Employers commonly provide several important benefits that can support people with cancer in paying for medical care and providing financial support during and after cancer treatment. These vary from one employer to the next, so it’s important to check with your human resources (HR) department and consult your employee handbook or benefits package to understand what is available from your employer.

Several common benefits and accommodations are described below:

• Health Insurance Coverage: Employers typically provide health insurance that covers medical treatments, hospital stays, and prescription medications, including those related to cancer treatment.
  • Employers with at least 50 employees are required to provide health coverage to employees and their dependents, although many smaller employers also offer health coverage as part of a benefits package.
• Paid Time Off (PTO): Employees may be able to use accrued sick leave and vacation time for medical appointments, recovery, or other health-related reasons.
• Disability Benefits: Short-term disability and long-term disability benefits can help employees replace income beyond their accrued sick and vacation leave.
  • Short-term disability pays benefits for shorter periods of time, typically 3-6 months or sometimes up to one year.
    • Short-term disability typically replaces 60-70% of an employee’s wages.
  • Long-term disability provides coverage for longer periods, typically for two years, but in some cases, coverage may last for several years.
    • Long-term disability typically replaces 40-70% of an employee’s wages.
• Family and Medical Leave Act (FMLA): Eligible employees of employers covered by the FMLA are entitled to up to 12 weeks of unpaid, job-protected leave per year for certain family or medical reasons. When eligible employees return from FMLA leave, they are entitled to return to the same job or an equivalent job.
• Flexible Work Arrangements: Some employers may allow employees to work an adjusted schedule or flexible hours, or work from home or telecommute to accommodate their medical appointments, cancer treatment, and recovery.
  • The Americans with Disabilities Act entitles employees with disabilities to reasonable accommodations in the workplace.
  • Accommodations are changes to the work environment or how things are customarily done to enable people with disabilities to enjoy equal employment opportunities, and they are considered to be reasonable if they do not create an undue hardship or direct threat to the employer.
• Additional Employee Programs: Many employers offer additional programs and services that can support people with cancer.
  • Employee Assistance Programs may offer confidential counseling services and support for employees dealing with personal and health-related challenges.
  • Health and wellness programs that may include resources and support for managing chronic conditions, including cancer.
  • Some employers also provide employee resource groups or networks specifically focused on health challenges, where individuals with similar experiences can share information and support.

If you have questions or would like additional information about additional resources or benefits that might be available through your employer, contact your human resources department.

Family and Medical Leave Act (FMLA)

The Family and Medical Leave Act (FMLA) allows eligible employees of covered employers to take up to 12 weeks of unpaid, job-protected leave within a 12-month period for specific family and medical related events. To be eligible, employees must work for an employer that is covered by the FMLA.

• Employers covered by the FMLA include:
  • Private organizations with at least 50 employees
  • Government agencies and public and private elementary and secondary schools

In addition, employees of covered employers must meet the following criteria to be eligible for FMLA leave:

• The employee must have worked for the covered employer for at least 12 months
• During the past 12 months, the employee must have worked for the covered employer for at least 1,250 hours
• The employee must work at a location where the employer has at least 50 employees within 75 miles

Under the FMLA, eligible employees can take job-protected leave for one or more qualifying conditions, including:

• Medical leave when a covered employee is unable to work because of a serious health condition (including cancer)
• Leave to care for an immediate family member (spouse, child, parent) with a serious health condition (including cancer)
• The birth of a child and to bond with the newborn
• The placement of a child with the employee for adoption or foster care, and to bond with that child
• For qualifying needs that arise from an employee’s spouse, child, or parent being on covered active duty or call to covered active duty for the National Guard, Reserves, or Regular Armed Forces

The FMLA provides several important protections to covered employees taking leave. The FMLA provides job protection and entitles eligible employees taking leave under the FMLA to return to the same or an equivalent job when their leave ends. Additionally, the FMLA requires that group health benefits be maintained for covered employees while they are on leave, as if they had continued to work and not taken leave. The FMLA only requires that eligible employees be permitted to take unpaid leave; however, the law allows employees to take accrued paid vacation, sick, or family leave, or for the employer to require the employee to take accrued paid leave for some or all of the FMLA leave period. When substituting paid leave, the employee must follow the employer’s leave rules.

FMLA leave may be taken intermittently. When medically necessary, employees may take leave in separate, smaller blocks of time for a single qualifying reason (e.g., for regular oncology visits, or to accommodate regular radiation or chemotherapy infusions and recovery time). Employees may also request a reduction to their usual daily or weekly work schedule under the FMLA. When leave is needed for planned medical treatment, the employee is required to make a reasonable effort to schedule treatment so that it does not unduly disrupt the employer’s operation.

How to Access FMLA Leave

If you would like to take FMLA leave, the first step is to notify your employer once you know you need to take leave. Your employer must then notify you whether you are eligible within five business days.

If your employer notifies you that you are not eligible, your leave is not FMLA protected; however, employee eligibility can change, and you may request leave again in the future.

If your employer notifies you that you are eligible for FMLA leave, they must inform you of your rights and responsibilities under the FMLA. At this time, they may also request medical certification of a serious health condition that is covered by the FMLA.

The FMLA defines a serious health condition as an illness, injury, impairment, or physical or mental condition that involves either inpatient care or continuing treatment by a health care provider. Serious health conditions covered by the FMLA typically include a period where the individual is unable to work, attend school, or participate in regular daily activities because of the condition or its treatment or recovery.

Under the FMLA, employers may request that employees submit certification from a health care provider to support their need to take FMLA leave for their own or a family member’s serious health condition. The content of the medical certification required by an employer to support an employee’s FMLA leave may include:

• Contact information for the health care provider
• The date the serious health condition began and how long it is expected to last
• Appropriate facts about the condition, including symptoms, hospitalizations, or doctor’s visits
• If the employee is the person with the serious health condition, the certification may require information showing that the employee cannot perform the essential functions of their job
• If the employee is requesting leave to care for a family member, the certification may require a statement establishing that the family member needs care and an estimate of when and for how long the leave is needed
• If leave will be taken in short blocks of time, the certification may require an estimate of how much time will be needed for each absence, how often absences may occur, and information supporting the necessity of taking intermittent leave

Information in a medical certification of a serious condition should not include information about genetic tests, genetic services, or evidence of disease among the employee’s family members. Additionally, the health care provider may provide a diagnosis, but providing a diagnosis is not required under the FMLA.

Under the FMLA, health care providers who may provide medical certification include:

• A Doctor of Medicine (MD, DO) authorized to practice in their state
• A podiatrist, dentist, clinical psychologist, optometrist, or chiropractor (with limitations) authorized to practice in their state, and performing within the scope of their practice
• A nurse practitioner, nurse-midwife, clinical social worker, or physician assistant authorized to practice in their state and performing within the scope of their practice
• Any health care provider from whom the employer or the employer’s group health plan’s benefits manager will accept a medical certification to support a claim for benefits

Once they receive a completed medical certification, your employer must notify you whether your leave has been designated as FMLA within five business days. If your leave is not designated as FMLA leave, then it is not protected (but you may request FMLA leave again in the future). If your leave is designated as FMLA leave, your leave is protected, and when you return to work, your employer must return you to your same or a nearly identical job.

More information:

More information about the FMLA and accessing leave is available from the following sources:

• United States Department of Labor FMLA information
• FMLA Leave Process (including a graphical illustration)
• Medical Certification under the FMLA
• Triage Cancer Quick Guide to the FMLA

Michigan Earned Sick Time Act (ESTA)

The Earned Sick Time Act (ESTA) is a Michigan law that went into effect on February 21, 2025, replacing the previous Paid Medical Leave Act (PMLA). The ESTA requires employers to provide employees with paid medical leave to use for their or their family members’ medical needs, or for leave related to domestic violence or public health emergencies.

The ESTA applies to all employers with one or more employee(s) in the United States, regardless of whether the employees work full or part time, or how many hours they work. Unlike the PMLA, which had several exemptions related to which employees were covered, the ESTA applies to all employees except those employed by the United States government and those working in states other than Michigan.

Eligible employees accrue paid leave at the rate of 1 hour for every 30 actual hours worked, up to 72 hours a year. For small businesses (defined as employers with 10 or fewer employees), employees earn up to 40 hours per year.

Under the ESTA, paid leave is available as it is accrued, but employers may require an employee to wait 120 days after beginning employment to use accrued leave. Employees can carry over unused paid medical leave from one benefit year to the next and there is no cap on carryover hours. Employers can also frontload paid leave, making all paid leave hours available at the beginning of a benefit year rather than employees accruing leave over time. In this case, the employer does not have to let employees carry over unused leave from one year to the next.

Employers are considered compliant with the ESTA if they provide at least 72 hours of paid leave (or 40 hours for small businesses) to eligible employees in a benefit year. This paid leave includes, but is not limited to, paid vacation days, paid personal days, and paid time off. If employers already provide at least 72 hours of paid leave to eligible employees, they are not required to provide additional paid leave under the ESTA.

More information:

Additional information about the Michigan ESTA is available from the following sources:

• ESTA FAQs from the Michigan Department of Labor and Economic Opportunity
• ESTA Required Poster

Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) is a federal civil rights law that protects people with disabilities from discrimination in everyday activities, including in seeking and retaining employment. In the same way that other civil rights laws prohibit discrimination based on race, sex, national origin, age, and religion, the ADA ensures that individuals with disabilities have access to the same employment opportunities, opportunities to participate in state and local programs, and to purchase goods and services as everyone else. Title I of the ADA specifically addresses employment discrimination.

The ADA applies to employers that have at least 15 employees, including state and local governments, employment agencies, and labor unions. The ADA applies to all phases of employment and requires that employers provide people with disabilities an equal opportunity to benefit from the employment-related opportunities available to others, including in recruitment, hiring, promotions, training, pay, and social activities.

What Counts as a Disability?

Under the ADA, a person with a disability is someone who has a physical or mental impairment that substantially limits one or more major life activities. The ADA also protects people with a history of such an impairment, such as a person with cancer that is in remission, or who are perceived to have such an impairment.

Under the ADA, “major life activities” include those that an average person can typically perform with little or no difficulty. These include (but are not limited to):

• Breathing
• Walking
• Talking
• Hearing
• Seeing
• Sleeping
• Caring for oneself
• Performing manual tasks
• Working

Major life activities also include major bodily functions, including immune system functions, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions.

In 2009 the Equal Employment Opportunity Commission (EEOC) provided examples of impairments that “virtually always” constitute a disability. This list includes cancer, along with epilepsy, diabetes, HIV infection, and bipolar disorder.

Reasonable Accommodations Under the ADA

In addition to protection from discrimination, the ADA also entitles people with disabilities to reasonable accommodations in the workplace. Accommodations are changes to the work environment or the way things are customarily done that enable an individual with a disability to enjoy equal employment opportunities. An accommodation is considered to be reasonable if it does not create an undue hardship or a direct threat.

Reasonable accommodations apply to people with a current disability as well as those with a history of a disability (e.g., cancer that is in remission).

Types of accommodations that are generally considered reasonable include:

• Allowing a flexible work schedule
• Changing job tasks
• Improving accessibility in a work area
• Providing or adjusting a product, equipment, or software
• Reassigning the employee to a vacant position
• Changing the presentation of tests and training materials
• Providing reserved parking
• Providing an aid or service to increase access

Reasonable Accommodation Process

Requests for reasonable accommodations must be considered on a case-by-case basis. To seek a reasonable accommodation covered under the ADA, the covered employee should reach out to their supervisor or human resources department to disclose that they have a disability that is impacting their ability to do their job or to fully participate in one or more phases of employment. Ideally, this should begin a dialogue between the employer and employee to identify effective, reasonable accommodations that will allow the employee to fully participate in employment. The employee may need to provide documentation of the disability from an appropriate healthcare provider.

Discussions of accommodations should be kept confidential and shared only on a “need-to-know” basis. Other employees who may need to do something differently as a result of the accommodation may be told of the change, but not the reasons for it.

Once accommodations are identified and implemented, including any necessary training for the employee, the employee and employer should maintain communication to determine if the accommodations are working and to make adjustments, as needed. If the employer plans to deny an accommodation request, they should provide the employee with the reason for the denial.

Filing a Charge of Employment Discrimination

If an employee believes that they have been discriminated against based on a disability protected under the ADA, they should file a charge with the Equal Employment Opportunity Commission (EEOC).

Additional resources:

More information about the Americans with Disabilities Act and how it applies to people with cancer is available from the following sources:

• Introduction to the Americans with Disabilities Act – ADA.gov
• Quick Guide to the Americans with Disabilities Act – Triage Cancer
• Reasonable Accommodations in the Workplace – ADA National Network
• How to Determine Whether a Person Has a Disability under the ADA – Job Accommodation Network
• Cancer in the Workplace and the ADA – U.S. Equal Employment Opportunity Commission

One of the main concerns many people with cancer have is how to navigate work during and after cancer treatment. Your employer’s Human Resources (HR) department can help you understand your company’s benefits and policies and your rights, and responsibilities related to work and cancer.

Information related to your company’s policies and benefits may be available in your employee handbook or on your employer’s HR website. To get additional information, reach out to an HR representative by phone or email or request a meeting to discuss your questions or concerns.

Topics to address with your HR department – Your HR department may be able to provide information related to several common concerns of people with cancer and those caring for a loved one with cancer.

• Medical Leave – A representative from HR can help you understand your options for taking paid and unpaid medical leave during and after cancer treatment. The Family and Medical Leave Act (FMLA) provides eligible employees with up to 12 weeks of unpaid leave per year for certain medical and family reasons. There may also be options for taking paid leave using sick or vacation time or short-term or long-term disability coverage.
• Flexible Work Arrangements – It may be possible to request a flexible work arrangement, such as adjusted work hours, remote work options, or part-time schedules during and after cancer treatment, or while caring for a loved one with cancer.
• Reasonable Accommodations – In addition to flexible work arrangements, it may also be possible to request reasonable accommodations that can help you perform your job effectively. These could include modifications to your work environment, changes in duties, or assistance with certain tasks. The Americans with Disabilities Act (ADA) requires certain employers to provide reasonable accommodations to allow employees with disabilities to participate in all aspects of employment, but employers not covered by the ADA may also provide accommodations.
• Employee Assistance Programs and Other Resources – You may want to ask whether your employer offers any Employee Assistance Programs that may provide counseling, support, or other resources for managing the emotional and practical aspects of dealing with cancer. HR departments may be able to connect you with community resources, support groups, or external organizations that can provide additional assistance.

Things to consider when contacting HR:

• Disclosing a Cancer Diagnosis – Whether to tell your employer about a cancer diagnosis is a personal decision. Some people may want to inform their supervisor, coworkers, and customers or clients, while others may not wish to share this information at work. In general, employees are not required to disclose a cancer diagnosis to their employers; however, employees may need to disclose some information about their condition to request medical leave or reasonable accommodations.
• Confidentiality – HR professionals are typically trained to handle medical and other sensitive information discreetly. You can always discuss any concerns you have about how your information is shared with an HR representative.
• Documentation – In order to process requests for accommodations or medical leave, your HR department may require documentation such as a letter from your doctor or other healthcare provider outlining the nature of your condition.

HR professionals are there to assist employees and can guide you through the available resources and options. Updating your HR department about your treatment schedule and any changes in your situation or needs can help them better support you through treatment and recovery.

Additional information about working with your HR department and navigating work and cancer is available from:

• Triage Cancer – Work & Cancer includes resources related to working, taking time off, and returning to work after cancer treatment, disclosing a cancer diagnosis, and employee benefits.
• Cancer and Careers – At Work provides practical resources and information for managing work and treatment, including getting organized communicating with your employer.