Dr. Joseph Mikhael:
Does a patient have to disclose their diagnosis to their employer? Do they have to tell them exactly what they have?
Sherrie Guerrero:
No, you do not have to disclose your exact diagnosis. Some of the biggest challenges that patients have is knowing the facts and really knowing what benefits are afforded to them.
Dr. Joseph Mikhael:
Hi, everyone. Dr. Joseph Mikhael here, Chief Medical Officer of the International Myeloma Foundation. I'm delighted to be joined by Sherrie Guerrero, the Senior Director of Human Resources at the IMF. As we discuss together today, the concept of cancer and careers, and what patients and their care partners should know as they embark on this journey, what protections they have, and what specific challenges they may face.
Sherrie, it's always good to be with you, and I really appreciate you taking time to be with us today because this is a question that we receive so much at the IMF. And we know this is a really challenging issue for so many patients. They're faced with booking their chemotherapy appointments and all the demands and the fear of what's to come in the future. And for many of them, they want to keep their jobs because that's what's giving them insurance, that's helping them financially as they go through all of these challenges. So I'm hoping to ask you some of the questions that seem to pour into us at the info line on Myeloma.org, and with your experience and background. We really look forward to your insight.
Sherrie Guerrero:
Really glad to be here. Thank you.
Dr. Joseph Mikhael:
Excellent. Well, let's dive in with maybe the number one question we get, which is, "Will I lose my job if I miss time at work for my cancer treatment?" How do we think about that?
Sherrie Guerrero:
There are a lot of factors that come into play when you are asking an employer for time off. There are protections in place. You may have heard of FMLA or ADA. FMLA is the Family Medical Leave Act, and there are three qualifiers for that. First, your employer has to have 50 or more employees that are within a 75-mile radius. The second factor is you have had to have been working for your employer for at least 12 months. It doesn't have to be 12 continuous months, so as you can see, it starts to get a little more complicated. The third qualifier is you have had to have worked 1,250 hours at the time of taking leave.
If all of those things don't add up for you, that doesn't mean that you're in trouble, you can't take time off. It just means that we've got to look for other protections that might apply to you, which ADA is one of them, the Americans with Disability Act. And that's when you do need to talk to your employer about getting an accommodation for time off for treatment. It's up to you and your employer to have that conversation with one another, but I get it, that can be a scary thing to do, calling up your HR department or your supervisor who maybe you don't have a lot of contact with every day and sharing that you have a serious medical condition and you're going to start needing some time off.
Although it's new to you, this is something that your HR department works with on a daily basis. They know the ins and outs of taking a leave of absence or intermittent leave of absence is another way that you can get this time off that you might need. Perhaps you need to work part-time. They can talk all of that through with you. The technical term for that would be the interactive process to learn what your needs are, what you're asking, and then to have that dialogue.
Dr. Joseph Mikhael:
So that's really helpful because I guess that dialogue is also going to help with the second question that often comes up, which is, I've been granted 12 weeks, let's say, off with the FMLA because that's often a standard that's available. But what if I'm not well enough to return to work at the end of the 12 weeks? A lot of people sort of feel like it's black and white. Either you go back or you don't go back at all, or are there other ways to try and deal with that?
Sherrie Guerrero:
There is a process for that, and you can, as you're coming to the end of your 12 weeks, your employer will let you know in the weeks prior, to give them updates and check-ins along the way. And when you're getting close and you realize that you're not going to be able to come back, you'll ask your physician for maybe an extension. And you'll contact your HR department, your supervisor, whatever the protocol is for your particular company or organization. And you'll then go to them and say, "My doctor has provided me an extended leave of absence. I would like to request an accommodation to extend my leave." And this is where the ADA will come in, and you can potentially take advantage of the Americans with Disabilities Act and engage in the interactive process and extend your leave. Again, it goes back to just maintaining that open line of communication with your HR department and deciding what will work best for you, the company, and if it's an accommodation they can make.
Dr. Joseph Mikhael:
Excellent. So it's really not just a function of 12 weeks or bust. There tends to be flexibility there. And then another question that often comes in, which I think is really relevant right now is, when someone does come back, do they always have to come back in full capacity? Is there a way sometimes to return to work maybe because of their treatment and what they've experienced, they can't really work full time. Is there a way to come back gradually?
Sherrie Guerrero:
There is, and again, this is up to each employer and their policies, and it also depends on what state you're in. That is another factor. Of course, if you're in a state like California who has a lot of different benefits in place for employees, you can request coming back on a part-time basis and engage in that interactive process with your employer, and most of the time it will be approved.
Dr. Joseph Mikhael:
The next question that often comes up has to do with income, understandably. You know how much our patients experience with co-pays and challenges financially, of getting to appointments, the transportation, missed meals. I mean, there's so many things that financially stress our patients, especially if they're not able to work or can't work in a full-time capacity. Are there other sources of income support for them?
Sherrie Guerrero:
Yes. And that is going to also depend on what state you live, and certain states do have paid disability leave on short-term basis. It also depends on your company. Some companies have a temporary disability program that you can take advantage of. Don't forget to look into your benefits really closely and work with your company to understand what they are. You may have a long-term disability plan, so if you're going to be off of work, say beyond that three months, you can apply for long-term disability through a benefit that's offered through your employer, and that'll be able to give you partial wages. And you can supplement with that your vacation time, your sick time, so there's a lot of different factors in there depending on how much of each of these benefits that you have.
Dr. Joseph Mikhael:
One of the really critical questions we receive a lot, and maybe I should have led with this question, but does a patient have to disclose their diagnosis to their employer? Do they have to tell them exactly what they have?
Sherrie Guerrero:
I get that question a lot as well, and the answer is no, you do not have to disclose your exact diagnosis. You will need to talk about certain aspects of what your treatments are, how often you need treatment. That type of information will be needed to accommodate the request. But your exact diagnosis, you do not have to disclose that to your supervisor, HR, anyone within the company. And that sometimes does become a delicate conversation because your coworkers want to know what's going on with you. They're concerned about you, but it is private information, and it's not shared unless you would like to share it.
Dr. Joseph Mikhael:
Okay. That's really helpful because I know that is another source of stress. So before we wrap up, Sherrie, I'd just like you to, we've talked about so many things today. We've talked about the different sources of help for patients along the way in terms of shorter term and longer term disability, potential income support, the importance of close communication with their employer and their HR department to understand what resources may be available to them, even state by state with some differences. But what are some other sort of parting thoughts from you, other things in your experience that patients have either benefited from or maybe have been challenged by in this whole area of maintaining their career and their role as they're experiencing cancer treatment?
Sherrie Guerrero:
Some of the biggest challenges that patients have is knowing the facts and really knowing what benefits are afforded to them and what is available to them. And I understand sometimes it's really hard to do that homework. Even as an HR professional managing these types of leaves on a regular basis, I consistently have to do my homework. So I encourage anyone who needs to make this request to reach out to an HR professional, reach out to a social worker, patient navigator.
There's also different patient advocacy groups out there who are very knowledgeable in this subject. Reach out to them as well and just learn everything you can about what rights that you have. And also, the other thing you brought up earlier too is about health benefits. The longer you are employed and in the protected leave zone, so to speak, you continue your health benefits. While you're under protective leave, your health benefits remain intact, which is really important. So make sure that you are having that conversation as well with your employer so that it does not lapse.
Dr. Joseph Mikhael:
Thankfully, a lot of our patients are not facing this alone. They have a care partner, a caregiver, be it a spouse or someone else who's close to them. I wonder if you have any advice for them as well on how they may be able to be leveraging benefits that they have available to them.
Sherrie Guerrero:
It is important to know that caregivers also receive the same benefits if it is an immediate family member. And California recently also passed a law that you can designate a person, as well as your caregiver, and would also qualify under the protections that are provided.
Dr. Joseph Mikhael:
So that could potentially, as you described earlier, in terms of staggering benefits, it's possible that at different times those can be combined together.
Sherrie Guerrero:
They can, yes.
Dr. Joseph Mikhael:
That's really helpful, Sherrie. I just really appreciate your time today. And a few of the themes that I've taken away today is really the importance of advocating for yourself, of knowing in your particular job, employer, state healthcare plan situation, all the resources that are available to you. And there are a lot of people here to help. I mean, as the IMF, we try to do the best that we can to point people to resources. We work with a lot of organizations that can help provide these resources. So at our patient family seminars and our regional community workshops and at myeloma.org, we try and provide a lot of these resources to help patients to understand their journey and maximize the benefits that they have.
So really appreciate you taking the time with us today, and I'd really like to thank those who've been listening into this video today as we think about cancer and careers, and how our cancer diagnosis is so devastating in our life, but that there are protections for our patients, there are opportunities for them to maximize their benefits through this process. Please feel free to reach out to us at the IMF. We're more than happy to try and help in multiple ways, primarily at myeloma.org. You can call us at the infoline. You can reach out to us through multiple social media channels with the hashtag, ask the IMF, and we have people, great folks like Sherrie Guerrero here from our HR department to help us through this journey.
