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Working During Cancer Treatment

Will I be able to work while I’m getting treatment?

Whether you can work during cancer treatment depends on:

  • The type of treatment you are getting
  • The stage of your cancer
  • Your overall health
  • The kind of work you do

What you can do and whether you will need to limit how much you do will depend on how you feel during treatment. Some people with cancer can still go to work and do their usual everyday tasks while they get treatment. Others find that they need more rest or just feel too sick to do much. Your doctor may also want you to limit some of your activities.

Still, many people are able to keep working while they’re getting cancer treatment. Some people work their usual full-time schedules. Some work the same schedules with special conditions, like being closer to the office bathroom so it’s easier to deal with side effects. Others need a less demanding schedule, like taking extra days off or even working part time for a while.

The willingness and ability of your workplace to accommodate any special needs you might have will affect your success at working during treatment. Talk with your employer about what you might need at this time. Under federal and state laws, some employers may be required to let you work a flexible schedule to meet your treatment needs. See our documents called the Americans With Disabilities Act and the Family and Medical Leave Act to learn more. You can get them by calling us at 1-800-227-2345, or read them online at www.cancer.org.

Telling co-workers

How open you are with your co-workers about your cancer is a personal decision. In some workplaces, it may not benefit you to share details. For instance, it may not be a good idea to share everything with your colleagues if you work in a highly competitive and fast-paced work environment. You might want to decide who you know best and who will most likely understand your situation, then confide only in those few people. They might be able to help you develop the best plan for telling others and give you ideas on how to deal with work. Try not to feel pressured to share or explain things. Only you can decide what works best for you and your situation.

Some of your co-workers will react to your cancer diagnosis and absences with understanding and offers to help. Others may feel uncomfortable around you. Some people may be reminded of a loved one’s time with cancer. Many find cancer an unpleasant reminder of their own mortality. Some co-workers may resent that they had to take on extra duties on your treatment days. Others may ask intrusive questions about your health and treatment, or they might avoid you. Those you work with may react awkwardly out of a vague fear or uneasiness, thinking of cancer as some kind of lurking danger. For more on dealing with these people, you may want to read our document, Talking With Friends and Relatives About Your Cancer. It also helps to think ahead about how you will handle other people’s reactions, and have a plan for what and how much you want to share.

Tips for working while you are getting treatment

It’s important to figure out how you will continue to work while you are being treated for cancer. These tips might help you better manage your time and work:

  • Plan chemo treatments late in the day or right before the weekend to allow time to recover.
  • Explore options like working from home some days. This might help you feel less tired and allow you to take care of yourself more easily if you have problems.
  • Getting help at home can mean more energy for work. Certain daily chores may be divided among friends and family members.
  • Unless there is a reason not to, let co-workers know about your situation. They can be great sources of support. They may even be able to help you come up with ways to better manage your work during this time.
  • Keep your supervisor up to date on how well your schedule or other changes are working for you.
  • Make a log of your usual work schedule and duties. Refer to it when you set up flex-time, shifted duties, or time off.
  • Make a detailed list of job duties so you can direct others in handling things when you’re out of the office.

Legal protections

You have the same rights as anyone else in the workplace and should be given equal opportunities, regardless of whether you tell people at work about your cancer. Hiring, promotion, and how you are treated in the workplace should depend entirely on your abilities and qualifications. As long as you are able to fulfill your job duties, you can’t legally be fired for being sick. You also shouldn’t have to accept a position you never would have considered before your illness. Many people with job problems related to cancer are protected by federal laws like the Rehabilitation Act and the Americans with Disabilities Act (ADA).

Some people also benefit from the Family and Medical Leave Act (FMLA). This law lets many people with serious illnesses take unpaid leave to get medical care or manage their symptoms. The leave can take many forms, such as a part-time schedule for a limited time, or taking off 1 or 2 days a week for a while. Not all employers are required to follow FMLA. Talk to someone in your human resources department or another workplace expert to find out what your options are.

Reasonable accommodations at work

Employers are not required to lower standards in order to accommodate an employee, nor must they provide personal-use items like glasses or hearing aids. But an employer must accommodate a qualified applicant or employee with a disability unless the employer can show doing so would be an undue hardship. Examples of reasonable accommodations include, but are not limited to:

  • Providing or modifying equipment or devices
  • Restructuring a job
  • Offering part-time or modified work schedules
  • Reassigning an employee to a vacant position
  • Adjusting or modifying tests, training materials, or policies
  • Providing readers and/or interpreters
  • Making the workplace readily accessible to and usable by people with disabilities

A vocational rehabilitation counselor can help with some of your job-related legal questions, but you may also want to look into laws that affect you and how you deal with any problems that may come up. Some cancer treatment centers offer referrals to vocational rehab counselors, so ask your cancer team’s doctor, nurse, or social worker.

To find out more about job accommodations and employment of people with limitations, contact the Job Accommodation Network at 1-800-526-7234 or visit their website, http://askjan.org. They can talk with you about the requirements of the ADA or the Rehabilitation Act, if either one applies to you.

Worries about discrimination

Even though the public’s understanding of cancer is getting better, sometimes prejudices and fears are found in the workplace. Even after your cancer treatment has ended, you may face work and workplace discrimination issues. If your workplace has a union, its officials can be good sources of information about illnesses and the workplace.

Keep notes and records of your contacts with office personnel, including the names of the people you spoke to about your illness, the date and place you spoke, and the information you received. It’s also a good idea to keep copies of your job performance evaluations and any other written information about your work. These can be very helpful if problems come up later.

If you want to file a discrimination complaint

If you think you have been discriminated against at work on the basis of disability, you can file a complaint with the United States Equal Employment Opportunity Commission (EEOC). You must do this within 180 days of the time you think the discrimination occurred (although some states or local laws allow you to take up to 300 days).

For more specific information about ADA requirements affecting employment, contact the EEOC at 1-800-669-4000 or 1-800-669-6820 (TTY). For general ADA information, answers to specific questions, free ADA materials, or information about filing a complaint, call the ADA Technical Assistance line at 1-800-514-0301 or 1-800-514-0383 (TTY).

Get more help and information

If you would like to read more about working during cancer treatment, get our document Americans With Disabilities Act: Information for People With Cancer by calling our toll-free number, or read it on our website. If you need extra time off during treatment, you may also want to ask for our document Family and Medical Leave Act (FMLA). These documents explain more about federal laws that can help many people with medical problems.

Along with the federal laws, some states also have laws about employing people with various illnesses, including cancer. These state laws might help you in other ways. You can find out more from your state’s Department of Labor. Contact information can be found in the blue pages of your local phone book, or visit the US Department of Labor website (www.dol.gov/whd/contacts/state_of.htm) to find your state office.

What if you can’t keep working during treatment?

Sometimes, even with good planning and extra time off, you find it’s just too much to keep working during cancer treatment. If cancer treatment starts causing too many problems for you at work, talk to your supervisor. Explain that you want to keep working, but you need to take some time away from work.

Talk to someone from your human resources department to find out if you have short-term or long-term disability insurance at your job. If you do, get applications for both – just in case. In general, short-term disability pays you some portion of your income for the first few months you are unable to work. If you must be out longer, some employers also carry long-term disability insurance, which usually starts after 6 months of disability. You must meet the insurance company’s definition of disability to get this income.

Talk with your doctor about how your treatment and symptoms are affecting your work to decide whether or when you should think about taking time off. Your doctor will need to help you by filling out part of the disability application.

Keep in mind that it can hurt you to put off going on short-term disability. Some people have had to go to great lengths to prove that they can’t do their job after they’ve spent weeks forcing themselves to go to work when they could barely get out of bed. Don’t wait until your work performance suffers before you decide to take time away from work. If you are fired for doing a poor job, you can lose your health insurance as well as your income. And if you’re fired, you cannot collect disability benefits. If you need time off from work to focus on getting well, take it.

Protecting your rights

David S. Landay wrote Be Prepared – The Complete Financial, Legal, and Practical Guide to Living with Cancer, HIV, and other Life-Challenging Conditions and founded Survivorship A to Z. He says that, although you may be protected at work by law, it’s also important for you to find out how your work place treats people living with cancer. Find a trustworthy mentor, someone who knows the company culture or who has had cancer, to help you set up a practical plan. Think carefully before you tell – once the information is out, it can’t be taken back.

For example, you might decide to wait before telling anyone about your illness if you are expecting a raise in the near future. If do you share your diagnosis and then find that you get less of a raise, it’s hard to prove the amount of a raise or bonus you would have gotten, were it not for your diagnosis.

If you do decide to talk about your cancer, have a face-to-face meeting with your supervisor and express a strong desire to keep working. Give details about your treatment and the work hours it may require. Keep in mind that your situation might change and the details can’t be predicted with certainty. Still, if you tell supervisors and co-workers about these details, you can work together to set realistic expectations. But keep in mind that what you tell your boss is protected information – what you tell your co-workers is not.

Landay also suggests keeping a daily log. Write in it actual work events that demonstrate how well you can do your job and the good things people say about your work. Include how your condition or treatment affects your job. This will help you in case you need an accommodation or need to take time off work. An accommodation is a special action your company takes so you can keep working. Examples may include changing your work schedule or supplying special equipment. See our document Americans With Disabilities Act for more on this.

If you believe you have been discriminated against, you should first learn as much as possible about the company’s attitude, track record, and grievance procedures. (Grievance procedures are formal ways to tell your company about concerns and seek positive solutions). This is important because it might help avoid a situation that could drain you both financially and physically.

Landay also suggests contacting a lawyer who is an expert in the field to advise you of deadlines and procedures for taking legal action in case you have to do so. It helps if you know something about the legal process before taking action. You should learn about state and federal laws, especially the Family and Medical Leave Act and the Americans with Disabilities Act, which may provide certain legal protections. Sometimes you can’t work out a solution with your employer, and a lawsuit may be the next step. Be sure you get information on time limits for filing suits, and understand the potential costs and possible outcomes.

To learn more

The following information may also be helpful to you. These free materials may be ordered from our toll-free number, 1-800-227-2345, or read on our website, www.cancer.org.

Employment

Americans With Disabilities Act: Information for People Facing Cancer (also in Spanish)

Family and Medical Leave Act (FMLA) (also in Spanish)

Returning to Work After Cancer Treatment

Health insurance and financial issues

In Treatment: Financial Guidance for Cancer Survivors and Their Families (also in Spanish

Health Insurance and Financial Assistance for the Cancer Patient (also in Spanish)

What is COBRA? (also in Spanish)

What is HIPAA? (also in Spanish)

Coping with cancer

Coping With Cancer in Everyday Life (also in Spanish)

Talking With Friends and Relatives About Your Cancer (also in Spanish)

Helping Children When a Family Member Has Cancer: Dealing With Treatment

National organizations and websites*

Along with the American Cancer Society, other sources of information and support include:

Job Accommodation Network
Toll-free number: 1-800-526-7234
TTY: 1-877-781-9403
Website: http://askjan.org

    This free service from the US Department of Labor, Office of Disability Employment Policy has information about job accommodations for people with limitations, accommodation ideas, and tips on how to approach employers and ask for accommodations

Americans with Disabilities Act (ADA) Technical Assistance
Toll-free number: 1-800-514-0301
TTY: 1-800-514-0383
Website: www.ada.gov

    For general information about the ADA, answers to specific questions, free ADA materials, or information about filing a complaint

Cancer Legal Resource Center (CLRC)
Toll-free number: 1-866-843-2572
TTY: 213-736-8310
Website: www.cancerlegalresourcecenter.org

    Offers free, confidential information and resources on cancer-related legal issues to cancer survivors, their families, friends, employers, and others coping with cancer

US Equal Employment Opportunity Commission (EEOC)
Toll-free number: 1-800-669-4000
TTY: 1-800-669-6820
Website: www.eeoc.gov

    Offers information on your rights and the laws that apply to your state, including filing charges for discrimination. Also has special information for people with cancer: “Questions and Answers About Cancer in the Workplace and the Americans with Disabilities Act (ADA),”which can be found on the EEOC website at www.eeoc.gov/laws/types/cancer.cfm

Cancer and Careers
Website: www.cancerandcareers.org

    For information on dealing with the potential impact cancer may have on your career, creating an action plan, sharing your diagnosis with employers and co-workers, legal issues, and insurance issues

Survivorship A to Z, Inc.
Website: www.survivorshipatoz.org/cancer

    Has financial, legal, and practical information on dealing with employers and co-workers for people facing a cancer diagnosis

References

Landay, DS. Be Prepared: The Complete Financial, Legal, and Practical Guide to Living with Cancer, HIV, and other Life-Challenging Conditions. 1998. New York, St. Martin’s Press.

Survivorship A to Z. What Is The Right Time To Go On Disability? Accessed at www.survivorshipatoz.org/cancer/topics/work-preparing-for-disability-short-term/?sid=567 on April 2, 2014.

US Department of Labor. Employment Laws: Disability & Discrimination. Accessed at www.dol.gov/odep/pubs/fact/laws.htm on March 21, 2014.

US Department of Labor, Office of Federal Contract Compliance Programs. Fact Sheet: Final Rule on Section 503 of the Rehabilitation Act of 1973 (2013). Accessed at www.dol.gov/ofccp/regs/compliance/factsheets/Sec_503_508c.pdf on March 24, 2014.

US Equal Employment Opportunity Commission. Disability Discrimination. Accessed at www.eeoc.gov/laws/types/disability.cfm on March 24, 2014.

US Equal Employment Opportunity Commission. Questions and Answers About Cancer in the Workplace and the Americans with Disabilities Act (ADA). Accessed at www.eeoc.gov/laws/types/cancer.cfm on March 21, 2014.

US Equal Employment Opportunity Commission. Filing a Charge. Accessed at www.eeoc.gov/facts/howtofil.html on March 21, 2014.


Last Medical Review: 04/01/2014
Last Revised: 04/14/2014