When Erin Allen of Martinez, Calif. underwent surgery to remove a rare intestinal tumor, the last thing she wanted to worry about was keeping her job.
"My chances of survival ran around 20 to 25 percent," said Allen, who worked as an office manager for a large corporation at the time. "I lost three inches of intestines, a small portion of my stomach and some of my pancreas."
Although Allen's doctor had predicted she'd be recuperating six to eight weeks, complications kept her laid up for 10.
Unfortunately, Allen's boss, who'd only been with the company a few months, seemed less concerned with Allen's well-being than how soon she'd be back at her desk, Allen said.
"During my hospital stay, he would call and ask me when I would be back to work and why it was taking so long," Allen said. "The day I went back to work, he informed me that I needed to start working 16 hours a day and weekends to get caught up."
Smelling the setup, Allen said she resigned before her boss had a chance to fire her. That way, she could still qualify for COBRA and keep her health insurance.
"It was a risk to quit without a backup plan," said Allen, who has since taken a part-time job with a real estate firm. "But if I had tried to work the hours the boss wanted, I don't think I would be here today."
Employer reactions to the news that you've fallen gravely ill or sustained a serious injury will of course vary. Likewise, the size and location of your employer can dictate how much legal protection you have should you require an extended leave or changes to your work schedule or job duties.
What you can control, however, is how -- and when -- you give your employer the necessary details of your medical condition.
Be Candid, Clear and Flexible
Cluing in your employer as soon as you can screams "considerate, responsible employee," said Kairol Rosenthal, a patient advocate and author of "Everything Changes: The Insider's Guide to Cancer in Your 20s and 30s."
The bigger the heads-up you give about your scheduling needs, the easier it will be for your boss to accommodate you and find suitable backup for the hours, days or weeks you'll miss, said Rosenthal, who was diagnosed with thyroid cancer at age 27.
Make your request for time off or other accommodations as specific as possible. "I'm sick and need time off for my doctor's appointments" won't cut it, Rosenthal said.
Instead, say something like, "I've been diagnosed with cancer and need radiation treatment Monday through Friday for five weeks, which means I won't be able to start work until 10:30 a.m."
It's important to not view this as an adversarial process, said Scott I. Barer, an employment attorney in private practice in Woodland Hills, Calif.
"In a perfect world, an employer will work with you to come up with a game plan that will allow you to continue to perform your essential job functions," Barer said. Despite the existence of the Americans with Disabilities Act (ADA), "There's no hard and fast rule on what is and is not a reasonable accommodation."
You can help the process along, Barer said, by bringing your own suggestions to the table (for example, making up the morning work you've missed by telecommuting evenings or weekends). Flexibility is key, he added. You may not get the precise solution you hoped for, but if it accommodates your health needs and allows you to keep working, that's still a victory.
Stay in Close Contact
Conveying your continued enthusiasm for your job and staying in touch with your boss and co-workers about your scheduling needs over time is critical, too.
Not only can doing so protect your job, it can help you avoid overtaxing yourself, said Melinda Villagran, associate professor of communication at George Mason University, who's researched and published extensively on communicating about serious illness in the workplace.
"There is a natural tendency to want to say, 'Don't worry. I am totally confident I can maintain my schedule and I will be able to do my job even though I am undergoing chemotherapy,'" Villagran said. "Patients want to believe they will be able to schedule their illness into their regular life, but it does not always work that way. Maintaining an open a line of communication can help you adapt and amend your work plan as treatment progresses."
That's what Robin Mayhall from Baton Rouge, La. did. Rheumatoid arthritis has caused her to replace both knees and hips in the past decade. This summer, a staph infection in her left hip became life-threatening and required three surgeries and two months off work.
"The situation was changing every few hours at first, so my boss and co-workers were more concerned that I just take care of myself," said Mayhall, who works as a communications professional at a health insurance company.
"When I told them I had to have a pretty major hip surgery, I didn't know at the time how long I'd be out. So I just kept in communication with my boss as often as I could. I'm now back at work using a Jazzy chair to get around, and even though I am not quite working full-time, everyone is very patient about it."
Despite all the above, experts recommend keeping your colleagues on a need-to-know basis.
"You do not have to tell co-workers or clients every detail of your illness," Rosenthal said.
Leave out the minutia of your symptoms and doctor's visits. Just give them the facts that directly affect your ability to work, Rosenthal explained. Remember, you want to assure people that you're a productive team member and still engaged in your work.
Thinking about -- and even practicing -- how you'll respond to the various questions you'll likely be asked by your boss, HR and co-workers can be a big help, Villagran said. So can appointing a trusted co-worker to act as your unofficial spokesperson if you don't want to answer the same questions over and over, she added. Same goes for delivering the key messages about your condition through a private Web site like Lotsa Helping Hands.
"You have a right to maintain some privacy," Villagran said. "Our insurance is often tied to our job -- so no matter how honest you might want to be, you have to consider the impact disclosure might have on your employment."
This work is the opinion of the columnist and in no way reflects the opinion of ABC News.
Michelle Goodman is a freelance journalist, author and former cubicle dweller. Her books -- "My So-Called Freelance Life: How to Survive and Thrive as a Creative Professional for Hire" and "The Anti 9-to-5 Guide: Practical Career Advice for Women Who Think Outside the Cube" -- offer an irreverent take on the traditional career guide. More tips on career change, flex work and the freelance life can be found on her blog, Anti9to5Guide.com.