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Should I work or not?
As you draw closer to stage 5 (End-Stage Renal Disease), you may be experiencing symptoms such as fatigue, swelling, and high blood pressure. Hopefully, you are following your doctor's advice regarding proper diet, exercise, and medications in order to combat these symptoms. Yet, even with precautions and "doing the right things," you will feel your body changing in response to the kidney disease. These changes may have you questioning your ability and desire to be employed. Before you make employment decisions, there are a number of things you need to consider. Let's take a look at some common concerns regarding employment and how this may impact you.

I feel so tired. I think it might be best if I just quit work.
Wait. This may not be in your best interest. If you are currently employed, you should do what you can to keep your job. While this may not sound appealing right now, giving up your job can make it much harder for you to go back to work later when you will probably be feeling better. Also, you need to consider that having a steady income and health insurance is helpful for you. Private insurance will reduce your out-of-pocket cost for treatments. Many times when people quit work, they end up sitting at home and battling depression. Working gives many people a sense of purpose. So find a way to keep working!

I don't think I can continue in my current job because I have kidney disease.
Keeping your current job really depends on what type of job you are doing. You should sit down and evaluate your job requirements. Your doctor may have advice on what type of job functions you should limit or avoid. You may be surprised to find that small adjustments can be made to accommodate your condition. Ask your doctor to provide you with information that describes kidney disease so that you can share it with your employer. Then, work with your employer to focus on what you can do. If you can't perform your current job, maybe your employer can help you find a different job that better accommodates your needs. If you need to switch employers, work with a vocational rehabilitation (VR) counselor to help you find employment that works with your lifestyle. The Rehabilitation Services Administration (RSA) in Washington, DC, oversees all state VR agencies, which are funded by federal and state tax dollars. If you apply for Social Security disability, Social Security may refer you to your state's VR agency. Otherwise, the best way to find a vocational rehabilitation counselor is online at www.socialsecurity.gov/work/ServiceProviders/rehabproviders.html.

Do I have any rights when it comes to work?
Yes. Because people with health problems can face challenges in finding and keeping jobs, there are laws designed to protect them. Here is a short list of laws that you may want to explore:

Americans with Disabilities Act, Titles I and V

Employers who have 15 or more employees must make minor changes, called "accommodations" to help people with disabilities work. Employers do not have to make changes that cost too much or that change job functions. Examples of "reasonable" things people with kidney disease may need include:

  • A clean room to do a PD exchange
  • Flexible work hours to keep doctors' appointments or go to dialysis
  • A chair to sit in or tools so you can do the job
  • An extra rest break

Age Discrimination in Employment Act of 1967

This law applies to companies with 20 or more workers. If you are 40 or older, the ADEA protects you from work discrimination. Age is rarely a proven qualification for work.

Rehabilitation Act, Sections 501 and 504

If your health limits at least one major life activity and you work for or want to work for the federal government, this Act protects you. Section 504 of the Rehabilitation Act states that "no qualified individual with a disability in the United States shall be excluded from, denied the benefits of, or be subjected to discrimination under" any program or activity that either receives Federal financial assistance or is conducted by any Executive agency or the United States Postal Service.

Now that I have been diagnosed with chronic kidney disease, how much time will I be spending at the doctor's office?
The amount of time you will need to spend in a doctor's office will vary along with the progression of your kidney disease and the treatments you are seeking. Take a look at the following chart to get a better idea of the accommodations you will need that may impact your work schedule. Remember you may be able to minimize missed work time by scheduling your doctor's visits on your days off or by working with your supervisor to rearrange your schedule to accommodate for doctor's visits throughout the day.

I'm worried that my employer will fire me for missing work, even if it is to go to the doctor.
There are ways to plan your time off for doctor's appointments so that you can use your employer's benefit offerings, such as sick time, personal time off, or vacation time. There are also other options such as short-term and long-term disability that you may want to discuss with your human resources department at work.

You may also want to explore the Family Medical Leave Act. This act allows some workers to take up to 12 weeks of unpaid leave per year if they or a family member have a serious health problem. To qualify for FMLA leave, you or your family member must meet all of the following:

  • You work for a government agency, school, or company with 50 employees working within 75 miles
  • You have worked for the company for at least 12 months
  • You worked at least 1,250 hours in the last year (about 25 hours/week)

When possible, ask for FMLA leave at least 30 days ahead or as soon as you know you'll need it. Your employer can ask you to get your doctor to certify that you really need the leave. You can take all 12 weeks of FMLA leave at one time, take time on certain days until you use up your FMLA leave, or even take as little as 15 minutes each day. Your employer can ask you to use vacation time and sick days as part of your FMLA leave. While you are on leave, your employer must hold your job or a like one with the same pay, benefits, and working conditions. Your employer must keep you on the group health plan but you may have to pay the premium. For more information visit http://www.doleta.gov.

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