Working with Chronic Illness | Family Medical Leave Act | FMLA | AAmericans with Disabilities Act | ADA Accommodations | Short Term Disability | Long Term Disability | Employee Expectations with Chronic Illness
Accommodations and disability benefits, Work Life

FMLA, ADA, and Short Term Disability? Oh my!

Are you confused about the difference between Family Medical Leave Act (FMLA) and short term disability benefits at work? And what about the Americans with Disabilities Act (ADA) Accommodation, have you ever heard of that one?

With FMLA, ADA accommodations, short term disability and long term disability, things can get confusing, and it can be hard to keep track of what each accommodation or disability benefit does.

Before I got sick, disability benefits and FMLA seemed pretty easy and straightforward if I ever needed to apply for them.  FMLA seemed to go along with short term disability so I didn’t think much about that either. I didn’t even know ADA accommodations existed until my first relapse almost five and a half years after my illness began.

For most people, FMLA and short/long term disability are relatively straightforward, but if you have a chronic illness, especially one that is not clearly defined or almost no one has heard of, it can be a whole other ballgame. It can become especially tricky if you can still work but only on a part-time basis.

My Journey with Disability Benefits and Accommodations

I’ve been out on full short term disability three times during my career. Once when I first got sick and twice for maternity leave. I applied for and received partial long term disability benefits for two years while I was working my way back to full-time status after my illness started.

I’ve also used my disability accommodations, FMLA and ADA accommodations to work on a reduced schedule of 20 – 30 hours per week since my relapse. In addition, I’ve used an ADA accommodation to request additional accommodations that help me perform my job while being ill.

After all this, I now have a better understanding of what disability benefits/accommodations are offered and how the process works.

Disability Benefits and Accommodations

Since working with a chronic illness is hard enough, I thought I’d share with you my knowledge of the different types of disability accommodations and benefits available so you could have them all in one place.

The accommodations and disability benefits that may be available to you are FMLA, ADA Accommodation, short term disability, and long term disability. Your company may also offer patient advocate services.

Now I know not all companies offer disability benefits, but depending on the size of the company you work for, FMLA and ADA accommodations are available.

Disclaimer: Before we get into all the details, I’d like to state that I am not a human resources, insurance or law professional. The information provided is for informational purposes only and is based on my research, experience, and knowledge.

This information does not guarantee you will receive benefits and/or accommodations. Please consult your employer’s Human Resources department, disability insurance company or attorney for specifics related to your disability accommodations/benefits you might be eligible to receive.

What is FMLA or Family Medical Leave Act?

According to the Department of Labor, FMLA is a federal law that provides you up to 12 weeks of unpaid, job-protected leave within a 12-month period for

  • Your own serious health condition,
  • The care of a spouse, child, or parent with a serious health condition,
  • The birth and/or care of a newborn child, or
  • The placement of a child via adoption or foster care.

The catch is:

  • Your employer has to employ more than 50 employees within 75 miles of your job site,
  • You need to have worked for your employer for at least 12 months, and
  • You need to have worked at least 1,250 hours over the past 12 months for you to take advantage of this accommodation. (Department of Labor – FMLA)

FMLA can cover you if you have to miss entire days of work or if you’re on a consistent reduced schedule called intermittent leave.

The key here is FMLA protects you from getting fired for not being able to work your full work schedule.

When you need to be out of work because of your chronic illness, the first step is to contact your Human Resources (HR) department. If your company uses a disability insurance company your FMLA will most likely be processed and tracked through the disability insurance company as opposed to someone in HR. Once you contact HR, they’ll be able to walk you through the process specific to your company/organization.

State FMLA

Some states have their own FMLA laws which can offer you additional protected leave. This is a major bonus for anyone with a chronic illness because it allows you to take additional time off if needed. In fact, in some states FMLA leave is paid by the employer. So an even extra bonus!

I happen to work in a state that offers FMLA on the state level. Since I am only able to work part-time at the moment this has really helped me because otherwise, I might have to go back to work full time before I’m ready.

I found two sites that I offer good information on state FMLA. The first is the National Conference of State Legislators (NCSL) which provides a table and a high-level review of the states that offer FMLA. Be sure to scroll down to find the table.

The second site is NOLO, which provides in-depth detail about FMLA at the state and federal levels. If the state you work in doesn’t offer FMLA, then it will only discuss FMLA provided at the federal level. You’ll need to scroll down and select the state you work in.


Check out additional information provided by the Department of Labor:

  • FMLA FAQs for specific questions you may have.
  • Read all about the FMLA process and verify if you are eligible to apply by checking out the FMLA Employee Guide. This guide also provides flow charts which you may find helpful.

Check to see if the state you work in offers FMLA:

Lastly, don’t be shy to ask your HR department if you have any further questions about FMLA.

A few examples of how you can use FMLA:

1 – Intermittent Leave (Unable to work a full-time schedule):

Despite how hard you try, your illness has been keeping you from being able to work a full-time schedule. If your symptoms are consistently making you late to work or causing you to leave early, it might be worth looking into a reduced schedule.

A reduced work schedule could mean you still work five days/week but you work fewer hours each day, either coming in late or leaving early. Another option would be working a certain number of full days and taking other days off.

If your end goal is to return back to work as soon as possible, think about which schedule would allow you to keep up your endurance while getting enough needed rest to function fairly normally.

In my particular situation, I work 5 days/week for 6 hours each day, and FMLA covers me for 2 hours each day I don’t work. I planned my schedule this way because my brain fog usually starts to creep in after 6 hours of work.

This way I can keep up my endurance of working 5 days per week while getting the necessary rest to do my job.

2 – Doctor Appointments:

You can apply for intermittent leave if you have recurring doctor appointments, therapy appointments or treatment appointments that occur during your work hours.

You can also apply for FMLA if you’re going to be admitted for an inpatient rehabilitation/treatment program.

3 – Unscheduled full day leave:

If you have symptoms that flare up or you have mini relapses every so often, FMLA can protect you if you have to take unexpected leave for the day or week while you’re recovering.


Your employer has the right to ask for recertification of FMLA over a certain period of time. This means your doctor needs to fill out the FMLA form again and submit it for review.

My intermittent leave FMLA was approved for a year but 6 months into the leave my employer asked to recertify the leave.

You can read more about certification and recertification in the Fact Sheet #28G: Certification of a Serious Health Condition under the Family and Medical Leave Act provided by the Department of Labor. Recertification can be found starting at the bottom of the second page.

Employer Paid Disability Benefits

Short term and long term disability benefits are typically voluntary benefits offered by employers.

Short term disability will cover a percentage of your pay for a limited amount of time you’re out of work, generally three to six months.  However, I’ve never worked for a company that offered more than three months of short term disability.

Long term disability will also cover a percentage of your pay, which is usually less than the short term disability coverage until you are able to work full time or you hit the max number of years in your employer’s policy. If you are still unable to work full time when your short term disability ends, you should be eligible to apply for long term disability.

Both disability benefits require signed paperwork from your doctor that details what your chronic illness is and how it is keeping you from working full time.  You can use disability benefits to go on full disability where you are not working at all or you can use it for partial disability if you are able to work part-time.

Elimination Period

There is typically an elimination period before your short term disability benefits can go into effect. An elimination period is a preselected amount of time an employee is out of work before disability benefits can be applied, usually 7 – 14 days in a row. During the elimination period, the employee can use paid time off or sick leave to cover these days.

Applying for Partial Short Term Disability

If you’re reducing your work schedule and want to use your short term disability, you will most likely need to take time off to meet your elimination period. Check with HR to confirm this for your plan.

Knowing whether or not you need to complete the elimination period will help keep your short term disability request on track. Otherwise, your disability benefits may be delayed, and I know this from first-hand experience.


Check out your employer’s policies and procedures manual/employee handbook to find out:

  • What is your elimination period?
  • How long can short term and long term disability last?
  • How much of your salary do you receive on short term and long term disability?

If this information is not included in the manual/employee handbook it’s definitely worth a follow up to your HR department.


Your disability company will most likely ask you to recertify your disability around every 6 weeks. I’m sure each insurance company is different but I would be prepared for that amount plus or minus a week or two.

There may be times when you question whether your disability benefit is worth all the hassle of the back and forth between your doctor and the insurance company. In the end, I believe it is because most likely you need the money to pay bills while you’re unable to work.

I have totally been the middleman between my doctor and the insurance company, with my doctor’s office saying they faxed the information but the insurance company coming back and saying they didn’t get it. For me, it can become stressful when the recertification deadline is the next day, and the insurance company is still saying they haven’t received the documents that have been faxed by the doctor multiple times. So if you’ve felt/are feeling stressed out about this, you’re not alone!

I think some insurance companies are better about this than others, and the insurance company I have now has a grace period if your medical documents are submitted late your denial can be reversed.

A Note about Long Term Disability

I don’t want to cause anyone stress, but I think it’s best to know things upfront. If you ever need to apply for full long term disability (where you cannot work at all), ask HR what your employer’s policy is for keeping employees on the payroll when they are out on full long term disability.

When I first got sick, I was on full short term disability and used FMLA for three months. When I applied for long term disability, I was told by HR that if I was applying for full long term disability that my boss was no longer obligated to keep me on staff.

Luckily, I was planning to apply for partial long term disability and start working 20 hours per week so this was a non-issue.

But if I wasn’t well enough to do that, it would have been an extremely stressful time knowing my job could be in jeopardy. I don’t want to stress you out, but I wanted you to know this could be a reality for you depending on who your employer is.


Check out your employer’s employee handbook regarding long term disability. If the section is vague, follow up with HR regarding the process, any policies specific to long term disability, and employee responsibilities relating to applying for long term disability.

What’s the difference between disability and FMLA?

If your company offers short term disability benefits then paperwork for short term disability and FMLA are usually filled out at the same time, and you might not be sure as to what’s the difference between the two.

FMLA protects your job while you’re on leave, but you won’t receive any pay for time not worked.

Disability insurance provides you with a percentage of your income for the time you are absent from work, but it doesn’t offer job protection.

If available, FMLA and short term disability are typically used at the same time in order for you to receive job-protected leave while still receiving part of your salary.

What is an Americans with Disabilities Act (ADA) Accommodation?

An ADA accommodation requires employers, with 15 or more employees, to make a reasonable accommodation to an employee or qualified applicant with a known disability, as long as, the accommodation doesn’t impose an “undue hardship” on the operation of the employer’s business. The ADA’s nondiscrimination standards also apply to federal sector employees under section 501 of the Rehabilitation Act. (Equal Employment Opportunity Commission – Facts About the Americans with Disabilities Act)

This means if you request an accommodation that doesn’t impact the day to day business operations then it should be granted. For example, if you have the equipment to work remotely, and you can do your job remotely, you could request to work from home one day per week in order to help reduce your fatigue.

You will be provided a form to submit to your doctor which allows your doctor to discuss your illness, limitations and the reasonable accommodation requests to help you perform your job. This form will then be shared with HR, who will then determine if the accommodation is reasonable.

In my personal experience, I have used an ADA accommodation to:

  • Work from home one day per week, which was a huge energy saver for me. My company already let travelers work from home, so all of the technology was already in place, and I didn’t need to be in the office to perform my job-related duties.
  • Use a stool that attaches to my chair so when I feel fatigued I can put my feet up. This one really helps with the fatigue too.
  • Receive high-quality earplugs. I sit in a cubicle and I can get auditory sensory overload sometimes when too many people are talking on the phone at once.
  • Work a reduced schedule. In combination with the FMLA, HR suggested that my doctor include my reduced work schedule in my ADA Accommodation for additional protection.

Job Accommodation Network (JAN)

Are you unsure about what type of reasonable accommodations you can request? Then I recommend checking out the Job Accommodation Network (JAN). You can research accommodations by disability and/or limitation to see what accommodations can be requested that relate to your symptoms.

According to their website “JAN is the leading source of free, expert, and confidential guidance on workplace accommodations and disability employment issues…. JAN helps people with disabilities enhance their employability, and shows employers how to capitalize on the value and talent that people with disabilities add to the workplace.

JAN’s trusted consultants offer one-on-one guidance on workplace accommodations, the Americans with Disabilities Act (ADA) and related legislation, and self-employment and entrepreneurship options for people with disabilities. Assistance is available both over the phone and online.”


Check out JAN and research reasonable accommodations related to your illness/condition or call to speak with one of their consultants.

Patient Advocate

Some employers may offer a patient advocate service. A patient advocate can help you manage the back and forth between the disability insurance company and your doctor, explain your health benefits, find you new doctors/specialists, reconcile a dispute with your insurance company or doctor and more.

Honestly, I sometimes forget about this benefit and it certainly could have helped me when I was going back and forth between my disability insurance company and my doctor.

I have used them to help dispute a bill I had been double charged on, and they have offered guidance regarding a third party appeal with my health insurance company.

Employee Expectations

If you decide you need to take extended time off or can’t work a full-time schedule because of your health, please be sure to contact your HR department as soon as possible. It’s also a good idea to revisit your company’s employee handbook regarding employee responsibilities/expectations when using any of these accommodations or disability benefits.

Also, always keep your manager informed, preferably in writing, about any changes to your schedule and disability status, such as if your short term disability is ending and you’ll be applying for long term disability.


To recap, here’s the complete list of helpful links I posted throughout the post and don’t forget to check out action items from each section.

I know this information can be very dry and boring, but I think it’s necessary information to know if you have a chronic illness and a job.  I know from personal experience when you’re not feeling well the last thing anyone wants to do is search through multiple articles hoping to find some information that’s helpful related to work benefits and accommodations. To also help with this, I created a cheat sheet with all of these accommodations and benefits.  If you sign up for the mailing list below you will get the cheat sheet for free.

Not knowing about all these accommodations and benefits, in the beginning, hindered me from getting the help I needed when I needed it. Knowing this information would have helped me ask better questions and reduce the amount of frustration I endured.

If you have any questions/comments please feel free to post them below or send me a message.

I hope you have found this helpful, and I wish you the best of luck in your working with a chronic illness journey.

FMLA | Family Medical Leave Act | ADA Accommodation | Short Term Disability | Long Term Disability | Working with a chronic illness | working with invisible illness

Sara at Managing Chronic

Sara has worked in corporate America for almost 15 years, and she's worked the last eight years with FND. Her FND comes with paroxysmal dystonia, chronic fatigue, brain fog, sensory overload, muscle pain, and more. She is currently a part-time career woman, a mom and a wife.

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