Talking to Your Employer About Cold Agglutinin Disease

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by Mary Chapman |

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If you have cold agglutinin disease (CAD) and are working, you may be wondering how best to speak with your employer about your condition, or whether to disclose anything at all.

Here are some considerations that may help you decide how to handle CAD in the workplace.

What is CAD?

CAD is a rare autoimmune disorder in which exposure to cold temperatures causes autoantibodies, or cold agglutinins, to bind tightly to red blood cells, inducing their lysis (disintegration) and resulting in anemia.

The disorder may manifest as a primary disease, in which the underlying cause is unclear, or as a secondary disease that develops following another medical issue, such as infections, certain types of cancer, or other autoimmune diseases.

Employment and CAD

In the U.S., 60% of adults have at least one chronic condition. If you have CAD, your condition may not be readily apparent to your supervisor or colleagues, particularly if you work remotely. However, you may experience heart problems, fatigue, or episodic joint or chest pain. These symptoms may affect your ability to perform your job, at least on occasion, and may result in an emergency.

Should you speak with your employer about CAD?

Living with a chronic disease such as CAD means that you may require more days off than your coworkers, or special accommodations such as a workspace with no air conditioning. You may therefore want to alert your boss about what’s going on to avoid assumptions being made about you.

A focus group study aimed at exploring solutions that people with chronic disease use to overcome difficulties they experience at work found that disclosing the disorder to employers and colleagues was effective in the work environment. Disclosure can make work less stressful and improve your relationship with your employer. Your employer and colleagues also will know what to do in case of an emergency.

Before the discussion

If you do decide to speak with your employer about your condition, you should consider how you’re going to explain your needs.

You may want to talk with your physician about how CAD can affect your work.

You also may want to prepare educational materials to give to your employer. This can help them better understand your condition and diagnosis. Do try to keep the materials as concise and as clear as possible.

List what you are doing to manage your condition and how these steps can affect your work.

Consider whether your employer may be open to possible options, including reduced or flexible working hours, or working from home, if this would be of benefit to you.

You also may want to double-check any nondiscrimination policy your organization may have. In some cases, disclosure can help protect your rights. Many employers have employee assistance programs that can help you.

Note that you are not required to tell your direct supervisor any specifics about your symptoms. If it’s better for you, you may be able to work through your employer’s human resources department.

The discussion

During the discussion, focus on how CAD affects your work and any special accommodations you may need. For example, this could be a space heater or a non-drafty work area. In some cases, your employer may be legally required to make such adjustments.

Because good hygiene and avoiding getting infections are critical for CAD patients, you may need your supervisor’s support to, for example, stay away from sick coworkers or avoid conferences or other activities where crowds are expected.


Last updated: March 4, 2021


Cold Agglutinin Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.