My name is Natalie and I am a primary school teacher living with several chronic illnesses and invisible disabilities.

I have rheumatoid arthritis, Crohn's disease, an ileostomy, adrenal insufficiency and a recurring eye condition called iritis. While each condition presents its own challenges, together they affect almost every aspect of my daily life, including the way I work. From managing pain and fatigue to attending hospital appointments and coping with unpredictable flare-ups, there are many things happening behind the scenes that most people never see.

Despite these challenges, I love teaching and am passionate about making a difference in the lives of my pupils. Like many people with chronic illnesses, I don't want sympathy - I want understanding, flexibility, and the opportunity to do my job well. 

One of the things that matters most to me is how employers approach disability and chronic illness from the very beginning of the recruitment process.

Interviews can already be stressful, but when you are also managing pain, fatigue or anxiety about whether your health will be judged, they can become even more daunting. I always discuss my chronic illnesses at the interview stage. This can be terrifying – while disability should not be used against someone qualified for the position, why would an employer choose me over another suitably qualified candidate when I have this extra baggage? Well, because it has helped make me who I am which is a passionate, driven and hardworking teacher. 

My health may be unpredictable, but I am not and I work harder on staying healthy than the average person. I talk about my conditions and what my strengths are. For example, a much better understanding of inclusion due to personal experiences and great organisational skills due to managing appointments and medication. 

While I understand people thinking keeping their health conditions under wraps at interview is beneficial, I still think that honesty is the best policy and helps you get an idea of whether your new employer is likely to be supportive if you land the role. 

Reasonable adjustments are legal adaptations or changes made by employers, service providers, or educational institutions to ensure that individuals with disabilities or physical/mental health conditions are not substantially disadvantaged. They are designed to create equal access and opportunity for everyone 

Once in the workplace, small adjustments can have a significant impact on my wellbeing and my ability to perform at my best. As a teacher my role cannot be done remotely, however having the flexibility to complete my Planning, Preparation and Assessment (PPA) time at home whenever possible allows me to conserve energy, manage pain more effectively and reduce unnecessary physical strain. Working from home for part or the whole of the week is something that can really help disabled people get back into working. 

After joining the school I am currently at, I had a meeting with someone from the trust about reasonable adjustments. Most of mine are small, simple and practical adjustments that make a real difference when I need them - they do not have to be huge requests that cost a lot of money or make things really awkward! Having drinks and snacks available at my desk helps me manage my Crohn's disease and ileostomy and maintain my energy levels throughout a busy school day. I have a radio to call for support to cover my class should my ileostomy bag need emptying or changing – luckily this has only happened a couple of times in the last 3 years, but it is good to know the support is there. 

Due to my eye condition, I find reading black text on white paper difficult at times, so I am allowed to have my Kindle in class to use during reading lessons. I have a fan in my classroom as the medications I take make me run very hot, even in the Winter months! These are relatively small accommodations, but together they allow me to continue doing a job I genuinely love. 

Barriers 

One of the biggest barriers for people living with invisible disabilities is that our conditions often cannot be seen.

From the outside, I may appear completely healthy, but appearances rarely tell the full story. Pain, fatigue and nausea are symptoms I battle with every day. Because these conditions are largely invisible, people sometimes assume that I am "fine" simply because I am smiling or continuing to work. In reality, many people with chronic illnesses become experts at masking their symptoms. We often push through pain because we don't want to let colleagues or students down, but this can come at a significant cost to our physical health. 

Having an employer and colleagues who are understanding and supportive can make a huge difference to how we feel about taking a break and ensuring we are looking after our mental and physical health and not pushing ourselves to burnout. 

There is also the emotional burden of deciding whether to explain our conditions repeatedly or stay silent to avoid awkward conversations or misconceptions. Before I had my boys, I worked as a nursery nurse for 10 years and went for an interview for a nanny position. As I said previously, I always open up about my health during the first stages of application and interview to start that open conversation and ensure both myself and the employer are getting what they need. I was interviewing with the Mum, and we had discussed all sorts of things when I opened up to her about my rheumatoid arthritis. Her demeanour changed instantly as she looked me up and down and said, "my friend has that, she can barely walk, never mind anything else". Misconceptions around chronic illness can be rife and can be dangerous. Everyone manages and are affected by their conditions differently, at different times. 

The fact I am willing to share about my health at an early stage in the process is my choice and it is in the hope that there can be an open and honest conversation about the expectations and support I can expect. Employers should not be bringing assumptions and misconceptions into an interview – they should take each person as the individual they are and should they want to know more, then ask! 

Another barrier is the unpredictability of chronic illness. I cannot always plan when my symptoms will flare up or when I may need additional medical treatment. This unpredictability can create anxiety around work, particularly if workplaces have rigid attendance expectations or limited understanding of fluctuating health conditions. Many people with chronic illnesses are incredibly dedicated employees, but we sometimes need flexibility to continue contributing successfully over the long term.  

Ultimately, what I want most from employers is understanding rather than assumptions. Every person's experience of disability is different, and the best support often comes from simply asking what adjustments would help rather than making decisions on someone's behalf.

When employers create inclusive workplaces, everyone benefits. 

What can businesses and employers do to help? 

• Avoid assumptions and misconceptions by listening to the employee and asking what reasonable adjustments would make the biggest difference. 
• Offer flexibility where possible, including opportunities to work from home 
• Recognise that invisible disabilities are just as real as visible ones. 
• Be understanding about medical appointments, hospital treatment, and occasional flare-ups. 
• Create a workplace culture where employees feel safe discussing their health without fear of judgement. 
• Focus on an employee's skills, contribution, and potential rather than their medical conditions. 
• Promote awareness of invisible disabilities through training and open conversations. 

Living with chronic illness has certainly changed the way I work, but it has not changed my passion for teaching or my determination to make a difference.

With understanding, flexibility and a willingness to make reasonable adjustments, people like me can thrive in the workplace.

Inclusion is not about lowering expectations - it's about removing unnecessary barriers so that everyone has the opportunity to succeed.