Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.

You’re doing the best you can at work. But still, living with a chronic condition can make it difficult to perform the functions of your job. If so, it might be time to ask for accommodations.

Sure, this is a hard conversation to have. Maybe you’ve been thinking about having this conversation and weren’t sure how. Maybe you’ve been waiting until you are absolutely sure you need to take this step, and you’ve reached that point. Or maybe you anticipate needing to have this conversation in the future.

Before you open your mouth, do your homework

Wherever you are in this decision, it’s important to have a strategy in place. The following are some steps to help you manage this conversation.

Start out by being prepared. Here’s how:

Understand your rights. If you are disabled in some way, you are protected by the Americans with Disabilities Act (ADA). Be familiar with what it covers and doesn’t cover in terms of reasonable accommodations. To help you, here’s a link:

Know your company policy. Most organizations have a procedure in place for requesting accommodations. Check your employee handbook or look on your organization’s HR Intranet to learn what yours is. Your organization may have a clearly outlined procedure, including the individuals you need to be in touch with. The person to contact may or may not be your boss. If your company doesn’t have a procedure in place, then use your judgment regarding whom you should talk to first.

Ask yourself some hard questions. I am going to be straightforward here. I have had clients who truly needed accommodations at their job, whether that meant changes to their workload, changes to their work environment, or a new role in their organization. I have had other clients who, when we really got down to it, just didn’t like their boss or their job, or who had a job that was a bad fit with their personality and interests. Be honest with yourself. And don’t move forward with requesting accommodations until you feel comfortable with your intentions. It might help to sit down and talk with someone who can be objective and help you to sort this out. Look at it this way: Your boss may be giving your request the “So what?” test, so be prepared to respond.

Talk to your doctor. Let him/her know you are requesting accommodations at work. Chances are, your physician may already have talked with you about how your chronic condition affects your ability to do your job. Get your physician’s perspective on what he/she feels you can do and what you shouldn’t be doing, based on your condition. Keep in mind that you may need a letter from your doctor at some point, so be sure that you are both on the same page. You might also want to consider obtaining a second opinion from another physician who can provide an independent evaluation of your condition.

Prepare your talking points. Before you go in, be clear with yourself on exactly what you want to accomplish in terms of specific accommodations and how you want to say it in the meeting. The better prepared you are, the more likely you will be to obtain the accommodations you are requesting. Practice going through your bullet points out loud to yourself, and maybe to someone in your support network. If something doesn’t sound right to you when you hear yourself say it, then consider whether it belongs in the conversation. You might want to bring in a list of talking points.

With a strong foundation in place, you’re ready to proceed

Here some steps to consider in having the conversation:

Set a positive tone. Your boss and whoever else is involved in this conversation may be anticipating an unpleasant or confrontational discussion. It doesn’t have to be that way. One way to help prevent hostile energy is to start on a positive note. You might say something like, “I really appreciate working here. It’s always been my intention to do the best job possible, and I hope I’ve been able to demonstrate that to you.” It might help to mention your accomplishments, to briefly review your history with the company, or to say something positive about your relationship with your boss or the company’s mission and your commitment to it. If anyone at the meeting is feeling defensive, this might help them to open up to what you have to say.

Start with what. The first thing your employer needs to know is what your condition is. Keep in mind that you don’t have to give the details of your condition or the specific diagnosis, but you will need to give enough information for your employer to determine if you are eligible for reasonable accommodations. For example, “I have been diagnosed with an autoimmune disorder,” or “I am experiencing the long-term effects of my auto accident,” or “I am living with a mental illness.” Follow this with: “My condition is making it difficult for me to continue to work in the way I’ve been working up until now.”

Move on to why. Explain why you need accommodations. Be specific about the aspects of your job that are especially difficult, such as difficulty talking on the phone, difficulty using the keyboard, difficulty walking from one area of the office to another, exhaustion from long hours with no breaks, etc. Be clear about how performing these tasks impacts your well-being. “For example, I have reached the point where ___ (task, work condition), causes ___ (impact on you). Because of that, I need to request some accommodations so I can continue to do my job to the best of my ability.”

And then explain how. Get specific on how your job situation needs to change. In other words, don’t drop this in your boss’s lap to figure out. Saying “I need accommodations” doesn’t help your boss and it doesn’t help you. And keep in mind that this process may be new to your boss, so he/she will most likely expect—and possibly appreciate—specifics on what accommodations you are seeking. Examples might include changes to your work environment (e.g. lighting, noise level), a more flexible work schedule, shorter hours, changes in the tasks you perform, adjustments in your workload, a different work location, and others. Start out with: “I’d like to go over a list of accommodations that I am requesting.” And then go through the list. It might help to provide your boss, or other company representatives, with a written list that you can go over together.

Stay solution-focused. Provide a scenario of what you would expect your workday to look like if you are provided with the accommodations you are requesting. Again, keep it positive, emphasizing the strengths you bring to your job and how the accommodations will allow you to contribute as much as possible. You might also address ways in which the accommodations can have the least negative impact on the organization. Introduce your solution with: “I have thought about this a lot, and would like to describe how I think we can work together to maintain daily productivity in the department.” Again, specific and brief. Notice the use of the words, “we” and “together.” Keep it collaborative, not you against them.

Be prepared to negotiate. Your employer is not required to give you the exact accommodations you request. Chances are, your employer may have some suggestions as well, and may present them to you immediately, or may want to consider your request and come back with what they feel is reasonable. Be ready to answer questions about your what, why, and how.

Be prepared to revisit this conversation. You may need additional meetings, which you will need to prepare for by reviewing your company’s offer and deciding whether it meets your needs or not. You may need to have an additional conversation with your physician to help make this determination.

Review the plan. Once you and your employer have negotiated the terms of your accommodations, ask to go over them together. “I just want to make sure I understand what this will look like going forward. Can we take a moment to go over this and also be specific about what this will look like day to day?”

Ask for it in writing. Again, keep it positive. This is a document to “help make sure I am clear on what we’ve decided, and so I have something on hand that we can both refer to going forward.”

Always end on a positive note. Saying thank you is a good start, even if are still working out the details. “I really appreciate that you are willing to talk to me about this. Thank you.” Or, “Thanks for considering my request.”

And if the answer is no: Again, review your rights, based on the ADA guidelines and the policies of your organization. You may be able to revisit this conversation. But if you are hitting a wall, then it may be time to consider other options, including the Family Medical Leave Act (FMLA), or even another job. Get some support as you consider the next steps.

Having the accommodations conversation: Do your homework. Know what you need. Say what you mean. Be willing to work with your employer to find a solution.

More from Dr. Gary:

You'd Rather Not Know? Nine Steps toward Facing the Facts
When Your Doctor Won't Talk about Your Emotions
Looking for a Partner? How About Falling in Love with Yourself First?