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Your patient may need to take time off from work during the cancer journey. And as his or her caregiver, you may need time off from work as well. In a study of caregivers, up to 24 percent needed to decrease work hours, 47 percent needed to leave work to accompany their loved one to medical appointments and 76 percent missed work at some point during their loved one’s cancer journey.1Grunfeld E, Coyle D, Whelan T, et a. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004 Jun 8;170(12):1795-801. However, in this study, 100 percent of the caregivers were able to keep their jobs.1Grunfeld E, Coyle D, Whelan T, et a. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004 Jun 8;170(12):1795-801.

The good news is there are often programs to protect people’s jobs and enable them to get time off for medical treatment or give care while still keeping job benefits such as insurance. These include programs such as the Family and Medical Leave Act (FMLA), which we will review here.

The Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) will not allow employers to discriminate against employees who have a disability or a health complication that may limit a person’s ability to perform daily activities. By law, from the time a person is diagnosed with cancer, he or she meets the criteria to be categorized as disabled, and the ADA should provide protection.Interpretation of the ADA is challenging, however.3Blank, PD. The economics of the employment provisions of The Americans with Disabilities Act: Part I -- workplace accommodations. DePaul Law Rev. 1997;46(4):877-914. The challenge is determining whether accommodations will cause hardship to the employer.

If a company determines that the employee alone is qualified to perform his or her job, and that a temporary employee either could not or that it would be costly to the business, the company may categorize its loss of the employee as a hardship for the business and accommodations will not occur.

To obtain accommodations, the employee must inform the employer of his or her disability.3Blank, PD. The economics of the employment provisions of The Americans with Disabilities Act: Part I -- workplace accommodations. DePaul Law Rev. 1997;46(4):877-914. The employer decides on the best accommodations for the employee.

With the ADA, an employer cannot fire an employee because of a cancer diagnosis or health problems that disrupt one’s ability to perform tasks. In addition, an employer will also be required to provide accommodations, although the type of accommodations are dependent on factors such as employment hours or job requirements. These accommodations could include providing an employee with a flexible schedule or permitting the employee to work from home.3Blank, PD. The economics of the employment provisions of The Americans with Disabilities Act: Part I -- workplace accommodations. DePaul Law Rev. 1997;46(4):877-914.

Your loved one may qualify for work accommodations. Upon diagnosis with head and neck cancer, your friend or family member should consider telling the employer about the diagnosis and find out what accommodations the employer may provide. If a company provides your loved one with a flexible schedule as an accommodation, for example, then he or she may be able to go to medical appointments without taking unpaid time off.

The Family and Medical Leave Act (FMLA)

The Family and Medical Leave Act (FMLA) mandates that employers permit their employees to have up to 12 weeks of unpaid leave for the purposes of either receiving treatment for their own illness or to help a family member, such as a child, parent or partner.During the leave of absence, the person’s job will be protected.In addition, work-related benefits, such as health insurance, must be maintained during the leave of absence.2Hoffman B. Cancer survivors at work: a generation of progress. CA Cancer J Clin. 2005 Sep-Oct;55(5):271-80.

There are requirements that the company and employee must meet: The company must have 50 or more employees, and the employee must have worked a minimum of 25 hours/week for one year or more.2Hoffman B. Cancer survivors at work: a generation of progress. CA Cancer J Clin. 2005 Sep-Oct;55(5):271-80.

The FMLA policy will enable an employee to have at least a few weeks off while keeping his or her job, plus medical insurance.

You and your loved one may each want to look into this option.


References

1 Grunfeld E, Coyle D, Whelan T, et a. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004 Jun 8;170(12):1795-801.

2 Hoffman B. Cancer survivors at work: a generation of progress. CA Cancer J Clin. 2005 Sep-Oct;55(5):271-80.

3 Blank, PD. The economics of the employment provisions of The Americans with Disabilities Act: Part I -- workplace accommodations. DePaul Law Rev. 1997;46(4):877-914.