Chronic Illness and Disability: Key Differences and How to Get Support

Chronic illness is more common than you may think. According to the Centers for Disease Control and Prevention, 6 in 10 adults in the US are living with a chronic illness, and 4 in 6 adults have two or more chronic illnesses. This includes cancer, heart disease, diabetes or Alzheimer's disease -- any disease that has lasted longer than a year, requires medical attention or limits your day-to-day life may count as a chronic illness.

Living with a chronic illness is different for everyone, and not everyone with a chronic condition has a disability. But if your chronic condition alters how you live your life to a debilitating degree, when does it become a disability? And how can you get support at work, school or other parts of your life if you need it?

First, let's go over the differences between a disability and a chronic illness. 

What is a disability?

A disability involves any physical or mental condition that limits a person's interactions with the world and can include impairment of any or all of the following functions:

• Mental 
  
• Physical
  
• Learning
  
• Intellectual
  
• Vision
  
• Communication
  
• Hearing
  

The World Health Organization defines disability on three dimensions: impairment, activity limitation and participation restriction.

Impairment 

In the context of a disability, an impairment is a significant difference in someone's body structure or mental functioning that limits a person's movements, senses or activities. Impairments can include a missing or underdeveloped limb, hearing loss or a mental health condition that makes it difficult to take care of basic needs on your own.

Activity limitation

Another component of a disability, according to the WHO, is that it can affect your ability to do common activities, such as walking, speaking or mentally processing information.

Participation restriction

Finally, disabilities can affect your ability to participate in everyday situations, such as working, spending time with friends, going to events and getting health care.

Chronic illness and disability

How does chronic illness relate to disability? Legally defined, many chronic illnesses can cause a disability, both temporary and ongoing. In the US, the Americans with Disabilities Act lays out the federal framework by which disabilities are categorized and handled in public life. 

The National Center for Chronic Disease Prevention and Health Promotion defines chronic disease as a condition that both:

• Lasts one year or longer
• Requires ongoing medical attention, restricts daily living activities or both

Each country approaches chronic illness and disability a little differently. For example, the UK refers to disability based on its "'substantial' and 'long-term' negative effect on your ability to do normal daily activities," while Australia refers to people with disabilities as having at least one daily activity restriction.

While both chronic illnesses and disabilities can have a similar effect on your body, relationships and everyday interactions, not every chronically ill person is disabled. 

Could my chronic illness be considered a disability?

After looking at the definition of chronic disease, this question may seem simple, but the answer is different for everyone. Not every chronic health condition is a disability, and not every disability stems from chronic illness.

Ask yourself

• Does this condition debilitate my everyday life? 
  
• In the past 90 days, have I had trouble feeding myself, going to the bathroom, walking or bathing?
  
• Has my condition significantly limited my activity and participation in life?
  
• Are one or more symptoms causing significant impairment to my mind, senses or body?
  
• Do I require more supervision to get through my daily routines?
  

If you answered "yes" to one or more questions, your chronic illness may be considered a disability. This is important to know when applying for insurance, disability accommodations or professional care. But what does this mean for the workplace?

Workplace accommodations

The US Equal Employment Opportunity Commission highlights three areas of reasonable accommodations based on the ADA:

• Providing an accessible job application for a person with a disability 
  
• Adjustments to physical labor so the job may be reasonably performed by a person with a disability 
  
• Accessible benefits and privileges in line with other employees, such as break rooms, conferences and transportation 
  

The ADA also lists other workplace accommodations that are generally considered:

• Modified job tasks
  
• Flexible work schedule 
  
• Reserved parking
  
• Access to service animals
  
• Equipment or software changes
  

In order to start the process for accommodations, you must first disclose that you have a disability to your employer or human resources representative. It's important to note that this is a completely voluntary process that you can begin at nearly any time. You can do this during the application process (many applications include a space for voluntary self-disclosure) or when you are actively working.

And if you don't need or want an accommodation, you don't have to disclose it at all.

Regardless, employers are very limited in what they can ask about your condition, whether you're applying for a job or actively working. According to the EEOC, "An employer can ask if you can perform the duties of the job with or without reasonable accommodation. An employer can also ask you to describe or to demonstrate how, with or without reasonable accommodation, you will perform the duties of the job."

Depending on the kind of work involved, you may need to undergo an examination or provide documentation of your condition. From there, you and your employer should determine and document the right workplace accommodations as needed.