Workplace attitudes to people with serious illnesses are changing, writes Owen Thomson.

To disclose or not to disclose? Those with chronic illness can find themselves in a quandary when deciding whether to discuss their health at work.

If they reveal they have a significant ailment, they run the risk of being treated differently: either handled with kid gloves or ruled out for promotion.

But holding back means putting their lives at risk and lying to workmates. For 24-year-old Kate Alexander the choice was clear. A youth worker with the social welfare charity Anglicare, she has been totally open about living with epilepsy.
"I think if you're honest with employers and you tell people up front that that's what you've got, it's not usually an issue," she says.

Alexander, who was diagnosed with epilepsy when she was 12, says an awareness of her physical limits helps her manage her condition at work.

"I think you have to have a management plan in place for yourself," she says. "I know what my limitations are."

Epilepsy is one of scores of chronic illness that Australians manage in the workplace everyday. Others include asthma, cancer, cystic fibrosis, motor neuron disease and diabetes.

In a healthy working culture, people living with these conditions can have stellar careers.

The acting president of the NSW Anti-Discrimination Board, Elizabeth Wing, says if they encounter discrimination there are avenues to pursue.

"[People living with a chronic illnesses] have the right to a working environment that's free from harassment," she says.

"They're also entitled to participate in the workplace the same as anyone else who doesn't have that condition. They're entitled to be treated with respect and dignity and if their condition doesn't have any impact on their work and they're able to perform the inherent requirements of that job, there should be no difference to their treatment at all."

Wing says it is up to individuals whether they notify employers of their pre-existing conditions.

However, Kristen Hazelwood, an educator with Diabetes Australia-NSW, contends that disclosure is the best policy.

"I believe it is important to tell employers, especially if you're on medication, simply because you're protecting yourself and your own health," she says.

"Also if you don't tell them and something happens on the job you may not be covered [by insurance]. In certain instances, there are jobs that people with diabetes who are on insulin can't apply for, for instance, the emergency services."

Hazelwood says many diabetes sufferers are reluctant to reveal their status for fear of receiving different treatment or missing career opportunities. However, they may be risking their health in doing so.

"If a [medical] issue happens then people are aware and they know what to do," she says.
 
"It's not like the old days. Diabetes used to be a real stigma."

While some jobs may be unsuitable for people with certain conditions, Wing says people with chronic illnesses become top professionals in a range of fields.

"It boils down to what are the inherent requirements of that position," says Wing.
 
"If the person is able to [meet them] they should be able to participate. If they do require some sort of adjustment, then that adjustment has to be reasonable. If it imposes what's called an 'unjustifiable hardship' on an employer then the employer is entitled to say that that person might not be able to work in that environment."

Wing says if there's a problem at work, the issue should first be raised with the boss.

"If it is a question of reasonable adjustment, then the employer may be able to accommodate it. If it becomes anything more than that then they can approach the Anti-Discrimination Board for advice. We can give them information about their obligations and their rights - and that goes for employers as well as employees."