Navigating Your Career with a Chronic Health Condition

Jason* was watching his vacation and sick days dwindle. The 47-year-old Army veteran lives with chronic neck and back pain, hearing loss, memory issues, and post-traumatic stress disorder. Whether he’s seeing the physical therapist, visiting the hearing clinic, meeting with his mental health counselor, or attending therapeutic yoga classes, Jason has more appointments than most of us – sometimes a lot more. Maintaining health with his chronic conditions was eating away at his paid leave options.

A fellow veteran suggested applying for leave under the Family and Medical Leave Act (FMLA) to garner more time for these necessary appointments. This U.S. government program allows for up to 12 weeks of unpaid leave each year. You can use it for your own or a family member’s health needs if they qualify.¹

Because FMLA can be taken when you need it, not necessarily all at once, Jason can use the time for his appointments and treatments. However, it’s important to check with your employer whether you are able to keep your annual paid vacation and sick leave benefits while taking FMLA or if you need to use them before qualifying.

You’re not alone! Chronic health conditions at work

You don’t have to be a veteran to have a chronic health condition. They affect millions of people worldwide, impacting their daily lives and ability to work. Ginevra, an artist and professor with lupus, feels fine some days thanks to medications, nutrition, and a whole person approach to health. When she feels good, she maintains an active work life, going to her studio and teaching classes. At times, however, she has a stretch of days or even weeks called a lupus “flare” when it may be impossible to get out of bed or go to work due to crushing fatigue and pain. At those times, she calls on a colleague or graduate student to help her teach.

Finally, when we think of cancer, we mostly think about the need for treatment. But that need comes with a hidden price for some: almost half of everyone diagnosed with cancer in the U.S. is in their working years, facing the need to juggle cancer, treatment, and work responsibilities.² Six in 10 people with cancer have reported making job-related changes such as taking extended time off, switching to part-time work, or turning down a promotion because of their cancer.³

Less life threatening conditions, such as chronic migraine, also affect your work life. Janet knows that when she gets a telltale pain behind her left eye, she has three or four hours before she’ll need to leave work to lie down in a dark room. If it happens at 8 a.m., she knows the day will be short, and her manager, who has never had a migraine, is starting to doubt the reality of her symptoms, adding stress to Janet’s days. Workplace accommodations are crucial for enabling individuals with chronic conditions to maintain productive careers while managing their health effectively.

What accommodations are available?

In the U.S. and Canada, employers are legally required to provide reasonable accommodations for employees who have chronic health conditions. But what is “reasonable?” Quite a bit, as it turns out. Accommodations can include:

Flexible work schedules
Modified job duties
Ergonomic adjustments to your workspace, such as a standing desk, modified lighting or other changes to the physical environment
Remote work options
Extended breaks for medical needs
Time off for medical appointments

The Americans with Disabilities Act in the U.S. and similar laws in Canada protect employees from discrimination and require employers to work with you to determine what’s needed.

Benefits of post-2020 changes

The post-pandemic shift to remote work has significantly benefited many employees with chronic conditions. One survey found that 77% of employees with chronic conditions or chronic pain reported missing less work due to remote working arrangements.⁴ More flexible working options may allow you to:

Manage your symptoms better, for example by working in a quieter setting
Reduce the physical strain or infection risk of commuting
Access medications and treatments more readily

Many employees now have the ability to adjust their work schedules to accommodate their health needs. You may find you’re more efficient during nontraditional hours, like graphic designer Leah, who likes to work at night. The capacity to accommodate your own work style can be particularly helpful for those managing chronic conditions that affect their energy levels or symptoms at different times of the day.

Communicating with your employer

Taking advantage of your rights as an employee requires teamwork. For example, Jason, the veteran living with several chronic health conditions, talked to his manager about the possibility of using FMLA. His manager directed him to human resources, where Jason worked with an HR staff member to complete an application, gather the necessary documentation from his family doctor, and understand how to use FMLA appropriately.

Like Jason, you should expect to talk to more than one person and perhaps to work through a process of building support for a healthy work life with a chronic condition. Many HR departments might outsource this work to a third party and you may have to show proof of your condition through a qualification process. This can feel challenging and overwhelming.

When you do talk about your needs, here are some tips:

Be clear and specific about your condition and required accommodations.
Focus on how accommodations will help you do your job effectively.
Be prepared – and willing – to provide medical documentation.
Emphasize that you are committed to your work and to making a strong contribution.

Remember that your employer must maintain confidentiality about your condition. This can provide peace of mind. You aren’t required to tell everyone in your workplace what’s going on, even if someone asks you – you can simply refer them to your boss or HR if you don’t feel like sharing about your new schedule or other accommodations.

Making health care easier and more convenient

Making changes at work is just one way to stay productive when you live with chronic conditions. New health care options such as virtual visits have revolutionized the way many of us receive care.

The benefits of virtual health care include:

Improved access to specialized care, specialist choice – Maryam, who lives in Seattle, can work with a specialist in Denver virtually instead of being limited to who’s close by.
Enhanced medication management – Kenneth has Parkinson’s disease and lives in a rural town with no neurologist. Telemedicine allows him to get the care he needs regularly – and keep his medications managed – without making a long drive to see the specialist. He also takes online movement and balance classes, which help him keep working part-time.
Frequent monitoring – Telemedicine makes it easier to see your health care provider more often.

Being employed with a chronic condition gives you the advantage, in most cases, of receiving health insurance through your workplace. You can also explore if you are eligible for disability benefits, a health savings account, or flexible spending account through work.

The importance of whole person health

Your quality of life is an important measure of how healthy you are. Your chronic condition may be controlled with medication, but it’s also important to ask how you feel from day to day. Are you able to work? Is your work meaningful? It’s possible to have a productive, rich work life even if you live with a chronic health condition.

Ways to advocate for yourself when you have a chronic condition include:

Prioritize your health goals, perhaps with a tool like the HOPE Note, and communicate them to your health care team. Watch a video of Dr. Wayne Jonas using this.
Take advantage of non-medication treatments when available. Many workplaces offer yoga, meditation, or tai chi classes, chair massage, or social events that can help keep you connected with coworkers and reduce stress.
Keep a detailed health journal to track symptoms and treatments and, if needed, time off taken or remaining.
Pay attention to your mental and emotional health. Living with any chronic condition takes a toll that goes beyond the physical. Seek support when you need it. Many workplaces offer an employee assistance program that includes counseling or support groups.

The future of work and health care for chronic conditions

As we move forward, it’s crucial for both employers and health care providers to continue adapting and refining approaches to support people working with chronic health conditions.

The evolving landscape of work and health care has created new opportunities for people with chronic health conditions to thrive in their careers while managing their health effectively. By understanding your rights, leveraging available accommodations, and taking advantage of new health care delivery models, individuals with chronic conditions can maintain productive and fulfilling work lives.

Learn more from Dr. Wayne Jonas about living with a chronic condition in this article from Psychology Today. Also check out Family Leave and Other Rights for Workers with Chronic Health Needs.

Looking for a job, but concerned because you have a chronic health condition? Visit www.chronicallycapable.org for support and information tailored to employees and employers.

*Names have been changed to protect privacy

References

US Department of Labor. Family and Medical Leave (FMLA). Available at https://www.dol.gov/general/topic/benefits-leave/fmla. Accessed January 15, 2025.
Blinder VS, Gany FM. Impact of Cancer on Employment. J Clin Oncol. 2020 Feb 1;38(4):302-309. doi: 10.1200/JCO.19.01856. Epub 2019 Dec 5. PMID: 31804857; PMCID: PMC6992498.
Jinnett KJ. Self-Reported Work Performance among Employees with Cancer: Implications for Employers. Value in Health. 2016 May;19(3): A161 – A162.
George TJ, Atwater LE, Maneethai D, Madera JM. Supporting the productivity and wellbeing of remote workers: Lessons from COVID-19. Organ Dyn. 2022 Apr-Jun;51(2):100869. doi: 10.1016/j.orgdyn.2021.100869. Epub 2021 Jul 23. PMID: 35719173; PMCID: PMC9190665.