Financial and Legal

Balancing Work

The many responsibilities of caring for someone often leads to job conflicts. Work is a financial necessity and a major source of personal satisfaction, but for many caregivers, it is often difficult to balance the twin responsibilities of caregiving and working. Each caregiver’s working conditions are different. Talk to your supervisor and look in the employee handbook or other human resources publications to learn about your company’s policy on caregivers.

• Ask your employer if there is an employee assistance program.
• Ask your human resources or personnel department to give you information about the Federal Family and Medical Leave Act (FMLA). Have a copy sent to your supervisor as well, if appropriate. Read more about FMLA in Family and Medical Leave Act (FMLA) for Caregivers, below.
• Take advantage of flex-time policies. Consider asking for a flexible schedule if a formal policy is not in place.
• Offer to work a less desirable shift or be willing to make up time taken for caregiving by working days or shifts when most people want to be off. This flexibility on your part shows your employer that you are committed to the company and your job.
• Consider job sharing or working part time, if possible.
• Avoid mixing work with caregiving responsibilities. If you need to make phone calls or search the Internet for information related to your loved one’s needs, do it on a lunch break.
• Manage your time well. When you must take time off for caregiving, set priorities and accomplish the most important things first. Delegate responsibilities when you can. Pace yourself; don’t do so much in one area that you can’t be effective in another.
• Get all the support you can from family members, friends and community resources.
• It’s a personal choice about whether to disclose information about a medical situation to your employer. People have the right to keep the information to themselves. There are some instances when disclosing some information about a medical condition is necessary, but it doesn’t have to be everything or even a specific diagnosis. Visit Triage Cancer for more information.

You may find that the people you work with treat you differently because you are spending less time at work. You can tell your coworkers either as little or as much as you want to about your situation. In most cases, your coworkers will probably be understanding. Most people know someone or have a loved one who has been in a similar situation. However, do not feel obligated to share details, except with your supervisor. Be sure to thank people at work for their consideration and assistance.

Family and Medical Leave Act (FMLA) for Caregivers

In order to care for your loved one, it may become necessary for you to take a leave from work. There are laws in place to help protect caregivers in these types of situations.

Eligible employees (who have worked at least 1,250 hours over the last 12 months for private companies with 50 or more employees) can take unpaid, job-protected leave for specified family and medical reasons under the provisions of FMLA. Employees continue to receive their group health insurance coverage under the same terms and conditions as if they had not taken leave.

Eligible employees are entitled to

• Twelve workweeks of leave within a 12-month period to care for the employee’s
  • Own serious health condition that prevents the employee from performing the essential functions of his or her job
  • Spouse, child or parent who has a serious health condition
• Twenty-six workweeks of leave within a 12-month period to care for a covered service member with a serious injury or illness who is the spouse, child, parent or next of kin to the employee (military caregiver leave).

Note: As of February 2015, the US Department of Labor’s Wage and Hour Division announced a Final Rule to revise the definition of “spouse” under the Family and Medical Leave Act of 1993 (FMLA). The Final Rule amends the definition of spouse so that eligible employees in a legal same-sex marriage will be able to take FMLA leave to care for their spouse or family member, regardless of where they live.

There are three kinds of FMLA leave. They are

• Continuous FMLA leave: An employee is absent for more than 3 consecutive business days and has been treated by a doctor.
• Intermittent FMLA leave: An employee is taking time off in shorter blocks of time due to a serious health condition that qualifies for FMLA. Intermittent leave can be in hourly, daily or weekly increments. Intermittent FMLA leave is often taken when an employee needs ongoing treatment or must go to follow-up appointments for his or her condition.
• Reduced-schedule FMLA leave: An employee needs to reduce the amount of hours he or she works per day or per week, often to care for a family member or to reduce fatigue or stress.

Managing Health Insurance and Finances

As the caregiver, you may be responsible for managing your loved one’s health insurance and finances.

Know the patient’s coverage. Newly diagnosed patients need to know

• Exactly what medical treatment and services are covered by their insurance
• How to protect their benefits
• What resources are available to deal with gaps in insurance coverage
  What out-of-pocket expenses there will be.

Cancer survivors who will need follow-up care also need to know what is covered by insurance.

See the Insurance Coverage page to learn about coverage and types of plans.

Be organized. Create a filing system that works for you. This will allow you to find information quickly and easily. Keep a copy of all claims and related paperwork in an organized folder, by category. The folder would store letters of medical necessity, bills, receipts, requests for sick leave, etc. Also, keep a written record of any phone conversations with insurers; be sure to include the name of the person you were speaking to, what was said and the date.

Create a budget. Planning a budget in advance and sticking to it is an important part of managing finances after a cancer diagnosis. If you and your loved one share finances, work together to create a budget. If you do not share finances, offer to help your loved one to create one. You may also want to create your own budget since caregiving can bring additional expenses, too.

Research financial assistance. There are a number of ways to find financial assistance for expenses related to treatment or to replace lost income. Some organizations can also help with transportation costs, living expenses or prescription costs.

Read the PDF, Financial and Legal, for more information.

See the following Worksheets:

• Worksheet 14: Insurance Call Log

• Worksheet 15: Understanding the Health Insurance Plan

• Worksheet 16: Health Insurance Appeal Tracking Form

• Worksheet 17: Budgeting

• Worksheet 18: Financial Assistance Record

Advance Directives

Advance directives are a patient’s instructions about future medical care either if or when he or she can no longer speak for himself or herself. Ideally, advance directives should be in place before a person becomes ill or before a crisis.

If your loved one doesn’t have an advance directive, choose a practical time and place to have this conversation with him or her. Let your ill relative set the pace of the conversation. Use good listening skills, but expect some initial resistance. Whatever your loved one’s wishes are, acknowledge and sustain them, even if you don’t agree.

An advance directive is generally made up of one or two legal documents: A living will and/or a medical power of attorney. You or loved one can obtain information about advance directive(s) (and the relevant documents) from the healthcare team.

Each type of advance directive is regulated differently by state. For this reason, you may wish to consult with an attorney when preparing an advance directive.

For more information, download or order The Leukemia & Lymphoma Society's free booklet Advance Care Planning. 

The information on this page is current as of June 2018.

Related Links

• Financial Support
• Insurance Coverage
• Managing Insurance and Expenses During Illness
• Public Programs
• The Affordable Care Act
• Download or order The Leukemia & Lymphoma Society’s free booklet, Cancer and Your Finances.