Working while in treatment: Know your rights.

Highlights For a list of helpful resources on this subject, click here. You are not likely to encounter problems in the workplace, but if you do, the law is on your side.

Working while in treatment for cancer can help you maintain your identity and even boost your self-esteem. Your job may remind you that you are a valued employee, a great boss, or a trusted coworker. You’ll also have regular contact with others at your work – and because cancer can be isolating, this can be a great comfort.

If you’ve decided you would like to work while in treatment, you have all of these things to look forward to. You also have some things to think about – including your rights as an employee with cancer.

Even though the public’s understanding of cancer is generally improving, some prejudices and wariness remain in the workplace, so it helps to be aware of your rights.

There are three congressional acts that you should know about just in case you must deal with work-related issues:

Americans with Disabilities Act (ADA)

This 1990 act gives civil rights protection to people with disabilities, helping them gain equal opportunity in employment, among other areas.

Under the ADA, a person with cancer has the same rights as anyone else in the workplace and should be provided equal opportunities.

Hiring, promotion, and treatment in the workplace should depend entirely on ability and qualifications. As long as an employee is able to fulfill the job duties, he or she can’t be fired for having cancer.

Most states also have laws related to employing people with various illnesses, including some laws that are specifically aimed at cancer.

Reasonable accommodations

Employers are not required to lower standards in order to make an accommodation for an employee; however, an employer is required to reasonably accommodate a qualified applicant or employee with a disability unless the employer can show it would be an undue hardship to do so. Examples of reasonable accommodations may include:

• providing or modifying equipment or devices
• restructuring a job
• offering part-time or modified work schedules
• reassigning an employee to a vacant position
• adjusting or modifying examinations, training materials, or policies
• providing readers and/or interpreters
• making the workplace readily accessible to and usable by people with disabilities

More specific information about ADA requirements affecting employment is available from the Equal Employment Opportunity Commission (EEOC) at 1-800-669-4000 or Telephone Device for the Deaf (TDD) at 1-800-669-6820. For general ADA information, answers to specific technical questions, free ADA materials, or information about filing a complaint, call the ADA assistance line at 1-800-514-0301 or 1-800-514-0383 (TDD).

The Family and Medical Leave Act

The Family and Medical Leave Act (FMLA) of 1993 provides certain employees with up to 12 weeks of unpaid, job-protected leave per year when the employee is unable to work because of a serious health condition. It also requires that the employee's group health benefits be maintained during the leave.

A “serious health condition” is defined in more than one way, but it generally means a condition that involves a hospital stay or prolonged treatment. A person with cancer meets this definition.

The FMLA leave can be taken all at once or in shorter blocks of time, such as 2 days a week, or 1 week a month, as long as it is taken for a single reason. FMLA can also be used to reduce the amount of time one works each day.

An employee does not have to provide medical records to use FMLA. An employer may request that, for any leave taken due to a serious health condition, an employee provide a medical certification which confirms that a serious health condition exists. This is usually a note or form signed and dated by a doctor.

Employees are generally required to be restored to the same job or an equivalent one. Employers are not allowed to interfere with, restrain, or deny any right provided under this law. Employers cannot use the taking of FMLA leave as a negative factor in employment decisions, such as hiring, promotions, or disciplinary actions.

To learn more about FMLA provisions and rules, read the FMLA fact sheet or call the Wage and Hour Division's referral and information line at the Department of Labor at 1-866-4 US WAGE (1-866-487-9243).

The Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 protects a worker’s ability to purchase health insurance despite his or her having a health condition that existed prior to trying to purchase the insurance. It protects people who might otherwise have trouble getting coverage after losing a job or after the expiration of COBRA.

It cannot set limits on what health care companies charge, but it can keep individuals covered when changing from one job to another. Again, depending on the health plan and the situation, HIPAA prevents an insurance plan from denying coverage or charging higher premiums, co-payments, or deductibles based on a person's health history or a pre-existing condition.

The law includes several parts that may help cancer patients:

• It limits the insurance company's options to reject people who have pre-existing medical conditions.
• It limits the time an insurance company can exclude the pre-existing condition from being covered.
• It does not allow employers or insurers to discriminate or act unfairly against employees and their dependents based on their health status.
• It guarantees certain employees and individuals the ability to renew and get health insurance coverage.

In 2002, the HIPAA laws were expanded to give patients greater access to their own medical records and more control over how their health information is used. Health information may not be shared without written permission of the patient. The law now addresses the need of health care providers and health insurance plans to protect the privacy of patient health information, too.

Eligibility requirements for HIPAA

If a person has no health insurance, the following requirements must be met before HIPAA can help:

• The person must have had 18 months of coverage without a break of more than 63 days and the most recent coverage must have been through a group health plan.
• The person cannot be eligible for Medicare or Medicaid or have other health insurance.
• The person needs to have used up his or her COBRA coverage or any similar ongoing coverage.

If eligibility requirements are met and the person acts within 63 days of losing coverage, HIPAA guarantees that an employee can purchase some type of coverage and that he or she will have a choice of at least 2 options.

For a more detailed discussion of HIPAA, click here.