Chronic illness and disability in the workplace

As the world marked International Day for Persons with Disabilities on Tuesday December 3, Dr Armand Bam, Head of Social Impact at Stellenbosch Business School, calls for a renewed focus on invisible disabilities and chronic illnesses in the workplace.

He says these unseen conditions—often stigmatised and misunderstood—create significant barriers for individuals striving to succeed professionally while concealing their struggles.

“Invisible disabilities, like chronic illnesses, exist at the paradoxical intersection of invisibility and judgment,” says Dr Bam.

“Those living with these conditions often face stereotypes that question their capabilities, forcing them to navigate professional spaces under a shadow of doubt, become isolated and conceal conditions to preserve themselves and avoid being viewed as unreliable or weak.

“In South Africa, where systemic inequalities rooted in race and gender persist, the intersection of disability with these identities creates a complex matrix of exclusion.”

Dr Bam’s research highlights the layered challenges faced by individuals with chronic illnesses such as Lupus, an autoimmune disease affecting over 3.4 million people worldwide, with women accounting for 90% of cases.

“Research shows that the illness presents more severely among those of African descent, which is marked by severe and episodic symptoms.

“Lupus operates like a wolf lurking in the shadows—always present, yet unseen. Unlike visible disabilities that may elicit sympathy (albeit sometimes in problematic ways), invisible illnesses are often dismissed and ignored.”

Dr Bam say this type of disregard is often experienced in professional and social contexts more commonly addressing issues of gender, race, and other marginalised identities.

“Consider how racism and sexism manifest in professional spaces: subtle, pervasive, and often denied by those who perpetrate them.

“Invisible disabilities share this insidious characteristic. A woman disclosing her chronic illness may face compounded scepticism dismissed not only because of her gender but also because her symptoms are unseen.

“Similarly, individuals from marginalised racial groups often contend with systemic inequities that amplify the challenges of living with a chronic illness.”

How should workplaces evolve to include individuals with invisible disabilities?

Dr Bam highlights that workplaces that evolve to include individuals with invisible disabilities do so by committing to more than policies and procedures - they commit to culture.

“Inclusion requires a shift from treating accommodations as exceptions to embedding them as norms. It begins with training leadership and teams to understand that invisible disabilities, such as chronic illnesses, neurodivergence, or mental health conditions, are real and impactful, even if unseen.

Creating environments where individuals feel empowered to disclose their disabilities starts with fostering empathy at all organisational levels.”

He says in achieving this organisations must move beyond transactional approaches to inclusion.

“Flexible work arrangements, tailored accommodations, and supportive practices must be paired with a cultural shift that values diversity in how employees show up and perform their roles.

Training on unconscious bias can reveal the ways stereotypes about ‘ideal workers’ perpetuate exclusion, while open discussions about mental health and chronic illness normalise these experiences within workplace narratives.”

“When disclosure is met with empathy rather than suspicion, trust thrives. Empathy in this context is not just about sympathy but about active listening, believing in lived experiences and responding with tangible support.

An employee who discloses should never have to fear professional repercussions, but instead, experience reassurance that their uniqueness is an asset, not a liability.”

Dr Bam says that unfortunately biases both conscious and unconscious, remain barriers due to our ingrained assumptions about productivity, capability, and professionalism which often exclude those who do not conform to traditional expectations.

“Addressing this requires a reckoning with systemic inequities and intentional action to rebuild workplaces that are inclusive by design.”

“True inclusion of individuals with invisible disabilities transforms the workplace into a space of belonging. It benefits not only those directly impacted but also cultivates innovation and resilience in the broader workforce.

This journey is not just an organisational challenge; it is a moral imperative.”

He stresses that although management theories, such as Freeman's stakeholder approach, emphasise the need to prioritise the diverse interests of all organisational members, when applied to disability inclusion, these theories often falter, as organisations remain rooted in practices that marginalise those with chronic illnesses.

“Managers must critically examine their own roles in perpetuating oppressive structures which will involve acknowledging internalised biases and actively reshaping workplace cultures to prioritise empathy and equity.”

Dr Bam’s research on chronic illness underscores the urgency of systemic change.

"Managerial training focused on fostering inclusive environments could mitigate the stigma and isolation experienced by individuals with chronic conditions.

“Safe spaces, supported by organisational policies, is critical for enabling individuals to disclose their conditions without fear of retribution or judgment.”

“In South Africa, access to healthcare is deeply stratified, with the public sector serving the majority under resource constraints while the private sector offers better access but remains inaccessible to many.

This disparity exacerbates the challenges of managing chronic illnesses. How do we reconcile these inequalities within a framework of inclusive workplace policies?

Can employers bridge these systemic gaps by providing comprehensive healthcare support for employees?”

“Resilience should not be a prerequisite for survival in professional spaces,” he says.

“This International Day for Persons with Disabilities challenges us to move beyond performative allyship and confront the biases that exclude invisible disabilities from workplace narratives.”