Working with a Chronic Illness | Family Medical Leave Act | FMLA | State FMLA | Americans with Disabilities Act | ADA Accommodations | Short Term Disability | Long Term Disability | Employee Expectations Chronic Illness | Tell your boss about chronic illness | HR confidentiality chronic illness
Accommodations and disability benefits, Work Life

Working with a Chronic Illness? Here are 8 Things You Should Know

When I entered the corporate workforce at age 22, I was a healthy individual who worked hard for my money. Then at 28, I became very ill with a condition that took me six and a half years to get a diagnosis.

In the meantime, I was still trying to work as hard as possible while juggling the effects of Functional Neurological Disorder (FND). You can read my story here.

Through my journey, I’ve learned many things that would have been helpful to know back when I first got sick or even when I relapsed.

Also, I’m sure I’m not alone when I say when I’m feeling my worst and need assistance at work, the last thing I want to do is go to different websites and try to decipher what my options are.

Talking to your Human Resources (HR) department can help, but sometimes HR doesn’t have all of the answers, or they may not provide you with all of the options that are available to you. That’s where this post comes in.

Maybe you’ve recently been too sick to work for a few weeks or months.

Maybe you’ve been working with your chronic condition for some time, but you feel your symptoms are getting worse, and they are negatively affecting your job performance.

Or maybe you’ve been out of the workforce for a couple of years because of your illness, but you’re feeling better and are looking for work again.

Whatever the case may be, I want to provide you with some key information that could help you manage working with a chronic illness.

Here’s a list of eight things anyone working with a chronic illness in the US should know. If you’re looking for more in-depth information about the disability benefits and accommodations described, feel free to check out my post on The Ultimate Guide to Disability Accommodations and Benefits at Work.


While I worked a decade with a chronic illness, I am not a human resource, 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. For specifics related to disability accommodations/benefits you may be eligible for, please consult JAN, your Human Resources department, disability insurance company, or attorney.

1. What Family Medical Leave Act (FMLA) is.

There are three important things you need to know about FMLA:

  • What it is.
  • Employer and employee eligibility.
  • Whether your state of employment offers FMLA.

What is FMLA?

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, as well as other scenarios.

You can use FMLA:

  • If you will be out of work completely,
  • If you can only work on a part-time schedule,
  • For unscheduled days off due to your illness, or
  • For work missed due to appointments related to your illness.

Employer and Employee Eligibility

There are requirements that your employer and you need to meet before you can apply for FMLA. Such as,

  • Your employer must employ 50 employees.
  • You have to have worked for your employer for 1,250 hours within a 12 month time.
  • You have to have worked for your employer for at least 12 months. (Department of Labor – FMLA)


Check out the flowchart on page 3 of the FMLA Employee Guide to see if you’re eligible to apply for FMLA.

State FMLA

Working in a state that offers state FMLA is a bonus because it allows you to apply for additional job-protected time off.

Also, the states may have different qualifying factors, and while you may not be eligible for Federal FMLA, you could qualify for state FMLA.


Find out if the state you work in offers FMLA. Check out the National Conference of State Legislators (NCSL) or NOLO for states that offer FMLA.

2. What an ADA accommodation is and what is considered a reasonable accommodation.

The American Disabilities Act (ADA) accommodation helps people with disabilities and illnesses do their jobs with reasonable accommodations.

There are some qualifying factors like your employer must employ 15 or more employees, and your accommodation request cannot impose “undue hardship” on the employer’s everyday operations.

An ADA Accommodation can really help you manage work with a chronic illness if you’re struggling with fatigue, distraction, sensory overload, physical limitations, etc. It is worth applying for an ADA accommodation to help you manage or even reduce these symptoms while you’re at work. (Equal Employment Opportunity Commission – Facts About the Americans with Disabilities Act)


An excellent resource to check out is the Job Accommodation Network (JAN). It has information on what is a reasonable accommodation. If you have any questions specifically related to your condition, you can contact them to speak with one of their consultants.

3. What Short Term and Long Term Disability Benefits are.

Short term and long term disability benefits are optional employer benefits that can provide you with a percentage of your income while you’re unable to work.

Check your Employee Handbook or with your Human Resources department for

  • The length of the elimination period, and
  • The time frames of short term disability and long term disability


Always confirm the elimination period, especially if you will be reducing your hours from full-time to part-time. You want to avoid any confusion around the elimination period because it could delay when your paid benefits begin.

4. Knowing the difference between FMLA and Short Term Disability.

FMLA protects you from getting fired for not being able to work your full-time schedule with your employer, but you will not get paid for the time not worked.

Short term disability covers a portion of your salary/pay while you’re unable to work, but it doesn’t protect your job while you are out.

If your company offers both FMLA and short term disability, you will most likely sign up for both at the same time if you’re going to be out for a short period of time. However, there could be a situation when you’re not eligible for short or long-term disability, but you are still eligible for FMLA and vice versa.

5. Always follow up with your doctor regarding paperwork.

I have learned this the hard way multiple times. Every time I think my doctor’s office has a handle on submitting my paperwork for FMLA and/or short/long term disability, something inevitably goes wrong.

To avoid this, I highly recommend the following:

  1. Call your doctor’s office to confirm they received the disability benefits paperwork you faxed to them.
  2. A week later, call to confirm that your doctor’s office did indeed fax your paperwork to your employer or insurance company. If it hasn’t been faxed, give them 2 – 4 days and call them back. Repeat the process until you receive confirmation the paperwork has been faxed.
  3. Call your insurance company or employer to confirm your paperwork was received. For some insurance companies, it may take a day or two for your paperwork to show up in the system.
  4. If there’s any confusion with populating the paperwork, ask your doctor if you can provide a version of the paperwork populated with what you need in the request.

This may seem tedious, time-consuming and you may even feel like you’re babysitting your doctor’s staff. All of these things are valid, but it will save you a headache and stress if these steps are done in the beginning as opposed to later.

From personal experience, it’s no fun chasing down your paperwork after the deadline to submit it has expired. Some insurance companies provide more leeway than others on the deadline, but it is a hassle nonetheless. My advice is to follow up every step of the way.

6. Employee Expectations – Keeping your manager informed of all schedule and disability status changes.

Always know what the employee expectations are when you are using disability benefits and/or accommodations. They should be listed in your Employee Handbook, but if not, or if they are vague, follow up with HR.

Always provide your manager, in writing, notifications of all schedule and disability status changes. Whether you’re applying for FMLA for the first time or applying for long term disability after your short term disability runs out, keep your manager informed at all times.

7. To tell or not to tell – Telling your boss about your illness.

This is a very personal decision, but it’s up to you whether or not you tell your boss your diagnosis or any symptoms that could affect your job performance.

If you do end up telling your boss, he/she cannot hold your illness against you. If you feel your boss is making inappropriate comments about your illness or not treating you fairly, bring it up to your boss.

If that doesn’t help, you can always reach out to HR for advice or to report your manager. You should not feel discriminated against at work because you have an illness, especially if you have disability benefits and accommodations in place.

If you decide to go to HR, know that scrutiny will be placed on your boss, but it could also be placed on you. However, this should not deter you if you’re working in a hostile work environment.

Most companies also have a no retaliation policy if your boss is still mistreating you after HR is involved. If things are horrible, and you don’t feel you have the support of HR, you may wish to seek guidance from an attorney at this time.

8. Confidentiality – What HR is allowed to tell your boss.

This is my understanding based on a conversation with HR from my job.

  • HR is allowed to tell your manager about any approved ADA accommodations since your manager may need to be involved in accommodating you.
  • HR is also allowed to tell your manager about any approved or denied FMLA, short term disability, and/or long term disability.
  • HR is not allowed to tell your manager what your diagnosis is.

HIPPA laws seem to be a little complicated in the workplace. I also read that some of the ADA accommodation confidentiality rules contradict the HIPPA rules. If there’s interest, I plan to find an expert to discuss this with us in the future.


These are the eight items I feel are the most important to know if you’re working with a chronic illness.

  1. Family Medical Leave Act (FMLA)
  2. ADA accommodation and what is considered a reasonable accommodation.
  3. Short Term and Long Term Disability
  4. Knowing the difference between FMLA and Short Term Disability
  5. Following up on disability paperwork
  6. Employee Expectations – Keeping your manager informed
  7. What to tell your boss about your illness
  8. Confidentiality – What HR is allowed to tell your boss

Do you have any others? I’d love to hear about them in the comments below.

Below are all of the links I posted throughout the post if you’d like to check them out.

Working with Chronic Illness | Work Accommodations | FMLA | ADA Accommodation | Family Medical Leave Act

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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