Most people don’t have the luxury of letting work slip, even when serious illness strikes. Everyday bills keep coming and new health care expenses pile up. For many, the workplace is the main source of health insurance and provides social support that can help through stressful times.
When Rick Daniel suffered an acute brain hemorrhage in December 2005, wheels were turning in his Dallas workplace even as he lay in a coma. Coworkers donated vacation leave to the 49-year-old applications engineer, the human resources director helped his wife fill out disability papers and supervisors reassigned his workload.
As he recovered, Daniel felt no corporate pressure to return to work, but he acknowledges that his situation is atypical: “Your mileage may vary for sure.”
For Christine Cook, 26, a music teacher in Calvert County, MD, illness came on less suddenly. In January 2006, she learned that she had Crohn’s disease, a chronic and debilitating digestive condition. She wasn’t sure how much to reveal at work or if she could function during exacerbations.
As a young, untenured teacher with little sick leave built up, Cook was anxious to protect her livelihood.
Could you lose your job if you became ill? Much of the research in this area focuses on women with breast cancer. Two large studies found that about 80 percent to 90 percent of breast cancer survivors keep their jobs and most of those who leave say it was their choice.
However, reality could be harsher for people with blue-collar or nonprofessional jobs, noted psychologist Leslie Schover of the University of Texas M. D. Anderson Cancer Center, in a 2004 editorial.
Jackie Lynn Jeter is president of the Amalgamated Transit Union, Local 689, which represents workers for the Washington Metropolitan Area Transit Authority.
“In some ways, we are blessed with good benefits,” Jeter says, “but when it comes to getting sick people back to work, this employer tends to put obstacles in their way. They’re hardnosed when it comes to blatantly disqualifying workers,” preventing some from returning to work.
If illness or injury prevents someone from working, they have three years to find another position within the Metro transit authority, Jeter says. But a worker might find that there’s no replacement job waiting.
“Usually it’s a less-skilled job; if you’re a custodian, it’s hard to find something else you could do. Chances are slim,” Jeter says. “A station manager might have to go down to custodian. Say you’re a mechanic with some skills, you could enter a retraining program.”
In certain cases, if “a person is disqualified and their illness or injury should not really disqualify them, we will step in and take it to arbitration and see if the Authority overstepped its bounds,” Jeter says.
Know Your Rights…and Responsibilities
“You can still seek out your benefits, even if you don’t say what the illness is,” says Theresa (Terry) Perry, the managing principal with Pink Slip, a San Francisco-based benefits and retirement consultancy.
“There may be a lot of information online, if the company has an intranet,” she adds. “Also, pull out that enrollment booklet that you never read when you were hired.” Also, she says, “insurance vendors can tell you about add-on benefits” such as coverage for disease management and pharmacy costs.
At the WMATA, if somebody develops a serious illness, “their first recourse is to call their division or station location,” Jeter says. “We — the union — advise people to tell supervisors their symptoms if they’re not comfortable giving their illness. Once you call in sick, bring in your first doctor’s certificate and take it straight to WMATA to medical unit.”
Bypassing paperwork is not an option, Jeter says.
Workers “could lose their job if they don’t have medical coverage — a doctor’s note from the time they went out to the day they return to work, or if they don’t come back when a doctor releases them from care.”
Asked about reduced duty, for instance for a transit worker on chemotherapy, Jeter says, “No, we don’t have light duty; it’s one of the things we’re lacking.”
Larry Kessler, Sc.D., is the director of the Office of Science and Engineering Laboratories in the Center for Devices and Radiologic Health of the Food and Drug Administration.
Being too closemouthed could put your job in jeopardy, Kessler says: “Recognize that if you are ill and nobody knows (and your work is slacking) people will want to know why the boss is not disciplining or firing you.”
“At first, I didn’t want people to know, other than my music department colleagues,” Cook recalls. But her students knew something was wrong.
“I lost 30 pounds because I had no appetite,” Cook said. “I told the kids that I didn’t lose the weight because of some crazy diet, but because of my diagnosis. Later, some parents came back and thanked me for doing that.”
She told the principals at both of her schools, and keeps them posted. “I’ve had conversations where I’ll say, ‘We haven’t found a happy balance of drugs. As we’re trying to find that balance, I can’t always get appointments at 4 p.m., after the school day.’
Kessler is sympathetic to the plights of sick workers, but productivity is still the top priority. “[As the boss] you’re still responsible for getting it done,” Kessler says.
Sometimes the supervisor gets sick. “If you have a team under you, say that you’re going to need some help,” Perry says. “It’s time to delegate.”
The Long-Term Picture
Nearly three years after her diagnosis, Christine Cook reports that her condition is relatively stable and administration remains supportive. Her middle school principal periodically asks, “How are you feeling? Are you OK? Is there anything we can do for you?”
The outlook isn’t always so optimistic.
Theresa Perry recalls the case of a terminally ill person with a degenerative bone disease. As the illness progressed, the employer “continued to let that person work at home, in the hospital, over the telephone. The person would just call in and that would count as time worked.” Perry says.
“Typing was a huge part of that role. The company did a creative ADA-type of implementation with voice-recognition software.”
Because the organization was large, it could make every effort to allow this person to keep working, Perry says. “It’s expensive, but the respect it demonstrates boosts morale of all the workers; they feel the company cares.”
But people who’ve lived through the experience warn that employers’ patience with illness often changes over time. Some will bend over backwards initially, but eventually, they have to get the work done and if you can’t do it, you might have to leave.
“It’s extremely important to protect your job and income,” Perry says. “If it’s overwhelming for you, pull in a friend, a trusted person” to help gather information and be your advocate.
By Lisa Esposito
Health Behavior News Service
