The Centers for Disease Control and Prevention reported that about 60 percent of Americans live with at least one chronic illness. Although many people with these conditions take medicine to remain productive, that’s not always the case.
If you have a chronic disease, you may have days when you’re not well enough to work. And if you manage employees with chronic illnesses, you’ve likely observed that challenge as well. Here’s how leaders and employees can manage chronic illnesses in the workplace.
A chronic illness is a health condition that lasts at least a year and requires regular medical attention and/or limits someone’s daily activities. Some common examples are heart disease, cancer, diabetes and long COVID-19, as well as less-common conditions such as Crohn’s disease.
In addition, experts are increasingly categorizing mental health conditions, such as depression and generalized anxiety disorder, as chronic conditions. These ailments are often less visible to others than a chronic disease that limits someone’s mobility, such as rheumatoid arthritis.
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.
Stigma persists around chronic illness, but open communication discredits perceptions. Managers who have employees with chronic diseases should remain understanding and open to discussion.
Although chronic illnesses present challenges for the employees who experience them as well as for their managers, taking thoughtful steps to address these difficulties and maintaining open communication can help create a supportive and productive work environment for everyone.
Here are some tips for managing chronic illness at work. To understand employees’ perspectives, leaders also may benefit from this advice.
Your illness is a condition that you are trying to manage, 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 Damron, director of patient engagement at the National Kidney Foundation, many people are afraid of losing their job, don’t know their rights or fear they can’t keep up. However, pushing yourself too far and placing your health at risk will only hurt you in the long run, she said.
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 [had] needed to happen for me to be able to keep working as much as I can until a time that I feel better.”
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, she said, so addressing your issues and channeling your toolbox of strategies will help.
Many people put work before their health, but that shouldn’t even be an option. Your condition doesn’t have to prevent you from thriving in your career, but 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 Damron 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 physical and/or mental limits can result in poor work quality and increased health risks, neither of which is worth proving a point to yourself or to your boss. You have a legitimate reason to slow down — don’t ignore it. Find a healthy way to get work done without exhausting your body or mind.
You don’t have 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 and then involving HR to avoid any frustration or miscommunication. Ultimately, you choose whom you want to involve.
“It depends on your work environment and how comfortable you feel with people,” Damron said. “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, as well as which people 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.”
If you expect your illness to 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,” Damron said. From there, your manager can understand your limitations and make accommodations.
In addition, try to prepare for days when you cannot work, rather than waiting until the last minute to notify your supervisor, Russinova advised. 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.”
As an employee with a chronic health condition, you have the right to request reasonable accommodations, like flexibility, extra feedback or supervision time, additional instructions on assignments and, most importantly, support from your company, Russinova said. Know your rights, and don’t be afraid to exercise them.
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 for help. However, there’s a way to do 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.”
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.
For example, in New Jersey, you earn an hour of paid sick leave — up to 40 hours in 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.
In many states, cities and counties, employers must pay you sick leave at your usual wage for a certain number of hours missed.
More than three-quarters of workers who can do their jobs remotely work from home at least some of the time, and more than one-third work remotely all the time, according to the Pew Research Center. A remote work setup is an option that increases productivity for all workers, but especially for those who have chronic illnesses that involve symptoms such as low energy.
Hybrid or remote work setups can reduce the burden of commuting, which can help people with chronic physical conditions that make it more difficult to travel. It can also reduce the anxiety of being in an office environment with other people, which can help people with mental health conditions. If a person with a chronic illness has multiple doctor appointments, remote work can improve productivity, because instead of taking an entire day off, they can work some hours from home.
Whether you are an employee with a chronic condition or an employer managing an employee with a long-term illness, you should pay attention to what is needed. For employees, that means assessing themselves honestly and listening to their bodies to manage symptoms and work successfully.
Employers should seek to create a workday structure that allows their employees to work despite their illness. Listening to your employees is important and will help make people comfortable when sharing information about their chronic conditions. Your employees are clearly qualified and can do the work, but some may require minor modifications to improve their productivity. For people with chronic conditions, remote work can be an option to help them manage their symptoms while operating at a high level.
Tejas Vemparala and Max Freedman contributed to this article. Source interviews were conducted for a previous version of this article.