Case Study Sunday: Surgery, Extended Leave, and Returning to Work

The question:

I need surgery on my foot that will significantly limit my ability to walk for several months. My doctor expects it could take 12–16 weeks before I can walk well enough to do my job normally.

I work in outside sales, so I spend a lot of time driving and on my feet meeting with customers. I don’t think there’s a way for me to perform my job as usual during my recovery, although I do think I could remain productive doing sales work by phone. My boss strongly prefers that sales be done face-to-face, so I’m not sure that would be an option.

My biggest concern is whether my employer can eventually terminate me because I’ve been unable to perform the essential functions of my job for too long. At what point could they decide that my absence or restrictions can no longer be accommodated and end my employment? I’m nervous about bringing this up with HR because I don’t know what could happen to my job once I do.

There’s a lot happening here, but the question I would start with isn’t, “At what point can they fire me?”

It’s: What options and protections need to be explored before we ever get to that point?

Start with leave

Because this employee is in Washington, there are potentially multiple forms of leave to consider.

Washington has a Paid Family and Medical Leave program that can provide up to 12 weeks of medical leave for an employee’s own qualifying serious health condition. Eligibility for the paid benefit is generally based on having worked at least 820 hours in Washington during the qualifying period. Those hours don’t necessarily have to be with the employee’s current employer.

Job protection under the Washington program is a separate question. Beginning in 2026, job-protection provisions generally apply when an employer has at least 25 employees in Washington and the employee has worked for that employer for at least 180 days.

Federal FMLA could also be part of the picture. Its eligibility requirements are different, and when an absence qualifies under both FMLA and Washington Paid Leave, the two may run at the same time.

We don’t know how long this employee has worked for their employer, how many employees the company has, how many hours the employee has worked, or whether they otherwise meet the requirements of these programs.

So I wouldn’t tell this employee, based on this question alone, “You have 12 weeks of protected leave.”

I’d tell them there are leave programs that may apply, and determining exactly what they qualify for should be one of the first steps.

A 12–16 week recovery doesn’t necessarily tell us what 12–16 weeks of work looks like

The employee expects it may take 12–16 weeks before they can walk well enough to perform their normal job.

But that doesn’t necessarily mean they will be completely unable to work for 12–16 weeks.

Their restrictions may change throughout recovery. They may initially be unable to work at all, then become capable of sedentary work while still unable to drive or spend significant time on their feet. Or their medical restrictions may prevent them from working throughout the entire recovery period.

That distinction matters.

If this situation landed on my desk in HR, I’d want to understand what the medical provider anticipates: how long the employee is expected to be completely unable to work, what restrictions are expected afterward, and whether those restrictions are expected to change as recovery progresses.

That gives us something much more useful to work with than simply, “Recovery takes 12–16 weeks.”

The employee says the job can’t be modified — but then describes a possible modification

This is probably the part of the question that stands out to me most.

The employee doesn’t believe the job can be modified because outside sales normally requires driving and meeting with customers in person. But they also believe they could continue doing productive sales work by phone while they recover.

That doesn’t mean the employer has to convert an outside sales position into a phone-based position.

Face-to-face sales may genuinely be an essential function of this particular job. There may be legitimate reasons that driving, visiting customers, or conducting business in person cannot simply be removed from the position for several months.

But I wouldn’t make that determination based solely on the fact that the boss prefers things to be done face-to-face, either.

I’d want to understand the actual job.

What does the employee normally do? Which duties truly require them to be physically present? Which could be performed another way? How long would the modification be needed? Would shifting those duties create significant operational problems or require other employees to take over essential parts of this employee’s job?

Those are much more useful questions than simply deciding in advance that the job cannot be modified.

And what happens if protected leave runs out?

This is where we eventually get back to the employee’s original fear: Could I lose my job?

Suppose they qualify for leave, use it, and reach the end of that leave while still unable to perform their regular duties.

That still doesn’t give me a universal week on the calendar when I’d say, “Now we terminate.”

I’d want to look at what restrictions remain and how long they’re expected to last. I’d want to understand the essential functions of the position. And I’d want to consider whether there are reasonable options that could bridge the gap between the end of leave and the employee’s return to full duty.

Depending on the circumstances, that could mean additional finite leave. It could mean a temporary modification to how some work is performed. It could mean another accommodation that neither the employee nor the employer initially considered.

It could also ultimately mean that there isn’t a reasonable way for the employee to perform the essential functions of the position within the circumstances the employer can accommodate. And yes, depending on the individual circumstances and what protections apply, termination may eventually be one possible outcome.

But that conclusion should come at the end of the analysis, not the beginning.

“I don’t feel comfortable bringing it up to HR.”

I understand why an employee might feel this way.

When someone knows they need major surgery and is already worried about whether their job will still be there afterward, bringing the issue to their employer can feel like opening a door they can’t close.

But avoiding the conversation doesn’t preserve options that might otherwise exist.

This employee has already started making several decisions on the employer’s behalf: the job can’t be modified, the boss won’t accept another way of working, the absence will be too long, and eventually the company will be able to terminate them.

Some of those things may ultimately be true.

But some may not.

An employee doesn’t need to know exactly which leave program applies, understand every eligibility requirement, or arrive with the perfect accommodation already designed before they talk to HR.

From an HR perspective, I would much rather have this conversation early enough to understand the anticipated surgery and recovery, identify what leave programs may apply, obtain the appropriate medical information when needed, and start thinking about what the eventual return to work might look like.

The question here isn’t simply, “How long can I be gone before they can fire me?”

There are several questions that come first:

What leave is available? What will the employee actually be capable of doing at different stages of recovery? What are the essential functions of the job? Are there reasonable ways to temporarily bridge the gap? And if there aren’t, what does that mean for the employee and the employer?

Those answers are going to depend on facts we simply don’t have from a short question.

But the employee shouldn’t assume the answer is termination before anyone has even started asking the questions.