helped workers move from one job to another without loss of health insurance. Since the enactment of these laws (and their enforcement), employment practices have improved and employees have gained some protections (Hoffman, 1999). Common accommodations made for those living with illnesses include reduced and flexible schedules. Such flexibility is increasingly common in the workplace to meet the needs of employees with family responsibilities. However, providing flexibility in production or assembly line scheduling can be more difficult for “blue collar” workers (Voelker, 1999). Even with these new protections and improvements in employer practice, contemporary workers may lose employment because of cancer (Box 6-1).

To fully understand the impact of cancer on work outcomes, one would

BOX 6-1
Examples of Cancer-Related Job Loss

Allison Yowell, a seventh-grade teacher in a Virginia public school, was forced from her job when her Hodgkin’s disease recurred. Although her prognosis was good, school officials notified her that she must resign, or face firing, because she had used all her sick days. As a recent hire, she was ineligible to request leave without pay. It was recommended that she resign before being terminated to avoid marring her teaching record. She submitted her resignation, but was reinstated only after adverse publicity regarding the case. Ms. Yowell, who wanted 4 months of leave without pay, couldn’t take advantage of the federal Family and Medical Leave Act, which grants 12 unpaid weeks per year, because it applies only after an employee has worked a full year.

John Magenheimer, who had headed a research laboratory at a major company, was recovering from surgery, chemotherapy, and radiation treatment for cancer when he learned that his company had fired him and that his health, life, and dental insurance had been terminated. He and 180 other employees of the company who had been placed on long-term disability were fired. Most companies used to pay health benefits for the long-term disabled until they were 65, but as health insurance costs and the number of disabled employees have climbed, more companies are firing them. According to a survey of 723 companies in 2002, 27 percent had a policy to dismiss employees as soon as they went onto long-term disability and 24 percent dismissed them at a set time thereafter, usually 6 to 12 months. Only 15 percent of companies had a policy to keep the disabled on as employees with benefits until age 65. Mr. Magenheimer had the option of continuing his health insurance through a federal law known as COBRA, and as a disabled worker he could purchase Medicare coverage after 18 months. Both kinds of coverage cost thousands of dollars a year, which many disabled workers can ill afford.

SOURCES: Pereira (2003); Laris (2005a,b).



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