The Americans With Disabilities Act (ADA) and Breast Cancer

Health often isn’t the only concern a person has after being diagnosed with breast cancer. Many people also worry about how breast cancer will affect their jobs. Luckily, the Americans with Disabilities Act (ADA) provides many protections for employees with breast cancer.

The ADA is a federal law that protects the rights of people with disabilities in the United States. Title I of the ADA forbids employers from discriminating against eligible workers with disabilities. It also requires that employers give these workers reasonable accommodations, or changes to the job or work environment, to help them successfully perform their jobs. 

The ADA covers many but not all jobs in the U.S. It protects people who work for private employers with 15 or more employees, but not those who work for smaller businesses. It includes state and local government employees, but not federal employees. (The Rehabilitation Act gives many of the same protections to federal employees. And most states have laws that protect workers with disabilities at places with fewer than 15 employees.)

The ADA also gives some protections for people who do not have a disability. Caregivers of people with disabilities are protected against discrimination at work but don’t have a right to accommodations. For instance, they can’t be denied a promotion because their supervisor assumes they’ll be too tired to handle it, but they still can be let go for performance problems. People who used to have a disability but no longer do are also protected from discrimination and have a right to reasonable accommodations, such as time off to attend follow-up appointments. 

Breast cancer is often considered a disability under the ADA, says Monica Bryant, a cancer rights attorney and chief mission officer of Triage Cancer, a cancer education and advocacy nonprofit. That’s because the law considers people to be disabled if they have a mental or physical condition that substantially limits a major life activity or impairs them. 

The ADA requires that employers provide reasonable accommodations to workers with disabilities to help them do their jobs. Accommodations can include giving employees adapting equipment or devices. For instance, if treatment-related neuropathy in your hands is making it hard to write or type, you may need a voice-to-text program to get your job done. 

Other accommodations may also include changing how, where, or when you work. For instance, your employer may allow you to work from home to better manage symptoms while receiving treatment. Other accommodations at a work site or while teleworking may include a modified schedule, more rest breaks, or restructuring the job so you can do more difficult tasks at the time of day you have the most energy.

To access accommodations, you must tell your employer enough information about your medical condition to show why you’re eligible, but you don’t need to tell them your exact cancer diagnosis, Bryant says. You may be asked to provide a note from a medical provider stating that you have a disability and why you need an accommodation. This note does not need to include every detail of your medical history.

If you prefer to not tell your employer about your diagnosis, ask for a note from a medical provider who is not an oncologist. Have them describe your symptoms or side effects from treatment, rather than sharing that you have breast cancer.

Before you ask your employer for an accommodation, think about your job, the challenges you’re facing at work, and solutions to help address these challenges.

You can request a specific accommodation to meet a need, but your employer can give you a different one so long as it meets that need. If breast cancer treatment makes you sensitive to temperature, for instance, you could request to work from home because your workplace is too cold. But if it’s better for your employer, they could give you an office with a thermostat instead. 

If you need help coming up with a reasonable accommodation, visit the Job Accommodation Network and try their Situations and Solutions Finder. This checklist from the Triage Center can help you understand the process for getting reasonable accommodations. 

An employer does not need to provide an accommodation if it is “unreasonable,” or if providing it would be dangerous to others or an undue burden — for instance, if it’s too expensive.

A common accommodation for people with breast cancer is time off, Bryant says. People in some jobs can take 12 weeks of unpaid time off per year via the Family and Medical Leave Act. You can request an accommodation of more unpaid time off for medical appointments, treatment, or to manage symptoms.

Your employer must allow you to take a “reasonable” amount of time off. What is considered “reasonable”? It varies. Some states, including Indiana, Illinois, and Wisconsin, have ruled that taking multi-month leave is not reasonable.

The ADA protects eligible employees with breast cancer from discrimination by their employer for having breast cancer during all phases of the employment process, including:

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  hiring and training

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  job assignments

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  pay and raises

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  benefits and promotions

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  tenure

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  firing and layoffs

To be protected, you still must be able to fulfill the essential duties of your job. These duties usually can be summed up as those on the job listing when you were hired. If you can’t fulfill these duties with reasonable accommodations, you may be let go. Similarly, an employer can refuse to hire you if you cannot meet the qualifications or responsibilities of the job with reasonable accommodations.

You can still be fired or laid off, but not because you have breast cancer or need accommodations. Unfortunately, this does happen, but is not legal under the ADA.

If you suspect that an employer covered by the ADA is discriminating against you for having breast cancer or isn’t providing reasonable accommodations that you’ve requested, your first step is to consider your goals, Bryant says. If you’ve been fired, for instance, do you want your job back? Or is your goal justice or financial compensation?

If you’re employed and the problem stems from your supervisor, you can try talking with their supervisor or Human Resources, Bryant says. You may be able to solve the situation without legal involvement.

If you want to take further action, you can file a complaint with the Equal Employment Opportunity Commission. Be sure to do so quickly after the incident because there is a time limit; generally, it is 180 days, but it may vary by state and situation. But be aware that proving discrimination can be difficult, Bryant says. To have a better chance of proving your case, document all instances of unfair treatment.

For legal assistance, you can contact the legal advocacy nonprofit A Better Balance through their free and confidential legal helpline. LawHelp.org may also be able to help you find local legal aid organizations that handle employment issues. 

For more information about the ADA and how it relates to people with cancer, visit Triage Cancer. For one-on-one help, you can contact their Legal and Financial Navigation Program.