Reprimanded at work for an ITP flare

Hi all!

I've been dealing with ITP for the past four years. I was in remission for the past year and a half, enjoying normal platelet counts. I had a stomach virus a couple of weeks ago that flared up the ITP and my counts crashed down to 19. A short course of Prednisone and my counts are back up again, hopefully to stay. The latest problem is that I received a written and verbal warning at work for being out sick. Oh, by the way, I work in a medical office! They told me I can't be sick any more and that I may need to "change" my work hours (reduce down, where I'd lose my insurance, or go per-diem, where I'd be at their beck and call....) They don't like the "pattern" they are just now starting to see. I've been employed at this office for the past eight years and have kept them fully informed of any illnesses, treatments, etc. I have a good record and have been a good employee and now I feel I'm being singled out and punished for having a chronic but rare blood disease. Help! I need support. I'm looking into legal ramifications for this. I've had ALL the testing out there possible and I know for sure all I'm dealing with is ITP.

Wow. I don't know the legalities here but I don't think they can fire you. How much time did you miss?

How many employees are there at your office? If enough to be covered by Americans with Disabilities Act, then they probably can't do that. I have to look it up, I forget if ADA is 7 or 10 or 15 employees... If not covered, they may be able to legally do this but of course it is a stupid thing for them to do. If the # of employees is close I'll look it up, let me know.
Erica

I just looked that up recently but can't remember. I think it's more than 9 though because my office didn't qualify (which is really stupid because what difference should it make how many people work there?) Basically, if you are disabled, make sure you have a job in an office with a lot of employees.

All I can say is that I support you all the way. Did you keep photocopies off anything you handed in? It wont matter too much because hopefully they be on the medical file.
I hope you do fight it because they are being unfair

Sandi,
The intent of the # of employees rule is to not place an unfair burden on small businesses. They also are exempted from some other civil rights type employment laws. This is consistent with conservative politics today, to place less restrictions on small business which in theory will make them more profitable and help the economy. Rand Paul represents an extreme version of this perspective. I'm trying to state this pretty neutrally and hope I succeeded, my intent is not to get into a politics discussion but just to explain the reasoning.
Erica

Oh no, I understand all that. My Mom was a sole proprietor for a long time and I know she couldn't have afforded all of the extras that big businesses do. It just seems unfair for people who need help but work in a small office. You're SOL.

Sure, there are consequences to offering these protections to small businesses. That is so true. I feel much much safer in a large organization, knowing I have the protection of the full scope of civil rights laws and access to COBRA should I lose my job. I'd feel like I didn't have a net in a small business.

I always thought it was weird that Congress as an employer is also exempt from most of that employment law. What's with that?
Erica

You do see big and small businesses occasionally going above and beyond what is required. My BIL works for CVS (stocking, not management or anything) and his retina detached suddenly out of the blue. They held his job for him longer than required by FMLA, we are so grateful.
Erica

I found out just how unprotected I was last summer when I erroneously quit. The kicker is, the company I work for has the money, but not the right number of employees. I've never asked for any special considerations, ever, and most likely won't. It would be nice to know I had rights though if needed.

I would like the fluorescent lights in my office taken out or covered. I've been meaning to do something about that for a long time. I will probably end up just buying lamps.

Sorry, Kitcher, we started a discussion. Please jump back in!

Hi again,

I posted this message this morning and want to thank everyone for their thoughts and comments. My office emmploys approx. 55 people, so it is not a small business. It is, however, a private company and their claim to being able to reprimand someone is that they are "free will" employers. I only missed six days of work and have not gone over any time off that I hadn't already earned. In fact, my benefits are quite good where I work and I will still have three weeks of personal/vacation time through the rest of the year. I just felt like I was kicked in the teeth when I was down because they claimed to be short staffed. I've covered many a shift when it was totally short staffed and never once complained. Anyone with ITP knows that you cannot plan for when a flare up happens, it just does. I did take eight weeks of medical leave last year because of a flare up and bad reaction to Prednisone but it was at my work place's recommendation. I had some physchosis due to a very high dose of steroids. I told my hematologist that I never wanted to be on steroids again, yet that is exactly what they do each and every time I have a problem. It typically happens once or twice a year, depending on how healthy I can stay. I am 50 years old and a medical assistant and I am VERY good at my job and work my heart out when I'm there to the point where I suffer sometimes afterwards. Again, I am not one of the problem employees and other than when I'm having a flare of ITP and ill, I rarely miss any work. I'm seeing the hematologist tomorrow and he is going to blow his cork when I let him know what is going on. The office manager put a "note" in my work record about my using up all my time to be out sick. I know they can't fire me, but they can make things quite miserable for me. My next step is to find out how I'm doing first, then try to go reason with my boss yet again and get that mark removed from my work record. Isn't this some form of discrimination? Does ITP qualify one for having a disability? I didn't think my case of ITP is too bad.

Kathy Ichter

Kathy,
You ought to consider having a talk with HR - your employer sounds big enough to have a person who is in charge of HR and hopefully knows what they are doing. Since they are aware of your medical problems, you might want to mention, using terms like this, that the 'accomodations' you are asking for are simply to be allowed to use your sick days. Mention that you think using six days of three weeks is 'reasonable'. You aren't making threats, but rather reminding them of their responsibilities to employees who may have disabilities.

It isn't clear if ITP would qualify as a disability but they might be concerned enough that it could to back off.

Could be that your boss is just untrained and incompetent in this area.

It's true that everyone is an employee at will, but I think that term is being misused here. It basically means that anyone can be let go at any time for no reason. If you have circumstances though, that statement can backfire for them. Sounds like a scare tactic.

If you are protected by a civil rights law or ADA, there are employment actions they can't take - like they can't fire you for getting pregnant, or marrying someone of a different race.

They could totally fire someone for a variety of stupid reasons - like, they root for the wrong baseball team or whatever - but they can't take employment actions against a person based on 'protected class status' which an illness could possibly be (not always but sometimes).

Erica

I think you should speak to someone higher up in authority. My team leader has spoken to out centre manager and he is fully aware of my situation and is really good at making sure my accommidations are met. I am only off sick when i am really sick that i shouldn't be a work and for medical appointments and he fully understands and supports me. You should speak to someone about how this is all making you feel.

Unfortunately the person who I spoke with and gave me the "verbal/written" warning was the highest up that I can go in my company and the head of HR too. Seeking legal advice on the situation, I spoke with a lawyer yesterday, who is an expert in the state of CT labor laws. There isn't one darn thing I can do about this situation at work! The laws are written to attract employers into the state and favor the employer, not the employee. I would have thought working in a medical office they would understand better, but alas, their expertise doesn't cover hematology issues. They are even confused about exactly what it is I have, although I have spoken to them numerous times and even given PDSA literature to them. They are protecting themselves with this verbal/written warning being in my file now.

Some good news from the legal adivce is that I now have a very strong case for disability. I go tomorrow to see what my latest platelet count is and if it has stabilized again or not, then have to go back to work to "play dumb" and be nice in order to get several items from my work files to go towards my case, and see what other options my employer has in mind. What I'd like to do is just leave, but I know that would mess things up far worse than they are already. Nope, I'm going to have to bite my tongue (I'm a fighter too, when cornered, so this will be really tough to do!) and bide my time and let the situation play itself out.

Kathy (Platelet count, 19)

Sadly am in the UK and here I would say go to the citizens advice bureau and find out about tribunals of which would be fully supported all the way through - but even that is unclear in UK at moment with CAB's being reduced etc... but I would certainly strongly recommend a tribunal via the trade union if you are British....

I don't know what the american system is at all. ITP itself is not a dissability at all It is how it affects you personally that is the key question. It sounds like they are using last year experience thinking that will happen this year and ever on and as we all know on here ITP don't work like that and thus targeting you and in UK whilst that might happen it be definately bad practice without question.

Are you a member of a trade union or union? If so make it the next thing you do to ring them up and seek advice. Yes staff can make it very uncomfortable for you without being illegal. But hopefully the record cards and everything you have be up to date and be evidence if you do get to tribunal stage. They given you verbal warning. You give them written warning via the union. If you not a member of one it isn't too late to join. They are well aware some people join to get support at such times. Certainly in UK it be beneficial to join one if about to seek legal advice what to do next. People underestimate unions and see them as just trouble. But they do a whole lot more work than calling strike at times:)

So my advice to you, is if you are a member of a union, ring them now. If you are not a member of a union, join one and explain the situation you are in!

I looked into it last summer and realized that I can't live without the health insurance that long.

Also, for ITP, it's hard to get approved:

www.socialsecurity.gov/disability/profes...dLymphatic-Adult.htm

Chronic thrombocytopenia (due to any cause), with platelet counts repeatedly below 40,000/ cubic millimeter. With:
A. At least one spontaneous hemorrhage, requiring transfusion, within 5 months prior to adjudication; or
B. Intracranial bleeding within 12 months prior to adjudication.

Sorry - that link didn't work. I'll try again:

www.socialsecurity.gov/disability/professionals/bluebook/7.00-HemicandLymphatic-Adult.htm

No unions around for Medical Assistants. I'm not a nurse, although I am treated very much like one on the staff where I work. Sometimes they forget and ask me to administer medications or injections. I guess that is a compliment but here in CT MA's are not allowed to administer medications of any type. I politely remind my bosses that I'll inform a nurse to do as they ask.

I've been on my job for eight years now and have never seen anything like the way I'm being treated. New management in charge now. In my opinion it's ruining the practice but they don't care as long as their own paychecks are getting fatter. I would imagine others that they consider problem workers are going to be targeted too and they will start losing good people.

I applied for disability last spring and of course it was denied. However, speaking with the attorney a couple of days ago, he seemed to think that by my employer giving me that warning about absenteeism, and by the latest episode with my ITP, that I now have an excellent case for disability. He specializes in labor laws and disability claims and actually said it would be better if I were working when we first applied. I know it can take some time and I also know I need some sort of income coming in. My husband can put me on his insurance so at least I would have coverage. Guess I can always go to home mending and sewing if need be to get by. I cannot imagine working at any other place or starting all over again at the bottom of a new job or office. I'm getting too old for all of that! (Ha!) All I've ever done is clinical medical assisting, which means I am right on the front lines to deal with the sickest of people that walk through our office door. Of course germs are everywhere and I can just as easily pick up a nasty virus at the local Walmart from the shopping cart handle. I don't want to have to live in a bubble, but every time I get sick with something "common" it activates my ITP and off we go on the merry-go-round of steroids again and again. I had one treatment of IVIG that nearly destroyed my kidney function and don't want to go there again, and the steroids make me crazy. Well, as I've said before, tomorrow is another day and we find out what the latest platelet count is plus see my Dr. Funny thing is, before I got my current job, I used to work in the hematology/oncology office as a medical assistant too. I knew exactly what they were telling me when I was first diagnosed and what to expect and it scared me quite a bit. It isn't easy to get blood out of me either and I hate needles, but I know now where all the good spots are to draw that CBC.

i am a union rep for the past 16 years here in canada and i know that they can not reprimand you here because it is discrimination because of handycapp union or no union they can not do that, it may be the same in the usa check with a labour council or even if you know someone in a union that can check for you .i hope this helps

Thank you, Porqupine, for the thoughts. I never considered myself handicapped, disabled, or really of having a problem other than once in a while. Suddenly I find myself having to fight for my basic human rights at work. It doesn't make any sense. I work for Doctors! They just don't know about ITP much. I've been in remission for as long as a year and a half, and as short as a few weeks. Who knows what tomorrow will bring but I typically am an upbeat person and don't ask for any special favors at work. Perhaps they rely on me too much now and when I'm out, there isn't anyone else who can take my place and do what I do, although I've tried to teach my coworkers. Here in the USA things favor the employers more, not the employees. Perhaps Sandi is right, this is just a scare tactic on their part. Perhaps they are looking for ways to get rid of me no matter what. I don't know. I would think they'd want to keep a good worker who ocassionally has a health problem once or twice a year. This last time I called out sick I was told I couldn't be sick, that too many people were already out and asked if I was dead. My response? "Yep, I'm calling out dead, from my hospital bed, hooked up to IV fluids for hydration, with a platelet count of 19." I was greeted by silence at the other end of the phone. When I did return to work, I got a half hearted apology, then the reprimand and warning about too much time off being sick! Good grief. I'll have to deal with them again soon enough. After tomorrow's appt. with heme, I go see my boss who will have "other options" about work to discuss with me. At least there is hope that they will keep me on, even if it is on a part-time basis. Perhaps they can find something for me to do that isn't putting me in direct patient contact? I'll keep posting updates as to how the situation is unfolding!

Kathy Ichter

Good luck. I have a very similar situation, but I'm not dealing with ITP right now (Lupus). I have not found a solution.

I am suprised that there isn't a union that medical people such as yourself cannot join. In England everyone can join a union if they so wanted. Even the unemployed can find a union to join I believe... though making a sweeping statment there. Just know we have quite a few big unions that would cover just about everyone who wanted to join.

I hope you find support and fight it through because they will be hoping you will just pass it off. It how companies get away with such incidences.

I'm sure there is a union for physicians in the states and I know there is one for nurses, but alas, I am at the bottom of the food chain as a medical assistant so no union for me. The unions in the USA serve their purposes, but there aren't any around for me.

On a brighter note, my platelet count today was 167,000! My Dr. is attempting to contact my employer on my behalf and state the obvious, that ITP is unpredictable, that is is a medical necessity that I seek treatment when I know I'm having a flare up, and that anything that activates my immune system will activate my ITP, and that I should be able to use my sick time as needed. I typically have one or two flare ups per year, and apparently I do respond very quickly to steroids, which is the first line treatment of choice. That isn't bad for someone with ITP to only use six sick days per year. I figured if I have to, I can use up some vacation time as well as sick time if needed. If I go over any time off that I have earned, then I know if I am out, I don't get paid. Here's the kicker; I went to speak more with my boss today and she was out for the day, took the day off. With a normal platelet count like I had today, you can be sure I'm going to have to go deal with work tomorrow. Hopefully they will not escort me out the door, or anything like that, but with this new office manager in charge, anything is possible. I have to be prepared either way and most of all, I need to act professional and try to reason with them. Stay tuned, I'll post updates as I can and as things happen.

Kathy

Good luck Kathy.
I'm glad you've got your doctor on side as that should be influential with other medical people.
It is stressful having to fight for your rights but it is good to know you have support. People need to become more aware of auto- immune diseases because they are certainly on the increase. You would think medical people would be the most aware but I have found that this is not the case and have posted on this forum that I think there is some conscious ignorance (an oxymoron??)
By standing up for yourself I am sure you will be helping others inadvertently.
Best wishes, Sally

well it wasn't a cure for me though improved the situation somewhat from having a platelet count of 1 if lucky for six weeks to balancing out to normal levels. And whilst I still have platelet drops they recover of which pre splenectomy days they weren't recovering. So it kind of a cure but I know what you mean Sandi:(

Hi all!

I went in to work today and was basically ignored for the first half hour. As I went through all my paperwork for the day to make sure all was ready, I was called into a "meeting" between myself and the office manager. Two of the physicians I work for also showed up. They tried to convince me to go part-time, that it would be to my benefit, and basically the same lines they have been giving me all along. Of course this benefits them more than it benefits me as I would no longer be covered under the health insurance plan at work. Then they actually told me that they are scared of the disease that I have, and how hard I make it on the rest of the office when I am out for what they called "unexcused absences." They did not like having my hematologist calling them; also, the entire office knows what is going on and it's like the latest drama of the week in there right now. The whispering going on behind the scenes is at an all time high and I think they are loving it. They have made it now impossible for me to continue there. I am totally devastated. I asked to be excused for the rest of the day and came home to do some more research. Got more advice from the attorney. I still feel trying to go for disability again is my best option; it will take some time but no money gets paid unless I win my case. Both my husband and I feel it would be better to just start over with a clean slate at a new job. I can get on his health insurance without any issues. The attorney also said I should try for unemployment benefits too as my work place is trying to change the conditions under which I was hired. I guess that's worth a shot too, but I've been down that avenue before and know there will be an informal hearing where my employers would also be present. I was able to get a copy of the written/verbal warning so at least I have evidence to support me. Talk about being ambushed though! No one could have been prepared for what I had to endure this morning.

Kathy

If you think you can get another job go for it. Otherwise can you not appeal to your office manager's compassionate side - Perhaps talk to the manager about your concerns regarding health insurance and concerns about getting unemployment benefits. If you don't feel strong enough to do that surely there must be some HR person or union rep or similar who could advocate and support you in a meeting with the manager.
I have worked in the health department in Australia and we have systems set so that everyone is entitled to some sort of support in the work place. Surely it is the same in that great country of yours.
Take care or yourself and good luck.

Sorry, Kathy. I'm sure that was very uncomfortable.

I was researching disability again last night to be sure I had my facts straight. I was wrong about being off of work for a year before you can apply. I did find this though:

To decide whether you are disabled, we use a step-by-step process involving five questions. They are:

1. Are you working?

If you are working in 2011 and your earnings average more than $1,000 a month, you generally cannot be considered disabled.

If you are not working, we go to Step 2.
2. Is your condition "severe"?

Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, we will find that you are not disabled. If your condition does interfere with basic work-related activities, we go to Step 3.

www.socialsecurity.gov/dibplan/dqualify5.htm

If they do switch you to part-time, you probably could collect partial unemployment.

Does your doctor not allow you to work with low counts? I'm only asking because a lot of us have worked with counts under 10 if the job isn't hazardous. That might save you from having to call off during a drop. You might also look into other treatments that would maybe be better suited to you. I did that because I found working while on high doses of Prednisone to be very difficult too. My performance was suffering and I couldn't do my best for anyone.

Why were they "scared" of ITP? Geez - they need to get informed! I've never had anyone react like that!