Concerns around work can be a primary stressor for those who are working when they are diagnosed with cancer. Navigating the practical, financial, legal, and identity aspects of changes in work can be challenging. Understanding your legal protections and rights will help ensure thoughtful decision-making around work and cancer treatment.
Understand the Terminology
If you are undergoing treatment for cancer and are no longer able to work, disability insurance may provide you with income. There are various types of disability programs available. Some employers offer private short and long-term disability plans, but there are also federal and some state options available with specific eligibility requirements. Having a general idea of each program will help you better understand what programs you might qualify for and what questions to ask your employer.
- Family Medical Leave Act (FMLA): FMLA is a federal law that provides eligible employees with up to 12 weeks of unpaid, job-protected leave per year. This leave can be taken continuously or as needed, known as “intermittently leave.” This is also a benefit your spouse or close family member’s caregiver is entitled to use while you are in treatment.
- Short-term disability insurance (STD) and long-term disability insurance (LTD): This is a service you either purchased individually or is offered as a benefit of your employer. Typically, it supplements your income while you are undergoing treatment. When evaluating your short and long-term disability insurance benefits, get clarity on your benefits, the policy’s definition of disability, and eligibility requirements.
- Social security Disability Benefits: There are two federal, long-term disability benefits programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both programs require a diagnosis of a disability that will last 12 months or longer. Qualification for Supplemental Security Income (SSI) also evaluates if the person is low income and has limited resources.
- Compassionate Allowance List (CAL): The Compassionate Allowance List details medical conditions that meet Social Security’s standard for disability benefits when evaluating SSDI or SSI applications. Your cancer may be listed, but the staging and treatment plan are also considered when qualifying for the compassionate allowance list.
- State Disability Insurance: Some states offer state-sponsored disability insurance options. Rules and benefits vary by state.
- Reasonable Accommodations: A federal law that provides protections to individuals with disabilities in the workplace.
Once you understand the general terminology, explore all your available options. Gather information from your oncology medical team and your employer to help evaluate your options and how they might impact your financial situation.
Understand Your Diagnosis
Discuss with your oncology team your diagnosis, stage, prognosis, and the planned length of treatment of your cancer. This will help you determine which disability insurances you qualify for and how much time you may need off. If your treatment plan involves radiation, surgery, and/or chemotherapy, you may have to coordinate with multiple physicians to understand the length of your treatment plan. Ask your doctor about the possible side effects of each treatment. Discuss the type of work you do and if they have a sense if you will be able to work while in treatment. Your medical team may not be able to give you a definitive answer, but they may have experience with what others have done and how the specific treatment impacted your ability to work.
Talk to Your Employer
Depending on your employment situation you may work directly with your manager or with HR to navigate both your benefits and employment options.
Consider that you have more options than just working or not working during treatment. You can discuss with your employer reducing hours, take intermittent time off, request reasonable accommodations, change jobs, and consider if retiring is right for you.
It is important to review your health insurance protections and options if you decide to reduce your hours or take a leave of absence.
If you are self-employed, there can be a different set of important questions to review including if and when to disclose to clients, as well as what businesses and projects are required to keep running while you are in treatment.
Putting It All Together
Once you have all the information you need to review what benefits you are entitled to, how long treatment will be, and what choices you have regarding your employment options it can be helpful to review your budget.
If you are a dual or multiple-income household, factor in the financial impact if your loved one is planning to take time off to be your caregiver. Regardless of the plan, it can be helpful if the working adults in your household review their employment rights, including Family Medical Leave Act (FMLA), which protects their job, but does not offer paid time off to care for you.
Once you have looked at all options and reviewed your financial benefits, you may have concerns about your income or medical bills. There are financial grants for cancer patients and most hospitals offer patients financial assistance applications and/or payment plan options. Ask your Iris Nurse or Mental Health Therapist to connect you with the Iris Resource Navigator to discuss additional support resources or to further discuss specific financial concerns.
Understanding your rights and options regarding work and disability can help relieve anxiety about the financial impact of your treatments.
Once you understand your choices you may still have questions about the best fit for you. Having a plan at the start of treatment can be helpful and you can always change or adapt your plan as treatment progresses.
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Reviewed by the Iris Clinical Editorial Board
This article meets Iris standards for medical accuracy. It has been fact-checked by the Iris Clinical Editorial Board, our team of oncology experts who ensure that the content is evidence based and up to date. The Iris Clinical Editorial Board includes board-certified oncologists and pharmacists, psychologists, advanced practice providers, licensed clinical social workers, oncology-certified nurses, and dietitians.