How Managers Can Better Support Employees With Chronic Illness

Managers don't need to know every detail about an employee's health to create a work environment that supports people with chronic illness. Clear expectations, reasonable prioritization, thoughtful flexibility, and an understanding that employees won't all work best under identical conditions are good management practices whether or not someone has disclosed a medical condition.

Because many chronic illnesses aren't visible, an employee could be managing changes in energy, pain, mobility, cognition, medical appointments, or other health-related needs without their manager or coworkers knowing what's happening. Requiring employees to disclose personal medical information before considering their individual needs will inevitably leave out people who could benefit from a different approach.

In my conversation with Dr. Amy Behimer, a board-certified health and wellness coach, pharmacist, and healthcare leader who has multiple sclerosis, we discussed chronic illness from the perspective of both the employee and the manager. Amy has managed her own health throughout most of her career while also leading other professionals, and her approach demonstrates how managers can maintain high expectations without assuming that every employee needs to work under identical conditions.

Don't Assume Chronic Illness Means Poor Performance

After being diagnosed with MS at 27, Amy worried about how other people would perceive her professionally because terms like chronic illness, disability, or limitations can quickly lead people to focus on what someone won't be able to do. Chronic illnesses, symptoms, treatments, jobs, strengths, and support needs vary significantly from person to person, so a diagnosis alone doesn't tell a manager how someone will perform or what they're capable of contributing.

Rather than making assumptions about what someone's health means for their career, managers can evaluate whether the employee is meeting expectations, what they're doing well, where they're struggling, whether expectations are clear, and whether something about their performance has changed. Those are useful management questions regardless of whether the employee has a chronic illness.

Amy has applied the same strengths-based thinking to her own career by choosing to remain in a people-management role that fits what she enjoys, what she's good at, and how she wants to manage her health rather than pursuing higher titles simply because that's the expected progression. She has continued developing professionally for nearly 20 years at that level, challenging the assumption that someone who doesn't continue climbing the organizational ladder has stopped growing.

Employees with chronic illness may still want challenging assignments, promotions, leadership opportunities, professional development, or long careers with their organizations. Managers can discuss those goals with employees and evaluate them based on their interests and performance instead of deciding what their health will allow on their behalf.

Manage the Work, Not the Medical Condition

Understanding what needs to get done, setting expectations, establishing priorities, providing feedback, and addressing performance problems are management responsibilities that don't require knowing the details of an employee's medical history.

Amy asks employees to bring her everything on their task list and calendar that's weighing on them so she can help determine what needs to happen first. She uses the same approach with her own leader by explaining what she's trying to accomplish within the hours available and proposing which responsibilities should take priority.

An employee struggling with capacity may respond by working longer, trying to keep up with every request, or assuming everything carries equal importance when their manager would happily move three things to next week. Regular conversations about workload give managers an opportunity to clarify what matters most, identify what can wait, and make sure the amount of work they're assigning is consistent with their expectations.

Clear expectations also make accountability more useful when someone isn't meeting an essential requirement of the job. Instead of trying to determine whether a health condition explains the performance problem, the manager and employee can discuss the specific expectation, what isn't happening, whether something about the work needs clarification or support, and what needs to happen moving forward.

Create Flexibility Where the Work Allows It

Distinguishing between requirements that are essential to accomplishing the work and processes that exist primarily because they're familiar can help managers identify where employees have room to work differently. When Amy discussed changing capacity, she encouraged people to experiment with how work gets done and consider whether there are other ways to reach the same goal.

Amy has used that approach when employees have different strengths or preferences for particular responsibilities. If one responsibility drains one employee but aligns well with another employee's strengths, redistributing the work may create a better fit while still accomplishing what the department needs. That won't be possible with every responsibility or every team, but managers who understand the outcome they're trying to achieve are in a better position to recognize where flexibility exists.

During the pandemic, the expansion of remote work also allowed some people with chronic illness to perform jobs they had the skills and ability to do without navigating the physical demands of regular office attendance. As organizations have reduced remote options, some employees have lost flexibility that materially affected their ability to work, even though their ability to perform the work itself didn't necessarily change.

Schedules, meeting structures, task assignments, communication methods, and when different types of work are completed can offer similar opportunities for flexibility depending on the role. Managers don't need to eliminate legitimate job requirements, but they should be able to explain why a requirement exists rather than relying exclusively on how the work has traditionally been done.

What to Do When an Employee Discloses a Chronic Illness

When an employee chooses to disclose a chronic illness, understanding what they're communicating and what they need is more useful than trying to become an expert on their diagnosis. Someone sharing information because they want their manager to understand a change in their work may need something different from someone requesting a formal workplace accommodation.

Formal accommodation requests should follow the organization's established process and involve HR or the appropriate internal resource. The U.S. Equal Employment Opportunity Commission provides guidance about disability discrimination, reasonable accommodations, medical inquiries, and confidentiality, while the Job Accommodation Network offers practical resources for employers and employees navigating workplace accommodations.

Managers also need to protect an employee's privacy when coworkers notice changes in someone's schedule, responsibilities, or work arrangement. A coworker's curiosity doesn't automatically give them a right to know why a change was made, and managers who aren't sure what information can be shared should work with HR rather than unnecessarily discussing an employee's medical information.

As Amy learned to manage her own health and career, she became more intentional about creating an environment where the people she leads could take care of themselves and work from their strengths because, as she put it, “I had to go first.” Employees notice whether managers consistently work while sick, respond to messages late at night, avoid taking time off, or treat exhaustion as evidence of commitment just as they notice managers who communicate priorities, use flexibility appropriately, take care of themselves, and maintain clear performance standards.

Managers can support employees with chronic illness without lowering expectations or knowing every detail of someone's health by understanding what the work requires, communicating priorities clearly, managing people as individuals, and using flexibility where it allows employees to contribute effectively while still meeting the needs of the organization.

For more on chronic illness, work, and career management, 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: Workplace Accommodation Toolkit
https://askjan.org/toolkit/index.cfm

CDC/NIOSH: Total Worker Health
https://www.cdc.gov/niosh/twh/index.html

CDC/NIOSH: Healthy Work Design and Well-Being Program
https://www.cdc.gov/niosh/research-programs/portfolio/hwd.html

‍