How to Talk to Your Employer About Cancer

The Americans with Disabilities Act does not require you to volunteer that you have cancer. The EEOC states this directly. Telling them matters when you need an accommodation. Not before.

That shifts the whole conversation. The talk you are planning is usually not "I have cancer." It is "here is what I need to keep doing this job well."

The National Cancer Institute adds a point about job hunting. You are under no legal duty to reveal a cancer history when seeking a new job. The exception is when it directly affects the position.

The rules change at three points in time.

Before a job offer. The EEOC bars several questions here. An employer may not ask whether you have or ever had cancer. They may not ask whether you are getting chemotherapy or radiation. They may not ask how much medical leave or sick time you used in the past. They may ask job-related questions about physical capabilities or travel.

Say you mention cancer yourself at this stage. The employer may then ask only two things. Whether you will need an accommodation, and what type. Nothing about diagnosis or outlook.

After a conditional job offer. Medical questions and exams are allowed here, as long as everyone offered that type of job is treated the same way.

During employment. The EEOC allows medical questions when the employer has a reasonable belief that cancer will stop you safely performing the essential functions of your job. Questions are also allowed to the extent they are needed to support an accommodation you have asked for, to verify sick leave when the employer asks that of every employee, or to run a voluntary wellness program.

People blur these together and end up asking for the wrong thing.

The ADA is about changing how the job works. It applies to employers with 15 or more employees. That threshold took effect on July 26, 1994. Under the ADA, cancer counts as a disability in three ways. Currently having it, which substantially limits the major life activity of normal cell growth. Having a record of it. Or being regarded as having it.

The FMLA is about time away. The Department of Labor sets it out numerically:

• 12 workweeks of unpaid, job-protected leave in a 12-month period
• 26 workweeks in a single 12-month period for military caregiver leave
• You must have worked for the employer at least 12 months
• You must have at least 1,250 hours of service in the 12 months before leave starts
• Your worksite must have at least 50 employees within 75 miles

Group health benefits continue during FMLA leave. They stay on the same terms as if you had not taken it. Confirm that in writing with HR before your first day of leave.

Note the gap between them. A 20-person company falls under the ADA but not the FMLA. Check both thresholds against your own employer before you plan around either.

Vague requests get vague answers. Ask for something from this list, which comes straight from the EEOC's cancer guidance:

• Leave for medical appointments, or to get treatment and recover from it
• Periodic breaks, or a private area to rest or take medication
• A modified work schedule or a shift change
• Permission to work at home
• A change in office temperature
• Permission to use a work phone to call doctors
• Shifting marginal tasks to someone else, meaning the parts of the job that are not essential
• Reassignment to a vacant position

The EEOC also notes that one employee may need several accommodations over time. Chemotherapy weeks and recovery weeks are not the same. So the request can change.

NCI advises starting informally with your supervisor or the personnel office. Write down every request and what came of it. Build the request like this:

1. Name the job function affected, not the diagnosis
2. Name the specific change you want, using the wording above
3. Say how long you expect to need it, even if the answer is "reviewed monthly"
4. Put it in writing after any verbal conversation, and keep a copy
5. Ask what medical documentation the employer needs, and who it goes to

You do not need to hand over your full medical record. Ask what information is truly required for the accommodation you asked for.

The EEOC limits disclosure of your medical information to four groups:

• Supervisors and managers, if necessary to provide the accommodation
• First aid and safety personnel, if you may need emergency treatment
• People investigating compliance with the ADA
• Those handling workers' compensation or insurance

Everyone else is outside the circle, including the coworkers who ask.

This is the part people dread, and the law is on your side. The EEOC says an employer may not tell coworkers that an employee is getting a reasonable accommodation. Instead the employer should stress its policy. It does not discuss any employee's work situation with colleagues.

You can ask your manager to use exactly that line. NCI adds three practical steps. Plan what you will say ahead of time. Deal with individual coworkers directly. Bring in your manager or an employee assistance counselor if a problem continues.

An employer cannot fire you for having cancer. The EEOC guidance leaves one narrow exception, called a direct threat. That means a significant risk of substantial harm to you or to others. It must be a risk that no reasonable accommodation can remove or reduce.

That finding requires objective, factual evidence. The employer must weigh four things. How long the risk lasts. How severe the harm could be. How likely it is. How soon it could happen. A general worry about your stamina does not qualify.

The limits run the other way too. Undue hardship means significant difficulty or expense for the employer. The EEOC is also clear on two points. An employer need not remove an essential function of the job. It need not accept performance below its standards.

Try something close to this:

"I have a medical condition that will need treatment over the next few months. I want to keep doing this job, and I want to be straight with you about what will help. I am asking for two things: flexibility on appointment days, and the option to work from home the day after treatment. I have written it up. Who should I send it to, and what documentation do you need?"

That opening does four things at once. It signals commitment. It names specific accommodations. It keeps the diagnosis optional. And it moves straight to process.

Working During Cancer Treatment covers the day-to-day side. Managing Cancer Appointments With Work covers scheduling. Cancer and Disability covers benefits if work becomes impossible.

• U.S. Equal Employment Opportunity Commission — Cancer in the Workplace and the ADA
• U.S. Equal Employment Opportunity Commission — The ADA: Questions and Answers
• U.S. Department of Labor — Family and Medical Leave Act
• National Cancer Institute — Going Back to Work