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Financial health

Cancer can have a ripple effect on your financial security.

There are potential financial as well as physical side effects when you have cancer. While some turn out to be temporary, others can have major consequences. So it helps to be aware of the kinds of issues you might face — just as it helps to know what you might experience after chemotherapy or surgery.

On the job

What effect does a cancer diagnosis have on you as an employee? You may find that the long-term answer is "None," or "Nothing significant." But initially you may need to take time off — sometimes an extended period if the treatment is complex. That may happen as well if you have a recurrence.

The Family and Medical Leave Act (FMLA) ensures the right of eligible employees to take up to 12 weeks of unpaid leave every 12 months, and sometimes more, in addition to paid sick time for a serious health condition, including most cancers. FMLA guarantees you’ll have a job to go back to, provided you’re able to do it, and insurance coverage if you’ve been covered before the leave.

There are some conditions. You must work for an employer with at least 50 employees and have been on the job at least 12 months for this protection to apply. But many smaller employers provide this recovery time if you ask.

Disability protections

If cancer creates a disability that means you can do your job but need some accommodation — like a flexible schedule or special equipment — you may also be protected by the Americans with Disabilities Act (ADA). You can’t be fired, have your pay cut, or be denied promotions just because you’re disabled. But you do have to tell your employer about what you need to do your job.

As important as ADA protection is, though, it can’t ensure you won’t encounter setbacks despite doing your job well. The factors that influence who receives pay increases or moves up the ladder are often subjective, and concerns about your long-term health may be an issue even if it’s never articulated. Among your employer’s concerns may be the increased cost of insurance, which can be a particular burden for a small employer.

Though pressing a job discrimination complaint is probably the last thing you’ll want to deal with, and it can be expensive and time-consuming, you may find you have to stand up for your rights.

Pressure to stay

What if you prefer to stop working because you want to concentrate on getting well, or you simply don’t have the energy or enthusiasm you’re used to having? It’s obviously a personal as well as a financial decision that you’ll want to explore with your support team of professionals and loved ones.

One solution may be to ask about limited or flexible hours, the option of working from home, or other interim solutions that may make it easier for you to do your job effectively. Obviously the answer will depend on your relationship with your employer and your unique abilities.

The choice is frankly much more complicated if the health insurance you have through your employer is your only access to a comprehensive group plan. If you move from a current job to a new one that offers insurance, your right to enroll with coverage for pre-existing conditions is protected. But that isn’t the case if you resign from a job and then go back to the workforce later.

This might be another reason to explore a reduced schedule, as long as you worked enough hours to qualify for the group plan.

The reality is that finding affordable individual insurance if you’ve been treated for cancer can be extremely difficult. Providers do have the right to turn applicants down based on health history or to refuse to cover pre-existing conditions. Yet insurance is something you can’t afford to be without.

Job hunting

Looking for a new job after an experience with cancer raises a number of issues, many of them practical, that you’ll want to resolve in your own mind before you begin the interview process.

Remember that prospective employers are forbidden to ask about your health — and there’s nothing unethical in not volunteering this information.

You should expect to be asked about gaps in your resume. Dishonest answers to legitimate questions will generally catch up with you sooner or later and may even mean losing your job.

If you’re asked to provide references, you may want to let the people whose names you’re using know how much you’ve said to your prospective employer about your illness. That will make it easier for them to anticipate questions and have answers prepared.