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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Overview

Starting work for a new employer raises a batch of questions because of your health history. Think about these questions now rather than put them off. If you wait, decisions may be made for you -- and not necessarily the decisions you would prefer.

The questions to consider:

  • Do you tell about your health condition if you haven't already? The new group of people you'll be working with know nothing about your health history. 
  • Do you need an accommodation because of your health to be able to perform your job?  If you do, the sooner you ask for it, the sooner you are protected under the Americans With Disabilities Act (ADA) and similar laws. Without the law's protection, you may be fired if you're not doing your job up-to-par.
  • If the employer offers a choice of benefits, which do you choose?

While thinking about these questions, it is advisable to also start the following:

  • Look for clues about what makes people successful in the new company
  • Set up an expectation of how you will perform in the job over the long haul. For instance, don't start working 80 hours a week in the new job if that is not what you are going to do over the long term. Expectations are developed in the first few months. Do a great job, but in a way that worksk for you. If your health history has changed your perspective about how much personal time you want to have compared to work time, now is the time to start putting the new view into practice.
  • Start looking for an advisor   - someone you can trust, with enough experience in the company to help guide you through the corporate culture, and in case your health starts to affect your work..
  • Start keeping track of information which would be useful if you ever have a claim for discrimination, or if you want to stop working, because of your health. This includes positive comments as well as negative ones. The sooner you get into the habit of keeping track.

Read every document you are asked to sign carefully.

  • It is easy to unknowingly sign away rights.
  • Make note if the document requires arbitration in case of a dispute instead of allowing you to sue in the courts.

It is recommended that you make an alert on your calendar to read At Work as soon as you are settled in to the new job. It provides information to make working less stressful and more productive. 

For more information, see:

Choosing Benefits From A New Employer

Benefits can be a major reason to join or remain in the workforce. It is likely that qualify for most of the benefits employers offer despite your health history.

The general guideline in deciding which benefits to take as a new employee with a health history is to "take as much as you can get."

  • You can always drop a benefit. 
  • Because of your health history, it may be more difficult to sign up later or to increase amounts of a benefit. There are usually "Open Enrollment" periods during which you can make changes without health questions or an exam. However, they may not cover all benefits or increases in coverage.

When you review benefits,check: each of the following:

  • The definition of the benefit. For example, if it is salary continuation, how much salary will be paid and for how long?
  • Does the list of eligible employees include you?
    • Does the list include your type of job? Larger employers in particular may provide different benefits for different classifications of employees. For example, employees who work on the factory floor versus executives.
    • Does the employer distinguish between part time and full time employees?
      • Most employers only offer benefits to employees they consider to be full-time employees. The definition of "full-time" varies from employer to employer. As a general matter, employees who work thirty (30) hours or more per week are full-time.
      • A minority of employers offer benefits to part-time employees. If part-time employees are eligible for benefits, the benefits are generally less than those offered to full-time employees.
  • Is there a probation period before are eligible for the benefit? The probation period is the period of time between the date of hire and the date benefits become effective. For example, an employer offers health insurance to new employees, but not until 30, 60 or 90 days after the employee starts work. The 30, 60 or 90 day period is the "probation period." A probation period gives you time to examine the employer's benefits and decide which ones you want to enroll in.
    • If there is a probation period, how long it is?
    • If there is a probation period, you will have to look elsewhere for health insuranceFor example, if you have continued health coverage under COBRA from your previous employer, you need to continue it until the new coverage starts at the end of the probation period.
    • A probation period doesn't count with respect to HIPAA, the federal law which limits an employer's right to impose a new pre-existing condition exclusion in a health insurance policy in certain circumstances. The date of hire becomes the enrollment date for purposes of determining whether you have been without creditable health insurance for more than 63 days. This becomes important if you are considering letting your previous health insurance lapse until the new employer's coverage starts -- which we do not recommend. (If money is an issue, see How To Deal With A Financial Crunch). If you nonetheless want to let your previous coverage lapse and are relying on HIPAA to eliminate a new pre-existing condition exclusion, contact the new employer's insurer to confirm that their practice is to consider the date of hire the important date with respect to a pre-existing condition exclusion -- not the end of the probation period.
  • Is there a period during which pre-existing health conditions are excluded? If so, does your condition count as one of those which are excluded? For example, some pre-existing condition provisions provide that a condition is pre-existing if a reasonable person would have seen a doctor for the condition in the past 6 months. If there was no reason to see the doctor, your condition may not be considered to be "pre-existing."
  • Who pays for what?
    • There is no legal requirement that employers provide benefits or, if they do, the portion the employer pays, if any.
    • Most employers pay at least a portion or many employee benefits. The amount paid by the employer depends on many factors, including management philosophy, insurance company requirements, union contracts, geographical location, type of industry, and size of the pool of potential workers in your geographic area. The question remaining for you is how much you will be expected to pay for each benefit, if anything.

If there is a question concerning whether the employer's health plan legally can exclude coverage for your pre-existing health condition, and if so, for how long, read: HIPAA

For a list of benefits offered by employers, and guidelines concerning their value to a person with a history of a serious health condition, click here

What Can An Employer Do When It Learns About Your Health Condition?

The fact that you have or had a life changing health condition may not be used to withdraw a job offer if you are able to perform the fundamental duties ("essential functions") of a job, with or without reasonable accommodation, and without posing a direct threat to safety. (A "direct threat" is a significant risk of substantial harm to the individual or others in the workplace that cannot be reduced or eliminated through reasonable accommodation.)

Therefore, the employer can evaluate your present ability to perform the job rather than make unfounded assumptions. To do this, an employer may ask medically related follow-up questions about your health condition, such as whether you are undergoing treatment or experiencing any side effects that could interfere with the ability to do the job or that might require a reasonable accommodation.

Example: Sarah is asked to complete a medical history questionnaire and have a medical examination after receiving an offer of a security guard position.  In the section of the questionnaire asking about various current and/or past medical conditions, Sarah indicated that she was diagnosed with very early-stage colon cancer six years ago.  When the doctor conducting the medical exam asked follow-up questions about the possibility of recurrence, Sarah explained that she did not require any further treatment after the malignant polyp was removed and that her annual colonoscopies for the past five years have shown no evidence of disease.  Because she is able to perform the duties of a security officer without posing a direct threat, the employer may not withdraw Sarah's job offer.  

Employment Agreement Arbitration Clauses

Some employers require that employees sign an agreement stating that any workplace disagreements will be settled in arbitration instead of the courts. It's your choice whether to sign such an agreement.

Arbitration is an informal dispute resolution process in which an independent person or people hear arguments about a dispute, look at evidence, and make a ruling. Arbitration decisions can usually be enforced in court.

From the employee's point of view, the advantage to arbitration is that the informal process may be quicker and less expensive than going to court. The key word here is: "May".

On the other hand:

  • People who start an action in arbitration have less access to evidence in the employer's control.
  • Arbitration is less likely to include an award of punitive damages. Punitive damages are damages over and above actual damages. In this case, punit ive damages are meant to keep an employer from doing wrong again.
  • Arbitration keeps the situation away from the public view. If your position is just, public opinion can help pressure an employer to settle.

Be aware that even if you sign an agreement to arbitrate, if you feel you have been discriminated against in the work place in violation of the Americans With Disabilities Act (ADA) and similar laws, you can also file a complaint with the EEOC or other appropriate agency. That agency will try to work out the problem informally with your employer. If no agreement is reached, the agency can sue the employer because it was not a party to the arbitration agreement. (To learn how to enforce rights under the ADA, click here.)

Getting An Accommodation If You Need One To Help You Do Your Job

As long as you're able to perform the essential functions of your job, you are probably entitled to an accommodation if you need one because of your health condition or a treatment. What accommodation you'll receive is a matter of negotiation with your employer. 

Even if you're not entitled to an accommodation, use the same negotiation techniques to get an accommodation. Without an accommodation, you stand a chance of being fired for not performing your job well enough.

Now is the time to ask for the accommodation you need.

In order to get an accommodation, you must:

  • Tell your employer about your health condition, at least as a general matter and
  • Request the accommodation

To learn more about accommodations, including what to ask for, how to take to prepare for the negotiation, and how to negotiate for it, click here.

Start Looking For An Advisor Who Can Help With Advice

It will be helpful to have an advisor at work to help make decisions and to help mentor you in the work place. To learn what to look for in an advisor, click here.

To Learn More

More Information

Advisor

Start Keeping Track Of Facts That Will Be Difficult To Remember Or Prove Later

You're just starting to work for a new employer. Likely the last thing on your mind is the possibility that you may be discriminated against some time in the future, or that you may want to stop work and be considered to be "disabled"  because of your health condition or treatment.

However, now is the time to think about of these matters -- at least to the extent of starting to keep notes.

Keep notes about the positive things that happen to you at work, and those that could be considered to be discriminatory in a Work Journal.  Keep notes of how your health condition or treatment affects your ability to do your work in a Health Diary. The few minutes it takes you to make the notes can prove to be very valuable. Making the notes will also help keep you in control. 

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Work Journal