Understanding chronic conditions
A fine balance
People leaders navigate multiple responsibilities daily. The key to successful accommodation isn’t choosing between employee needs and organizational goals, it’s finding practical solutions that serve both. When we approach accommodation as collaborative problem-solving, we create win–win scenarios that benefit everyone.
Beyond “seeing is believing”
Many health conditions don’t announce themselves by name.
Take it from Stacey Lintern, CEO of Muscular Dystrophy Canada.
“It can take up to 17 years to get a diagnosis in some cases. It might start with muscle weakness in the hands, or a drop foot, and a lack of awareness even within the medical profession means people aren’t referred to neurologists.”
During any journey to diagnosis, people may struggle with symptoms that affect their work, without having the documentation traditionally required for accommodations.
This reality challenges employers to lead with compassion, rather than compliance.
When someone gathers the courage to disclose, they’re taking a big risk.
How you respond shapes not just their experience, but the willingness of others to speak up.
By building a culture of responsibility and trust, you’re empowering your employees to be productive and effective on their terms.
No excuses. No apologies. No judgment.
While organizational culture can be slow to transform, individual leaders can create islands of trust within their teams. Research shows that many employees will hesitate to approach managers or HR about accommodations, which means that a network of trained, trusted peers is essential for a truly accessible workplace.4,5
It’s hard to explain how unexpected [a diagnosis] felt. How unprepared I was. I sat there, in stunned silence, without a clue about what to do next.”
— Laura Syron, President and CEO, Diabetes Canada
4. The most common reasons for not requesting accommodations are feeling uncomfortable asking an employer (45%) and not wanting to disclose the accommodation need (36%).
5. Research from Federal Public Servants with Disabilities: October 2019 Follow Up Survey on Workplace Accommodations and Statistics Canada’s Accessibility barriers related to employment among persons with disabilities or long-term conditions, 2024 found that the most common types of barriers that people experienced were difficulties disclosing their disability to their potential employers (54%) and difficulties related to accommodations such as unmet accommodation requests, inability to request accommodations or lack of awareness that accommodations were available (32%).
“We’ve all had a moment when life delivers news that turns our reality on its head. Not everyone with chronic disease is at the same stage of their journey. They might be struggling with symptoms but not have a diagnosis yet. They might be dealing with shock and stress as they manage symptoms while reorienting their expectations and their life. Your job is to meet them where they are. With flexibility. Patience. Compassion. And, most importantly, with the understanding they aren’t just adapting to a condition — they’re learning a whole new language to describe their experience in the world. It may take them some time to find the words." problems and strive for true equity.”
— Liz Horvath
Chronic disease: You can never “punch out"
Consider the display of mental strength and resiliency required by those living with chronic disease.
“I’m sorry, my [glucose] monitor is beeping here. This is life with diabetes. You’re never off the clock.”
—Laura Syron, President and CEO, Diabetes Canada
Unlike an occasional headache or temporary injury, chronic conditions like diabetes require
- monitoring blood glucose levels (for diabetes) and other symptoms throughout the day
- taking medication at precise times
- making constant adjustments
- managing all this while meeting professional responsibilities.
The mental load of constant health management adds invisible effort to everyday tasks. But isolation doesn’t have to be part of the load.
Small adjustments, such as flexible break times, private spaces for monitoring health or taking medication, and remote work options, allow these employees to go from surviving to thriving.
When wellness comes in waves: Managing episodic conditions
Many chronic conditions follow unpredictable patterns of flares and remission that can challenge traditional workplace expectations of consistent performance.
“You can’t see arthritis; it’s sneaky, one day you’re fully functional, the next you’re laid low by a flare; you’re isolated and afraid of the judgment that comes with being labelled as unwell.”
- Trish Barbato, President and CEO, Arthritis Society Canada
This unpredictability creates unique challenges:
- Employees may hesitate to take on high-profile projects because they fear a flare.
- Colleagues may misinterpret inconsistent abilities as lack of commitment.
- Traditional performance metrics may penalize fluctuations in capacity.
Practical approaches for managers
Build trust through regular, informal check-ins where employees feel comfortable discussing challenges. Show openness to flexibility before it’s needed, and ask what would help your team members work at their best. When challenges arise, focus on collaborative problem-solving — you don’t need to have all the answers immediately. Being honest about needing to research options shows you’re committed to finding real solutions.
Here are some starting points:
- Create backup systems and cross-train team members.
- Focus on overall outcomes rather than consistent daily performance.
- Establish flexible deadlines where possible.
- Develop contingency plans together during an employee’s well periods.
- Normalize conversations about changing capacity.
By acknowledging the natural rhythm of episodic conditions, workplaces can retain talented employees through difficult periods and benefit from their full contributions during well periods.
Twice the burden: When symptoms and stigma collide
For people living with major or chronic disease, symptoms may come with the added weight of stigma.
Recent research from HealthPartners’ Health Advisory Network reveals that 21 per cent of respondents chose not to disclose a health condition in their workplace for fear of negative consequences. Of those who did disclose, 31 per cent reported experiencing negative repercussions. Of most concern is the finding that people with lived experience of mental health conditions were the least likely to disclose, with 45 per cent choosing to keep their condition private.6
The real risks of non-disclosure
Employees7 who fear stigma or job loss are significantly more likely to hide substance use issues and continue working — potentially creating serious safety hazards, affecting decision-making, and increasing the risk of accidents. This pattern extends beyond substance use to other undisclosed health conditions, where employees might
- operate equipment or drive when they are not medically fit to do so
- make critical decisions while experiencing cognitive symptoms
- struggle silently until they reach a crisis point requiring extended leave.
Our Insta-perfect, hustle culture can make an employee who is considering disclosing a health condition feel like they’re taking a gamble — with their reputation, their promotion prospects, and even their livelihood.
Creating a workplace where stories of resiliency are shared, management leads with vulnerability, and humanity trumps hubris builds a place of work where people feel empowered to share experiences that shape their personal and professional lives.
Did you know?
Certain health conditions involve
- bodily functions deemed “inappropriate” for workplace discussion (the chronic diarrhea that may flare up due to inflammatory bowel disease can be debilitating, but it doesn’t have to be shame-inducing, too)
- symptoms that mimic those of other conditions (a low blood sugar episode experienced by someone with diabetes can look like intoxication)
- associations with lifestyle factors that invite judgment.
This stigma goes beyond individual harms. It creates systemic barriers to inclusion that rob organizations of valuable talents and perspectives.
And we all lose out.
Through living with a chronic condition, employees develop valuable workplace strengths. A daily reality of health challenges naturally builds problem-solving skills, self-advocacy, and adaptability — qualities that benefit the employee and their team.8,9
6. HealthPartners Health Advisory Network survey, 2025
7. Canadian Centre on Substance Use and Addiction.
8. Personal strengths reported by people with chronic illness: A Qualitative Exploration of Resilience among Patients Living with Chronic Pain
9. Neurodiversity and long-term illness at work: What I wish all employers knew | TED-style talk
Doubling down: Mental health and chronic conditions
The relationship between mental wellness and physical health works both ways. For example, people with depression have an increased risk of developing diabetes, while those with diabetes are two to three times more likely to experience depression.10 Similar patterns exist across virtually all chronic conditions.
What does this mean in a workplace setting?
- Employees managing chronic conditions often experience anxiety, depression, or grief.
- Extending both mental health and physical health accommodations yields powerful benefits.
"When someone feels hopeless or overwhelmed, it can affect everything from medication adherence to their willingness to consider treatment options."
— Elizabeth Myles, National Executive Director, The Kidney Foundation of Canada
Research shows that people with adequate mental health support demonstrate
- better treatment adherence
- improved physical outcomes.11
In a workplace setting, this may translate to reduced absenteeism, stronger performance, and greater retention.
Chronic conditions dramatically impact mental health, and mental health challenges often develop in people living with chronic conditions. Naturally, supporting the whole person yields better outcomes than addressing symptoms independently.