Chronic Illness and Employment

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Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

Do you or does someone you know suffer from a chronic illness that threatens their ability to continue to go to work? Do you know your rights under these circumstances, including the definition of a “chronic illness” or “disability?” These questions and issues provoke lots of anxiety and worry for these workers and their friends and family. The following is a review of this important issue.

On Saturday, June 20 2009, The New York Times printed an important article on the problem of employees coping with a chronic illness and attempting to protect their job. In this time of high unemployment, the issue is of particular importance and a source of great anxiety for those in the situation. What is striking about suffering from an illness while trying to keep a job is that the United States is the only wealthy nation that does not guarantee workers paid time off for illnesses. In fact, other nations not only provide paid sick days but time off for cancer and other treatments.


Nevertheless, there are Federal laws in the United States that do provide some protection for workers who are ill.

According to Chris Kuczynski, director of the division of the Federal Government that deals with the disability act at the Federal Equal Opportunity Commission, a disability is defined as a “physical or mental impairment that substantially limits one or more life activities. Chronic illnesses such as major depression, multiple sclerosis, diabetes, lupus and others are examples of the types of sickness that can suddenly flare up and interfere with the ability to work, from time to time. The law becomes vague in these circumstances. U.S. employers provide limited paid sick leave for minor ailments such as the flu or outpatient surgeries. After that, many companies may provide time off for treatment but with a loss of pay for the days away from work.

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Two laws provide some protection for American workers and they are: 1. The Family and Medical Leave Act. This law allows employees to take off up to 12 weeks for medical or family emergencies but without pay; 2. the American With Disabilities Act that requires employers  to make “reasonable adjustments” for disabled, often in the form of additional time off.

If and when an illness becomes so acute that it is no longer possible for a person to work, it is possible to apply for Social Security Disability Insurance. The application process is long and frustrating but, once approved, the individual is paid an amount that is based on their life time earnings to that point. Once approved for SSD, the person may qualify for Medicaid or Medicare Health Insurance. It is necessary for each individual to check with Social Security about the amount they are likely to receive and whether they qualify for Medicare and Medicaid.

According to the Times article, there are some actions that are recommended for anyone in the situation of having a chronic illness:

1. Inform your employer because a chronic illness is likely to affect not only attendance but, possibly behavior in the office. That is why it is important to speak to a supervisor or boss and enlist their help and support. If a problem develops then it is important to go to the Human Resources department of your company and discuss the problem. You do have rights under the law.

2. Under the law, if your illness qualifies as a disability, the company is required to make certain adjustments to the work environment to help you continue to function. Of course, the adjustments must be reasonable in nature. For example, a parking space closer to the entrance to the building is reasonable. The employer is not required to provide accommodations if it means huge expense. A good idea is to contact the Job Accommodation Network at: 800-526-7234 to learn about what adjustments you may be entitled to.

It is often worth exploring with your employer such things as part-time work, a shift to another department where the work may be less demanding and today, in the world of computers, your employer may be able to provide a computer so that you can complete your work at home.

3. Learn and understand the “time off” policies of your company and also review the law as to what you are or are not entitled to in this regard. Many companies have short term time off policies and some may even have longer term policies. In some cases it is permissible to use vacation time when sick leave is depleted and it may be possible to borrow sick days from the coming year.

4. Many, if not all the chronic illness categories, have advocacy organizations that provide advice and assistance. For example, if you have cancer, call the American Cancer Society at: 800-227-2345. There, you will find many departments designed to provide for your needs including dealing with health insurance or the lack thereof. A search of the Internet under your particular illness will give you the names of the organizations and their phone number. You can also call 411, information, and ask for the name and phone number of the type of organization you are looking for.

Please remember that psychiatric illnesses can and do fall under the heading of chronic illness and even disability, depending on the diagnosis and types of symptoms. It is important that you know your rights, the law and the organizations you can turn to for help.

You can find this New York Times article in the business section, Saturday, June 20, 2009.

Questions and comments are encouraged.

Allan N. Schwartz, PhD

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