Pattern of workplace disputes in cancer survivors: a population study of ADA claims.

BACKGROUND: The Americans with Disability Act (ADA) claim patterns can provide information on sources of potential work discrimination faced by employees with various health problems. This study investigated the pattern of ADA disputes among cancer survivors and non-cancer related impairments.
MATERIALS AND METHODS: Using multivariable logistic regression adjusting for demographics, employees with cancer related claims were compared to employees with other impairment related claims for alleged violations from 2000 to 2005. The impairments were grouped into orthopedic, behavioral, medical, neurological, sensory, cancer, cancer comorbid (cancer and non-cancer impairments), and comorbid "other" (non-cancer comorbid disorders). The dispute categories included: termination, reasonable accommodation, relations, terms, hiring, and a nonspecific "other" category.
RESULTS: This study analyzed 59,981 cases over a 6 year period. All comparisons were made in relation to the cancer group. There was a protective effect for any impairment other than cancer (OR = 0.29-0.63, 95% CI = 0.25-0.72) related to discharge from work. Also, orthopedic (OR = 0.81, 95% CI = 0.71-0.93), general medical (OR = 0.82, 95% CI = 0.72-0.94), and neurological (OR = 0.83, 95% CI = 0.71-0.96) impairments were found to be protective for claims related to terms of employment relative to cancer. Cancer survivors who reported a second impairment in addition to cancer were more likely to file disputes that involved relations with others at work (OR = 1.47, 95% CI = 1.16-1.87) in comparison to those with cancer only. Orthopedic (OR = 2.42, 95% CI = 2.13-2.76), neurological (OR = 1.50, 95% CI = 1.30-1.72), and sensory (OR = 1.50, 95% CI = 1.29-1.73) groups were more likely to file accommodation related disputes than the cancer group. Sensory (OR = 4.41, 95% CI = 3.45-5.63), other-comorbid (OR = 2.33, 95% CI = 1.85-2.94), medical (OR = 1.92, 95% CI = 1.51-2.44), and neurological (OR = 1.59, 95% CI = 1.23-2.05) impairment groups filed more disputes related to hiring than the cancer or the cancer-comorbid group.
CONCLUSION: Cancer survivors are more likely to file job loss claims and differential treatment related to workplace policies. Those with cancer and another impairment file more claims related to relationship problems at work than cancer only. The factors accounting for these claims need to be explored in future research in order to develop more specific evidence based policy and practice. IMPLICATIONS FOR CANCER SURVIVORS: While the percentage of cancer survivors who file claims are relatively small, job termination and terms of employment are more likely to be concerns for cancer survivors than employees with other types of impairments. If a cancer survivor has another health problem as well relationship disputes are likely to emerge.