Here’s what you need to know about managing COPD in the workplace, including how to talk to your employer about your condition, asking for reasonable accommodations at work, and what to do if you and your doctor decide it’s best for you to leave your job.

Benefits and Challenges of Working if You Have COPD

COPD can greatly impact your day-to-day life, including your ability to work. One in two Americans with COPD has to limit their activities because of health problems, one in three has trouble walking or climbing stairs, and one in four uses special equipment for health issues, according to the Centers for Disease Control and Prevention (CDC). Difficulty breathing and chest pain can also make it difficult to sleep, which can cause you to be drowsy and unfocused during the day. Taken together, these challenges can compromise your ability to work: People who do remain at their jobs say COPD symptoms cause them to miss work, and a quarter of adults with COPD aren’t able to work at all, according to the CDC. “We know that people with COPD take more sick days and time off,” says Frank Sciurba, MD, associate professor of medicine at the University of Pittsburgh School of Medicine and medical director of the Pulmonary Physiology Laboratory at UPMC. “Most patients with advanced disease have had to give up their jobs, not only because of shortness of breath but because they have flare-ups where they have to take time off of work, which disrupts their jobs.” Although COPD can make working challenging, many people with COPD continue to work for financial reasons or simply because they enjoy their careers. The good news: Advancements in COPD treatments, along with oxygen therapy, pulmonary rehabilitation, and social support, may help make it possible to stay in the workplace.

Should You Continue Working or Switch Jobs?

If COPD is making it hard for you to work, talk to your doctor. He or she can help you to decide if your job is too strenuous or if your work environment affects your COPD. “It’s a patient’s preference, but it’s up to the doctor to support them if they’re suffering too much or are too symptomatic and it interferes with their ability to perform their job,” says Dr. Sciurba. If your job requires extensive physical activity, your doctor may advise you to ask your employer to modify your tasks or move you to a less physical job. If you work in an industrial environment where you’re exposed to dust, smoke, gases, or fumes, you might need to change jobs to protect your lungs from further damage. You might also need to switch roles or leave your job if you work in extreme temperatures or high altitudes, which can make breathing difficult even for people without a chronic lung condition.

How to Talk to Your Employer About COPD

It’s not an easy conversation, but it’s important to share your diagnosis with your employer. COPD can affect your ability to do your job even if you’re not in a role that requires extensive physical labor. Explain that COPD is a long-term condition that can make it very difficult to breathe, even during everyday activities like walking and talking. That means you may need to rest during the day, reschedule meetings, or take time off of work. You may also need to consider reassigning tasks that you can no longer complete to coworkers, or you may possibly need to take another role at the company. Because COPD can also lead to more frequent respiratory infections and serious exacerbations, you may need to take time off to go to the doctor, and you might need to schedule visits for pulmonary rehabilitation during the workday. If you’ve been prescribed oxygen therapy, let your employer know if you’ll be bringing an oxygen tank with you to work. Keep in mind that oxygen tanks should be kept away from open flames and other heat sources as well as aerosols and petroleum, which may impact your ability to do your current job.

Ask for Reasonable Accommodations Under the Americans With Disabilities Act

The Americans with Disabilities Act (ADA) guarantees that neither public nor private employers can discriminate against you if you have a disability. That means your employer can’t fire you, refuse you a promotion, or otherwise compromise your role if a condition keeps you from performing certain tasks. Your employer must also offer you reasonable accommodation, or adjustments to your role that enable you to do your job. COPD may qualify as a disability under the ADA if it substantially limits your ability to do your job. “There is no process to ‘apply’ for coverage under the ADA,” says Sharon E. Rennert, senior attorney advisor for the Equal Employment Opportunity Commission (EEOC), ADA Division. Your ability to function is measured when you’re not using treatments like medications or inhalers, she adds. If you think you could benefit from accommodations at your job, talk to your employer about exactly how COPD affects you and adjustments that might help. “An employee should suggest possible accommodations that would address the problem. The individual should also be open to any suggestions the employer might offer,” says Rennert. “Not everyone with COPD will need reasonable accommodations, or the same reasonable accommodations.” The kinds of accommodations you might want to request from your employer to make the workplace more accessible could include (but are not limited to):

An accessible parking space closer to the doorA flexible work schedule or ability to work from homeA smoke-, dust-, and fume-free environmentAdvance notice of construction or cleaning near your workspaceApproval to use a motorized scooterJob restructuring or reassignment to a vacant role in the company if your job requires significant manual labor or talking with clients, which can be taxing for people with COPD

Tips for Managing COPD in the Workplace

In addition to asking for accommodations from your employer, there are steps you can take to make it easier to work with COPD:

Fit in time for fitness. One of the most important things you can do to continue working as long as possible is to stay active, says Sciurba. “If patients stay fit and manage their disease, they can be productive and continue to work.”Don’t skimp on care. While you might be tempted to skip doctor appointments or pulmonary rehabilitation sessions to avoid missing work, you’ll be better off in the long run if you take the time now to manage your disease. In pulmonary rehab, you’ll learn techniques to breathe more efficiently, how to use essential medications like long-acting inhalers, and other ways to optimize your health. “The disease will affect you less so you can do your job,” says Sciurba.Apply breathing techniques. Before doing any potentially tiring activity, practice the pursed lip or diaphragmatic breathing techniques that you learn in pulmonary rehab.Reassess your schedule. Schedule breaks between meetings as much as possible, since talking can be tiring if you have breathing problems. Also try to plan the most strenuous activities at a time of day when you have the most energy, or schedule a restful activity between strenuous ones. “Having some flexibility on a day-to-day basis helps, so if you have bad days you can do something with less aerobic stimulus and stay engaged,” says Sciurba.Break big jobs into smaller steps. Figure out how much time you’ll need to complete a potentially tiring task and spread the work over several days or several periods throughout the day.Limit your baggage. If you take more than your lunch bag to work, consider buying a briefcase on wheels to transport work items to and from your office.Reorganize. Put the things you use the most in drawers or shelves that are between waist and shoulder level so you don’t have to bend down or reach up.Maintain good posture. Poor posture affects your ability to breathe. If you’re slumped over your desk all day, your rib cage can’t expand as much. That limits your diaphragm’s range of motion, so it’s harder to take deeper breaths.Use your supplemental oxygen. If you need supplemental oxygen, don’t hesitate to use it at work: It’s essential for your health. “A lot of times people won’t use their oxygen in public or around their colleagues,” says Sciurba. “It’s important to get over the stigma. We should support people so they’re not self-conscious.”

What to Do if COPD Is So Severe You Can’t Work

If your COPD is severe and significantly disrupts or prevents you from doing your job, you can apply to be approved for disability benefits through the social security administration (SSA). Monthly SSA disability benefits can be used to pay for essentials including rent, groceries, medical bills, medications, childcare, and specialized training if you wish to eventually return to work. The SSA’s Blue Book manual determines eligibility for disability benefits; COPD is under Section 3.02. In order to qualify, the SSA needs evidence of your lung function, which often includes blood tests, spirometry, and pulse oximetry tests. It’s also helpful to provide notes from your doctor about your symptoms and treatments, along with records of any hospital and emergency room visits and treatments for COPD complications. “We have to document lung function, and there has to be some degree of abnormality,” says Sciurba. “We look at whether people can perform to the level required in their job.” Ask your doctor if your symptoms automatically qualify you for disability benefits, and he or she can help gather the paperwork you’ll need for a strong application. You can apply online at the SSA website or at your local SSA branch.