Being diagnosed with cancer or any serious illness is devastating, and can quickly turn your life upside down.
But for most, coming to terms with the diagnosis and undergoing treatment has to be handled alongside tackling a whole host of practical issues – one of the most significant being your job.
For some this means juggling work with chemo or radiotherapy, while for many the struggle is getting back after recovery.
Whatever the situation, it’s important to arm yourself with a good understanding of your rights to make sure you feel confident in your return to work and to ensure you are treated fairly during the process.
Return to work: Your employer should make ‘reasonable adjustments’ to help
Unfortunately, as if battling cancer isn’t enough to cope with, an estimated 20,000 of those who are diagnosed with cancer each year in the UK will face discrimination in their workplace, according to Macmillan Cancer Support and YouGov research.
This could be anything from pressuring you to give up your job to passing you over for a promotion you deserve or rebuking you for not reaching targets without reasonable allowances.
But this isn’t fair or legal.
There are also strict rules around dismissal and demotion that mean your employer must have reasons beyond the state of your health.
Currently 120,000 people of working age are diagnosed with cancer each year and by 2030 it’s estimated that there will be as many as 1.7 million people in this bracket coping with the disease.
Want to know more?
At This is Money we want to arm you with the tools you need to manage your money as easily as possible so you can focus your attention on your health and family.
This is the first in our ‘cancer and your finances’ series which will look at how to claim on health insurance, workplace and Government benefits if you’re ill among other things.
If you have a subject you’d like us to include in the series, email email@example.com
Anyone with cancer, undergoing treatment or who has previously been treated is protected by the Equality Act 2010, and by the Disability Discrimination Order 2006 (part of the Disability Discrimination Act 1995) in Northern Ireland.
Both laws mean that while you concentrate on getting yourself back to good health or learn to manage a longer term condition, certain allowances must be made.
They give you the same rights against discrimination as anyone with a disability which ultimately means employers can’t treat you differently because of your illness.
Many people are also not aware that these rights don’t stop with the end of your treatment, they in fact last for the rest of your life, and these rules are not just limited to cancer patients.
The Equality Act states that a disability is a physical or mental impairment which has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities.
You are automatically included in this bracket from the day you are diagnosed with an HIV infection, cancer or multiple sclerosis, but some more progressive conditions such as osteoarthritis, rheumatoid arthritis, fibromyalgia and ME may also be covered.
You can find out more on the Citizen’s advice website here.
Do I have to tell my boss about my cancer diagnosis?
Jane Amphlett, head of employment at law firm Howard Kennedy, explains: ‘Generally, you do not have to tell your employer about any medical condition. But there are some exceptions, for example if there are likely to be health and safety implications or if it is a regulatory requirement.
‘Employers are often an important source of support and telling your employer about a disability early on will trigger the requirement for your employer to make reasonable adjustments. You should consider what suggestions you can make about possible adjustments and you may need to co-operate in obtaining relevant medical advice.’
Having to talk about it your diagnosis can be difficult and deeply personal. So remember if you are uncomfortable with the idea of your colleagues knowing, your employer must keep it confidential.
Office work: You may want to shift your responsibilities to help manage your symptoms
Time off and sick pay
Each employer will have slightly different rules regarding time off and sick pay so you will need to check your contract as a top priority.
If your employer doesn’t offer additional sick pay, you will receive Statutory Sick Pay for 28 weeks at a rate of £89.35 per week.
This kicks in if you have been off sick for more than four days and is paid to you by your employer (available for up to 28 weeks).
You will usually need to get a note from your doctor if you are off sick for more than a week.
How should my employer support me at work?
Some people may be unable to return to work after treatment while others prefer take a step back and go part-time or shift their focus.
But equally, cancer puts a huge strain on your finances and working can also help you retain a sense of normality. Everyone is different.
If you take the step to go back to work, you may need to make some changes to help cope with symptoms or side effects – both physical and mental.
Genevie Isaacson, an associate at Working with Cancer, which specialises in mentoring and educating employers and employees about working with cancer, stresses the importance of flexibility.
She says: ‘The most important thing to consider is for anyone going back to work or continuing to work through treatment is managing expectations.
‘One of the most difficult things for an employer to understand is that your treatment might have finished but the effects continue longer term, often up to two or three years after treatment.
‘Both the employer and employee will need to be flexible. There is no vanilla policy an employer can roll out for all, they will need to consider each individual.’
Returning to work is a process, and it can often feel like you are taking two steps forward and one step back.
WHERE TO FIND HELP
If your employer has an occupational health department they will help you come up with a phased return to work plan.
You can get your GP or employer to refer you to the Fit For Work scheme which offers free assessments and tailored programmes to help you phase in coming back to work. They can also be reached over the phone without a referral.
Don’t forget to speak to your healthcare team.
Working with Cancer is a not-for-profit company that helps mentor employees working through and after treatment and provides training for employers.
Macmillan also has a Macmillan at Work scheme which offers free tool kits and advice to employers about how to best support their staff suffering from cancer.
Speaking to your employer to explain the need for flexibility is key as your symptoms can change constantly.
Companies are however required to make reasonable changes to help you do your job or make the transition back to full-time work easier, and these should be reassessed as your condition changes.
There is no definition of what a reasonable adjustment is, but it will likely depend on the cost, the benefit to you, how practical it is to make and the potential effect on the business or its financial situation, according to Macmillan.
The steps that can be taken will of course depend on the type of job you have.
If you have an office job this might involve more breaks and adjustments to your duties to help with mental strain and tiredness.
If your job has more physical requirements it could mean providing extra tools to help you cope or building in more time to rest.
It is best to suggest options to your employer you think will help or highlight areas you are struggling with to help them consider a solution.
You could consider a phased return to work or a change to shorter hours or working from home.
One of the biggest hurdles for many coping with cancer and recovery is fatigue and hand-in-hand with this, the effects on concentration and memory, often known as Chemo brain. If this is a problem for you, you may also want to consider shifting your responsibilities, taking extra breaks or reducing your hours.
Chemo can also make you more vulnerable to infections, weakening your immune system. If this is something you struggle with you may want to find ways to help cut the risks of catching viruses and infections in the office.
Working from home, asking your employer to let you know if others in the office are sick and changing your working environment could be options worth asking about.
Practical changes to help with physical effects may also be possible, including making your work space more accessible, offering disabled facilities or special equipment to help you do the job.
It’s worth noting that your local Jobcentre Plus Office may be able to help you apply for an Access to Work grant which can help fund changes to your work space or special equipment if you need it.
Commute: You may want to adapt your working hours to avoid peak-time travel
Will I still receive annual leave?
If you are off sick you will still accrue at least basic holiday, plus if you can’t take it because of illness you are allowed to carry it over. If you are phasing back to work, this will be worked out on a pro-rata basis.
It’s also worth knowing that if you are ill during your scheduled holiday you are also allowed to take the time as sick leave instead.
Is there a limit on the amount of time I can take off?
Going back to work can be daunting and choosing the right time is hard – but you should never feel rushed.
Liz Egan, Macmillan’s work and cancer progamme lead, explains that a lot of people go back too quickly and that while everybody is different it can be years before people feel the effects of treatment wear off.
She advises: ‘An occupational health department or your own healthcare team will be able to help you decide when to go back to work and what adjustments are necessary, for example, how long a phased return you might need.’
It’s important to keep in mind that you are entitled to sick leave, and legally taking it should never affect your job
Your employer should never lean on you to return more quickly or hand in your notice because of your treatment.
It’s important to keep in mind that you are entitled to sick leave, and legally taking it should never affect your job or any evaluation of your performance.
If you can’t make it back to work in the longer term, there are instances where your employer can dismiss you – but they must first have made efforts to help you return.
Egan explains: ‘An employer may be able to terminate an employee’s contract when on long-term sick leave, if the employee is not capable of doing their job.
‘However, employers need to follow fair procedures, which should include looking at the possibility of the employee returning to work within a reasonable time frame, and they should consider any reasonable adjustments that would assist the employee.
‘The main areas an employer must look at before dismissal on grounds of capability are: reasonable adjustments, foreseeable return dates and alternative job roles.’
As a general rule you are protected from less favourable treatment, including dismissal, in most cases unless that is justified, according to Jane Amphlett, head of employment at Howard Kennedy.
‘If you are sacked you may have a claim for discrimination and for unfair dismissal (usually only if you have two years’ service),’ she says. ‘It is important to obtain advice promptly as there are time limits, generally three months, in which to bring claims.’
Egan adds: ‘If someone has less than two years’ employment service, then the dismissal would have to be connected to their cancer for a disability discrimination claim to be made. Again they would need specialist employment advice, and contact ACAS conciliation.’
A Waiting game: Hospital appointments are often last minute and frequently run late
What about hospital appointments?
More than a third or people (35 per cent) report negative experiences when managing work with a cancer diagnosis, feeling guilty for taking time off for medical appointments or a loss of confidence at work, according to Macmillan.
Unfortunately, the nature of a serious illness means a lot of time spent having tests, receiving treatment, managing after-effects and going for regular check-ups at the hospital or with your GP.
You have a right to attend these during working hours as if you need to – but it doesn’t have to be paid.
Liz Egan says: ’Your employer could consider time off for appointments as reasonable adjustment, but there is no absolute legal right to paid time off unless it’s in your contract.’
She advises speaking to your employer as far in advance as possible and addressing the subject of appointments when discussing possible adjustments.
What you will be offered is personal to individual employers but Egan says time attending appointments could be included in sickness absence, approved paid or unpaid leave, compassionate leave and part of a reduction in working hours.
In some cases your boss will exercise their own discretion, but if you are attending appointments more regularly you will need check your contract for the policy on leave and pay.
What happens if I apply for a new job?
Companies may ask you about your health or a disability in some circumstances – largely if it helps them decide whether you could perform the job or take part in the interview process or if adjustments need to be made.
Job interviews: Employers shouldn’t ask about an illness unless they have a good reason
They can also ask if they want to increase the numbers of disabled people they employ or they need to make national security checks.
Amphlett explains: ‘You are not required to make any disclosures other than to comply with a regulatory requirement or to respond to lawful health check questions, for example related to any benefits which the employer offers, such as health insurance.
‘These health questions should not usually be asked before an offer is made, unless they are relevant to the job.
‘When responding, take care not to make any dishonest or misleading statement.’
Remember your employer has however crossed the line if they then withdraw an offer without any other reason than your illness.
How to fight back if you are having problems at work
The first step is to talk to your line manager or boss or alternatively speak to human resources or even a union representative.
Approaching it this way typically has the best outcome, particularly if you want to maintain a good relationship with your employer.
If you are planning on making a complaint it can be useful to keep a record of what happened. Check your employee handbook or contract for details of your firm’s grievance procedure.
Citizen’s Advice suggests you put complaints in writing as well, as this can help back up your claim should your employer penalise you for complaining.
The next stage in the process is contacting the Advisory, Conciliation and Arbitration Service (ACAS) to attempt an early conciliation.
If this doesn’t work, you can proceed with an Employment Tribunal as a last resort.
Remember, while you can claim substantial damages you should always seek legal advice before you proceed.
Bear in mind that pursuing a claim can come with a hefty fees of up to £1,200 for discrimination claims or unfair dismissal.
If you need help, you can access free legal advice through a union rep (find a list here), Citizens Advice, the Equality Advisory Service plus it’s worth checking your home insurance policy which sometimes covers legal costs.
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