Chronic illness affects 6 in 10 adults in the U.S., according to the Centers for Disease Control and Prevention (CDC). As the population ages — and continues working later into life — chronic illness becomes a more prevalent issue in workplaces across the country.
To develop a culture that is inclusive of employees with chronic illnesses, there are specific considerations and requirements that people managers within your organization must be aware of.
Two primary pieces of legislation dictate the treatment of employees with chronic illness: the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). You must stay aware of these and other changing federal and state regulations and guidelines from the U.S. Equal Employment Opportunity Commission (EEOC).
Defining a Chronic Illness
The CDC defines a chronic disease as one lasting more than one year that requires ongoing medical care or limits daily activities, or both. Chronic disease is the leading cause of death and disability in the U.S.
The ADA defines a disability as “a physical or mental impairment that substantially limits one or more major life activities.” These life activities can include walking, eating and sleeping, as well as things like concentrating and processing information.
Life altering chronic illnesses fall under this category, including diabetes, epilepsy, bipolar disorder, HIV and cancer. Obesity is also considered a chronic condition or a disability under the ADA because of the limitations it poses to daily life.
The ADA does not outline an exhaustive list of these chronic illnesses, but the Job Accommodation Network provides some guidance for determining if a condition not listed in the ADA would fall under the category of a disability.
Reasonable Accommodations for Chronically Ill Employees
Not all employees are comfortable disclosing chronic conditions to their employers or coworkers. If they do decide to notify you as their employer, and if they ask for certain changes or exceptions because of their illness, you have certain obligations under the law.
The ADA says that companies with 15 or more employees must provide “reasonable accommodations” to employees with disabilities, including chronic illnesses. These accommodations are intended to neutralize the impairment so that employees can effectively perform the essential functions of their job outside of the effects of their condition.
These reasonable accommodations help to ensure that:
- There is equal opportunity in the hiring process.
- A qualified individual with a disability can perform the essential functions of a job.
- It is possible for an employee with a disability to enjoy equal benefits and privileges of employment.
Employees with certain illnesses may need to account for frequent doctor’s visits, extensive medication regimens, medication side effects, need for a service animal and other effects of their illness throughout their work day. Reasonable accommodations that chronically ill employees may need can range from altered work schedules to job or workspace modifications.
Reasonable accommodations must be made as long as they do not put undue hardship on the employer. Most reasonable accommodations carry very little cost for the employer — more than 80 percent of accommodations cost a company less than $100. There is a high threshold for what is considered “undue hardship” on the employer in making accommodations, so legal counsel should be sought if you do not intend to make a specific accommodation.
Need help determining how to go about making reasonable accommodations? Check out SHRM’s step-by-step process.
Time Off for Chronically Ill Employees
If you have 50 or more employees, chronically ill employees are covered by FMLA. FMLA gives employees who have worked for you for at least 12 months (can be non-consecutive) the right to take unpaid time off work for their own health conditions or to care for ill family members. During this time, their job must be protected, and they must retain health insurance benefits with the same employer contribution.
Under FMLA, eligible employees are entitled to 12 work weeks of leave within a 12-month period for:
- a serious health condition that makes the employee unable to perform the essential functions of his or her job
- the birth of a child and to care for the newborn child within one year of birth
- the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement
- to care for the employee’s spouse, child or parent who has a serious health condition
- any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter or parent is a covered military member on “covered active duty”
Conditions that warrant time off from work often need case-by-case consideration. However, certain conditions are rarely considered serious or warrant FMLA leave, including routine dental work, cosmetic procedures (unless complications arise), cold, flu and other minor ailments.
Employees wishing to use FMLA leave must complete the appropriate government forms.
SHRM provides additional guidance on working with chronically ill employees who need to take FMLA leave, including a checklist for managers.
More than the Law
It’s important to remember that managing employees with chronic illness goes beyond your legal obligations to them. To ensure an inclusive work environment, those with disabilities and chronic conditions should be considered in your organization’s operations and set up for success just like every other employee.