Some people tell their employer as soon as they are diagnosed with arthritis, joint pain, or back pain; others prefer to wait until they need to say something. Whatever the circumstances, for most people this is not an easy conversation. It makes all the difference to have the support and understanding of an employer.

30–50% of employees with RA do not disclose their arthritis to their employer (Lacaille, 2019).

Employees might not disclose their arthritis, joint pain, and back pain because they are afraid of the impact of disclosure on their career, people’s perceptions, or feelings of futility:

• Fear of job loss or slowed career progression: Although employees cannot be fired because of a chronic condition, they might worry that they will be more likely to be included in lay-offs or not considered for a promotion.
• Fear that they will be perceived differently: People with arthritis, joint pain, and back pain may worry that they will be seen as less competent or more of a liability. They may worry about unconscious bias that employers, HR, or co-workers have about people with a chronic condition.
• Feelings of futility: Some employees with arthritis, joint pain, and back pain may think there is nothing their employers can do to help or they may be reluctant to accept help.

In addition to deciding if they want to disclose or not, employees also need to consider when, to whom, with whom the information can be shared, and how much information they want to disclose. Disclosure can also depend on factors such as the type of work they do or how much their condition affects their ability to do their job.

It takes courage for employees to disclose a health condition, particularly if it’s an invisible disability like arthritis:

To ensure employees are comfortable disclosing their arthritis, here are some actions to take:

• Be prepared for a disclosure. Understand what your workplace processes are and how to protect both your and the employee’s rights. These details are covered in the privacy section.
• Ensure the processes around disclosure are clear. Ensuring employees know who to talk to and what the process looks like reduces stress around disclosure conversations.
• Start having conversations about workplace wellness. The more health-related challenges are talked about and accepted, the easier it will be for employees to feel comfortable coming forward with them.

The Workplace Accommodation Process Question Guide in the Tools and Resources section can help you before and during disclosure. This question guide is helpful for employers, and can also be shared with employees to help them feel prepared and confident when going into these conversations.

Having communication tools around accommodations supports both you and your employee when identifying and implementing accommodations.

For employees who do not want their co-workers to know about their health issues, careful thought needs to be put into how the accommodation will be addressed and presented.

See the Accommodations section for more information about adjustments or accommodations and the Tools and Resources section for more information about tools and resources around requesting accommodations.

Remember to focus on what the employee can do and not just what they can’t.

Regular communication and check-ins provide opportunities to evaluate and discuss the appropriateness of an accommodation. Scheduling a series of review meetings makes time and space available and allows discussion about how the employee is doing, including if any further adjustments need to be made. Using open questions such as “How are you doing at the moment?” or “Is there anything that we could do to help?” can assist the employee in expressing concerns.

Tips for checking in:

• Ask your employee how they would like you to check in.
• See if they would like to schedule a series of review meetings to verify if the supports in place are working, or if there are other adjustments they might need. In these meetings, you may also want to include an occupational therapist or other appropriate people.
• Let the employee know who they can talk to if their situation changes.

As an employer, it is very important to respect your employees’ privacy. This includes if, when, and how you discuss their condition or accommodation with others.

Two key legal points related to communication and arthritis are disclosure and privacy. Here are the basics:

• If it does not interfere with workplace safety, an employee doesn’t have to disclose a health condition to you.
• If an employee has requested an accommodation, they are required to share the limitation or restriction they are experiencing, but do not need to disclose what their illness or disability is.

Legally, you can ask an employee about their functional limitations and their prognosis (a doctor’s opinion about how the condition can change over time). The information provided does not need to include the medical condition, and special care should be taken to protect the privacy of the employee.

Check with the employee before talking about their health to others, and make sure that any communications are only going to those who need to know. It is your responsibility to protect your employee’s privacy and confidentiality.

For example: When an employee tells you they have rheumatoid arthritis, they may want to tell their co-workers or to keep this information confidential. If they want to tell their co-workers, discuss and jointly agree about the best way to do this, including who will be told, when and how, what will be disclosed, and why (e.g., requesting accommodations).