Returning to work after cancer: know your rights

This law applies to workplaces with 15 or more employees. Under this law, employers must make reasonable accommodations for people with disabilities. Some cancer or treatment side effects like fatigue, pain, and trouble concentrating, may be considered disabilities.

Reasonable accommodations might include:

• Flexible work hours
• Ability to work from home on some days
• Time off for medical appointments
• Change in duties if you can no longer do your old job
• Work breaks so you can take medicine or call your health care provider

You can request a reasonable accommodation at any point while you are working. For instance, you can make a request on your first day back and after several months. Your employer may ask for a letter from your provider, but cannot ask to see your medical records.

This law applies to workplaces with more than 50 or more employees. It allows people with cancer and other serious illness to take unpaid leave without risking losing their job. It also covers family members who need to take time off to care for their loved one.

Under this law, you have the following rights:

• 12 weeks of unpaid leave. If you are on leave for more than 12 weeks in a year, your employer does not have to keep a position open for you.
• Ability to return to work as long as you return within 12 weeks.
• Ability to work fewer hours if you need to. If you cannot do your old job, your employer can transfer you. Your rate of pay and benefits must be comparable.

You have the following responsibilities under the Family and Medical Leave Act:

• You must give your employer 30-days notice or as much time as you can before taking leave.
• You must schedule your health care visits so they disrupt work as little as possible.
• You must provide a provider's letter if your employer requests it.
• You must get a second opinion if your employer requests one, as long as your employer covers the cost.

The Affordable Care Act went into effect on January 1, 2014. Under this law, a group health insurance plan cannot refuse to cover you because you had cancer. The law protects you in these other ways as well:

• A health plan cannot stop covering you once the cost of care reaches a certain amount.
• A health plan cannot stop covering you because you have cancer.
• A health plan cannot charge a higher rate because you have cancer.
• A health plan cannot make you wait for coverage to begin. Once you sign up for a plan, coverage starts right away.

Many preventive services no longer include copays. Your health plan has to cover the full cost of:

• Pap tests and HPV vaccine for women
• Mammograms for women ages 40 and older
• Colorectal screenings for people from age 45 to 75
• Tobacco cessation counseling
• Some medicines that help you quit smoking

When returning to work, there are some things you can do to make things go more smoothly.

• Set up a meeting with your manager to work out transition issues. Set up ongoing meetings to check in about how things are going.
• Tell your manager about what types of follow-up appointments you may need.
• Discuss what accommodations you may need, if any.
• Try to be realistic about what you can handle. You may need to ease into a full workload.
• Decide whether to tell your coworkers about your cancer. Who you tell is up to you. You may only want to tell a few people, or you may decide to let everyone know. Keep in mind that not everyone will react the same way.

It is your choice whether to talk about your cancer history during a job interview. It is not legal for the person interviewing you to ask about your health or medical condition. Even if you tell them you had cancer, the person interviewing you cannot ask questions about your diagnosis or treatment.

If you have gaps in your work history, you can organize your resume by skills rather than dates of employment. If a question comes up about the time when you could not work, it is up to you to decide how much information to share. If you do not want to talk about cancer, you may just want to say you were out of work for a health-related issue, but that it is in the past.

You may find it helpful to talk to a career counselor or oncology social worker about job-hunt strategies. You can also practice role-playing so you know how to handle certain questions.

If you feel you have been discriminated against, you can contact a counselor at the U.S. Equal Employment Opportunity Commission -www.eeoc.gov/federal/fed_employees/counselor.cfm. You have 45 days after the day the event took place to file a complaint.

American Cancer Society website. Returning to work after cancer treatment. www.cancer.org/cancer/survivorship/be-healthy-after-treatment/returning-to-work-after-cancer-treatment.html. Updated May 13, 2019. Accessed June 3, 2024.

HealthCare.gov website. Health coverage rights and protections. www.healthcare.gov/health-care-law-protections/rights-and-protections/. Accessed June 3, 2024.

National Cancer Institute website. Going back to work. www.cancer.gov/about-cancer/coping/day-to-day/back-to-work. Updated January 24, 2019. Accessed June 3, 2024.

National Coalition for Cancer Survivorship (NCCS) website. Employment rights. canceradvocacy.org/resources/publications/employment-rights/. Accessed June 14, 2024.

Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.