Millions of Australians have a chronic illness. So why aren’t employers accommodating them?

More than 20 million Australians^[1] have at least one long-term health condition, 63%^[2] of whom are in the workforce.

The causes of chronic illness^[3] are complex and are often unconnected to a person’s work. But at times, the continued exposure to work stressors can lead to or exacerbate chronic health conditions including musculoskeletal disorders^[4], heart disease^[5], anxiety^[6] and depression^[7].

Our research^[8] found 73% of people believed their chronic illness was at least partially caused or worsened by their job. Almost one in five people believed work entirely caused or worsened their illness.

These findings accord with data from Safe Work Australia^[9] which indicates health conditions (particularly mental health) account for an increasing proportion of serious workers’ compensation claims.

Read more: The impact of work on well-being: 6 factors that will affect the future of work and health inequalities^[10]

Our research also found^[11] people with chronic illness were likely to report various forms of workplace discrimination, including being rejected from a job (63%), being treated unfairly in the workplace (65%) and harassment (52%).

So what are employees getting so wrong? And what are the solutions to improving working conditions for people with chronic illnesses?

Employers’ responsibilities have grown

In 2022, Safe Work Australia^[12] updated its work health and safety regulations to include specific guidelines on the management of “psychosocial” hazards in the workplace.

A psychosocial hazard^[13] is anything that can cause psychological and physical harm, including the design or management of work and workplace interactions or behaviours.

Common examples include job demands, low job control, poor support, lack of role clarity, exposure to traumatic events, harassment and bullying. The failure to eliminate or minimise psychosocial hazards can cause work-related stress, resulting in poor health outcomes for workers.

Organisations need to improve their engagement and management of chronically ill workers to meet their legal obligations.

How employers are getting it wrong

Few organisations have sophisticated approaches to managing employees who are chronically ill^[15]. And managers often feel ill-equipped^[16] to effectively support chronically ill employees.

Instead, there is a tendency to rely on outmoded human resource and occupational health and safety systems originally designed to accommodate short-term absences and acute illnesses.

Return-to-work^[17] policies tend to fall short because they assume a phased and linear return to full working capacity. This is often not the case for people with chronic illness, whose symptoms may be degenerative or fluctuate over time.

Chronically ill workers are rarely considered^[18] in organisational diversity and inclusion policies and procedures. At best, they may be incorporated into umbrella disability policies, which can be problematic as people with chronic illness do not necessarily self-identify as “disabled”^[19].

Many chronically ill workers fly under the radar. This is partly because organisations don’t collect this data but it’s also due to the often invisible nature of chronic illness. Someone living with conditions such as long COVID or endometriosis, for example, may present as unimpaired to their colleagues. However, they will often be dealing with complex, fluctuating symptoms that are largely invisible at work.

Workers may also choose not to disclose^[20] their illness due to fears of being stigmatised, treated differently, or passed over for promotion. Our research^[21] on leaders living with chronic illness found only 18% fully disclosed their illness to their employer. Almost three-quarters of leaders with chronic illness (73%) deliberately hid their illness at work.

Read more: Should you tell your boss about your mental illness? Here's what to weigh up^[22]

What can employers do?

Here are three ways employers can begin to proactively meet their obligations to workers with chronic illness.

1. Make adjustments

Workers with chronic illness sometimes experience fluctuations in their condition which can impact their ability to complete tasks or meet deadlines. It may be necessary for managers to consider sensitively discussing a revised work schedule, the delegation of time-sensitive tasks, or discuss implementing reasonable adjustments to improve workflow.

These can be challenging conversations, but engaging with them directly means employers can allocate the resources they need to meet their business objectives, while also reducing employee experiences of overwhelm.

2. Accept reasonable requests

Workers with chronic illness may require reasonable adjustments, such as flexible working, to enable them to perform to the best of their ability.

Take these requests at face value and minimise the administrative hurdles associated with approving such accommodations. Failing to do so is likely to erode trust, entrench feelings of not being supported and increase an employee’s psychological distress.

3. Train managers

Managers may sometimes deny a request for a reasonable adjustment based on the belief that this creates a precedent for all team members. Decisions like these can compound feelings of stress, as they may be experienced as a lack of procedural fairness by employees living with chronic illness.

With appropriate training, managers are more likely to recognise that chronically ill workers are generally not seeking “special treatment”, but ways to work more effectively within their changed capacities.

By recognising the value of employees of all abilities, and proactively and systematically addressing the needs of their chronically ill workforce, employers can minimise extended workplace absences and improve the productivity of their workforce.

Read more: Symptoms of menopause can make it harder to work. Here's what employers should be doing^[24]

References

1. ^{^} More than 20 million Australians (www.abs.gov.au)
2. ^{^} 63% (www.abs.gov.au)
3. ^{^} causes of chronic illness (www.health.gov.au)
4. ^{^} musculoskeletal disorders (www.ccohs.ca)
5. ^{^} heart disease (www.ncbi.nlm.nih.gov)
6. ^{^} anxiety (bmcpublichealth.biomedcentral.com)
7. ^{^} depression (pubmed.ncbi.nlm.nih.gov)
8. ^{^} Our research (apo.org.au)
9. ^{^} Safe Work Australia (data.safeworkaustralia.gov.au)
10. ^{^} The impact of work on well-being: 6 factors that will affect the future of work and health inequalities (theconversation.com)
11. ^{^} also found (apo.org.au)
12. ^{^} Safe Work Australia (www.safeworkaustralia.gov.au)
13. ^{^} psychosocial hazard (www.safeworkaustralia.gov.au)
14. ^{^} Chuttersnap/Unsplash (unsplash.com)
15. ^{^} managing employees who are chronically ill (link.springer.com)
16. ^{^} ill-equipped (hbr.org)
17. ^{^} Return-to-work (theconversation.com)
18. ^{^} rarely considered (www.researchgate.net)
19. ^{^} self-identify as “disabled” (chronicillnessinclusion.org.uk)
20. ^{^} not to disclose (hbr.org)
21. ^{^} Our research (fbe.unimelb.edu.au)
22. ^{^} Should you tell your boss about your mental illness? Here's what to weigh up (theconversation.com)
23. ^{^} Jason Goodman/Unsplash (unsplash.com)
24. ^{^} Symptoms of menopause can make it harder to work. Here's what employers should be doing (theconversation.com)