We have developed this fact sheet to provide information and direction on supporting people with chronic illness. It is a starting point for a range of matters you may wish to consider when offering employment related support to this group of job seekers.
Understanding chronic illness and its impact on job performance
People with chronic illness often have a good understanding of their condition and will understand the impact of their condition on work performance and what workplace adjustments they may need at interviews, while training or on the job.
A chronic illness is by definition one that is ongoing. You may end up working with job seekers with a wide range of illnesses like:
Each illness has its own particular characteristics and symptoms and can affect people differently. Differences aside, some generalisations can be made about how work performance may be affected.
A person with chronic illness may experience periods of wellness where they are able to fully participate in employment activity and periods of illness where participation may be affected and greater flexibility in the workplace required. If the illness is degenerative, as many are, then work may only be a viable option for a limited period of time. There may also be psychological issues present related to reactive depression, adjustment to the onset of a chronic illness and grief regarding the impact of the condition on themselves, family and significant others. There may also be the effects of ongoing pain, medication or fatigue to be considered.
The Workplace Adjustment Tool contains further information on a range of chronic illnesses. The Workplace Adjustment Tool is a searchable database that allows you to search for ideas for workplace adjustments and solutions based on a particular disability and the type of job being undertaken.
Put the person first
When developing a job search plan or offering post-employment support, it is necessary to be flexible and treat each person with chronic illness individually. Tailor your approach to individual needs and capacities and focus clearly on each person’s goals and abilities. This should also entail reassessing and adapting plans and support as necessary and linking people with relevant specialist services.
Tapping into existing support networks may also assist in realising vocational ambitions. Use current and valid assessments and reports (school, previous employer feedback, medical, rehabilitation or work capacity) to help you gain a full understanding of the person’s strengths, barriers and any assistance they will require along the road to employment.
Directly discuss with the job seeker pre-employment and post-placement strategies for dealing with any medication, pain management and ‘time-off’ issues, or other special requirements associated with their illness.
Pre-employment strategies
You can assist job seekers with chronic illness find suitable and durable employment by developing an individualised pre-employment plan that incorporates the following:
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an exploration of realistic job options—this process needs to include a consideration of how medical health care requirements will be met
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a job development strategy covering resumes, interviews and job search techniques, including the job seeker’s and your roles in these activities
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consideration of disability disclosure
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requirements for workplace adjustments or modifications
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exploration of the need for mobility allowance, if the job seeker is unable to use public transport and is eligible for assistance, or taxi subsidy schemes
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consideration of post-placement support needs.
Job search
Sometimes people with chronic illness may have unrealistic ideas about jobs in which they could succeed. This may occur more often in instances where the person had a strong pre-illness work history. Unrealistic work ideas may be a result of the person not yet coming to terms with any post-illness changes to their capabilities or to a lack of awareness of the impact of such change.
Whatever the cause, it is crucial to carefully explore each job seeker’s work skills and interests through personal discussion, checking any post-illness employment referees or talking frankly to treating health professionals. For those job seekers who are still coming to terms with their illness, consider adjustment to disability counselling. For others with limited or no recent work experience, it may be beneficial to arrange work experience or voluntary work to assist in determining future job choices. Work experience may also assist in clarifying the most appropriate number of hours and time of day the person is able to work. Further to this, work experience also allows exploration of the potential new work environment.
This process of exploration may also help determine whether a person will be able to work for full wages or be eligible for the Supported Wage System and be paid productivity based wages. Historically, only a very small percentage of those accessing the Supported Wage System have been job seekers with a chronic illness.
Most job seekers will benefit from personal involvement in preparing suitable resumes and using a range of job search methods. Where the illness has led to gaps in the employment history, discuss with the job seeker how to address this in the resume and later in job interviews. A good rule of thumb is to involve a person to the maximum level of their abilities in the whole job search experience.
Job interviews
When it comes to actual job interviews or face to face meetings with employers, people with chronic illness will usually not require any advocacy support to fully understand the job requirements and ‘sell’ themselves to a prospective employer.
However, they might occasionally due to previous knock backs and low confidence request your presence at an interview or meeting as a support person to help explain to an employer the nature of the illness, how it will impact on work performance and what reasonable adjustments might be necessary. You may also be able to support the job seeker in describing any employer incentives that may be available, including information about the Workplace Modifications Scheme.
All job candidates, whatever their interview skills, can benefit from interview practice opportunities and from understanding what job interviews entail from start to finish. Also make sure the job seeker has a good understanding of what are acceptable and legally permissible interview questions in relation to their disability.
Disclosure issues
There is no single answer to the question of disability disclosure for people with chronic illness.
For some, this may not be a critical issue if their disability is apparent. In this case it may be a matter of working out a way of discussing information about a person’s disability with prospective employers in a manner with which the person is comfortable.
For others, whose illness may not be readily apparent, disclosure can become a real issue that warrants careful consideration. Whilst it is always a personal decision to disclose and the potential impact of disability may not be considered relevant during an interview, it may become an issue later on in the job. In this case, developing appropriate disclosure strategies is important to ensure that the worker receives the training and support they need to make the job placement succeed in the longer term.
Post-placement strategies
Job commencement—support needs
Starting a job can be a testing time for any new employee and for some with chronic illness, there may be the need for settling anxiety in addition to any employer incentives you may arrange. This will vary depending on the job seeker, the severity of the illness and the nature of the workplace. It is unlikely job seekers with chronic illness will require extra initial on the job skills training.
The ideal situation is when the employer takes ownership of employee induction and provides the same level of training they would for any new employee. Though for new employees with chronic illness they may need your advice and assistance on long term support strategies to manage the effects of illness and the need for breaks from work for occasional or regular medical appointments or treatment. This may require some flexibility with use of paid and unpaid leave provisions, an agreed timetable of employer and employee communication while absent and carefully staged return to work plans.
For example, someone with a chronic kidney disease may have to attend dialysis three times a week, the treatment may only be available during the day and if their paid sick leave expires then single day use of annual leave may be necessary. Someone experiencing a severe asthma attack may only need a short period of time off work now and again using regular sick leave provisions, whereas someone with rheumatoid arthritis may at some stage need to have one or more hip or knee replacement operations and require an extended recuperative period of unpaid leave.
Such support might initially also include proactive education of the employer and co-workers on the impact of a person’s illness with the aim of avoiding misunderstandings on the job. This may involve full or partial disclosure to break down possible misunderstandings in the workplace.
Ongoing support
Once an employee with chronic illness has commenced work and been given all necessary initial assistance, you can increase their chances of maintaining employment by providing ongoing support as required.
Ongoing support requirements and the way this support is delivered should be discussed with the employee. With this group of employees you need to consider that their support needs may alter at times, due to changes in their condition. Ongoing support may include:
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visits, email or phone calls to monitor performance and if required, to provide personal support
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assistance with resolution of work related problems
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ongoing coaching of employers and co-workers on relevant disability issues
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advice on job redesign (tasks, processes, hours, flexible work schedules, or flexible use of leave)
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provision or arrangement of ergonomic or workplace assessments
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workplace adjustments (structural modifications, special aids/equipment, communication strategies)
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assistance with time management, task prioritisation, memory aides or stress management
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off site or on site counselling or performance feedback
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referral to external services or linkage into internal support mechanisms
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if required, negotiate Work Based Personal Assistance for eligible employees receiving assistance from a Disability Employment Service, to assist with personal care support needs
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assistance with training and expansion of duties, including regular performance reviews and appraisals.
More information
For information and step by step instructions on the financial help available to employers of people with disability, including the application process, visit:
The following fact sheets, developed for service providers, are also a useful resource: