Navigating Health Issues in the Workplace? Consider This

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On this week’s Rich Girl Roundup: If you’re dealing with chronic illness or mental health issues, how do you strike the best balance between work and health? What kinds of flexibility or accommodations can you ask (and advocate) for?

Welcome back to #RichGirlRoundup, Money with Katie’s weekly segment where Katie and MWK’s Executive Producer Henah answer your burning money questions. Each month, we’ll put out a call for questions on her Instagram (@moneywithkatie). New episodes every week.

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Mentioned in the Episode

• CDC brief on Chronic Illnesses and the Costs of Healthcare

• How Managers Can Support Employees with Chronic Illnesses (Harvard Business Review)

• Americans with Disabilities Act and ADA accommodations (Department of Labor)

• Visible vs. invisible (non-apparent) disabilities

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Katie:

Welcome back, Rich Girls and Boys to the Rich Girl Roundup weekly discussion of The Money with Katie Show. As always, I’m your host, Katie Gatti Tassin, and every Monday morning my executive producer Henah and I use this segment to talk through listener questions, interesting money stories in the news, casual financial topics. And I want to start working in listener feedback too, because we’ve done a couple episodes recently that we’ve gotten some really thoughtful responses too. So we’re going to pepper that in where appropriate. Here’s a quick message from our sponsors.

Okay, so before we get into it today, just want to put you on to this week’s upcoming main episode. It’s all about the myth of making it professionally and the cost of raging ambition. Henah, what is our question today?

Henah:

Hi, KG. This week’s question has come up a few times kind of circling the topic of flexibility and mental health in the workplace. And this felt relevant to me because I personally do have a few chronic illnesses and I feel like we’ve really hit that sweet spot of working together well while also having accommodation. So I thought it’d be a really good—actually, this is the conversation where I quit and blast you.

Katie:

You’re going to ask me on air for more…

Henah:

This is actually being live streamed. Anyway, I thought it’d be a good opportunity for us to walk through what this actually looks like in practice. And also you and Samhita had a conversation in that myth of making an episode where we talked about this, I don’t remember the exact term she used, but it was like margin of power or margin of…

Katie:

Maneuverability. Of maneuverability. Yeah, I loved that. Stuck with me.

Henah:

Yeah, I thought it was a really great phrase, and I think that kind of applies here, if you have any degree of power in the workforce, how you can also approach this, whether you are someone who has a chronic illness and needs support or if you have an employee that has this. So I could start off with some context, but I’ll let you open if you have anything.

Katie:

No, I actually think that this is a topic that I would say is nearer and dearer to your heart because of your experience. So yeah, let’s get some context.

Henah:

She said you’re sick, so let’s start there.

Katie:

Listen, my chronic illnesses is a chronic case of bad vibes that prevent me from doing good work and there’s currently no cure.

Henah:

Well, I do have one small thing I’m going to drag you about later, but we’ll get there. You always will drag me and then be like, excuse me, miss girl, you don’t want to mess in me. So I’m back. I’m back baby.

So we don’t have to get into too many of the details, but I think I’ve been pretty open about this with you. And also online, I have PCOS and I have migraines and I have a couple of other things, but they don’t necessarily come into play during my day-to-day work. But oftentimes these are all sort of hormonally related. And so the kinds of migraines I have are called cluster headaches, and so they’re not as commonly known, but basically they’re always in the same spot. They throb behind my eye and it gets to the point where it’s debilitating and I truly cannot do anything except hold my head and lay down, and sometimes it lasts for a whole day or sometimes it’ll last the entire night and then I can’t function during the next day.

Katie:

So hard.

Henah:

I found it really, really refreshing when I started that you were kind of like, yeah, bro, do what you need to do. Feel better, work is a last thing that you should be thinking about. And so I wanted to talk about that here because in the beginning I used to feel really guilty about needing time for my health, and you sort of challenged me to be like, why do you feel guilty? What makes this any less valid than you needing a sick day if you had food poisoning or if you broke your leg? And I don’t know, I guess I want to start there. Did you already have that perspective as a manager, as a leader to be flexible or were you just like, no, if I needed it, I would do the same for me. I am a millennial. You know what I’m saying?

Katie:

Well, I think I could give a super high-minded and flattering to myself answer of like, yeah, I just understands that things happen, but I think honestly, you are really good at your job and you’re really freaking on top of it. So I never have to worry about things falling through the cracks. You can in that sense command a lot of flexibility, because what’s the alternative? Me being like, actually, no, I’d rather you work through your cluster migraine. It doesn’t make any sense.

Even just selfishly, it would not make sense for me to orient to you that way. If my end goal in the most ruthless, selfish version of the world is to get the best work out of Henah, that is not going to do it. So I think that there is that element of you make it pretty easy to be flexible, but at the same time, I do think that I have benefited a lot actually from working in workplaces where flexibility was the norm and people were really accommodating.

I worked on a team at Southwest, the only place I’ve ever worked in person in an office, where I observed managers and other people’s management styles, and the managers that I wanted to work the hardest for were the ones who were exceedingly sympathetic to personal life things and were more than happy to help you out, give you the day off. I remember when I had a death in my family, they asked no questions. It was like, take the week, we’ll revisit next week. Don’t even bring your computer. Never once made me feel any sort of way about needing personal time if something was going wrong. And there was someone on that team actually who had a similar situation where she was diabetic, but she also would get migraines. So she was constantly having to work with her own physical form to get it to comply to the average nine to five workday.

And if she came to work and started to get a migraine, our manager would be like, go home before it gets any worse. Make sure you’re home when it starts to really kick in. And I think that witnessing that early in my career really set the tone for me culturally of what is just basic human decency and how you should treat other people. And it’s also what I would want if I’m just having a bad day. Sometimes I’m like, I just don’t want to do this today because emotionally I’m not in a good place. I also want the flexibility to have the precedent be set. That work is not the most important thing in the world. And so if your humanity needs to come first in whatever way, shape or form that takes that, that should be the norm.

Henah:

So send this to your toxic bosses, everybody. Here we go.

No, actually, so this is another piece of the conversation I wanted to have because this is going to sound like it’s not related, but I promise there’s a connecting point here. So if you remember in our newsletter every week we have Rich Gigs, which we will highlight five jobs that we have seen in the last week. And they have the salary transparency, so you know what you’ll be paid. And we usually put any sort of non-traditional perks, we’ll say, so outside of paying for your medical care or having paid time off. And so sometimes we’ll say remote, or equity with ESPPs, or unlimited time off, and we got this listener email who was like, “Hey, I just wanted to flag for you that there’s obviously this huge debate about remote work and unlimited time off, and it’s a trap. Here’s all the reasons that the trap, blah, blah, blah.”

And we went back and forth and it was a really fruitful conversation. But one of the things that I was thinking about and reflecting on that conversation and this Rich Girl Roundup is that my life has also improved significantly for my health being both remote and having unlimited time off because when I used to have to go into the office, I would get far more headaches. I had a high stress commute. I also had to be “on” all the time. And so I think that just wears down your mental and energy bandwidth, but also having the flexibility to be at home when I’m dealing with something makes these reasonable accommodations a lot easier. And I think that sometimes that’s left out of the return to office unlimited PTO sick time conversation is like my husband, if he goes to a doctor’s appointment, he has to log two hours of sick time to go do that.

Katie:

No way.

Henah:

Yeah. He’s in a very corporate setting and he only gets the 15 days and they’re very strict about them. And I was saying to this person who emailed in, I understand why people don’t love unlimited time off because it’s not great from a payout option and this and that, but I also don’t ever have to worry about that if I need to go to a doctor’s appointment. I know that you one are not sitting there being like, oh, she’s been gone three hours, where is she? But two, I’m not worried that I’m going to get fired because I need to go to the doctor two times a week or something like that. And so I would just, I guess, encourage anybody who’s listening to this who’s never really dealt with a chronic illness, if they’ve ever had that thought about unlimited time off or remote work being a scam. Interesting. I will say in practice for me makes a huge, huge difference.

Katie:

Yeah, that makes a lot of sense. I think we should also ground ourselves in some of the statistics about how prevalent chronic illnesses are, because I was actually really surprised when I saw how common they were. According to the CDC, more than half of US adults had at least one of 10 diagnosed chronic conditions. And so they range, I mean, you mentioned migraines and PCOS, but arthritis, heart disease, asthma, diabetes, if you have hypertension, a lot of these things kind of fall into that category. And I know that you had mentioned when we were chatting about this that mental health conditions are, I don’t know if they’re bigger than that piece of the pie, but they’re like, what? Half?

Henah:

Yeah. I mean, they’re not even included in the top 10 diagnosed chronic conditions for the CDC, but I found a Harvard Business Review article that said each year, depression or anxiety account for up to 50% of chronic sick leave in Europe. So I’m assuming it’s that or more in the US too. And I know a lot of people actually that have depression need to take time off of work. And I’ve had a good number of coworkers actually go on short-term disability leave or FMLA to go deal with those kind of long-term things that require you to be outside of work.

Katie:

And so in the United States, at least the ADA requires that employers who have 15 or more employees to provide reasonable accommodations for these things. So that’s defined as any change to the application or hiring process, the job, the way the job is done, the work environment that allows a person with a disability who’s qualified for the job to perform those essential functions and have an equal employment opportunity. And so I thought that that employee threshold is notable that it’s only for businesses that have more than 15 employees. Your three person startup is not held to that same expectation.

Henah:

Which is kind of a shame, right? Because why not just apply it to everybody?

I also think that there’s the visible versus invisible disability piece of this too, in that it’s probably easier to see someone who deals with a broken leg than it is for someone who’s going through severe depression.

Somebody had asked, Rich Girl Jennifer had asked, can you cover the insane costs of having a chronic disease? And obviously we’re not going to go into all of that, but when we were talking about that margin of maneuverability, Samhita said something like, oh, I’m going to fight for the highest raise possible. And I really liked that because it reminds me that people who have chronic illnesses can use that money to help manage them, manage whatever that is, and this hellscape of USA healthcare without breaking the bank.

And so I looked it up and 90% of our 5.4 trillion in healthcare spending are for people with chronic illnesses. So obviously if you are an employee and you’re dealing with stuff like this, you will often need a better, more expensive healthcare plan. You do have additional copay costs, you might need alternative therapies that aren’t covered.

And so all that to say, I think that the cost of chronic illness really quickly adds up. And in the US where your employer is tied to your healthcare, it’s really powerful. I think if you are in a position of management that you can fight for that, especially if you know that something someone’s dealing with.

Katie:

And you’ve already referenced a couple Samhita quotes from the episode, so the episode that he’s referencing comes out on this Wednesday, so you’ll get to hear margin of maneuverability and its original form. But yeah, I think that you have talked to me before about how as you’ve earned more, you’ve been able to invest in things like your health that have improved some of these things that you’ve dealt with. So it’s kind of that whole self approach to money and work, if that makes sense.

Henah:

Yeah, I think so. One of the really refreshing things I think that you did in the beginning was you kind of said, Hey, you’ve told me that you have these things going on. What do you need? And that was really nice as opposed to me having to—

Katie:

Did I sk that?

Henah:

Yeah.

Katie:

I don’t even remember that.

Henah:

You were just like, what do you need so that you’re not stressed about these things?

Katie:

Oh, wow, that was so nice of me.

Henah:

I—

Katie:

I have no recollection of that but—

Henah:

That two plus years ago, but—

Katie:

I trust you.

Henah:

But I liked that because it was just more of, Hey, what do you need that I can support you with? And I really, really appreciated that. And then the part where I’m going to drag you a tiny bit…

Katie:

I knew it was coming. I knew that was softening the blow of something.

Henah:

I’m so sorry. One thing I wrote about as a manager, what you can do in the workplace to affect change is leading by example. And so I do feel like I’ve tried to, when we have other people on our team, I try to be really open about, hey, I’m not feeling well. I’m going to go lay down. I’ll see you guys in a couple hours. Nothing is urgent. And we’ve said what we’re doing is not heart surgery. We can step away, but you are really, really, really, really bad at taking a personal day for yourself. Do you feel like that’s improved?

Katie:

Push back! I feel like I have done a really good job of setting boundaries with when I will meet and that I do not make myself constantly accessible. And I have explored different things where I will say, okay, I’m trying a new time management thing. I’m only going to take meetings on Mondays and Thursdays, or I’m only going to meet from 10 to 12, but it can be any day and every three months I change my mind that I issue a new edict to Henah. And then it’s your responsibility to go tell everyone else and go, alright. The new thing is Katie will only meet with anyone.

Henah:

I’m talking when you’re sick though, I feel like you generally still tend to still be working.

Katie:

It depends. It depends. I have had ever since I had Covid, I get sinus infections all the time now, and I generally try to work through them only because they’re not debilitating to the point where I’m just kind of bored and feel under the weather. But yeah, I don’t know.

I think that’s something that I am working on with flexibility with myself with work is and where my time management, my new technique that is totally working right now where it has helped, which is that I will set a time box for something and go for these two hours I am going to work on this task. And if by the time those two hours are up, the task is not done, that means that it’s going to have to, I’ll find more time tomorrow to do it. Whereas my old approach would basically be, oh, there’s still light outside. I’m going to keep going. And it has helped me a little bit with getting over that innate sense of urgency or that feeling of got to do it all right. Now there’s still stuff on the to-do list. I can fix him. No, really. I can get through the to-do list if I just keep going. And I think it took me 30 years to realize it, but there’s always going to be more stuff on the to-do list.

Henah:

Well, it’s like the work expands to fill the time that you give it kind of thing.

Katie:

Exactly. So now I’m time boxing baby. You heard it here first.

Henah:

Progress. I have noticed you’ve been better at not Slacking super late. I mean, last night is different. I did get a slack from you at 10:00 PM but that’s 7:00 PM for you, which is progress. So I know we’re working on it.

Katie:

Yeah, flexibility, we’re approaching it in the ways that we can.

But I will say, I think that the flip side of this equation and what you’ll often hear when we talk about these things is like, well, it’s like the given inch take a mile concern of like, well, what’s a reasonable accommodation? Or well, flexibility. These Zoomers are out of their minds. They want flexibility. Back in my day, we worked until our fingers bled this idea that if you have these well-meaning rules to protect a group of people who really need it, and this group of people we’ve learned in this episode is actually quite large, that there’s always going to be probably a small subset of people who are going to abuse that well-meaning rule and try to exploit it for personal gain.

And so I tried to find an example of this happening and there was a Reddit post on the Ask HR sub Reddit where this employer of a small business was posting that like, Hey, I have this employee. They constantly cite mental health and chronic illness as the reason why they’re taking excessive breaks, why they leave early, why they’re always late, they’re calling out multiple times a week, they’re being rude to other employees. And so they tried to accommodate. They said, oh, I let him pick his own schedule. I included him in bonus pools. He actually didn’t deserve, I didn’t want to discriminate. I paid for therapy, but things just keep continuing to devolve and I feel like I’m being taken advantage of.

And the top comment was someone saying, the ADA does not require you to provide any accommodation. This person demands if he has a disability, he’s entitled to reasonable accommodations that allow him to do his job. It does not mean that you need to overlook basically blatantly poor workplace behavior or disrespect.

And my guess is that after having worked with you and my former coworker who had migraines, my guess is that it is actually quite rare for someone to invoke this in bad faith because my experience has been that most people who live with chronic illnesses do not want to call excessive attention to themselves. They aren’t trying to make it known to everybody that they’re having to deal with this. It’s not something that they’re trying to take advantage of or abuse for personal gain.

Henah:

It’s a shame because it is just like the one bad apple ruins the bunch, but you are spot on. Actually, there is this excellent Harvard Business Review article I think I’d mentioned earlier, that actually talks about chronic illness at work. And I just wanted to quote a little piece of it. But basically it says, first being diagnosed with a chronic illness is usually a time of great change. Physiologically, psychologically and emotionally. They’re usually receiving a new and unwanted label. How does my identity change? How does my life change? How will I cope?

And so obviously there’s a lot of working through that, but it says second, those with chronic illness are not lazy, incompetent, or unmotivated, but they worry that you think they are. They’re painfully aware of the societal stigma and negative use of others surrounding illness and carrying heavy guilt about being a team player holding their fair portion of the workload or asking for special treatment while others see them as weak as a complainer unsuitable for promotion or leadership. And do others truly understand that while sometimes they cannot match the average person’s energy or output, they remain dedicated to their work?

I find this article really helpful because I think it does put out there the ways in which that is exactly what I’m thinking all the time. That is my thought of if I tell so-and-so that I need to take half a day, I feel like crap. There have been times where I’ve been like, Katie, here’s my sleep score from Oura. Here’s a screenshot so I can prove to you that this is real. And you’re like, okay, first of all, you should get some rest because that’s not a normal score, but also you don’t need to send these to me. And I have done that. I have been tempted to be on Instagram stories and post a photo of me in bed to prove that I am genuinely ill, and I wish I didn’t feel that way, and I know that you aren’t even looking for that, but it’s just something that I think when you have been in their corporate world and you’ve seen how other people react to needing sick time, you just start to internalize that like, oh, how do they know I’m not playing hooky? How do they know that I’m not doing something else?

Katie:

It also reminds me of almost the added labor of having to “perform” how bad you feel so people will believe you or you’re feeling like you’re going to get caught in something even though you’re not doing anything wrong. And I do wonder if that’s a, I would be curious how common that is in other places or how that varies by country as different places have different work cultures. But we’ve done ourselves a great disservice in corporate America, at least by putting this sort of self-sacrificial hue on hard work.

And I’m like, we’ve already been talking for 30 minutes, so I don’t really want to say the word eugenics, but it is a little eugenics-y. I’m like, that’s not totally the path that I want to take us down, but I almost can’t help but see the connection of when you use the word like, oh, people are going to see me as weak. I’m not as strong. In the Harvard Business Review quote, it’s like this weird survival of the fittest fetish coming home to roost. But within the cube farm.

Henah:

I already feel like I lost a genetic lottery by having these problems. So it just makes me feel worse for someone else to be like, well, okay, first of all, it’s frustrating when someone would think that you’re weak. No one’s ever called me that to my face. But the other thing is when people are like, oh, you’re so strong to deal with it. I don’t want to be, nobody wants to be strong in this.

Katie:

It’s like when, who was it that was like, I posed on the cover of this magazine in my bikini and people called me brave. They’re like, why is it brave?

Henah:

Nobody in this scenario wants to feel strong. They actually just want to—

Katie:

Feel normal.

Henah:

Sit in their bed and feel normal. What I will say is, if you do feel like you have been discriminated against for any reason, please consult an employment or disability lawyer as I’ll be doing after this episode for Katie.

Katie:

Hey, you know what? I did just get some blood work back. I got my blood drawn for the first time in four years.

Henah:

I did see that on your calendar, and I was like, I wonder how she’s doing.

Katie:

My cholesterol’s not great. I have pretty high, which we’re now trying to get to the root of, which is not fantastic. I started running now before work. I was like, well, I don’t really fit the other criteria of risk factors like excessive alcohol consumption, menopause, smoking. There are a lot of things that people typically, and I’m like, none of this really applies to me. I do eat a lot of fatty meats. So also after you’re done consulting your employment attorney, if you have any tips on lowering LDL and non HDL cholesterol moneywithkatie@morningbrew.com will be awaiting your recommendation.

Henah:

I do have a tip for you to lower cholesterol, which is fiber. Fiber lowers your cholesterol.

Katie:

Oh my gosh.

Henah:

Yeah. I learned that from PCOS because cholesterol also affects your PCOS levels quite a bit. And so my nutritionist said, eat more fiber and that will bring down your cholesterol.

Katie:

Incredible. Well, I’ve been scooping some chia seeds into my Greek yogurt in the morning.

Henah:

Are you ready for our money story?

Katie:

I am. Let’s go.

Henah:

Okay. I have to scroll down our 76 page document to find where I put it.

Katie:

I can’t wait for the doctors in our audience to tell me how to lower my cholesterol. Our inbox is about to be full of just incredible advice.

Henah:

This is from Mercy, and she said, no need to be too careful around anonymity and language. I don’t work there anymore and don’t have any current connections with these people for obvious reasons as how they started this.

Katie:

So basically the subtext is fuck ’em.

Henah:

They were an admissions coordinator at a private Christian school in a wealthy suburb of Northern Colorado for a year during the pandemic. Well, there were some things that they shared of things that happened to them that I cannot say in the air, but there was one where a teacher came up behind her and took a handful of her box braids and yanked really hard before saying, “I didn’t know Black… I mean, I didn’t know you could feel that.”

So that’s not even the story, but it was basically just kind of feeling very out of place in this community.

Katie:

Well, that does track because Colorado is like 98% white people.

Henah:

She said one story really sticks out. It was our first year enforcing a strict admission policy where if you didn’t unenroll your student in the spring, you owed the full tuition payment in the fall. So there are no half payments for leaving mid-semester. I had a family with seven children from kindergarten through high school who are moving to Jackson Hole, miss the unenrollment deadline. And when I called to inform them that they need to pay the full tuition for the coming school year, even though they’re moving to the wealthiest suburb in Wyoming in a few weeks, the mother didn’t even hesitate. She said, oh, no problem. Run it through. And I processed this transaction with her on the phone and $115,000 came out of her bank account without a hitch. I didn’t know there were people who could afford to drop $115,000 and something they would never even use without protest.

And she mentioned the new school that the kids would be going to in Jackson Hole, and it was two and a half times as expensive as the school they were currently in. And then Mercy closes by saying, I went to free public or charter schools my entire career. So the concept of a family paying the equivalent of my college tuition for seven children was wild to me. I can’t imagine being able to pay a $115,000 late fee, especially knowing I would be paying $275,000 at a new school just a couple months later.

Katie:

The self-flagellation that I would undergo if I made a mistake that cost me even a 100th of that amount.

Henah:

1% of that.

Katie:

Yeah, 1% of that amount. The way that I would beat myself up, that person, this is really, to me, this is proof that people with really high worthiness and self-esteem are just loaded beyond belief where it’s like, yeah, who cares? It’s like your fuckups don’t have consequences at that level. I mean…

Henah:

That is true “FU” money to just drop and not even think twice about it and you’re not even using it.

Katie:

That is unbelievable. Thank you for that money story. That was a good one.

Henah:

Oh, you were gasping all the way through. I was proud of myself.

Katie:

Hope you guys enjoyed it and gasped as much as I did. But I think that’s all for this week’s Rich Girl Roundup. So we will see you on Wednesday to talk about the myth of making it.