House Call: On the Job with Cancer

From OncoLog, November 2006, Vol. 51, No. 11

House Call: On the Job with Cancer

According to the American Cancer Society, approximately 1.4 million people will be diagnosed with cancer in the United States this year. Many of these people will be adults who will have to decide whether they can continue working while undergoing treatment.

Coping with cancer and the side effects—and after-effects—of its treatments can be difficult, and it is not uncommon for people in this situation to worry about losing their jobs. As with other illnesses that limit a person’s ability to do major life activities, cancer may meet the definition of a disability under the Americans with Disabilities Act (ADA).

Cancer as a disability

The ADA is a federal law that prohibits discrimination on the basis of disability in the workforce. The law defines “disability” as a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or being regarded as having such an impairment. Specific conditions and diseases are not defined, but cancer qualifies as a disability if the disease itself or the side effects of treatment substantially affect your ability to perform major life activities, such as caring for yourself, walking, interacting with others, or concentrating. Cancer survivors who experience longterm after-effects of cancer or its treatment, such as severe fatigue, depression, or cognitive functioning problems, may also be considered as having a disability. However, cancer may not be considered a disability unless the effects are permanent or long term.

Talking with your employer

Deciding whether or not to tell your employer you have cancer is a personal decision. However, you can be protected under the ADA only if your employer knows about your disability. Thus, it’s important to let your supervisor know, if you think your cancer or cancer treatment is going to affect your ability to work or your ability to carry out daily activities. The ADA limits your employer’s right to inquire about the specifics of your medical condition, but you may still need to supply documentation from your doctor. Employers can ask about your medical condition if they believe that it will affect your ability to safely do your job or if your condition may affect others in your workplace.

The law does not require your employer to lower job standards to accommodate your disability; you will still be required to perform the essential functions of your position. However, your employer must provide “reasonable accommodations” to help you perform those essential functions.

Reasonable accommodations

The ADA defines “reasonable accommodations” as making the workplace readily accessible to and usable by employees with disabilities. Such accommodations aren’t necessarily expensive or elaborate. For someone with cancer, they might include job restructuring, part-time or modified work schedules, telecommuting arrangements, assistive devices, rest breaks during the day, modifications of policies, and other similar accommodations. As long as it does not present a financial or “unique” hardship for your employer, you can expect them to make accommodations such as those listed above. However, reasonable accommodations do not include providing additional insurance coverage or paying for medical treatments.

Employees undergoing cancer treatments may consider requesting modified work schedules to accommodate their treatment regimens and medical appointments. A modified work schedule or part-time telecommuting arrangement is also a good idea if severe fatigue is one of the side effects of treatment. It’s good to know as much as possible about how your treatment and its side effects may affect you and to research alternatives that may work well for both you and your employer.

Additional resources

There are a number of other options that may be available to employees with serious health problems, such as the Family and Medical Leave Act, long and short-term disability insurance, variable work schedules, and others. Your human resources department may be able to help you with additional information or help you obtain the reasonable accommodations you need. For more information on the Americans with Disabilities Act, call the ADA Information Line at 1-800-514-0301. You can also find more information from the following: Job Accommodations Network, www.jan.wvu.edu; and Cancer Legal Resources Center, (866) 843-2572.

For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.

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