THE WORLD OF WORK

BY ELLEN KACHALSKY, LMSW, ACSW, CCM

If you have been working but are finding it increasingly hard to do your job, especially if your physical condition changes, you may wish to consider a number of tools which may help.

ADA Accommodations under the Americans with Disabilities Act

If you are working but having difficulty due to issues with your joints, pain, and mobility, you may want to consider asking for an accommodation at work. Please think about this if you have a visible disability, i.e. you have trouble walking and use a cane or walker.

Asking for help with specific tasks can include having someone bring you supplies or take supplies to someone else. It can include positioning you closer to an elevator and parking closer to an entrance (make sure to have a Handicap Parking placard or license. Your healthcare provider will need to complete a form). It could also mean you have access to a private room in case you need to infuse your factor medication. An ADA accommodation provides some protections when you make that request.

Family & Medical Leave Act

If ADA Accommodations are not enough to help with your situation, you may wish to request FMLA (Family & Medical Leave Act) time off. FMLA allows you up to 12 weeks off in a 12-month period, which can be used intermittently or continuously, and also provides some protections for you. You could use this time for periodically returning home for treatment and recuperation after a bleeding episode, or going to your health care provider for exams, tests, procedures, and treatment. You could use this continuously if you were to have surgery or a procedure which requires recuperation. If you need a family member to help you during these times, they can also request an FMLA from their employer so they can have the time off to help you.

Disability

You might be wondering, “What happens if I can no longer do my job?” If this might be temporary because you are having surgery and recuperating, then consider:

Short-Term Disability (STD): If or when it becomes extremely difficult to continue doing your job, you will need to find out if you can apply for short-term disability (if you have that as a benefit through your employer, or you purchased your own policy). STD is generally covered up to six months and provides limited income replacement.

Long-Term Disability (LTD): If your condition warrants being off longer than six months, long-term disability would start as long as you have that benefit through an employer or you purchased your own policy. Most LTD insurance companies, which continue to provide income replacement, now require you to apply for Social Security Disability also (see below).

Social Security

If you’ve been off work and on short-term disability and you have long-term disability, paperwork will be required for your doctors to complete and justify continuing that leave for medical reasons. Even if you do not have LTD, and your condition is a) expected to last a year or more OR b) prevents you from doing your job, you may apply for SSDI. The Social Security Administration has some other criteria you will need to meet, including being unable to adjust to other work because of your condition. For bleeding disorders, they will review if you’ve had at least three hospitalizations for your condition or complications from that condition within the year before applying. They will also look at other complications, including limitation of joint movement.

So, ask for advice from your Hemophilia Treatment Center (HTC) staff Social Worker or a disability attorney (usually initial consultation is free) before calling 1-800-772-1213 to start an application over the phone so you apply under the correct category. You also must have worked five of the last ten years and paid your FICA and Medicare taxes from your wages. If you have no source of income, then at the same time, tell them you want to apply for SSI (Supplemental Security Income).

In either case, if you are approved for SSI, payments will start from the month you applied and will allow you to have Medicaid through your state until your SSDI starts. Even if you do not have enough credits to get Social Security Disability (SSDI), you can usually get SSI through your state. IMPORTANT: Note the amount you get from SSI is usually an amount set by each state, and when your SSDI starts, that amount may then disqualify you for the state SSI and Medicaid, because SSDI is usually a higher amount.

If you are approved, SSDI payments start after five months of the “onset” of the disability. After you have been on SSDI for 24 months, you will then be eligible for Medicare (what most people get at age 65 upon retiring).

Because insurance coverage, as well as Medicare coverage is so complicated, please get advice from your HTC Social Worker, financial counselor, and other organizations that can help review your needs for coverage.