Lloyd Austin hid his cancer. When do employees need to disclose a serious illness?

That can blur the line between a personal health battle and an obstacle at work — territory that even some officials in some of the country’s most prominent positions have struggled to navigate in recent weeks. 

Secretary of Defense Lloyd Austin raised alarm among U.S. officials this week when it was revealed that the head of the country’s $800 billion defense department had been hospitalized for days in early January before President Joe Biden was made aware. Austin’s hospitalization, due to complications from prostate cancer treatment, left his deputy director unexpectedly running the Pentagon from a beach vacation in Puerto Rico. 

The precedent-breaking lack of disclosure spurred criticism from U.S. lawmakers. 

The incident shows the discomfort many of us may feel about breaching the topic of our health at work.

“A lot of people make the decision not to say anything [about a medical condition],” said Monique Gignac, scientific director and senior scientist at the Institute for Work & Health in Toronto. “They wait until there’s a crisis.”

But being transparent about health problems at work — particularly those severe enough to impact your ability to do your best in your job — provides employees with the most legal protection from job loss and can offer the best shot at securing the accommodations they may need to succeed, employment experts told MarketWatch. 

It can also help foster a workplace environment that is open, communicative and often more compassionate than we realize.

“I think nine times out of 10 people discover that,” said Kate Bischoff, an employment lawyer and human resources consultant based in Minneapolis. “When you combine that compassion with legal protection, I think it’s a winning combination.” 

Am I required by law to tell my employer about a health condition? 

U.S. employment law offers protections for eligible workers that require medical leave from their job or accommodations for a disability at work.

Eligible employees are entitled to 12 weeks of unpaid, job-protected leave for “a serious health condition that makes the employee unable to perform the essential functions of his or her job,” according to the Department of Labor. Some local or state laws provide qualifying workers with more extensive protections.

And the Americans with Disabilities Act requires employers to provide reasonable accommodation to qualified individuals with disabilities, unless doing so would cause “undue hardship” to the business, such as significant expense or difficulty. Those accommodations could include changes like a modified work schedule so that employees with chronic conditions can go to medical appointments. 

But to be protected by those laws, you’ll need to share at least some information about your health condition with your employer, said Edgar Ndjatou, executive director at the nonprofit employee-rights organization Workplace Fairness.

That doesn’t mean you have to disclose a specific diagnosis. But “you have to at least be clear about what the symptoms are and how it impacts your ability to work,” he said. 

How do you know that a condition is serious enough to consider sharing with your supervisor? It depends on your company’s policy and the state and local employment laws where you live, Ndjatou said. 

One good rule of thumb: if you know you’re going to be out for more than three days or it’s clear that the health issue is going to impact your ability to do your job at full capacity — in the short or long term — it’s a good idea to let your employer know, he said. 

“If you’re going to be late because you have doctor’s appointments, if you need something from your employer to be able to do your job, it’s a good idea [to inform them],” Bischoff added.

Another caveat: if your condition could threaten the safety of yourself or your coworkers at work (such as in, say, working with heavy machinery), it becomes even more important to disclose, Gignac said.

If you do share health information with your employer, they’re obligated by law to keep it private and safeguard it carefully, Ndjatou said. 

But “if you’re not following company policy or your obligation under the law to share [some information about your condition], that could be grounds for losing your job or facing some kind of discipline,” he said. “The law won’t look favorably on you for not disclosing that information.” 

Building workplace trust 

Employment law doesn’t always take into account the many complexities workers have to balance when deciding whether to disclose a medical condition, Gignac said. 

“People are often very worried about gossip or stigma,” she said. “They’re concerned about the reputational damage even if they have support [like sick days or other accommodations] available.” 

If employees don’t feel they can share critical information about the ways their health may be impacting their work, that’s often indicative of a larger problem with an organization’s culture, Ndjatou said. 

That may be one argument for employees, particularly those in leadership roles, to be more frank about their health challenges.

“Even sharing something as incredibly private as cancer —  if you can explain how this is affecting your ability to do your job, that kind of transparency builds more trust and creates a healthy work environment,” Bischoff said.

The healthiest workplaces are those that recognize that challenges in our personal lives — whether it’s a health scare, an aging parent, or having a child — are inevitable for every employee, Gignac said.

“Every single one of us is going to have something — and likely more than one thing — come up (over the course of our careers) where we need support from the workplace,” she said. 

As for a stint such as Austin’s secret hospitalization, “I wouldn’t advise it,” Ndjatou said. 

“I think it’s a fair criticism that this is something that shouldn’t have happened,” he said. “It’s a microcosm of many workplaces: when you have people in decision-making roles — whether it’s a CEO, a CFO, or anything like that — your people below and above you need to know where you are.”