When the CHRO Needs the Accommodation — And the Program Isn't There

When the CHRO Needs the Accommodation — Awkward

What My Own Silence Taught Me About the Inclusion Gap We Haven't Named

Sandra Beckett, MBA | guidedpathhr.com

I Think My Name Was on the List?

I think I remember I was reviewing our benefits utilization data, the kind of routine analysis I'd done many times when I I think I saw it. Was that my name on our organization's high-cost claimant report? I still don't know for sure, but try to put it out of my head, and think it was just one of those days . . .

I was the CHRO. I had built that reporting structure. I was the person my leadership team came to when they needed to understand workforce health trends, contain costs, and design smarter benefits with our broker. And I was on the list before I even knew why.

At the time, I was scheduling specialist appointments between back-to-back meetings. I was managing fatigue that didn't respond to sleep, joint pain I attributed to stress, and cognitive fog I was working hard to hide. I didn't have a diagnosis yet. What I had was a body that was starting to fail the performance schedule I'd kept for years and a role that required me to be the steadiest person in every room.

I never disclosed it to my team. I never disclosed to my exec team colleagues. I never requested an accommodation.

I had designed the accommodation process. I knew exactly how to use it. And I said nothing.

Some days, I just felt awful and some days I described to my husband that “my body is shutting down”. Blood test, scans, doctors–wash, rinse, repeat for at least ten years, dismissed as “it's probably nothing”. 2022 and 2023 were some of the most stressful years of my personal and professional life. It took another year before I was diagnosed with Sjogren's syndrome–an autoimmune condition that affects the moisture-producing glands and can cause debilitating fatigue, joint pain, cognitive fog, and a range of systemic symptoms that are largely invisible to everyone around you. By then, I had learned something I couldn't unlearn: the programs we build do not always reach the people who need them most. Sometimes they don't even reach us.

The Question That Keeps Me Up at Night

If I, someone with full knowledge of the system, full authority to use it, and zero fear of retaliation, stayed silent, who in your workforce is doing the same right now?

This is not a rhetorical question. It's an operational one.

The research states as many as 75%+ of U.S. employees are managing a chronic health condition, but 60% of them haven't told their company 2025 Harvard School of Public Health study and poll. Some percentage of your workforce is navigating chronic illness, an invisible disability, a caregiving situation that is breaking their capacity, or a mental health condition that doesn't show up in your engagement survey because they've already decided it's safer to manage it alone. They are your high performers who schedule doctor's appointments during lunch. Your senior managers who are three specialists into a diagnostic process their team knows nothing about. Your directors who have restructured their entire work day around a condition they have never named out loud at work.

Your inclusion metrics will not show you this. Your ERG participation rates won't tell you. Your pulse surveys won't capture it, because the people I'm describing have long since concluded that honesty carries more risk than silence.

The Gap Between Policy and Safety

Here's what I know from building these programs: having an accommodation process is not the same as having a culture where people feel safe using it.

Most organizations I've worked with have an accommodation policy. Many have a dedicated HR contact. Some have an ADA coordinator, an EAP, a disabilities ERG. They have, in the language of compliance, checked the boxes. And their employees are still not disclosing, not because the policy doesn't exist, but because the policy alone doesn't answer the questions that actually drive behavior.

What will my manager think? Will this follow me into my next performance review? If I ask for flexibility, will I be removed from high-visibility projects? Will my colleagues wonder what's wrong with me? Will leadership start to question whether I can still do the job?

These questions are never addressed in an accommodation policy. They live in between what an organization says it values and what employees observe actually happening to the people who speak up.

The more senior the employee, the sharper this calculus becomes. At the executive level, perceived invulnerability is often a core part of the professional identity. You don't get to the CHRO seat by asking for help. You get there by being the person others come to when they need it. Reversing that identity even privately and confidentially is not a policy question–It's psychological.

ADA Is a Floor. What Does Your Ceiling Look Like?

The Americans with Disabilities Act, expanded under the ADAAA, sets a legal baseline. It requires reasonable accommodation for employees with qualifying disabilities. It prohibits discrimination. It defines a process.

It does not require that the process feel safe. It does not guarantee that the person on the other side of the conversation is trained to hold it with any grace. It does not protect against the subtle, untrackable costs that employees fear more than overt retaliation, being seen as less capable, being managed differently, being passed over.

Compliance is necessary. It is not sufficient.

The organizations doing this well have moved past "we have a process" and are asking harder questions: What does the experience of using that process actually feel like? At what point does the conversation shift from "how do we support you?" to "how do we manage the risk you represent?" And who are the employees who would never start that conversation in the first place?

The ceiling is a culture where employees believe the answer to those questions will be in their favor — and where that belief is earned, not assumed.

What Actually Closes the Gap

There is no single fix, but there are three things that may move the needle.

Build pathways that don't require self-identification. Normalize the conversation before anyone needs it. Proactive manager check-ins with consistent, non-clinical language that sounds like, "I want to make sure you have what you need to do your best work" and create openings that formal disclosure requests do not. ERG structures specifically designed for invisible disabilities and chronic illness give employees a community that doesn't require naming their condition to participate. The goal is an environment where support doesn't begin with an employee raising their hand.

Decouple accommodation from performance management. The single biggest barrier to disclosure at every level is the fear that asking for help will be used against you. This fear is not irrational. Structural separation matters: the accommodation process should sit entirely outside the performance review cycle, and managers should be explicitly trained on why that line exists and how to hold it.

Train managers on the conversation, not just the policy. Knowing what the FMLA form says is not the same as knowing how to sit with someone who tells you they've been struggling for months and didn't know how to say so. That conversation requires skill, and some managers have never been taught how to have it. The training has to go beyond compliance into human capability: how to respond without fixing, how to ask without probing, how to hold information with discretion without making the employee feel like a problem to be managed.

The Workshop I Wish Had Existed

After my diagnosis, I spent a significant amount of time thinking about what I would have needed, not as a patient, but as an executive and an HR leader. What would have made disclosure feel possible? What would have changed the calculus?

That thinking eventually became the Autoimmune-Talent Workshop–a half-day program I now run for teams building genuine inclusion for employees with chronic illness and invisible disabilities. It draws on sixteen plus years of HR experience and, now, on the particular education of having been on the other side of the programs I designed. It is available through guidedpathhr.com.

The Real Question You Need to Ask

I've sat in dozens of HR strategy sessions; I've reviewed inclusion program decks; I've nodded along to commitment statements about psychological safety and belonging. And for a period of my career, while I was doing all of that, I was privately scheduling rheumatology appointments and wondering whether my fatigue or brain fog would be visible in my team meeting.

The programs were good. The people building them were committed. And they still didn't reach me.

If the person who designs the accommodation framework, who trains the managers, who owns the compliance posture–if that person stays silent, imagine who else in your workforce is doing the same right now.

That's not an indictment of intent. Most I&D programs are built by people who genuinely care. It is, however, a precise diagnostic of the distance between intention and impact.

The work is to close that distance, but not with a better policy deck. With an honest look at whether the culture you've built actually supports the question: Can I tell the truth here and still be okay?

If you're not certain the answer is yes, that's where the work begins.