“Going Out on Disability”

When someone is faced with a cancer diagnosis and treatment, they often wonder “do I Going Out on Disabilityneed to go out on disability?”  Unfortunately, they aren’t always sure what that actually means, or that it could mean multiple things.

The main confusion comes from not understanding the difference between disability leave and disability insurance.

Generally, the term “disability leave” is used to refer to time off from work, taken by an employee due to a serious illness or injury. However, it is important for individuals to understand how they are taking that leave.  Employees may be able to take time off from work under the Family and Medical Leave Act (FMLA), which is a federal law that provides eligible employees with up to 12 weeks of unpaid, but job protected leave, per year.  (Triage Cancer’s Quick Guide to the FMLA).  Some employees may also be able to get some time off as a reasonable accommodation under the Americans with Disabilities Act (ADA), which is a federal law that provides protections for individuals with disabilities. (Triage Cancer’s Quick Guide to Reasonable Accommodations). Disability leave may also refer to time off from work because of an employee’s medical condition, which is allowed under a specific employer’s policy rather than required by law.

If an employee has to take some time off, or has determined they are unable to work at all, the next thing they have to understand, is how they might be able to replace their lost wages. That is where disability insurance comes into play. Disability insurance benefits can be purchased directly from a private insurance company, or can be offered by an employer, some state governments, or the federal government.

You may be able to purchase a private disability policy directly from an insurance company. Unfortunately, there are very few regulations around the sale of these policies, so companies are allowed to take into consideration pre-existing conditions and health status when determine whether to sell you a policy and what to charge. So, if you already have a pre-existing condition, it is difficult to get a private disability insurance plan. However, it doesn’t hurt to look into your options in your state.  You can visit http://triagecancer.org/stateresources to find your state’s insurance agency, which should share information about which companies sell policies in your state.

Many employers also offer disability insurance as a benefit of employment.  Employers may pay all or part of the premium. One example of an employer-sponsored disability insurance plan is Aflac, but there are many others. These group plans are guaranteed-issue, meaning that you cannot be denied, but you may face exclusions of coverage for pre-existing conditions. Contact your employer’s human resources representative or your employer’s insurance company for more information about your specific plan.

There are also a handful of states (CA, HI, NJ, NY, RI, and PR) that have state disability insurance programs. The details vary by state, but generally these programs are for short term disabilities (up to one year).

Finally, there are two federal disability insurance programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  Both programs are run by the Social Security Administration and are based on having a long term disability.

Get more, customized information about disability insurance at http://cancerfinances.org, or check out Triage Cancer’s Quick Guide to Disability Insurance

The bottom line, is instead of simply saying “I’m going out on disability,” it can help to be clear about if you mean disability leave or that you are receiving disability insurance benefits, or both!

Medical Certification – Don’t Let It Disclose For You

If you choose to keep completely mum about your cancer diagnosis at work, you’ll be in triage-cancer-blog-medical-certificationgood company.  Grover Cleveland had a surgery for oral cancer in 1893, while serving as President of the United States, and nobody heard anything about it until 1917. President Woodrow Wilson had a serious stroke in 1919, and the country was basically run by First Lady Edith Wilson for the next two years. JFK flat out denied having Addison’s disease during his 1960 bid for the White House. Just like you, presidential candidates have no legal obligation to tell their employers (their constituents) about their medical health.

Generally, while you have no obligation to disclose, there are some instances where you might find it beneficial to share some information about your medical condition with an employer or potential employer. This is a very personal choice. The important thing to realize is that you have a choice. Triage Cancer participated in a free webinar about disclosure, privacy, and online brand.

There are also some instances where you could inadvertently stumble into a disclosure. For instance, if you want to use the ADA, or the Americans with Disabilities Act to request a reasonable accommodation at work, your employer will likely ask you to have your doctor fill out a medical certification form. Employers can create their own medical certification forms and can ask you about your diagnosis.  If you are not interested in sharing a cancer diagnosis with your employer, you only need to share enough medical information to show that you are eligible for the reasonable accommodation that you are asking for.  So you could talk about side effects that you are experiencing without talking about a cancer diagnosis.  But it is important to talk with your health care team about your disclosure decisions, before you ask them to complete your form.

Another law you might want to use is the FMLA, or Family and Medical Leave Act.  This law allows to take time off, unpaid, without the fear of losing your job. This law also allows an employer to ask for a medical certification form to be filled out by a member of your health care team. Even though the U.S. Department of Labor has created a model form for employers to use, some employers create their own forms and may ask for more information than they are entitled to have.

To help you navigate these decisions, Triage Cancer has some created some new, informative Quick Guides:

Quick Guide to Disclosure, Privacy, & Medical Certification Forms

Extended Quick Guide to the Family and Medical Leave Act (FMLA)

As always, knowledge is power, so get informed.

An Update on the Movement for Paid Sick Leave

Triage Cancer Blog Paid Sick LeaveThis past Labor Day, President Obama signed an executive order requiring federal contractors to offer workers up to seven days of paid sick time per year.

For some, paid sick leave is something that is taken for granted. Most employers are not required to offer their employees paid sick days. More than 43 million private sector workers (40% of the workforce) lack access to any paid sick time. Many of these workers are low-wage employees who cannot afford to miss a paycheck.

Employers that do offer paid sick days are often going above and beyond what is required under the law, because their workers tend to be more satisfied, productive, and healthy employees. There are also steep costs associated with hiring and training a new employee (estimated at about one-fifth of an employee’s salary), and paid sick leave can help to retain good employees.

Laws requiring paid sick days for employees are few and far between.  Check out the Triage Cancer Chart on State Laws to see if paid sick days (and other legal protections) are required in your state or city.

Latest news

On March 10, 2016, Vermont’s governor signed legislation to require paid sick leave, making Vermont only the fifth state to do so. This law goes into effect January 1, 2017. Learn more.

These is also a bill pending in the U.S. Congress right now, the Healthy Families Act (H.R. 932/S. 497), which would give people up to seven sick days per year to recover from their own illness, seek preventive care, or care for a sick family member.

For the cancer community, access to paid sick leave can allow for paid time off for medical appointments, treatment, and recovery. Paid sick leave can also work in coordination with reasonable accommodations, FMLA leave, and other employer benefits.

It is an election year, so if access to paid sick leave is something that is important to you, ask your candidates how they stand on this issue.

Learn more about existing paid sick leave laws and legislative campaigns at the state and federal level.

Taking Time Off in California & New York, Just Got Easier!

Triage Cancer Paid Family LeaveOn Monday, 4/11, California expanded its Paid Family Leave program, when Governor Jerry Brown signed Assembly Bill 908 into law.

Paid Family Leave (PFL) is a lifeline for families who need to take up to 6 weeks of time off work to bond with a new child or to care for a sick family member.  California is one of 5 states that offer this option. (New Jersey offers 6 weeks and Rhode Island offers 4 weeks. Washington passed a law in 2007, but it has not gone into effect.

While California’s PFL program is a great resource for families, it has only paid 55% of your wages when you take time off work. Starting in 2018, it will increase from 55% to 70% for those making minimum wage and 60% for almost all other workers. Watch this video from the bill signing.

Other cities and states have been working to offer paid leave programs. Just this month:

  • In San Francisco, the County Board of Supervisors unanimously approved full pay during family leave.
  • In New York, Governor Andrew Cuomo signed a family leave law that gives workers up to 12 weeks of paid family leave, twice as long as any other state. You can take time off to bond with a new child (including adopted or foster children), or to care for a gravely ill parent, child, spouse, domestic partner, or other family member.

For information on what might be available to you in your city or state, visit our website to see resources and our chart of state laws.

Join us in Chicago, on Friday, April 8th

chicago-theatre-890350_640For the third year in a row, Cancer and Careers will travel to the Windy City to host a free, daylong event focused on the challenges working people with cancer face in their efforts to balance treatment/recovery and employment.
Cancer and Careers’ Chief Mission Officer Rebecca Nellis will co-present with Triage Cancer’s Chief Operating Officer, Monica Bryant to provide patients, survivors, healthcare professionals, caregivers, and employers the information and tools they need to address important issues.  Among the topics that will be covered: disclosure, privacy & online brand; working through treatment and returning to work, including legal rights; managing finances; and health insurance options. In addition to the in-person presentations, attendees will be given helpful materials – including guides, workbooks & one-sheets – to take with them, for easy reference.
The Conference will be held at the Hotel Chicago Downtown and begins with breakfast at 8:00 AM. Lunch and parking are provided as well. To register, go to www.cancerandcareers.org/en/midwest. We hope to see you there!
If you’re unable to join us in April, we’ll be partnering with Triage Cancer again – this time in NYC – for Cancer and Careers’ annual National Conference on Work & Cancer, on June 17th. Triage Cancer has been an integral partner on this, CAC’s biggest event, since it launched six years ago. So we’re excited to have them involved again. Both Joanna Morales, Triage Cancer’s CEO, and Monica Bryant, will be there to present. For information and to register for the National Conference, go to www.cancerandcareers.org/conference. Travel scholarships are available for the National Conference; applications are due by April 15th.
If you’re on the West Coast, save the date of Saturday, October 15, 2016, when we’ll host our second West Coast Conference, in Los Angeles. Again, Triage Cancer will be there! Details and registration will be available at the end of March, at www.cancerandcareers.org/en/westcoast.

Can’t Afford to Take Time Off?

A cancer diagnosis can bring a lot of unexpected expenses. And if you have to take Triage Cancer Blog SSA Disability Insurancetime off work, how do you still pay your bills? Disability insurance can help you manage the costs of a cancer diagnosis.

However, navigating the various disability insurance options can be a challenge. The first step is to learn about the different types of disability insurance you may be qualified to receive.

If you are unable to work because of your medical condition, depending on your diagnosis, time spent working and contributing to the Social Security retirement system in the past, you may be eligible for federal disability benefits through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), state disability insurance programs, disability insurance offered by your employer, or private disability insurance that you buy directly from an insurance company.

SSDI is a federal program through the Social Security Administration (SSA) that provides a monthly payment for those who have worked for a sufficient amount of time, contributed to the Social Security retirement system by paying taxes, and meet SSA’s definition of disability. After receiving SSDI benefits for two years, recipients are also entitled to Medicare.

SSI is also a SSA program that pays monthly benefits to the elderly, blind, and people who have disabilities and very low income and assets. These payments begin immediately, and you would be able to receive them during the SSDI waiting period if you qualify for both SSI and SSDI. Typically, people who receive SSI benefits and are eligible for Medicaid.

Both the SSDI and SSI programs have the same standard of “disability.” To be considered “disabled” by Social Security, you must be “unable to engage in any substantial gainful activity (or any work activity where you earn more than $1,130 in 2016) by reason of any medically determinable physical or mental impairment that is expected to result in death or has lasted, or can be expected to last, for a continuous period of 12 months.”

If you are approved you will receive a letter with a date of “disability onset,” this date is the date that SSA believes your disability began and the start date of your “waiting period.” You must wait five months from this date before you will begin to receive SSDI benefits. Your monthly disability payment is calculated using a formula that takes into account how much you have paid in Social Security taxes over your work history.

If your initial application for SSDI or SSI is not approved you have the option of appealing the denial. In most states you can request a reconsideration of your application. If you are still denied, you may request a hearing by an administrative law judge (ALJ). If you are deemed disabled after appeals processes, you may receive retroactive payments.

In addition to the federal disability insurance programs, some states offer state disability insurance. California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico offer short-term disability insurance benefits to those who are unable to work due to a medical condition.

Private and employer-sponsored disability insurance is another option for you to consider. Private insurance is available for purchase directly from an insurance company. In some cases, employers offer both short and long-term disability coverage for their employees. A policy usually provides regular payments that replace a portion of your salary. One important thing to note is that you may qualify for your employer-based policy, even if you don’t qualify for SSDI or SSI.


Triage Cancer has resources to help you find out more about disability insurance and how it can help you:

  • Review our quick guide on Disability Insurance to see what type of disability insurance benefits might be available to you.
  • We also have a recent webinar, Demystifying Disability Insurance, delivered by Monica Bryant, Esq., CEO of Triage Cancer, which provides more detailed information on these options!

For more information about the Social Security Administration’s disability benefits, visit: www.ssa.gov/disabilityssi or read this guide: www.ssa.gov/pubs/EN-05-10029.pdf.

Another Supreme Court Decision Impacts the Cancer Community!

white house rainbowIn March, we posted about new changes to the Family & Medical Leave Act (FMLA), which is a federal law that allows employees to take time off from work because of their own serious medical condition; to care for a spouse, a parent, or a child; or for certain military family leave.

Click here to view the Triage Cancer Fact Sheet on the FMLA. The U.S. Department of Labor expanded the FMLA by changing the definition of spouse to include individuals who are in legal same-sex marriages, common law marriages, and marriages that were validly entered into outside of the U.S., if they could have been entered into in at least one U.S. state.

Later that month, the U.S. District Court for the Northern District of Texas, in Texas v. United States, issued a preliminary injunction with respect to the new definition of “spouse” under the FMLA. The effect of this decision, was that the new definition of spouse was put on hold.

Earlier during the year, the U.S. Supreme Court agreed to hear a case about the legality of same-sex marriage. That Supreme Court release their decision last Friday, in a 5-4 ruling, which requires all states to grant same-sex marriages and recognize same-sex marriages granted in other states. This landmark ruling has received much media attention, but it also has an impact on the cancer community.

While we are still awaiting official updates, same sex couples now have access to a plethora of new protections and benefits, including:

  • Hospital visitation and medical decision making (if a spouse is unable to make decisions for themselves)
  • Social Security benefits
  • Inheritance in the absence of a will
  • Filing taxes

While these new benefits will certainly positively impact the LGBT cancer community, there is still no federal law that prohibits discrimination based on sexual orientation in the areas of employment, housing, or public accommodations. Less than half the states have state laws that provide some of these protections.

We will have to wait and see how the courts handle these other issues in the future.

Paid Sick Leave

Paid Sick LeaveEver wish your co-worker with a cold would stay home, instead of bringing their germs to work? Maybe they can’t.

In most states, employers are actually not required to provide you with time off from work if you are sick or you need to see a doctor. If an employer offers you paid sick leave, then it is typically their choice to do so. However, more than 40% of all private sector workers and more than 80% of lower wage workers do not have paid sick days. This creates a difficult choice between caring for your health and keeping your job.

President Obama asked Congress to address this issue by passing a federal paid family and medical leave law. The Healthy Families Act is currently pending in Congress and proposes giving eligible workers up to 7 days of paid sick leave each year. In the meantime, states and cities are trying to fill the gap.

There are now a few states and cities across the country that currently, or within the next year, will require most employers to provide some form of sick leave to their employees:

  • California
  • Connecticut
  • Massachusetts
  • Washington, D.C.
  • Eugene and Portland, OR
  • Jersey City, Newark, Passaic, East Orange, Paterson Irvington, Trenton, Montclair and Bloomfield, NJ
  • New York City, NY
  • Oakland and San Francisco, CA
  • Philadelphia, PA
  • Seattle and Tacoma, WA

Each law varies a bit in the details. Here is a good comparison chart of the various laws: http://www.abetterbalance.org/web/images/stories/Documents/sickdays/factsheet/PSDchart.pdf.

Following this trend, there are additional states across the country now looking at this issue. For example, Maryland’s legislature is currently reviewing a bill that would require Maryland businesses with 10 or more employees to provide their employees with paid sick leave.

Advocates for these laws argue that they help employers by allowing workers to stay home while ill, preventing the spread of diseases (such as colds and flus) and getting them back on the job faster.

To learn more about paid sick leave legislation at federal and state levels, visit www.paidsickdays.org.

Changes to the FMLA!

FMLAThe Family & Medical Leave Act (FMLA) is a federal law that allows employees to take time off from work because of their own serious medical condition; to care for a spouse, a parent, or a child; or for certain military family leave.

Click here to view the Triage Cancer Fact Sheet on the FMLA.

While the FMLA can prove to be a useful tool for caregivers, to help balance job responsibilities and time spent caregiving, caregivers are only able to take time off if they are caring for a spouse, a parent, or a child. That doesn’t include parents-in-law, grandparents, siblings, or aunts or uncles. And until recently, the FMLA’s definition of “spouse” looked to the law of the place where people currently live, rather than where the marriage took place.

This meant that if a couple were legally married in one state, but moved to a state where same-sex marriage was not legal, than they would not be able to use the FMLA.

The Department of Labor has released a final rule, which:

  • Changes the definition of spouse to include individuals who are in legal same-sex marriages, common law marriages, and marriages that were validly entered into outside of the U.S., if they could have been entered into in at least one U.S. state.
  • Looks to the state law where the marriage took place, rather than where the couple lives

This final rule goes into effect on March 27, 2015.

For information about the FMLA, visit www.dol.gov/whd/fmla.

Three Tips for Navigating Cancer & Your Finances

Cancer rights attorney and advocate, Joanna Morales, shares her advice for managing the financial impact and questions that accompany a cancer diagnosis.      

Most cancer survivors are unaware of their rights and the resources available to assist them through the vast maze of legal, employment, and insurance systems that can arise after diagnosis. And many of those individuals are completely unaware of the financial impact that cancer may have on their lives.  Fortunately, there are organizations and agencies to help cancer survivors and their families answer these questions and others.  Here are 3 tips as you start thinking about these issues:

Tip #1: Decide if you are able to work through treatment or take time off

The decision whether or not to work through treatment is a personal one and it may depend on your course of treatment, so it is a good idea to talk with your health care team when making this decision.  If you want and are able to work through treatment you can ask your employer for a reasonable accommodation under the Americans with Disabilities Act (ADA) or a state fair employment law.  The Job Accommodation Network is a program of the U.S. Department of Labor that helps employers and employees navigate the job accommodation process under the ADA.  Cancer and Careers is a nonprofit organization that specifically focuses on the practical issues related to work and cancer, including free job search tools, resume review services, and career coaching.

If you decide that you want to take time off either for a short or longer period of time, you may be eligible to take time off work under the Family and Medical Leave Act (FMLA).  You may also have disability insurance benefits available to you through your employer, your state, or the Social Security Administration (SSA), which is the agency responsible for providing cash and health insurance benefits to individuals who are unable to work because of their medical condition, through two long-term disability insurance programs: Social Security Disability Insurance and Supplemental Security Income.

Tip #2: Look into your health insurance options

Health care is expensive.  In addition to your monthly health insurance premiums, you may also have co-payments and co-insurance amounts that you have to pay when you get medical care or fill a prescription.  If you are uninsured or if you have insurance, but it is expensive, you can check out the new health insurance options (Medicaid or private insurance) available through the Patient Protection and Affordable Care Act, by visiting www.Healthcare.gov or the Health Insurance Marketplace in your state.

Tip #3: Understand your consumer rights

Figuring out what your financial picture looks like can help you identify priorities (e.g., do you need to find a job, do you have a stack of bills that you have been too afraid to open, etc.).  Figuring out your next steps is entirely personal to your situation.  Consider talking with a financial planner.  Financial planners work with people of all income levels so don’t feel like you don’t have enough money to utilize one.  Consumer credit counseling agencies can provide you with practical tools (e.g., financial calculators or budget worksheets) or help you negotiate payment plans or settlements with your creditors.  As a consumer, you still have rights.  Be aware that some debt solutions may negatively affect your credit score.

It is important to check that your medical bills are accurate, dispute them if there are problems, and if you believe a procedure or treatment should have been covered, and it wasn’t, you have the right to appeal that decision.  Talking with your creditors before they turn over your unpaid bills to collections agencies, can help protect your credit.  If you can’t make a payment, ask for more time.  Check to see if they would be willing to negotiate a payment plan or accept a lower lump sum payment.  There are also many financial assistance programs available in the cancer community that may be able to assist you.

Arming yourself with information about your legal, employment, insurance, and consumer rights –  getting assistance from these resources can help you manage the financial impact of cancer.

 *This blog was originally posted on the My Colon Cancer Coach Blog in August 2014. For more information about colon cancer, visit My Colon Cancer Coach at http://www.mycoloncancercoach.org/.