According to the National Health Council (NHS), in 2019, 333 million Americans lived with at least one chronic illness and in 2020 that number was expected to grow to more than half of the population. There are numerous reasons for this. On the upside, Americans are living longer, which means they are also living longer with chronic conditions. Unfortunately, these numbers are also driven by an increasingly sedentary lifestyle and growing heart disease and diabetes rates.

Many of the people suffering from chronic illness are in the work force, and employers must find ways to accommodate them. Despite their inherent desire to help, accommodations can present both legal and practical issues for employers — here's what you need to know.

Legal Considerations

The NHS defines chronic conditions as any illness lasting longer than three months. They can include arthritis, musculoskeletal pain, diabetes, asthma, migraines, heart disease, irritable bowel syndrome, depression, endometriosis, fibromyalgia, and mental health conditions such as anxiety.

The Americans with Disabilities Act (ADA), the Family Medical Leave Act (FMLA), and many other state and federal laws govern when and how employers must accommodate workers with chronic conditions. The Equal Employment Opportunity Commission (EEOC) further ensures that the rights of workers suffering from chronic conditions, including their rights to privacy and accommodation, are protected.

Where Employers Should Start

The EEOC recommends that employers stave off any potential objections to special treatment for chronic illnesses by being both firm and open about accommodation policies. That means providing all employees with information and training on these policies and the employer's legal obligations regarding accommodation and privacy.

Training should also emphasize that workplace issues encountered by employees are personal and not open for discussion. Workers with chronic conditions have a right to privacy, and that cannot be violated even in response to a fellow worker's complaints about unfair treatment.

Finally, training and policies should direct all workers to an Employee Assistance Program (EAP) to address any further concerns.

Policy Considerations

In addition to training programs that emphasize fellow workers' rights concerning accommodations, policies should be designed to support and protect workers with chronic conditions. These policies should address worker behaviours and exposures that could adversely affect those with chronic conditions. Policies can also emphasize delivery of health-related programs and services and include health and disability benefits for workers.

The inclusion of an EAP is another critical policy component that can help workers deal with the financial, physical and social fallout from their conditions. Flexible leave programs can reduce the stress that can lead to or exacerbate chronic conditions and help maintain all workers' health status and well-being.

Policies should also contain health promotion programs that include nutrition, exercise and disease screening alongside other interventions and educational efforts.

Workplace Accommodations

It is important to note that in most states, and with most chronic conditions, employers do have a duty to accommodate workers wherever it is reasonable to do so until the point that the accommodation constitutes a genuine hardship. The employee must co-operate and help with the solution.

There is an almost infinite number of accommodations that employers can offer to workers suffering from a chronic condition. Some are relatively easy to implement, while others require a more significant investment. For example, an employee with a chronic illness may need to consume medication with food. An employer may have to accommodate this by allowing the employee to eat at a workstation or go to the lunchroom at unscheduled times. Additional accommodations could include:

• Modified job duties
• Flexible scheduling
• Additional training and supervision
• Ergonomic and physical changes to the worksite, such as increased lighting or elevator, or to the employee's particular workstation
• Parking or transportation assistance
• Time off for medical appointments
• Flexible work arrangements

From experiments in reduced workweeks to the mass remote work migration, flexible work arrangements are increasingly becoming the norm in today's workplaces. Work flexibility, whether related to time or location, can be a significant help to those suffering from chronic illnesses. Flexible work can include varying start and end times, compressed workweeks, telecommuting, job sharing and more.

For workers with chronic conditions, flexible work means they can often avoid long, uncomfortable or stress-inducing commutes. It also makes it easier to schedule doctor's appointments or appointments with other specialists during working hours. For those with conditions that include chronic pain, the ability to stagger the workday can provide significant relief. Most importantly, employers can arrange these types of accommodations with minimal disruptions and without stigma.

Resources and Support

Workplace support can be critical to the health and well-being of workers who are suffering from chronic illnesses. Encourage and develop empathetic, supportive supervisors through specialized training and communicate supportive policies to all staff, including those in management roles.

The creation of an Employee Assistance Program (EAP) is another way a company can provide support. The EAP is a voluntary and confidential service that helps employees and their families with personal concerns that might be affecting job performance or productivity. Counsellors with the EAP help the employee identify issues and find resolutions, usually within the span of a few meetings.

Most employers allow for three sessions, but some fund as many as eight and extend if necessary. EAP counsellors are also able to recommend additional outside professional services if they are required. Even without a formal EAP, some companies support their workers with a referral service that directs employees to vetted professionals.

A Better Situation For All

Living with a chronic condition can be extremely hard on a worker, but companies can take actions to make things easier for employees and safer for everyone.