Work Accommodations and Disability
Updated October 3, 2013
Balancing your breast cancer care and your career may seem like an impossible task, but staying employed can keep you grounded by maintaining some familiarity with your life before cancer. In many cases, continuing to work is the best way to keep health insurance coverage. Adjusting your work schedule around your treatments and doctor’s appointments and managing side effects like fatigue will be difficult, but there are many resources out there to help you.
- Taking Time Off. If you have employee benefits like sick leave, vacation days and personal days, consider using them for treatment and recovery. Plan ahead to schedule appointments, but remember to leave a few days for times when you are too fatigued or sick to work. Talk with your human resources department about exceptions that may allow you to borrow sick leave from your coworkers with their consent.
- Americans With Disabilities Act (ADA). If your employer has 15 or more employees, the Americans with Disabilities Act allows you to ask for “reasonable accommodations” such as shortened hours, time off for treatment, or use of employer equipment to communicate with your doctors so you can continue to work comfortably during and after treatment. State or local laws may also protect you, including when your employer has fewer than 15 employees. For more information and resources, visit the Job Accommodations Network at askjan.org.
- Family and Medical Leave Act (FMLA).
- The Family and Medical Leave Act allows you to take up to 12 weeks of unpaid leave without losing your job or health insurance benefits. To be eligible, you must have worked for your employer for at least 12 months at the time of your request and worked 1250 hours during the last 12 months that you worked for the employer.
- Employers with 50 or more employees must comply with the FMLA.
- Your spouse, child or parent may also be eligible to take FMLA leave to care for you if their employer and employment status meet requirements.
- FMLA leave can be taken in blocks of time or all at once. If your treatments will take longer than 12 weeks, plan accordingly.
- Note that you will need to share basic information about your medical condition with your supervisor or human resources representative to request FMLA leave, but you do not necessarily need to disclose your diagnosis.
- Employee Assistance Programs. Many employers offer employee assistance programs to help employees deal with personal problems that may affect their work performance, such as emotional or financial concerns. Services are usually free and may extend to family members. Talk with your human resources representative to find out what benefits, if any, are available.
Filing for Disability
When filing for disability, it is important to know ahead of time how long you will be out of work and if and when you are eligible for Social Security disability benefits. Discuss with your doctor the terms of your treatment plan, including side effects and recovery time, so that you know whether you are able to work through treatment or will need to file for short- or long-term disability.
- Employer-Sponsored Disability Insurance. You may have disability insurance as part of your benefits package from your employer. Employer-sponsored disability insurance plans may replace 50 to 90 percent of your income. The amount replaced and the length of time you are covered will differ among employers, so talk with your human resources representative about what benefits are available to you.
- Social Security Disability Insurance (SSDI). If you have worked for a combined 5 of the last 10 years, have a fairly consistent work history and have been out of work or expect to be out of work for at least 12 months due to a medical condition that meets the Social Security Administration’s definition of a disability, you may be eligible for SSDI.
- Women with metastatic and some other invasive breast cancers may qualify for cash benefits under SSDI.
- The application process takes 3 to 6 months, so apply as soon as you meet Social Security’s definition of “disabled.” After you are approved, benefits will not begin until the 6th month of full disability.
- Some states offer short-term disability plans to cover you during the first 6 months without Social Security payments.
- If you have COBRA, contact your COBRA representative to find out if your COBRA coverage can be extended because of your disability.
- If you are able to return to work, you may withdraw an SSDI application.
- If your application is denied, you may appeal the decision.
- Supplemental Security Income (SSI). You may be eligible for SSI cash benefits if you have not worked for long enough or did not contribute to Social Security and have limited income and very little savings.
- In most states, people who receive SSI are eligible for Medicaid.
- In some states, application to SSI doubles as an application for food assistance programs.
- Many states offer supplemental payments to SSI to certain eligible beneficiaries.
- To check your eligibility for SSDI or SSI, use the Benefit Eligibility Screening Tool.
- State Disability Insurance. If you live in a state that offers short-term disability insurance funded by deductions from your payroll, you may be eligible for state disability insurance. Details and coverage vary by state.
- To find out more, visit db101.org, talk with a social worker at your treatment facility, or contact the Patient Advocate Foundation.
Continuing Benefits if you Lose Your Job or Leave School
If a time comes when you have to leave your job or school, you lose your job, or you graduate and don’t have access to employer-sponsored health insurance, paying for your medical care can become difficult. There are several programs available to help maintain your coverage. Continuing your coverage ensures you will get timely care.
- COBRA. The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that allows you and your family to continue your employer-based group insurance on a temporary basis. To extend coverage through COBRA, you will have to pay the full cost yourself – but this is often less expensive than purchasing individual insurance plans, and significantly less expensive than paying for breast cancer treatment out-of-pocket.
- COBRA protects you if you lose your job or are no longer eligible for employer-sponsored health insurance because of reduced work hours.
- The plan may cover family members if they were covered by your insurance plan.
- For more information, contact the Employee Benefits Security Administration of the U.S. Department of Labor.
- HIPAA. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that provides opportunities for people to enroll in health plans if they lose their coverage, regardless of pre-existing conditions. You may be eligible to buy a HIPAA plan if you have exhausted your COBRA coverage and are not eligible for Medicare, Medicaid, or employer-sponsored health insurance. Plans are offered in each state and benefits vary depending on where you live.
- Young Adults Under 26. If you are age 26 or younger, the Affordable Care Act allows you to remain on your parents’ health coverage even if you lose your job or leave school for any reason.
Federal, State and Other Financial Aid
Learn more about lead reviewer Joanna L. Fawzy Morales, Esq, and the other providers who helped us write this page in our Guide to Understanding Financial Concerns, 1st ed., 2010.