Depression and Bipolar Support Alliance
Repeal of the Affordable Care Act will cause every state to lose jobs, says Josh Bivens. How can you be successful at work and protect your job when you live with a mood disorder?
According to the Holmes-Rahe Life Stress Inventory, loss of employment through dismissal or retirement rank among the top ten most stressful life events. So it’s important to know that several federal policies being debated can affect national job growth—among them repeal of the Affordable Care Act (ACA).
Every state in the country will lose jobs if the ACA is repealed, according to an Economic Policy Institute report by Josh Bivens. Further, this contraction in the job market will not be limited to health care positions.
There are several reasons for this. One, reduced funding for health care will hit hardest among those who can least afford it. Individuals and families who are receiving subsidies to offset monthly premiums and cost-sharing expenses can ill afford to absorb those costs once subsidies disappear. The result is that families and individuals will no longer have as much discretionary spending as more and more of their disposable income goes towards medical expenses.
Adding to the problem: the promised tax cuts won’t result in a boost to the economy. Those with the highest incomes will see the most benefit, and this group tends to disproportionately save, rather than spend, when they receive a boost to their paycheck.
The consequence of this perfect storm? According to Bivens, “this sudden withdrawal of money from the U.S. economy will result in a reduction in job growth by 1.2 million by 2019.”
No state is immune, says Bivens. While every state can expect job losses, there are several factors that determine the severity of the loss. One factor is whether a state has large share of high-income households relative to low-income households. Another factor is whether or not a state expanded Medicaid. In both cases, states can expect a larger loss of jobs, as the percentage of people needing to absorb higher medical costs increases.
States that did not expand Medicaid, however, are not off the hook. The amount of the GDP (value of the goods and services produced in a state) that went to subsidizing premiums and medical cost-sharing are 165% higher in the non-expansion states. If those cost-sharing benefits are lost, those households will be faced with the same loss of spending power as those who were receiving their health care benefits through Medicaid expansion.
While all very interesting, what does this have to do with job loss? Simple: when consumers have less money to purchase goods and services, the demand to provide those goods and services decreases and the jobs required to produce those goods and services decrease as well.
Could your job be affected? No one can say, but there are steps you can take now to support you in retaining your position or assist you should you need to find a new one.
Know your legal rights
Times of employment uncertainty can be a trigger for many people living with a mental health condition. Preparing for uncertainty is always a better strategy than reacting after the fact. Therefore, knowing your workplace rights before you need to use them makes good sense.
Now is the time to educate yourself about your workplace rights. Whether you are currently employed or seeking employment, you have certain protections against discrimination in most workplaces. You are also entitled to reasonable accommodations to support your overall job performance if your workplace has at least 15 employees (see Editor’s Note below).
If you are looking for employment, a potential employer is not allowed to ask you about a mental health condition as part of the hiring process until after they have made a conditional job offer. After the potential employer has made a job offer, they can only ask disability-related questions if they are asking the same question to all employees entering the same job category. Further they cannot reject you without objective evidence that your health, even with reasonable accommodation, prevents you from performing the requirements of the job.
Proving that you have been denied a job because you have a mental health condition can be difficult, however, so you may wish to bring up the topic of accommodations after you have been offered the job.
Asking for accommodations is your right and everyone has their own personal views on disclosure. However, because an employer does have the right to dismiss an employee for poor job performance, it could be prudent to have the discussion about needed accommodations with your employer prior to an episode that might affect your job duties or job performance. This discussion would be in your personnel file and you would be able to demonstrate that you proactively asked for accommodations.
- Altered break and work schedule to accommodate therapy appointments
- Quiet office space
- Devices that create a quiet work environment
- Changes in supervisory methods such as written instructions from a supervisor
- Specific shift assignments
- Permission to work from home.
The legal requirement for accommodations also acknowledges that your symptoms may come and go. What is important is that during a particular period the manner in which you are performing your job duties is limiting and that an accommodation would assist you in performing those job duties at the level required. This is why it may be wise to have the conversation with your employer before you need the accommodation.
Rights to the Family and Medical Leave Act
What if accommodations are not enough and you are still unable to satisfactorily perform your job duties? You still have rights to maintain your employment. If you feel a break is needed to focus on your wellness, ask for a leave from work under the Family and Medical Leave Act (see Editor’s Note below).
Many people are familiar with the FMLA as it applies to maternity leave or caring for a sick child or aging parent. But it applies to any medical condition for which you need to take a leave from work. In the October 2016 issue of the DBSA Making Mental Health Matter newsletter, Alexander Wolf shared that he typically experiences a bipolar disorder episode in the spring. Because he addresses his mental health condition as a routine fact of life and has put in place reasonable accommodations, disruptions to himself, his supervisor, and his employer are minimized when he takes a leave from work using the FMLA.
Many outside factors contribute to the economy, employment stability, and the amount of our weekly disposable income. We often don’t have control over these factors, but we can take steps today to support both our financial and mental wellness in the future.
Editor’s Note: This post relates only to federal protections regarding disabilities; your state may offer additional protections in the workplace, your union may have negotiated additional rights, and your employer may have policies that apply to your situation.
The Americans with Disabilities Act requires employers with 15 or more employees to provide reasonable accommodations to employees with disabilities, unless the accommodation would cause significant difficulty or expense to the employer. Generally, the person must be qualified for the job and have a disability, meaning she or he (1) has a physical or mental condition that substantially limits a major life activity; (2) has a history of a disability; or (3) is believed to have a long-lasting and not minor physical or mental impairment.
The Family and Medical Leave Act applies only to certain employers and eligible employees; download the U.S. Department of Labor Fact Sheet #28: The Family and Medical Leave Act.
- What kind of work accommodations have you seen that support employees with mood disorders?
- What advice would you give to someone living with depression or bipolar disorder about revealing their condition to a potential employer?