Breaking 'the autoimmune career ceiling': How chronic illness care supports workers

• Key Insight: Learn how chronic autoimmune conditions create an "autoimmune career ceiling" affecting workforce mobility.
• What's at Stake: Untreated workplace barriers could reduce female labor participation and increase healthcare-related turnover.
• Supporting Data: 70% of diagnosed working women report limited career potential; 39% reduced hours.
  Source: Bullets generated by AI with editorial review

Seven years ago, Ellen Rudolph was diagnosed with Lyme disease after a long and exhaustive battle with the healthcare system — an experience that nearly made her choose between her health and her career.

"I should have been in the prime of my health and my career," says Rudolph, who now works as the cofounder and CEO of virtual care platform WellTheory, but at the time of diagnosis was still fighting to climb the corporate ladder at a tech startup. "I didn't really quite know how to explain to my manager why I'd used all my sick days and why I was struggling to do my job — that lack of predictability was really scary."

Rudolph spent months in limbo without any clear answers on her health, all while her worsening symptoms left her nearly bedridden; she was worried about what would happen if she lost her job and her insurance. 

When she was finally diagnosed, Rudolph got on the path to managing her symptoms, but she couldn't shake the stress of living in the unknown. She channeled that energy into starting a healthcare company that would help support others struggling with chronic illnesses. WellTheory was born in 2021, and now helps provide relief to thousands of people with conditions such as rheumatoid arthritis, lupus, Type 1 diabetes, Hashimoto's thyroiditis and Multiple Sclerosis. 

Read more: Can increasing women's access to specialists decrease insurance costs?

Rudolph's story mirrors that of much of the workforce — especially women, she says. As many as 70% to 80% of people with autoimmune diseases are female, according to a recent study published by Ohio State University. In March, WellTheory released a report focused on the impact autoimmune diseases have specifically on working women, and found that 70% of working women diagnosed with an autoimmune condition reported that their disease limited their career potential, with two-thirds deciding to unhappily stay in a role due to the risk of losing necessary benefits. 

Their conditions also often interfere with their ability to progress in their existing roles due to unmanageable symptoms, most of which go undisclosed out of fear or stigma, Rudolph says. However, the reality is that 68% of women report experiencing negative effects at work since their diagnosis, according to WellTheory, with 39% reducing their hours, 28% switching to a less demanding role and 13% turning down a promotion.  

"Much like the glass ceiling, there's this concept of an autoimmune career ceiling," Rudolph says. "For people with chronic illnesses, there are all of these invisible, micro-decisions we have to make about our lives because of the unpredictability of these conditions."

In worst case scenarios, women can't keep up with the demands of their career and caring for themselves. As a result, 11% of women reported exiting the workforce entirely due to an autoimmune condition. 

Read more: ICHRAs, local health networks empower employees to access better care

"These obstacles women are facing, they're often invisible," Rudolph says. "You're not going to know people are suffering in silence, but that doesn't mean that it's not taking a significant toll on them." 

Rethinking health and wellness approaches

Providing better support doesn't have to be complicated, Rudolph says. It starts with flexible policies and more expansive benefits. For example, making remote work a core part of the business and simplifying the process for requesting and receiving accommodations could significantly improve women's (and all workers') ability to grow professionally. Voluntary benefits or programs like WellTheory, which offer specialized care such as personalized virtual nutrition, stress management, and sleep support at no cost to employees, can also help fill care gaps that may be limiting women from reaching their full potential.

A less traditional approach for benefits leaders is to restructure healthcare offerings by giving employees individual, subsidized stipends to apply toward the healthcare plans of their choice, such as through Individual Coverage Health Reimbursement Arrangements (ICHRAs).

Read more: Why ICHRA is no longer a fringe option

"When dealing with these types of chronic conditions we really want to be in the driver's seat," Rudolph says. "Thankfully we're seeing employers wanting to give their employees more choices and empower them to decide their ideal healthcare journey and experience." 

Rudolph urges organizations to work closely with benefits consultants, brokers and data partners to understand the greater picture of their workforce's health and wellness needs so as to build the most effective solutions and promote attainable professional development for all employees.

"I do feel hopeful and optimistic that there's progress being made because it means our stories are resonating," Rudolph says. "The silver lining to all of these cases women have shared is that there is more growing awareness, education and desire from employers to really take action."CEO of WellTheory shares her own experience