Before You Share Your Cancer Diagnosis at Work

When Marybeth heard the word “cancer” she felt like the floor had fallen out from under her. She had a million questions. So many, in fact, she was too overwhelmed to ask a single one the day she was diagnosed. However, as she absorbed the diagnosis and read the materials her doctor had given her, she began to have non-medical questions.  Such as, what would happen to her job if she needed a lot of time off?  How much of the cost of treatment would be covered by her insurance?

Marybeth debated telling her boss of her diagnosis. She wanted to know her options for taking time off, and if they’d be willing to let her work from home sometimes. However, she was also afraid of how her boss might react. She’d been working at the company for less than a year. And Marybeth was a single mom of a teenage son. She relied on her job to pay the bills and provide medical insurance. She was terrified her employer would cut her hours or even let her go.

Fortunately for Marybeth, people with cancer are protected by the Americans with Disabilities Act (ADA). It is illegal to fire someone because of a cancer diagnosis and employers must provide reasonable accommodations for employees who have cancer. However, even with legal protections in place, it’s important to prepare before telling your employer of your diagnosis.

Know When to Tell Your Employer

Marybeth waited until after she’d met with her oncologist and agreed on a treatment plan before telling her boss.  To her surprise, her boss seemed supportive and offered to work with her on adjusting the work schedule and asked human resources to send Marybeth information on taking FMLA (Family & Medical Leave Act) leave.

However, it’s not enough to know if you’ll have surgery or how many chemotherapy sessions you might need. Before talking to an employer, you should know how the treatment plan might affect you physically and emotionally. Your doctor can provide insight into how most people respond to treatment. It’s also a good idea to read or listen to patient experiences to get an appreciation for how diagnosis and treatment might affect energy level, ability to concentrate, and ability to handle stress or fight off an infection. The Patient Empowerment Network provides numerous resources to equip cancer patients and their caregivers with that kind of robust perspective.

While there’s no guarantee your experience will be like someone else’s, the more you know about the possibilities, the better prepared you are to talk to your boss. There will still be unknowns and you should explain this to your employer. It’s ok to say, “I don’t know.” Ideally telling your employer about your diagnosis is just the first of several discussions. Consider scheduling ongoing conversations with your supervisor to evaluate your needs and adjust.

Know What to Tell Your Employer

Most people find it helpful to write down what they want to say before their first time sharing information about their cancer. When talking to an employer you should cover:

  • The diagnosis
  • How your treatment may possibly affect your work
  • Ways you and your employer can work together to overcome the challenges of working during treatment, or—if you are taking medical or disability leave—the challenges of returning to work after treatment

The more you know, the better you’ll be at communicating what you expect and what adjustments you and your employer might need to make. You needn’t ask for these accommodations immediately. But it’s worth knowing what kinds of accommodations might be available.

The most obvious accommodation during and after treatment is time off. Cancer patients should consider not just the time off for surgery and medical appointments, but time to deal with fatigue or secondary illnesses. Some cancer patients request extra breaks during the day to rest or take medicine. Other common accommodations are temporary or permanent reassignment to less physically demanding roles, or permission to work from home. The federally funded Job Accommodation Network can provide a wealth of suggestions. It is often the employee who identifies the need and the most appropriate accommodation, not the employer, so familiarizing yourself with possible options is helpful.

An employer is not required to grant every requested accommodation. They only need to agree to accommodations that don’t create a hardship for them. They can require essential job duties be fulfilled and they don’t have to lower productivity requirements. Your employer may counter your requested accommodation with an alternative that is easier for them to implement. Most employers are willing to work with their employees to find an arrangement that works. However, the burden for educating them about your needs and accommodations to support your success may fall to you.

Know Who to Tell at Work

You don’t have to tell an employer about your cancer at all.  An employer can’t ask about an employee’s medical situation unless they believe a medical condition is negatively affecting job performance or workplace safety.

However, your employer needs to know you have cancer for you to be protected by the ADA.  It is within your employer’s rights to ask for medical documentation if you request disability or medical leave.

Once you have decided you have enough information about what to expect during and after treatment, start by telling your direct supervisor. He or she may ask you questions you aren’t able to answer and that’s ok. Your goal is to open communication and set expectations.  Don’t expect your supervisor to be familiar with your protections under ADA.  However, your company’s Human Resources department should be.  If your supervisor doesn’t inform HR after you disclose your diagnosis, you should.

After that, it’s up to you who you would like to tell.  Your employer is not allowed to tell other employees about your medical situation, not even if coworkers notice you receiving accommodations and ask about it. It is up to you which coworkers to tell. Some people tell only a trusted coworker. Some people want everyone they work with to know.

Decide how much information you want to share. If you are comfortable sharing your story, this is a great opportunity to educate others.  People will likely make assumptions about your ability to work, or your long-term prognosis. They may comment on changes to your physical appearance or ask personal questions. Most people have beliefs about cancer that are incorrect or based on experiences that have little to do with your diagnosis and treatment.  People are rarely intentionally nosy or hurtful. However, if you feel comments or questions are excessive or constitute harassment, report it to your company’s human resources right away.  This is a form of discrimination and your employer has an obligation to address it.

Keep a Record

Even if your employer responds well to your initial conversation and grants accommodations, it’s a good idea to keep track of discussions you have with your boss or human resources office. Keep copies of emails related to your diagnosis and requests. Also, keep copies performance reviews or other documents related to your job performance. This documentation will be helpful if you feel your cancer diagnosis or accommodations are ever held against you.

Discrimination can sometimes be subtle, such as being excluded from meetings or being disregarded for assignments or promotions. You have 180 days from the date of an incident of discrimination to report it to the EEOC, which is another reason to keep records.

Marybeth wasn’t aware of all the protections of the ADA and that those protections continued even after she’d completed her treatments and returned to work full time.  Six months after her last chemotherapy session, she still found herself struggling to keep up with her workload. She was exhausted and felt frustrated by her coworkers’ lack of understanding. Marybeth says she didn’t want to be known as “the woman with cancer” and she figured asking for more help would be held against her.  She struggled on but her job performance suffered, eventually resulting in a poor performance review and job dissatisfaction.

“I don’t know if things would’ve been different for me if I’d been more willing to talk to my boss about how I was feeling and to ask for more adjustments to my work. I’d like to think so,” said Maryann. “I hope I never have to go through treatment again, but if I do, I know I will be more open to talking to my workplace about it.”

It may be difficult to talk about your diagnosis and expectations with your boss.  However, it is almost always the right thing to do to protect yourself.  Armed with an understanding of your potential needs and rights, you are in a better position to take control of your cancer and your career.

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Resource Links:

Americans with Disabilities Act

Job Accommodation Network