Should You Disclose a Chronic Illness at Work?

Deciding whether to tell your employer about a chronic illness can be complicated, especially when your condition isn't visible to other people. You may want to protect your privacy while also wondering whether sharing more information would help your manager understand what you're experiencing or give you access to support you need.

There isn't one correct answer because your decision depends on your health, your work, the people involved, what you need from your employer, and how comfortable you are sharing personal information. It may also change over time as your circumstances change.

I recently discussed this with Dr. Amy Behimer, a board-certified health and wellness coach and pharmacist who has lived with multiple sclerosis (MS) for most of her career. Amy was diagnosed at 27, about five years into her career as a pharmacist and healthcare leader, and remembers worrying about how other people would see her and what the diagnosis could mean for her future.

Why Disclosure Is Complicated

Many chronic illnesses and disabilities aren't immediately apparent to the people around you. Amy described autoimmune conditions as potentially affecting energy, mobility, cognition, pain, and other aspects of someone's daily life even when coworkers have no indication that anything is happening, which means the person managing the condition also has to decide whether other people need to know about it.

Amy initially wanted to hide her MS diagnosis, but her relationship with disclosure changed over time. She became more comfortable sharing her experience and being an example of someone who could live with MS while continuing to build a successful career, although she doesn't suggest that everyone should make the same choice.

During our conversation, Amy emphasized examining the reasons behind your decision rather than assuming disclosure is inherently good or bad. Wanting to keep your medical information private is legitimate, but if you're reluctant to disclose because you're concerned that people will assume you're less capable, less committed, or unable to continue growing in your career, it's worth considering how much those concerns are influencing your decision.

Those concerns aren't entirely unfounded because terms like "chronic illness," "disability," or "limitations" can lead people to focus on what someone won't be able to do. A diagnosis doesn't automatically tell an employer how someone will perform, what they're capable of contributing, or what their career can look like.

What to Consider Before Disclosing a Chronic Illness

Instead of starting with whether you should disclose, consider why you're thinking about sharing the information and what you're hoping will happen as a result. Your health may be affecting your schedule or energy, you may need something about your work environment to change, or you may want your manager to understand a situation that has started affecting your work. You could also be considering a formal workplace accommodation or simply feel comfortable sharing what's happening because of the relationship you have with your manager.

Who needs to know and how much they need to know are separate decisions because telling your manager that you're dealing with a health condition that affects your energy is different from explaining your entire medical history, just as talking with HR about an accommodation is different from telling your coworkers about your diagnosis.

Before sharing, consider:

• Why am I considering disclosing this information?
• What do I want the person to understand?
• Am I asking for something to change?
• Who needs this information?
• How much am I comfortable sharing?
• What would a useful outcome from this conversation look like?

Your work environment can influence the decision because a supportive manager and an organization with established processes for accommodations may affect how comfortable you feel having the conversation. Previous experiences with your employer, organizational culture, and concerns about how the information could be perceived can reasonably make you more cautious.

Broad recommendations to either "tell your manager" or "keep your medical information private" aren't particularly useful without understanding the person, the health condition, the work environment, and what prompted the decision.

When Your Health Begins Affecting Your Work

When your health begins affecting your ability to do parts of your job, the decision about what to share can become more complicated. During the episode, I shared an experience working with a leader who had a chronic illness that wasn't initially disclosed to the broader team. As their health changed, they became less able to attend meetings, make decisions, and handle other responsibilities that affected the rest of the department, so other people began stepping in without understanding why the situation had changed.

The leader still had a right to privacy and didn't owe everyone on the team details about their medical condition, but there was eventually a work problem that needed to be addressed. Maintaining your privacy doesn't prevent you from recognizing when something about the work needs to change, whether that means clarifying priorities, changing how certain responsibilities are handled, asking for greater flexibility, requesting an accommodation, or talking with the appropriate person about what you need to continue doing your job effectively.

Amy and I also talked about the tendency of high achievers to keep pushing rather than acknowledge that their capacity has changed. She described realizing after her MS diagnosis that the "more, more, more, harder, harder, harder" approach that had helped shape her professional identity wasn't going to be sustainable.

A change in your health doesn't automatically mean you need to leave your job, stop pursuing advancement, or dramatically redesign your career. Managing your career effectively does require an accurate understanding of what your health requires, what your work requires, and where the two may no longer align without some type of flexibility, support, or change.

Know Your Rights and Resources

Disclosure is different when you're considering a formal workplace accommodation because there are laws and organizational processes that may apply. The Americans with Disabilities Act (ADA) provides employment protections for qualified individuals with disabilities, and employers are generally required to keep employee medical information confidential. The rules around what employers can ask, what information employees may need to provide when requesting an accommodation, and who can access medical information depend on the circumstances, so this is an area where it's important to use authoritative resources rather than general career advice.

The U.S. Equal Employment Opportunity Commission (EEOC) provides information about disability discrimination, reasonable accommodations, medical inquiries, and confidentiality under federal employment law. The Job Accommodation Network (JAN) also offers extensive resources for employees and employers, including guidance specifically addressing disability disclosure in the workplace and potential accommodations for different medical conditions.

If you're considering an accommodation or aren't sure what you're required to disclose, those resources can help you understand the legal and organizational processes involved while you consider the career decision itself.

Ultimately, deciding whether to disclose a chronic illness at work requires you to consider your circumstances, what you need, what you're comfortable sharing, and what you're hoping will happen as a result. Your health is part of the reality you're managing in your career, but it doesn't define your professional value or automatically determine what you're capable of doing next.

For more on managing your career when your health changes, listen to my conversation with Dr. Amy Behimer on Control Your Career: Managing Work, Energy, and Career Growth With Autoimmune Disease.

PODCAST PAGE LINK: https://www.ridethetidecollective.com/podcast/managing-career-with-autoimmune-disease

Additional Resources

U.S. Equal Employment Opportunity Commission: Disability Discrimination and Employment Decisions
https://www.eeoc.gov/disability-discrimination-and-employment-decisions

Job Accommodation Network: Disclosing a Disability in the Workplace
https://askjan.org/articles/JAN-s-Disclosing-a-Disability-in-the-Workplace.cfm

Job Accommodation Network: Disability Disclosure
https://askjan.org/topics/Disability-Disclosure.cfm

Job Accommodation Network: Workplace Accommodation Toolkit
https://askjan.org/toolkit/index.cfm

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