Chronic Illness Can Affect Every Part of Life. How Do You Talk About it at Work?

New York Times

13-02-2025

The flare-up started like all of the others: intense diarrhea, cramping and other gastrointestinal symptoms that left Christopher French in the bathroom for long periods.
Mr. French, who stocked shelves at a big box hardware store, was dealing with ulcerative colitis. But this was his very first job, and it required moving heavy fertilizer sacks, which only worsened his symptoms.
Mr. French called out sick for three weeks straight and was eventually fired from his job. Now 47, he still remembers his manager's words. ''I wish you had been upfront about it,'' his supervisor told him. ''We could have worked something out.''
Opening up about a medical condition can unlock support at work; laws like the Americans With Disabilities Act create pathways and protections for people to do so. But disclosure isn't without risk. In a 2023 survey conducted by the Society for Human Resource Management, nearly half of U.S. workers with invisible disabilities, which are medical conditions that are not readily apparent to others, said they had chosen not to share the information; those who did were more likely to report rude or insensitive behavior.
Mr. French later changed careers and started discussing his condition during job interviews. But he acknowledged that wouldn't be a safe choice for everyone. The Times asked experts for their advice on how to disclose a chronic health condition and what to do if you're met with pushback.
'A civil rights law doesn't change people's attitudes.'
Since its passing in 1990, the Americans with Disabilities Act has aimed to shield people with disabilities from discrimination in public life, including at work. Under the law, employers with 15 or more employees must provide reasonable accommodations to those who request them. Reasonable accommodations are defined as 'a modification or adjustment to a job, the work environment, or the way things are usually done in the hiring process.'
An employer is obligated to do more than 'open the door,' for people with disabilities, said Susan Mizner, the director emeritus of the Americans for Civil Liberties Union Disability Rights program. They must 'build a ramp to it,' she explained.
But the A.D.A. isn't a panacea. A study published in 2001 suggested that nearly 10 percent of disabled adults experienced workplace discrimination within the five-year period after the A.D.A. passed; a third of respondents exited the workplace entirely. More recent data indicates that people with disabilities are more likely to be unemployed, and when they do have jobs, they're often paid less than their counterparts who don't have disabilities.
Rachelle Bloksberg, a therapist in Grass Valley, Calif. who treats people with chronic illnesses, said that most of her patients know they're protected under the law. Still, she said, they fear that opening up will harm their careers: 'They worry, 'will people treat me differently?''
Kailey Townsend, a 29-year-old who works in social media management, kept her endometriosis diagnosis to herself for several months. 'I wanted to ensure that I was protected in the workplace,' she said, adding that as a Black woman, she feels even more pressure to prove herself.
These worries aren't unfounded, Ms. Mizner explained: 'A civil rights law doesn't change people's attitudes,' she said. 'It doesn't change people's comfort levels.'
'There are no magic words.'
Samantha Rosen's chronic pain makes work a challenge. The 34-year-old writing tutor needs to use a special chair and monitor to ease her symptoms, but she has struggled with how to ask her employer for accommodations.
Instead of explaining her history of chronic pain, Ms. Rosen told her manager that she had some neck and back issues. She got the accommodations she requested, but she often wonders if she should have been more forthright. 'I did try to diminish it,' she said.
When it comes to disclosure, 'there are no magic words that you have to use,' said Aaron Brock, a lawyer in Los Angeles who specializes in disability discrimination cases. What's important, he explained, is that you start the conversation. In his practice, he has seen employees who didn't disclose their conditions 'punished for conduct that was clearly related to the disability,' he said.
Here are a few other things to keep in mind:
Decide who you'd like to tell. Ms. Mizner suggests approaching your human resources representative; you can inform H.R. without letting your supervisor know. If you don't have a human resources department, you can share requests with a supervisor as they are held to the same standards by the A.D.A. as employers.
Share only what you feel comfortable disclosing. It's legal for your employer to request medical documentation that verifies your diagnosis and outlines potential accommodations, but you still have a right to privacy. You don't have to share every detail, Ms. Mizner said.
Have a plan for pushback. Employers aren't required to grant reasonable accommodations if it would impose 'undue hardship' on their business. So, if your employer suggests alternative accommodations, engage in that discussion, said Linda Batiste, a lawyer and program leader at the Job Accommodation Network, a service provided by the United States Department of Labor's Office of Disability Employment Policy.
And if they deny your accommodations without offering an alternative, try to find out why. You might be able to offer additional information or get them to reconsider, Batiste said. If the discussion reaches an impasse, Ms. Mizner said that JAN offers one-on-one consultations.
Ms. Townsend, the social media manager, eventually opened up to her supervisor and was comforted by her reaction. She believes she 'lucked out' with the amount of support she received, but she doesn't think she'll divulge sooner going forward: 'It takes time to build openness in the workplace,' she said.