From Your Navigator - February 17, 2017

6 Steps to Living & Working with Cancer

By Cheryl Bellomo, MSN, RN, OCN
Oncology Nurse Navigator
Intermountain Southwest Cancer Center, Cedar City Hospital
Cedar City, UT

According to the American Cancer Society, there are 15.5 million cancer survivors in the United States today, and more than 40% are of working age. By 2026, this number is estimated to be 20.3 million cancer survivors.

As reported by the AARP, participation of older people aged 65 to 74 years in the workforce is predicted to increase to 32% by 2022, up from 20% in 2002. With the aging population and the increasing number of cancer survivors, more cancer survivors will remain in the workforce beyond age 65.

As the number of cancer survivors in the workforce increases, it is imperative to empower and educate survivors to thrive in their workplace. Organizations such as Cancer and Careers have steps to guide survivors in making the transition process run smoothly. The following list is a good starting point:

Step 1. Get Organized

Creating a paper (notebook/binder) or electronic folder is a helpful way to systematically organize medical and insurance information. Electronic files on a laptop or a smartphone allow for quick access to information and for an effortless shift between work and appointments. Smartphone apps, such as iChemo Diary, Cancer Terms Pro, and iHealth Log, can be helpful organizational tools for keeping your information with you. Stock the folder with the following items:

  • Checklists of questions
  • Notes taken during consultations and appointments with physicians
  • Information regarding diagnosis, treatment options, complementary resources (nutrition and diet, exercise, psychosocial)
  • Medical history and medical reports
  • Health insurance information (copy of insurance cards, claim forms, estimate of benefits)
  • Copy of your employee benefit policies (insurance, disability, paid time off/vacation)
  • Disability and life insurance policies.

Step 2. Gather Information

Before approaching your employer and colleagues, consider talking with your physician about the ways that your diagnosis, medication, or treatment can affect your job performance or ability to work. Survivors should also know their legal rights regarding employment.

The Americans with Disabilities Act Amendments Act protects cancer survivors from discrimination in the workplace by requiring employers to make “reasonable accommodations” to allow employees to function properly on the job.

The Family and Medical Leave Act guarantees that eligible employees (those who have worked at least 12 months or 1,250 hours for a company of 50 employees or more) can take up to 12 weeks of unpaid leave while maintaining their health insurance benefits and their previous position or an equivalent job with the same salary and benefits.

The current Affordable Care Act (ACA) requires most Americans to have health insurance, which can be purchased through a health insurance exchange, prevents all health insurers from denying coverage to people for any reason, including health status and from charging higher premiums based on health status and gender.

In addition, HIPAA protects patients’ medical privacy, including a cancer diagnosis and treatment, and limits who can have access to a person’s health information.

Step 3. Know Your Health Insurance Plan

Be sure to familiarize yourself with your health insurance plan. You will want to know if you have traditional “fee for service” insurance or an HMO or a PPO. Determine if you have a health savings account or a flexible spending account, which you can use to pay for qualified medical expenses. You will want to also know the following details about your insurance:

  1. How to get a second opinion?
  2. Are appointments with an out-of-network physician covered by your insurance?
  3. Do treatments need to be preauthorized?
  4. Are appointments, treatments, hospitalization all covered?
  5. Do you have to meet a deductible before your insurance pays for appointments?
  6. Do you have a choice of specialists?

Step 4. Know Your Employer’s Policies

Be sure to discuss with your human resources department options to help manage your particular situation, such as job-sharing, working from home or telecommuting, using vacation time as sick days, shifting your duties temporarily, or even taking on a new role, accepting vacation or sick-time donations from colleagues, or being able to take short, scheduled breaks during the workday.

You may need to become familiar with your employer’s short-term disability policy. Short-term disability plans cover you if you need a brief medical leave from work, usually up to 6 months. Generally, short-term disability plans will pay between 55% and 100% of your wage. Depending upon your employer’s short-term disability plan, some plans will start immediately, and others may have a waiting period before benefits start.

Long-term disability plans are administered by the federal government, offered by employers as part of the employee benefits package or sold by insurance companies to individuals. To qualify, you will need to have worked and contributed to Social Security through past paychecks for a certain number of years, based on your age, and be determined to have an illness that is expected to last at least 12 months, or terminal.

Step 5. Work on Reducing Work Stress

To manage cancer and work, create and take advantage of opportunities to reduce stress. A few ways to get started include:

Breathe: take a few moments to breathe deeply; getting more oxygen helps to slow your heart rate and lower your blood pressure

Exercise: one of the most effective ways to combat stress; take short breaks to stretch, go for a walk at lunchtime, head to the gym, or take a yoga class

Listen to music: music therapy is being used for healing

Head outside: sunlight and fresh air can help to reduce stress

Laugh: laughter can reduce the physical symptoms of stress and release good endorphins in the brain

Just say no: know your limitations, and set up boundaries to prevent being overburdened

Step 6. Have a Plan of Action

To manage cancer and work, you will want to consider the type of work you do and your workplace limitations, assess the financial impact of any work-related changes, and health insurance and legal provisions that you may be entitled to, and determine your short-term and long-term work goals.

You will want to meet with your employer or supervisor to discuss your needs regarding your treatment and your work schedule. It is helpful to have suggestions and solutions prepared about handling your workload during treatment.

You may want to discuss your treatment with colleagues, how it may affect your job performance, and how you plan to cope. Communication with your employer and colleagues will help prevent your coworkers and supervisors from questioning your value and productivity as a staff member.

Prepare your workspace for maximum ergonomic comfort and efficiency. Prepare for changes in work priorities by focusing on one responsibility at a time instead of multitasking and writing down your work priorities.

Patient Resources

Cancer and Careers
www.cancerandcareers.org/en/at-work/back-to-work-after-cancer

Cancer Legal Resource Center
www.cancerlegalresourcecenter.org

Healthcare.gov
www.healthcare.gov

Job Accommodation Network
www.jan.wvu.edu

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