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Topic: Student Loans, Work Protection and breast cancer

Forum: Employment, Insurance, and Other Financial Issues —

Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Apr 14, 2018 01:54PM - edited Apr 14, 2018 01:55PM by buttercup1

buttercup1 wrote:

Hi Everyone,

I am 34 and newly diagnosed (two weeks ago) with DIC stage IIB(?) HER2+. I do not qualify for student loan discharge, but I will not be able to afford loan payments while on short term disability and while paying for huge medical bills. I know there was a 2017 proposed bill (Deferment for Active Cancer Treatment Act) to allow cancer patients to defer loans, but I don't think it has passed yet. Does anyone have any experience with federal student loans while being treated? I have about $70k in loans, so the monthly payments are pretty substantial.

Also, I work in a hospital in a highly infectious area (lab). My work is accommodating me during the required FMLA period by giving me a secretary job away from the lab for about a year, but they might fire me after my FMLA protection is up because they are already short staffed and would need to hire someone else who can work in the infectious areas. My degree is in lab science, so if I can not work in the lab, do I have any chance at getting my student loans forgiven because my degree would be useless? If I get fired due to an illness, is that an ADA violation, or is it legal because my FMLA protection would be over? Thanks for any advice!


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Apr 14, 2018 02:19PM NancyHB wrote:

Hi buttercup. Sorry you've been diagnosed but glad you found your way here.

Many of us work through treatment with few side effects or impact on our jobs. It’s not always easy, but it’s doable. It’s possible you won’t need as much time off as you worry you’ll need. When do you start treatment? Have you already had surgery? Have your employees given you any indication they aren’t supportive or are looking to let you go when your treatment is over? Or are you just trying to plan ahead just in case?

Like you I have substantial student loans. I had just started grad school when first diagnosed. There’s no way to discharge your loans, unless you become permanently disabled or you’re part of a SL forgiveness program (teachers and social workers often have these programs). You can always ask for a deferment for a few months off of payments, or you could refinance to stretch your payment period out to up to 30 years - longer time, lower payments (but more interest). I did that once I was dx’d with Stage IV with the expectation I’ll become permanently disabled at some point (highly unlikely I’ll be here in 30 years).

And yes, unfortunately your employer can let you go after your FMLA period has expired. Hopefully that doesn’t happen for you but it’s something I’m always aware of. We shouldn’t have to be terrified of losing a job while enduring life-saving treatment, but it happens.

If you have an ongoing disability after your treatment ends your employer may be required to make accommodations under the ADA, but you would still need to be able to perform the essential job duties or they might legally be able to let you go.

Good luck!
"Be happy for this moment. This moment is your life." - Omar Khayyam Dx 11/22/2011, IDC, Left, 1cm, Grade 2, ER+/PR-, HER2- (FISH) Surgery 12/5/2011 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 1/19/2012 AC + T (Taxol) Radiation Therapy 6/12/2012 Whole-breast: Breast, Lymph nodes Dx 1/27/2016, IDC, Left, 1cm, Grade 3, 0/4 nodes, ER-/PR-, HER2- Surgery 2/15/2016 Lumpectomy; Lymph node removal: Left Chemotherapy 3/1/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 7/21/2016 Mastectomy: Left; Reconstruction (left): DIEP flap Dx 1/31/2017, IDC, Stage IV, metastasized to bone
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Apr 14, 2018 03:53PM gb2115 wrote:

Has your oncologist told you that you can't work in the lab?

Dx IDC in October 2016, stage 2A, 1.2 cm ER/PR+ Her2-, Grade 2, 1/3 nodes. Mammaprint low risk luminal A, Lumpectomy + radiation + tamoxifen. Age 38 at diagnosis.
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Apr 14, 2018 07:27PM Moderators wrote:

buttercup1, You raise some great questions. Is there an HR person/department at your workplace that could provide more assistance.

We are sorry for all you are going through, but fortunate that they have adjusted your position, for now.


To send a Private Message to the Mods: community.breastcancer.org/mem...
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Apr 14, 2018 09:56PM - edited Apr 14, 2018 09:57PM by ksusan

This Post was deleted by ksusan.
Mutant uprising quashed. Dx 1/2015, IDC, Right, Stage IIA, 1/1 nodes, ER+/PR+, HER2- Dx 1/2015, DCIS, Left, Stage 0, Grade 3, 0/2 nodes Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Apr 15, 2018 11:27AM - edited Apr 15, 2018 11:34AM by buttercup1

Thank you all for the replies, I appreciate it. I'm glad I found this site. I think that I am just having a ton of anxiety (like everyone else on this site of course), but I feel like my employer is giving me an overall attitude of "be glad you still have your job, we can fire you at any time".

"When do you start treatment?Have you already had surgery?" I am having chemo first, then surgery (due to HER2+). I'm scheduled to get a port placed for chemo and the first dose should be around May 11,2018. Surgery will come later after chemo, probably in November.

"Has your oncologist told you that you can't work in the lab?" My entire medical team has said that they have never encountered this situation before, and consider my job a special case because we work in a highly infectious atmosphere. My surgeon has said I should not step foot in the lab ever during treatment, and my oncologist said that she does not want me working at all. It is still early though, and I will meet with my oncologist later this month to find out more about working then. They were all very clear that I should not be in the lab though.

"Have your employees given you any indication they aren't supportive or are looking to let you go when your treatment is over? Or are you just trying to plan ahead just in case?" My work told me they will put me in a secretary position temporarily, but my immediate supervisor mentioned the following: she told upper management that I needed to work outside of the lab for a while. They responded by asking her "well, do you want to keep her?" (That really scared me! My boss assured me that she did say she wants to keep me, but I'll explain why I'm still nervous in the following paragraph). My boss also said that FMLA protects me, but only until it runs out.

I have a feeling that they will only do what is required by law, then get rid of me. We had a coworker go out on FMLA a few months ago, and my boss was complaining about her the entire time, saying stuff like "why doesn't she just quit if she's that sick" and "I wish she'd just tell us if she's going to take long term disability so we can hire someone else". She was counting down the days until she could call HR to have her laid off / fired. Granted, that coworker didn't tell my boss what was wrong with her, but by law, you do not have to tell your boss anything. I already told her about my cancer though, because I am afraid of being treated like my coworker was. My coworker had to submit a letter of resignation on her last day of FMLA; I am not sure if she was abusing the system, or if she was just too unhealthy to come back, but I know she did have doctor's notes for FMLA. In summation, I have multiple reasons to be scared, and I feel as though my job is only protected if my employer wants it to be protected. I would just ask for short term disability then long term disability and quit my job, but I need the health insurance, not to mention money to pay mortgage, student loans, car loan, and bills.

"Is there an HR person/department at your workplace that could provide more assistance?" We unfortunately have an outsourced corporate HR department. Its just a phone number that you call. I've tried calling them to get more guidance, but the random people who answer each time are useless. They say FMLA protects my job, but after that it is up to each individual location as to whether they will keep people.

If I do happen to lose my job, does anyone know if I can collect unemployment, or would this be a disability case due to the fact that my doctor doesn't want me stepping foot in a lab? My degree is a specialized degree in laboratory science that does not translate easily into non-infectious jobs.

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Apr 15, 2018 12:44PM ksusan wrote:

If it helps, my MO didn't want me near groups of children because of the potential for infection. I also had a colleague who was a nurse post-kidney transplant and immunosuppressed who moved from a medical to a psych unit to decrease risk, and even there wouldn't have physical contact with anyone with HIV or viral hepatitis.

Mutant uprising quashed. Dx 1/2015, IDC, Right, Stage IIA, 1/1 nodes, ER+/PR+, HER2- Dx 1/2015, DCIS, Left, Stage 0, Grade 3, 0/2 nodes Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Apr 15, 2018 02:24PM buttercup1 wrote:

Ironically, amid all of this, I was just accepted into nursing school for Fall 2018. I had been working for the past two years to finish my prerequisites. I finally got in and I can't start because I won't pass the entrance physical and I'll be doing chemo. Life certainly requires a sense of humor.

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Apr 15, 2018 04:39PM - edited Oct 11, 2018 06:50PM by VVV

This Post was deleted by VVV.
Dx 10/23/2017, IDC, Left, 5cm, Grade 3, 0/3 nodes, ER+/PR+, HER2+ Targeted Therapy 12/4/2017 Perjeta (pertuzumab) Targeted Therapy 12/4/2017 Herceptin (trastuzumab) Chemotherapy 12/4/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 5/7/2018 Lumpectomy: Left; Lymph node removal: Sentinel
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Apr 15, 2018 08:51PM chronicpain wrote:

My understanding is that once your FMLA protection is over, as stated above, ADA only protects you insofar as you can actually do the job you were hired for with “reasonable” accomodation — not extraordinary accomodation. This would likely mean your employer would not have to keep you in a secretarial position they do not want you for if they really need someone to work in what you call the infectious risk area but cannot do due to getting chemo.

As for nursing school, at least in the short run until you are cured (hoping!) given you already have $70 k in debt for one career you want to change from, it would make little sense to incur more debt for another career you cannot physically handle the training for even if it is your new dream job.

But you should qualify for short term disability through your state program (and long term social security disability, and Medicare over time if you are not doing well and are totally and permanently disabled) . This would obviously be a major cut in income from being a lab worker in even the most generous states like CA, but if you and any spouse you may have have no or little other household income, you could get the equivalent of basic general relief welfare funding to be able to eat, get Medicaid, get low income housing, food stamps etc. until back on your feet. The student loans would simply not be paid, but maybe you could still preserve credit by getting a deferment, or do partial payments, given such extraordinary hardship, or maybe fund a personal or credit card loan to make minimum payments. Do you have any relatives or friends or church group who could temporarily help you get through this in case there is no go on deferring student loans, so your credit would not be ruined and you would not have to live bare bones?

I am so sorry you have to face all this financial worry, as the BC of course is bad enough. But from the employer perspective, the argument is that to stay in business over time they have certain essential functions that need doing and if there were no time limits on FMLA and ability to do the job condition limits on ADA, and you mutiplied unlimited government mandated extensions to unlimited US firms at employer expense, or had a bill for unlimited more generous free funding of citizens for all unemployability circumstances, the federal and state governments would have to get much bigger, taxes would be way higher, firms would hire less people if they came with more potential future expense baggage because they could not fire them (a problem many European firms have), many would be bankrupt very quickly or never start up in the first place, , and ironically government would then have little left to charge to spend on BC research benefitting future women and other health programs, like NIH, much less for controversial big expense and more politically divisive programs like defense, Medicare, social security, Medicaid and Obamacare subsidies for many on this forum, etc. It is economically very complicated in the big picture, but super scary for a young woman like you facing BC and debts.

Most young Americans do not think much about saving or planning for a rainy day with disability insurance, and then are understandably shocked when they have expensive physical setbacks that threaten their jobs. My parents came to U.S. from war-torn and tyrannical Europe, and pounded into me to save, save, save , avoid debt, and live modestly within one’s means, with a big focus on the future rainy day which was sure to come , but they were from a different generation and outlook and had almost died ( and frankly overdid it — my mom had three different private disability insurances she never used before she died).

I am older now but have saved for stormy days as best possible, , just in case, but was in a circumstance when I was younger before I got married where had I not had good health and ability to work, and work overtime, I would have had to move back in with my mother and have her take care of me with what she had saved, in her doublewide mobile home




After a decade of autoimmune problems, Dx 10/2017 at age 63, IDC, Left, 9mm, Oncotype 13, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2-, 11/22/2017 Lumpectomy, Arimidex. Declined radiation.
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Apr 16, 2018 02:49PM - edited Apr 16, 2018 02:54PM by buttercup1

Thanks everyone for your replies. I appreciate hearing from other people who went through similar situations. I do have access to a social worker, but unfortunately she told me during her initial consultation that she would be resigning shortly after our meeting. Her supervisor will be taking over her patients, but I have a feeling that I am not getting the usual amount of social work involvement due to her resignation. I'll follow up with her supervisor and hope for the best. I did buy short term and long term disability insurance, but I am getting the run-around from the HR phone line as to who can send me coverage paperwork. I am sure I'm not the only cancer patient who has had to jump through hoops to get coverage Loopy

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May 12, 2018 04:07PM Lumpie wrote:

buttercup1: So sorry you are going though this! Congrats on getting into nursing school! What makes you think you won't be able to pass the physical? Important: Having breast cancer will not make you not pass physical! I did - twice! (If your doctor is - or is threatening to - "fail" you on the physical because you have BC, you need to find a new doctor. (And consider filing a complain about the one you have.)

Don't assume you won't be able to go to nursing school while you're being treated. I did! If being a nurse is your dream, do not give up on your dream because you have breast cancer right now. For most people, early stage BC is temporary. In a few months, this should all be behind you! If you do decide that now is not the right time to pursue nursing school, be sure and seek a deferral on your offer of admission. This is an appropriate accommodation to request under the ADA and/or Rehabilitation Act. I worked with infectious patience during treatment. May not have been the best idea but it was my job and I did it anyway. I was careful about hand hygiene and wearing appropriate protective equipment. I am no worse for the wear. In my experience, most patients are not infectious. Again, asking to be assigned to non-infectious patients during times when you may be immunosuppressed would be a "reasonable accommodation." (Be sure to talk with you MO about colony stimulating factor to maintain WBC's if you need it.)

As far as the student loans go you could ask for forbearance during treatment. Depending on the lender, this may be a possibility. Review your loan documents carefully to see if there is any provision for forbearance during a temporary disability. I have not found there to be a great deal of support available from social workers. Their intentions are good, but there are generally too few "relief" resources available and too few social workers to meet the need. Most focus on end stage patients out of necessity. But it is worth investigating. Every little bit helps. You might check with local cancer organizations and even utilities to see if they offer special assistance during a temporary disability. Our HR department is not at all helpful either. So sorry for both of us that they are not a more valuable resource. I am sure you have checked on whether your employer allows employees to "share" PTO with one another during an illness or special need. This is a nice benefit that some employers offer.

Chronicpain: Regrettably, virtually no states provide government sponsored income for short term disability. Even those of us with private disability coverage often can't afford to use it (if we can possibly keep going to work) because the amount of income would be so minimal - sometimes not even enough to cover the cost of our ever increasing health insurance premiums while we are off. Many states do not provide Medicaid to non-elderly adults unless they are totally and permanently disabled... and destitute. Those that do have strict income limits (less than about $15,000 per year) and asset limits ($2,000). Housing assistance is non-existent or hard to come by in most jurisdictions and state sponsored food assistance (SNAP) often uses the same guidelines as medicaid. While saving for a "rainy day" is prudent advice, the cost of healthcare is such that, even when we save diligently, it is simply not possible for most of us to save the amounts necessary to cover healthcare costs - let alone living expenses on top of that - at today's rates. {A recent Bloomberg article reports that insurers are beginning to seek premium increases for 2019 ACA plans and that in some jurisdictions, the premiums are higher than rents/mortgages.}



"If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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May 12, 2018 11:03PM - edited May 12, 2018 11:05PM by buttonsmachine

The Deferment for Active Cancer Treatment Act would be great - I hope it passes. Here's the link in case anyone wants to keep tabs on it:

https://www.congress.gov/bill/115th-congress/house-bill/2976/text?format=txt

Initial diagnosis at 32 years old. Chest wall resection 18 months later due to skin metastasis, probably from needle track seeding during initial biopsy. Skin graft from right thigh! Dx 8/2016, IDC, Right, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2- Surgery 10/1/2016 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 11/1/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/1/2017 Whole-breast Hormonal Therapy 5/1/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 9/2017, IDC, Right, Grade 3, 2/5 nodes, ER+/PR+, HER2- Surgery 11/1/2017 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 12/27/2017 AC Hormonal Therapy 7/1/2018 Zoladex (goserelin) Chemotherapy 7/1/2018 Xeloda (capecitabine) Radiation Therapy Lymph nodes, Chest wall Surgery Lymph node removal: Right; Mastectomy
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Aug 22, 2018 06:23PM Lumpie wrote:

As of today (8/22/18), this bill is stuck in committee. It does seem to have fairly broad bipartisan support and there is a Senate version. It can be found here:

https://www.congress.gov/bill/115th-congress/senat...

Call your Representatives and Senators!

Sad but true.... maybe McCain's situation will draw some attention to cancer related this issues on the Hill...?

"If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Sep 29, 2018 11:52PM - edited Sep 30, 2018 12:12AM by buttercup1

Hi everyone! I have not been able to post for pretty much my entire chemo regime- it's been months! I had a rough go of chemo: extreme fatigue, a myriad of stomach problems, very low blood counts, and a slew of other things. Needless to say, I had to drop all school and most work aside from one or two weeks of very light duty work a month.

Lumpie: Thanks so much for the advice! I wish I could have continued school during treatment, but there was no way. My schedule was grueling. Every three weeks I had this schedule:

A doctors appointment and blood draws on Wednesdays (2 hours), then HER2 drugs and chemo (8 hours) on Thursdays, then fluid infusions (4-5 hours) on Fridays and Mondays.

Then, after the above, I'd be sick for a full week to week and a half, unable to leave the house due to uncontrollable stomach problems (both the bottom and the top of the GI if you know what I mean). I really did not think it'd be that bad, but my doctor said she had to give me a very aggressive regime due to my age (34), and being grade 3 cancer.

On the bright side, my lymph nodes were clear, and they found no more cancer in the tissue they removed during my bilateral MX! The aggressive crazy chemo did it's job, and fingers crossed that I'll stay cancer free! I had my nursing entrance postponed until next year so that I can finish reconstruction surgery and another 7 months of HER2 drug injections. I feel like the chemo put me asleep for 5 months, and I'm just now starting to wake up!

As far as FMLA is concerned, I'm on leave due to MX recovery, and I'm running out of FMLA fast! I am hoping to just make it back to work at the end of a four week recovery period, but I will have to leave my tissue expanders in for a wooping 8 months because I won't have any FMLA left to recover from another surgery for the exchange to permanant implants. My employer used a "rolling back" 12 month FMLA schedule, which means they make it as hard as possible to get more when you've just used. I'm just thankfull I've been squeaking by so far! BC is so hard, it's even harder when your younger and can't rely on Medicare or social security payments (not that they are a lot either). I thought it was hilarious when many people would ask me "why are you still working during chemo, your not doing too well?!?" My answer was always "well, I like living in a house, and paying the bills, and oh yeah I really need insurance to pay for the huge $300,000 chemo and surgery bills" 🤣 I didn't qualify for long term disability, yet my doctor's didn't want me working. Ugh BC changes everything!

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