Having a breast cancer diagnosis is hard enough without worrying about job security. With supportive employers, many women continue to work during cancer treatments like chemotherapy. But other women, often in low-paying positions or small organizations, are more vulnerable. And no matter what your career, cancer-related fatigue, nausea and medical appointments mean you’ll likely have to negotiate for time off and extra breaks throughout your treatment and recovery. If you’re among the 12 percent of U.S. women who develops breast cancer at some point in her life, experts provide insight about disclosing your illness, workplace protections and available resources if job loss looms.
[See: Which Medical Screenings Should You Have in 2017?]
Take a breath and reassess. Looking back, Molly MacDonald, would have handled her cancer disclosure differently. In 2005, between jobs and ready to join a start-up company as a principal in a sales capacity, MacDonald used the interim period to get routine dental and medical checkups out of the way. “And then the mammogram came back suspicious,” she says. When her biopsy confirmed that she had breast cancer, she informed her would-be colleagues of her diagnosis. MacDonald volunteered that this might not be the best time to move forward with their arrangement and the company agreed. “In retrospect, I probably could have done the work,” she says. And because MacDonald was no longer covered by employee health insurance, she suffered massive financial setbacks.
Think twice before sharing your diagnosis. You needn’t disclose the medical condition behind a leave request, MacDonald says: “It would be my recommendation that you look at the Family and Medical Leave Act and keep it quiet.” She also advises discretion and strong privacy settings on social media for women diagnosed with cancer. Through a nonprofit she founded, the Pink Fund, which helps breast cancer patients in active treatment with nonmedical expenses — such as making payments for housing, transportation, utilities and insurance — she’s heard from women who suddenly started getting poor performance reviews once they went public. It’s natural to reach out online with questions about breast reconstruction or nipple tattoos, she says, but cautions, “Employers have a right to look at your social media and you could lose your job.”
[See: HIPAA: Protecting Your Health Information.]
Assume you can work unless proven otherwise. In her studies on breast cancer and job status, Dr. Victoria Blinder, a medical oncologist with Memorial Sloan Kettering Cancer Center, has been struck by how much employment means to women, even beyond the financial and insurance issues. “One thing that shouldn’t have surprised me perhaps, but did, was how psychologically important work was for a lot of women and how that cut across different cultures,” Blinder says. Going to their places of work, being able to focus on their jobs instead of their treatment and feeling like they’re still in control for at least part of the day is crucial for many women. “When you’re treating stage 1, 2 or 3 breast cancer, there’s a finite period of treatment,” says Blinder, who is also a health outcomes researcher in epidemiology and biostatistics. “So really, there should be a time after which people should be able to go back to work, if they stopped working. Some people don’t need to stop working at all.”
Get a note from your doctor. Some patients describe ongoing fatigue coupled with a lack of flexibility in scheduling breaks at work. Blinder has written letters to employers requesting patients be granted accommodations like taking more than the usual allotted break time. She recalls a patient suffering from numbness and tingling in her legs, a treatment side effect. The patient was not allowed to sit on a stool for her job as a lab technician. “Because she looked so healthy, employers didn’t believe that she had these symptoms,” Blinder says. For this employee, a note from the doctor did the trick, although it doesn’t help in every case. A cashier or worker in a hair salon or dry-cleaning establishment might face more trouble if she couldn’t keep up.
Negotiate with your boss. In situations where protections may not apply for workers with an illness, such as small businesses or certain service occupations, it can help to be upfront with your employer about possible needs you might have and suggest workarounds (like hiring a temp). Blinder offers a conversational opener: “I would like to keep working and my doctor thinks I’ll be able to, but I don’t know exactly how I’m going to feel after the first treatment. So having some flexibility during the first few weeks will be greatly appreciated.” Arrangements needn’t be set in stone, she says; rather, it’s you and your boss working together so you can still be productive and take care of yourself.
Familiarize yourself with your leave policies and rights. Look into your organization’s basic sick leave, short-term and long-term disability policies, advises Rebecca Royals, an employment attorney with the Butler Royals firm in Richmond, Virginia. And before you’re in a job crisis, get acquainted with your rights under the Americans With Disabilities Act and the Family and Medical Leave Act, she suggests. As the worker, if you qualify for ADA or FMLA, get your ducks in row, such as asking for accommodations as soon as you require them and providing any medical forms your employer needs to comply.
Seek legal help sooner rather than later. “It is much easier to get out in front of such a situation and hopefully prevent issues from snowballing than to try and put the proverbial toothpaste back in the tube,” says Royals, who is among the attorneys who provide pro bono services for Cancer Linc, a nonprofit that helps Richmond-area cancer patients and their families with legal and financial issues unrelated to their medical treatment. A little legal nudge may be motivation enough for employers to find accommodations, after all. “Sometimes it just takes a phone call from an attorney saying, ‘Can you explain to me what’s happening to my client?'” says Denise Kranich, executive director of Cancer Linc.
[See: What Not to Say for a Breast Cancer Patient.]
Take advantage of resources. In a study led by Blinder published in the February issue of Health Affairs, researchers found that of nearly 270 women in New York City diagnosed with early stage breast cancer, low-income women were the least likely to have accommodating employers or retain their jobs in the four months after completing treatment. Racial and ethnic disparities emerged as well. Kranich recommends that vulnerable workers check locally for organizations similar to Cancer Linc or the New York Legal Assistance Group, or turn to their Legal Aid Society or the National Cancer Legal Services Network.
Be prepared. In light of the possibility of a cancer diagnosis or recurrence, MacDonald emphasizes the importance of being proactive and planning ahead. If you have access to a disability policy with your company, for instance, she strongly recommends that you take it.
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When Breast Cancer Threatens Your Job originally appeared on usnews.com
