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by Jen Leigh on March 3, 2019

Creating a Compliant, Caring Culture Toward Chronic Medical Conditions


The numbers tell the story: Given that a full 45 percent of the U.S. population suffers from at least one chronic condition - that's 133 million Americans - it's a safe bet to say that at least one member of your team is undergoing such adversity.

Plus, even if none of your employees are ill, there are likely several who are affected on at least an ancillary basis by chronic disease: Consider the mom who uses all of her leave each year because she's taking care of a sick child, or the son who frequently has to duck out to bring an elderly parent to a doctor's appointment.

More than 16 percent of Americans working full- or part-time also assist with the care of a friend or loved one. That's another 55 million members of the workforce who are essentially doing two jobs, at least.

Do these employees, who are facing issues outside of work, take away from productivity and thus from profitability? Sure, that can be the case, and from a financial perspective, having an employee with a chronic medical condition can be undesirable at best.

Take a moment to look at the situation another way, though: Caring for and accommodating these employees can actually be an opportunity to demonstrate the culture of your company, increase employee morale and create a better workplace for everyone - all factors that can dramatically improve employee engagement.

Leveraging your relationship with these employees into a tool that builds loyalty among your workforce depends on you going the extra mile, however. The "reasonable accommodations" required by law should not be seen as a bare-minimum requirement to be met.

Companies that go above and beyond to take care of their team members are burdened with issues relating to chronic disease don't have to suffer from decreased productivity. And moreover, it's possible to make your caring environment into an asset in developing an investment from the rest of your workforce as well as an attraction for potential new hires.

The cost of chronic disease

Chronic medical conditions are costly for everyone involved. While the ill employee or employee caregiver spends a great deal of money to take care of his or her health, the employer also makes a significant investment. Here are a few numbers:

Lost pay - While on average, employers shoulder the burden of 58 percent of the total medical costs of chronically ill employees, nearly 40 percent of workers in this country have no sick leave and so take a hit in the wallet on top of dealing with their illness. Absenteeism costs the average American worker about $300 per year, to say nothing of those who are chronically ill. Meanwhile, employees who are also caregivers are estimated to lose more than $300,000 in wages throughout their caregiving years.

Lower productivity - Individuals with chronic diseases report more than six times as much absenteeism as well workers. These employees also have statistically higher rates of "presenteeism," or reporting to work while compromised, as well as higher rates of adverse incidents at work, such as accidents. Caregivers, meanwhile, miss work at a similarly steep pace, as studies show that nearly half arrive to work late, leave early or take time off to tend to their responsibilities outside the office, while 14 percent reduce their hours or take a demotion. Obviously, these absences can dramatically impact a company's ability to effectively produce goods or services: the Centers for Disease Control estimates that absenteeism alone costs employers nearly $226 billion per year in decreased productivity.

Health care - Unsurprisingly, chronically ill workers raise corporate health premiums as well. One study in the state of Massachusetts showed that employers in that state would shell out over $41.4 billion in increased medical costs related to chronically ill workers.

Compliance - Finally, there's the increased cost of compliance to take into account when a company takes on these workers. Specific government regulations direct the manner in which these employees and their needs must be handled, and employers must adhere stringently to these requirements or face the potential of costly legal action.

On the other side of the equation: What employees affected by chronic illness bring to the table

In the face of those numbers, it might seem as though you should take a hard pass on employing a chronically ill worker or caregiver. Not only is that illegal in many cases - the Americans With Disabilities Act (the ADA) prevents covered employers from discriminating against candidates with illnesses - in reality, when you add such an employee to your staff, it's quite possible that he or she will bring value to the table.

• Employing a chronically ill worker or a caregiver is an important way to add diversity to your workplace, and diversity is a known predictor of profitability.

• These multitaskers tend to have excellent time-management skills. Many chronically ill employees have been students of their own conditions for years, and thus come prepared with highly developed coping techniques to manage their productivity relative to their illnesses. They're practiced at making a concerted effort to churn through more work when they're well in order to compensate for the times when they are not.

• There are ways to boost chronically ill employees' productivity without spending money. For example, many chronically ill workers and/or caregivers can function at full or nearly full speed if allowed to work from home. Working from home enables these employees to manage their symptoms in a familiar environment without workplace distractions, so when they're working, 100 percent of their focus is devoted to the task at hand.

Of course, there are many other reasons to bring these employees on board, not least of which is the fact that you might just have to. Given the aging of the American population, more and more workers will be either affected by a chronic condition or impacted by the need to care for a friend or loved one who is.

When making a cost-benefit analysis, ensure that you don't needlessly set aside a potentially valuable team member solely because he or she has more issues than the average worker. And of course, be sure that you know your legal responsibilities when interviewing a candidate who stipulates that they have such a situation.

What's the law got to do with it?

Speaking of the law, it has plenty to say about candidates and employees who suffer from chronic diseases or are caregivers. Let's take a look at the relevant rules and an employer's responsibilities in relation to them.

• The Americans With Disabilities Act (ADA) protects the rights of disabled Americans by leveling the playing field when it comes to barriers to participation in the world of work, among other things. According to the Department of Labor, Title I of the ADA makes it illegal for covered employers to discriminate against people with disabilities "in the full range of employment-related activities, from recruitment to advancement to pay and benefits." You're a covered employer if you have 15 or more employees or you're an employment agency, labor organization or joint labor-management committee. The Equal Employment Opportunity Commission provides guidance on this area of employment law online here.

• The Family Medical Leave Act (FMLA) gives employees meeting certain tenure requirements at companies with 50 or more employees up to 12 weeks of unpaid leave to care for themselves or a friend or loved one while dealing with a "serious health condition." The Department of Labor's definition of a serious health condition is broader than that of a disability, encompassing pregnancy, childbirth and many physical and mental illnesses and conditions. Employers can find more information and tools relating to the FMLA here.

• Workers' Compensation law - The Department of Labor also oversees Workers' Compensation programs, which apply to almost all employers and cover workers who are injured or disabled on the job. These programs are directly administered on a state-by-state basis, and links to the state offices can be found here.

• State laws - On top of all of the federal rulings, an increasing number of states have either laws that require employers to provide sick leave to employees, laws that require employers to provide leaves similar to that administered by the FMLA to employees, or in some cases, both. It's important to consult your state Department of Labor to determine what the regulations are in your state. Links to those bodies can be found here.

In today's litigious American society, it should go without saying that running afoul of your legal responsibilities in any of these areas carries the risk of being very costly - the "compliance" piece mentioned earlier.

If it seems like a dizzying array of regulations to keep up with, remember that you don't have to go it alone: Here's where a human capital management partner with extensive resources in the compliance area can be a literally priceless partner in managing your employees' needs.

Supporting your chronically ill or caregiver employee

We've now taken a thorough look at the issues and ramifications surrounding chronically ill and caregiver employees, including the fact that the data suggests you already have them in your workforce.

Considering that by the year 2020, 25 percent of American workers will be over the age of 55 - and with increasing years comes a higher probability of both illness and the need to be a caregiver - this trend will only accelerate.

The good news is that there are many ways for employers to support these workers with the goal of their presence and contributions being beneficial for everyone involved - the employee, their coworkers and the company itself.

Open the lines of communication: Quite possibly, the most important thing you can do for an employee facing their own health challenges or those of a loved one is to make it clear that you have an open-door policy regarding their needs. Encourage transparency and ensure that your team knows the rules with respect to protections for those in these situations so that anyone with a challenge feels comfortable speaking freely with you. After all, you can't solve a problem unless and until you know what it is.

Flexible work arrangements: As noted previously, many workers facing these challenges can flourish with work arrangements that are outside the norm. This could mean working solely or partially remotely to enable them to take care of their needs and responsibilities in their own space while balancing their work. Or, it could be something like flextime, wherein they are not required to cohere to standard work hours but instead can come to the office when they are able or when they are at their most productive. Job sharing is also an option, where they can be partnered with another employee to divide responsibilities. For more ideas, take a look at the European Network for Workplace Health Promotion's guide on this subject.

Many ways forward exist. The most important thing to remember is that it's critical to work together with the employee in question and give them the opportunity to discuss their particular situation with you in as transparent a manner as possible to come up with the best solution for all involved.

Lenient leave policies: Choose to look at providing extended leave to a chronically ill member of your team or someone who needs time off to care for a friend or loved one as an opportunity to raise overall employee engagement and invest in the loyalty of your workforce. Work-life balance, and management's recognition of the need for it, is a critically important factor in overall employee engagement. When you demonstrate a dedication to caring for your employees, it puts a positive spotlight on your organizational image, making the affected employee's coworkers proud to work for your company and inclined to invest more effort into their own work because they feel you'd "have their back" if they encountered similar issues.

Employee Assistance Programs (EAPs) - While they actually have their roots in the 1950s, these programs have only become the standard within the last decade and are now offered by 97 percent of large employers. Although studies show that these programs have overwhelmingly positive outcomes, they are underutilized, with only about 5 percent of those eligible accessing them on an annual basis. If you have an EAP, encourage your employees to make use of it by distributing information on all of its features and benefits, and do so on a regular basis. You never know when someone might be in need and this information could reach them just in time - potentially even in time to reduce absenteeism or presenteeism on their behalf.

Also, encourage modeling and "championing" of EAP use - for non-confidential reasons, of course - among management. If employees are clear that the leaders of a company make use of the EAP, they'll be more likely to call on it themselves.

As with much in life, employing chronically ill or caregiver workers really all comes down to your mindset. If you as an employer believe it's going to be a burden on you or your company, it will be; instead, look at it as an opportunity to practice compassion and empathy and exercise your creativity to find strategies that help everyone succeed.

For the resourceful leader, these relationships can represent unparalleled learning and bonding experiences that increase employee engagement and bring your team closer together.

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Jen Leigh

Jen Leigh is a Senior Product Specialist with Inflection HR's Cloud Based HR and Workforce Management Solutions. Connect with Jenni and the rest of the Inflection HR Team on Twitter, Facebook, Linkedin, or Google +.