Employment Concerns During and After Treatment
Many people coping with cancer also work. You need to think about how and what to tell your employer. You may be concerned about how your diagnosis and treatment will impact your ability to work.
If you are currently employed and thinking about taking off time from work
Do I need to tell my employer I have cancer?
You do not have to tell your employer you have cancer. You can simply tell them you are being treated for a “serious medical condition.” However, your healthcare provider will need to attest to your health condition. Be sure to tell your provider if you DO NOT want your employer to know you have cancer. They can use “serious medical condition” to describe your diagnosis. You may want to have your FMLA paperwork completed by your primary care provider or social worker, rather than your oncologist, as your provider does need to disclose their area of practice.
Do you have sick time?
Sick time is usually the first place to start when thinking about taking time off from work. However, many employers have special rules about how much time you can accrue and use. If you don’t have time saved, does your employer allow other employees to donate their sick time to you?
What are your other options for taking leave/time off from work?
Under the Family and Medical Leave Act (FMLA), employers with 50 or more employees and all public employers must offer FMLA. FMLA protects your job for up to 12 weeks of time away from work. Employees who have worked at least 12 hours and 1250 hours within the previous year are eligible. Smaller employers may also have leave policies, so it never hurts to ask human resources what options may be available.
What are your disability pay options?
Every employer differs in their offering of short and/or long-term disability options. Contact your human resources department for assistance with disability options and applications. Disability benefits provide some income while you are unable to work. If your condition will result in you being out of work for a least 1 year, you may be eligible for Social Security Disability.
How will you maintain your health insurance coverage?
Maintaining your health insurance coverage during your cancer treatment is essential. If you are taking FMLA leave, your employer is required to maintain your group health benefits while you are on leave. However, you must continue to pay any normal contributions you make toward the cost of your health insurance premiums while you are on leave, whether this leave is paid or unpaid. If you don’t return to work at the end of your FMLA period, your employer can make you repay their share of the insurance premium payment.
If you have exhausted FMLA and leave your job, you may be eligible for COBRA coverage. COBRA may allow you to keep your health insurance for 18-36 months, depending on the reason you lost your employment. However, you will have to pay for the entire cost of your health insurance coverage, which can be expensive, especially if you have lost your job (and income).
Other options for health insurance include:
- Applying for a plan through the Healthcare.gov marketplace (“Obamacare”).
- Applying for Medicaid if your income makes you eligible.
- If you have breast or cervical cancer you may be eligible for coverage through your state’s breast and cervical cancer program.
Your social worker, financial navigator, or advocate can assist you with figuring out if you are eligible and help you apply for these programs
Can social media impact my current or future work?
It can! Before you start a blog about your cancer experience, start posting on Facebook, or think about a crowdfunding campaign, remember your current or future employers can (and do!) search the Internet. They may come across information about you, your cancer diagnosis, treatment, and other personal information.
If you are Currently Employed and Thinking about Working Through Cancer Treatment
Do you have sick time you can use for intermittent appointments and/or days when you aren’t feeling your best?
It's important to review how much sick time you have, as well as rules your employer has for call-outs and the use of sick time.
Can I take intermittent leave under FMLA?
Yes. One of the great things about leave under FMLA is that you don’t have to take the 12 weeks all at once. Maybe you need chemo once a week, and you know you don’t feel well for the first three days after treatment. You could arrange to have your treatment on Fridays. You would then take Friday and Monday as FMLA time and also use your weekends for recovery. You have used two days from your 60 days FMLA bank. This really can help to stretch your leave time and accommodate your desire to work through treatment.
I’m worried about being able to perform the functions of my job now that I have cancer. What are my options?
You can request your employer provides you with a “reasonable accommodation” to complete your work-related tasks. Reasonable accommodations are part of the Americans with Disabilities Act (ADA) and can include anything from requesting a stool to sit on, to adaptive office equipment, to telecommunications. The key phrase is “reasonable.”
If you are Currently Not Working and Thinking about Getting Back into the Workforce After Cancer Treatment
- Under the Americans with Disability Act (ADA), a potential employer cannot ask about your health status as part of a job application.
- Your potential employer also cannot ask if you have a disability.
- Your potential employer can ask if you can perform “the essential functions” of a job with or without a reasonable accommodation.
- A potential employer can make a job offer conditional based on a medical examination IF this is required of every applicant.
- Prepare your “elevator speech” for when you are asked about gaps in your resume. For example: “I had some personal issues that needed to be addressed and forced me to leave my job. Those issues have resolved and I am ready to come back to work.” It’s an honest answer that is also purposefully vague.
- Perform a “digital inventory” by Googling yourself. If you shared about your cancer experience via social media, that information is now in the public domain. Be prepared to answer questions about all information on the Web that a potential employer could also access through a quick google search.
Resources for More Information
Cancer and Careers
The go-to for all things about working with and after cancer.
Provides education, support, and training for workplace-related concerns from taking time from work, maintaining insurance, accounting for resume gaps, and social media usage.
Donovan, S. A. (2020). Paid family and medical leave in the United States. Congressional Research Service.