The Cancer Legal Resource Center empowers survivors to learn their legal rights so that they can advocate for themselves before legal issues become a problem. Learn ways to manage some common cancer-related legal issues using the following 5 legal tips.
1. It Is Your Responsibility to Understand Your Health Insurance Coverage
We often assume that the doctors and nurses treating us understand our health insurance coverage, and that they know better than to suggest treatments that are not covered or that we can’t afford. Unfortunately, this is not always the case. To save yourself frustration (and possibly significant medical debt) down the road, learn as much about your insurance coverage as you can, so that you are not left with unexpected bills.
You can do this by reading your summary plan description or evidence of coverage booklet, both of which are usually available online. If you have questions about your health insurance plan, call your insurance company, and take detailed notes about what the customer service representative tells you.
And, if you’re not well enough to handle this on your own, ask a friend or a family member you trust, to help you. Insurance can be confusing, but knowing what is covered can help you plan accordingly.
2. Ask for Accommodations at Work Before Your Performance Is Affected
If cancer and the effects of treatment are making certain aspects of your job more difficult, you may be entitled to something called a “reasonable accommodation.” The Americans with Disabilities Act (ADA) protects workers with disabilities from discrimination at companies with at least 15 employees, and people with cancer are usually considered “disabled” under the ADA.
If you work for a smaller company, you may be protected by state fair employment law, depending on where you live. In addition to prohibiting disability-related discrimination, these laws also require your employer to make changes to the work environment (accommodations) to help you to keep doing your job, as long as the changes you request are not too expensive or too difficult for your employer to make.
For example, changing your work schedule so that you have time to go to your doctor appointments, working from home, or even adjusting the office temperature may be considered reasonable accommodations, depending on your job.
Keep in mind that you need to ask for accommodations before your work performance is affected. If you start showing up to work late, missing work, or missing deadlines, your employer may be allowed to write you up, or even fire you, if the employer did not know about your need for an accommodation.
3. You May Not Have to Quit Your Job Just Because You Have Cancer
The Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid, job- and health-benefit protected leave for eligible employees. If you have worked for your employer for at least 1 year, worked 1,250 hours in the last year, and your employer has at least 50 employees within a 75-mile radius of where you work, you may be able to take FMLA leave for yourself if you are sick, or if you are a caregiver for your spouse, parent, or child.
Under FMLA, you can take the 12 weeks all at once or in smaller increments. So, whether you are having surgery that requires a long recovery or you only need 1 day off per week for treatment, you may be able to use FMLA leave to maintain your job and insurance benefits while you are off work.
If you don’t qualify for FMLA, you may still be able to take time off as a reasonable accommodation under the ADA, as noted above. It’s also a good idea to check your employee manual or check with human resources about medical leave, because some larger employers provide even more time off than the law requires.
4. Prioritize Your Debt
Cancer treatment is expensive, even if you have great insurance coverage. You may not be able to prevent taking on some debt, so prioritizing which debts you pay first can help to improve your quality of life.
There are 2 main types of debt—secured and unsecured. Secured debt is a debt that is tied to a piece of property (such as a home or a car), called “collateral,” which means that if you do not pay the debt, that property can be repossessed.
Unsecured debt is not linked to collateral. If you don’t pay an unsecured debt, the company or the person to whom you owe money cannot get anything from you, unless they get a judgment against you in court. Examples of unsecured debts are credit cards, medical bills, and student loans.
Sometimes it can be a good idea to prioritize paying for necessary expenses over unsecured debts. For example, if you need your car to get to and from treatment, you will need to keep making your car payment so that it does not get repossessed.
Also, a landlord or a bank can start eviction or foreclosure proceedings if you do not pay your rent or mortgage, even if you have cancer. Having a place to live is obviously essential, so you may want to prioritize paying your rent or mortgage instead of making your credit card payment.
5. Don’t Take “No” for an Answer
If your health insurance company denies coverage of a certain service or treatment, appeal the decision. First, you usually have to appeal directly to your insurance company to get it to reconsider the decision.
If the insurance company still says “no,” most people with private health insurance now have access to an external insurance appeals process—sometimes called an “Independent Medical Review”—thanks to the Affordable Care Act.
An external appeal is when an independent third party reviews your request to consider whether the insurance company was right in denying you coverage.
In addition, most people are denied Social Security Disability benefits the first time they apply. If you apply for Social Security Disability Insurance or Supplemental Security Income because you are disabled and no longer able to work, and you are denied benefits, you have a better chance of getting approved and maintaining back pay you may be entitled to if you appeal, instead of submitting a new application. You usually don’t need a lawyer to help with a Social Security appeal until you are scheduled for a hearing.
Get to Know Your Rights
Learning your rights, and how to enforce them, can help to prevent legal problems down the road. The Cancer Legal Resource Center is a national program of the Disability Rights Legal Center in Los Angeles, California. The Cancer Legal Resource Center provides free education and resources on cancer-related legal questions to cancer survivors, caregivers, and healthcare professionals. For more tips or answers to cancer-related legal questions, or to download or order a free copy of our “Patient Legal Handbook,” contact the Cancer Legal Resource Center at 866-843-2572, or visit cancerlegalresources.org.
Through this article, the author is not engaged in rendering any legal or professional services by its publication or distribution. It is not intended to be legal advice or to establish an attorney-client relationship.
- Read your summary health insurance coverage plan description or evidence of coverage booklet, or call your insurance company
- If you work for a smaller company, you may be protected by state fair employment law, depending on where you live
- Patients with cancer are usually considered “disabled” under the Americans with Disabilities Act (ADA), and therefore protected from discrimination in the workplace
- The ADA also requires your employer to make necessary, reasonable accommodations to help you do your job
- If you have worked full time for your employer for at least 1 year and your employer has at least 50 employees close to where you work, you may be eligible for medical leave under the Family and Medical Leave Act