Workplace Accommodations and FMLA for People with Kidney Disease

Working while you have late-stage kidney disease, are on dialysis, or have had a kidney transplant, can be tough. But there are resources and legal protections to help you. This guide explains how to get accommodations at work or use the Family and Medical Leave Act (FMLA).

The Americans with Disabilities Act (ADA) ensures people with disabilities have the same opportunities as those who don’t. It prevents workplace discrimination and ensures that employees get the help they need.

Reasonable accommodations include:

• Flexible Hours: Change your work schedule for dialysis or doctor appointments.
• Modified Duties: Adjust job tasks to reduce physical stress.
• Remote Work: Ask to work from home if commuting or being physically present at the workplace is challenging.
• Extra Breaks: Take longer or more frequent breaks if you feel tired.

Learn more about working with kidney disease.

Kidney disease and its treatments may qualify as disabilities under the ADA, especially if they limit daily activities.

How to request accommodations from HR:

• Document Your Needs: Collect medical papers explaining your condition and how it affects your work.
• Initiate a Conversation: Speak with your HR department or supervisor. Explain your condition and the accommodations you need.
• Submit a Formal Request: Provide a written request for accommodations. Include medical documentation and suggested modifications. 

If your reasonable accommodation is denied, you can:

• Understand the Reason: Ask your employer for a written explanation. All employers with fifteen or more employees must provide reasonable accommodations. 
• Assess the Reasonableness: Consider if the accommodation is reasonable. Reasonable accommodations do not cause undue hardship to the employer. 
• Communicate with your Employer: Arrange a meeting with your employer or HR department. Clarify your needs, provide additional documents, and suggest other accommodations. Keep records of all communications.
• Follow Internal Grievance Procedures: If you cannot compromise with your employer, file an internal grievance. You may go to mediation, where a neutral third party helps resolve the dispute. 
• File a Complaint: If internal efforts fail, file a complaint with the Equal Employment Opportunity Commission (EEOC). The EEOC enforces the ADA. You must file a charge with the EEOC before other legal actions.  
• Seek Legal Advice: Consult an employment attorney specializing in ADA cases. An attorney can help you understand your rights, evaluate your case, and advise you.

The FMLA allows eligible employees to take up to 12 weeks of unpaid leave each year for medical reasons, including kidney disease or recovery from a transplant. Your job and health benefits are protected during this leave. Time can be taken continuously or in small blocks.

To be eligible for FMLA, you must meet the following criteria:

• Employment Duration: Worked for your employer for at least 12 months.
• Hours Worked: Worked at least 1,250 hours in the 12 months preceding your leave.
• Employer Size: Your employer must have at least 50 employees within a 75-mile radius.

Read or share our employer's guide to supporting employees with kidney disease.

If you know you need leave, give your employer 30 days’ notice. If it’s an emergency, notify them as soon as you can.

How to request FMLA Leave:

• Complete Required Forms: Request, complete, and provide any necessary forms your employer requires.
• Submit Medical Certification: Submit a medical certification form. Explain the nature of your condition and the need for leave.
• Follow-up: Confirm your employer processed your FMLA request. Make sure you understand how your leave will affect benefits or job status.

If your FMLA Leave is denied, there are several steps you can take.

• Verify Your Eligibility: Check that you or your employer meets the eligibility criteria for FMLA leave. 
• Understand the Reason for Denial: Ask your employer for a written explanation. Incomplete or incorrect documentation can lead to denial.
• Clarify and Communicate: Discuss the denial with your HR department or manager. Provide any additional information or documentation that might support your case. 
• File an Appeal: Many employers have an internal process for appealing FMLA leave decisions. Follow your company's procedures. Keep detailed records of all communications related to your FMLA request.
• Contact the U.S. Department of Labor (DOL): If internal efforts fail, file a complaint with the Wage and Hour Division of the U.S. Department of Labor. They'll explain your rights under FMLA and help you understand the next steps.
• Seek Legal Advice: If you cannot resolve the issue internally or with the DOL, consider consulting with an employment attorney specializing in FMLA cases. They can advise you on the best course of action.

Learn how to overcome financial hardships with kidney disease.

Contact NKF Cares, our patient helpline, to speak with a trained professional. Call toll-free at 855.NKF.CARES (855.653.2273) or email nkfcares@kidney.org.