How patients with chronic illness should talk with their doctors is a frequent topic online. Laurie Edwards wrote about what patients need to think about in terms of other patients (The patient to patient relationship).
But are you telling your doctor enough information about your current job situation?
Think about it. Does your physician ask you how your work is going or how your symptoms affect you at work? Unlikely, unless you mention it’s a problem first. Or unless your symptoms are so clearly disabling that the issue can’t be overlooked.
I’m not saying that you won’t find any physician willing or able to probe these issues. But given the demands of the current reimbursement environment, most doctors are too busy to talk about anything than what seems directly related to keeping you healthy.
But here is why it is very important to your long term job security strategy that your doctor write — in your medical records (which should be for his/her eyes only!) — a note about whether or not you have made some accommodations at work due to symptoms.
As my client (I’ll call him Craig) just found out, you can find yourself up a creek without a paddle if you don’t have a physician’s documentation that you are in fact “sick” or debilitated.
Craig thought he was keeping his job safe when he made minor changes regarding how he did his job – – without mentioning it to his supervisor or others. He deliberately did not inform anyone because he worried about backlash. He did not tell his doctor because he thought he was taking care of things successfully and didn’t want to be a complainer.
But, as Craig found out, when the time came that he ran out of the job modifications that he could make without getting his supervisor involved, he lacked the data he needed.
When Craig told his supervisor that he needed certain accommodations, his supervisor pushed back. From his supervisor’s perspective, Craig was doing his job well so accommodations weren’t necessary . Remember, he didn’t know the hoops Craig jumped through daily! When Craig explained that he’d already been working differently because of his symptoms, his supervisor demanded a doctor’s note confirming that Craig had these disabilities.
But, Craig’s doctor wasn’t able to support his claim. He had no idea about what Craig was or wasn’t doing at his job.
It would be easy to point to various mis-steps in Craig’s communication with his supervisor that might have prevented his supervisor’s response. But as he learned later, the doctor’s note verifying that Craig had been doing his job for several months using his own modifications would have overcome any objections.
Craig has managed to create a temporary work scenario that gives him more flexibility than he currently has — on a trial basis. But it’s taken time and unnecessary energy – none of which he has in abundance right now.
A doctor’s note – kept in his doctor’s office until necessary – with notation of Craig’s increasing disabling symptoms and the accommodations he was making at work would have allowed him to paddle far more easily.
If you’re thinking about asking for accommodations, I go into detail about what to say and how to say it in my book, Women, Work and Autoimmune Disease: Keep Working Girlfriend! and in my career thrive Guidebook, You Don’t Say.
Rosalind aka cicoach.com
James says
Thanks for the helpful post! I wonder if there are other reasons why having a “paper trail” would be helpful. What about insurance, or future jobs, or even close friends or family that don’t understand? I wonder because I am certainly one to make a lot of adjustments quietly, and that has gotten me in trouble before!
Mary says
I was quite distressed when I obtained a copy of my medical records that my allopathic care providers had not ever entered ANYTHING about chronic headaches or the work stress that I repteatedly emphasized. However, my chiropractors have definitely documented about work related stress. So I think the moral of my story is to periodically request a copy of your medical records, even if you do have to go through a lot of rigamorale.
mary
Mary says
this is a p.s. to my previous message. Now that I am seeing mental health tyhey are documenting all over the place, including in the diagnostic code, that I am being seen for work related stress.
Mary
Rosalind Joffe aka cicoach.com says
Funny how that happens.
Patricia Hauslein, Ph.D says
I had an unfortuante incident with this a few years back. I was in charge of teaching a large lecture class (200 students) with 10 sections of lab every week and supervising 3 TA’s. I was working 12 hour days. In agreement with my department chair we decided to file for accommadations so we could use that documentation to get me more help. My doctor was very helpful by writing a letter pretty much stating exactly what I asked for. Which was needing to get closer to a 40 hour week than a plus 60 week. Our HR person had never worked in an educational system and had no clue what a lab section even meant. Their solution to my request for accommadation was to re-issue my contract to a 2/3 rd’s workload with the accommpaning reduction in salary. It took two lawyers to get that worked out. I guess the moral of the story is.. be very specific what you ask for AND know the politics of the institution you work for.
Pat
Rosalind Joffe aka cicoach.com says
Thanks for sharing that Pat. This is very worthwhile information here. The landmines to avoid….
Natalie says
I sure wish I had this advice a few years ago. The law firm I worked for got a new HR director. The person I worked with for 15 years and who knew of my RA was replaced by one who viewed me as an expensive problem. As the firm self-insured, she had access to my medical expenses and figured she could save the firm a lot of money by getting rid of employees with high medical bills. I requested accommodation under the ADA, in writing, and she ignored any reference to ADA or accommodation. All I needed was a flexible start time. I failed to give my doctor’s office a heads up on my request. When I asked them to write a letter requesting the firm’s assistance, the physician’s assistant left a message on my work voice mail stating that he didn’t know why I would need such a letter. Unbeknownst to me, my supervisor had been instructed to screen my voice mail and e-mail. The firm used this question to ignore my request. The former HR director heard what was going on and advised me to request incremental FMLA leave. I was fired 2 days after I downloaded the FMLA form on my work computer. The firm had installed a “sniffer” on my pc and knew every keystroke I typed. Several others were terminated after me, and then the supervisor they used to do the dirty work was fired. I guess law firms don’t have to follow the law.
Rosalind Joffe aka cicoach.com says
Even all after all of my own years being employed in small and large firms – and then consulting to companies — and finally coaching employees, it never ceases to amaze how badly people/organizations can behave. You certainly had a case against them if you’d taken it to court – but would you have won? And at what price? Are you employed now? I hope it’s worked out for you.
Guy Thompson says
It is certainly hard to know how to handle relations with employers, who have genuine duties to other staff members as well as business owners / shareholders. I have had MS for over 20 years so I know the problems of never quite knowing from one day to the next how I will feel.
And if the patient doesn’t know, how will the employer be able to understand? Keeping lines of communication open is necessary, but not sufficient. There may not ever be an answer in an employment relationship because even when discriminatioin is illegal (as it is many countries now) there are so many overlapping and conflicting dutiies between the company and the employee. That’s why I have become self employed and started my own internet business, as well as writing ebooks about MS and other subjects..
Rosalind Joffe aka cicoach.com says
Being self employed does make the unpredictable part of a CI easier – but it also leaves you out there, all alone, often without a back up. It also takes a higher level of self motivation. And it can be isolating. There are no easy answers. That’s for sure. .
www.wingapo.com says
Hello! Someone in my Facebook group shared this site with us so I came to give
it a look. I’m definitely loving the information. I’m book-marking
and will be tweeting this to my followers! Exceptional blog
and wonderful design and style.
Rosalind says
Thank you for your comment. Love to hear that this is useful!