminates against you as a result of your diagnosis.
  • If will also come in handy if you ever apply for disability income through a private insurance policy, Social Security Disabilty Insurance or Supplemental Security Income.