- Chronic illnesses are any conditions that last at least a year and require consistent medical attention, or limit one's typical activities – or both.
- Employees with chronic illnesses should be honest with themselves about their work capabilities. They should strive for a balance between work and health, and be discerning about how they disclose their illness at work.
- Managers and employees should know the rights granted to people with chronic illnesses. The federal Americans with Disabilities Act and certain state, county, and municipal sick leave laws may apply.
- This article is for employees with chronic illnesses looking to balance their work and health, and for managers who support them.
In 2020, the Centers for Disease Control and Prevention discovered that over half of Americans live with a chronic illness. Although many people with these conditions take medicine to remain productive, that's not always the case.
If you struggle with a chronic disease, you know there are days when you're not well enough to work. And if you manage employees with chronic illnesses, you've likely observed that challenge. Here's how leaders and employees can manage chronic illnesses in the workplace.
What are chronic illnesses?
A chronic illness is a condition with symptoms that last at least a year and requires regular medical attention, and/or limits one's daily activities. Some common examples are cancer, diabetes and long COVID-19. It also encompasses Crohn's disease and other rare diseases.
Experts are increasingly categorizing mental illnesses, such as depression and generalized anxiety disorder, as chronic conditions. These ailments are less visible than a chronic disease like rheumatoid arthritis, which can limit one's mobility. Consequently, chronic illnesses – visible or not – can affect one's work.
To support their staff, managers should cultivate work environments where employees feel safe sharing how their chronic illnesses are affecting their work. While employees may need to get more comfortable with transparency when the fear of revealing their illness dominates.
6 ways to manage chronic illness at work
Below are some ways to manage your chronic illness at work. Leaders may also benefit from this material to understand employees' perspectives.
1. Be honest with yourself.
Your illness is a reality that you need to deal with, and you shouldn't deny it just because you're at work. If you're experiencing symptoms, acknowledge and approach them with care rather than working until you crash.
Be honest with yourself, both physically and emotionally. According to Kelli Collins, vice president of patient engagement at the National Kidney Foundation, many people are afraid of losing their job, don't know their rights or can't keep up. Pushing yourself too far and placing your health at risk will only hurt you in the long run.
Jean Paldan, founder and CEO of Rare Form New Media, was diagnosed with chronic fatigue syndrome after an emergency appendectomy two years ago. At first, this had a negative impact on her business because she couldn't dedicate as much time and energy as before. Paldan has since learned to accept the condition and prioritize her health over her business.
"I work more from home, and the rest of the staff take most of the meetings," Paldan explained. "It's not how I want it, but it's what needed to happen for me to be able to keep working as much as I can until a time that I feel better."
Dr. Zlatka Russinova, director of research at the Boston University Center for Psychiatric Rehabilitation, advised being mindful of your vulnerabilities. It's common for people to experience challenges in the workplace when dealing with a chronic illness, so addressing your issues and channeling your "toolbox" of strategies will help you.
2. Find a balance between work and health.
Many people put work before their health, but that shouldn't even be an option. Your condition doesn't mean you won't thrive in your career, you need to take care of yourself first.
"We've seen folks who become physically or emotionally unable to do the work but are scared to talk with their employer about that," Collins said. "On the other side, there's people who just power through and don't want to let any balls drop, and then crash because it's just too much."
Working beyond your limits can result in poor work quality and health risks – neither of which are worth proving a point to yourself or your boss. You have a legitimate reason to slow down – don't ignore it. Find a healthy way to get some work done without exhausting your body or mind.
3. Disclose your diagnosis sensibly.
You don't need to tell anyone about your condition unless you want to. However, depending on the severity of it, consider disclosing the information to your boss, especially if it interferes with your job.
"Part of the challenge an employee faces at the outset of an illness is determining what to share with their employer," said Thomas O'Brien, president of O'Brien & Feiler, a law firm that concentrates on disability and insurance law. "Some employees may be fearful of being fired outright (especially in at-will employment states). As such, it would be wise for an employee to consider the accommodations that may be needed in the immediate and long term before having this conversation."
O'Brien recommended disclosing the diagnosis with a supervisor first, then involving HR to avoid any unwanted frustrations or miscommunications. Ultimately, it's your choice with whom you speak about your illness.
"It depends on your work environment and how comfortable you feel with people," Collins added. "Sometimes it's a nice means of support. These are people you probably see more than your family some weeks. If there are folks that you work with that are comrades, I think it's a nice way to be supported and for people to understand if they are seeing changes in your schedule."
However, be mindful of what and how much you disclose, and whom you speak to – specifically about mental health issues. "There is psychiatric stigma and prejudice and discrimination," Russinova said. "Though there are increasing efforts to deal with [and decrease] public stigma ... it's still there."
4. Prepare for sick days.
If you expect your illness will conflict with your work schedule or responsibilities, alert your employer ahead of time.
"Employers do appreciate knowing as soon as possible so they can plan for that," Collins said. From there, your manager can understand your limitations and make accommodations.
Russinova added to prepare for days that you cannot work, rather than waiting until the last minute to notify your supervisor. You should also prepare a plan that you and your employer can follow if you unexpectedly need time off to address your illness.
"If an employee expects the illness to require regular physician appointments, then absences should be discussed," O'Brien said. "If there will be bad days or good days, then uncertainty should be discussed. If specific workstation accommodations are needed, those should be discussed, but there is not the need to discuss sensitive particulars with an employer unless the employee is comfortable doing so."
5. Know your rights.
As an employee with a chronic health condition, you have the right to request reasonable accommodations when needed, like flexibility, extra feedback or supervision time, additional instructions on assignments and, most importantly, support from your company, said Russinova. Know your rights, and don't be afraid to exercise them. [Related: Illegal Questions to Ask During an Interview]
If issues arise with your employer, turn to HR or the Americans with Disabilities Act (ADA). O'Brien explained that the ADA covers employers with more than 15 employees and requires them to provide reasonable accommodations to disabled employees, so long as they do not cause undue hardship to the company.
If you feel you're being discriminated against or have a case against your employer, don't hesitate to reach out to the ADA. However, there's a way to go about it without tarnishing your professional relationships.
"Use the ADA as a collaborative tool, not a sword," O'Brien said. "Approaching an employer with threats of ADA action is not advisable when attempting to continue employment."
6. Research local sick leave laws.
Your state or municipality might have its own sick leave laws, which are worth investigating. The laws will support you when your chronic illness is interfering with your ability to work. In that case, you may be able to claim a certain amount of paid sick leave time based on your location. Employers must pay employees at their typical wage for this leave.
In New Jersey, you earn an hour of paid sick leave – up to 40 hours total – for every 30 hours you work. Additionally, nine municipalities in the state have their own sick leave laws, and some states with no sick leave laws have their own rules you should know.
Overall, those suffering from a chronic condition should look out for themselves. Your illness does not limit what you deserve, nor does it give anyone grounds for mistreatment.
Max Freedman contributed to the writing and research in this article. Source interviews were conducted for a previous version of this article.