He needs surgery but cannot take the time off

Reader: I'm a chief operating officer at a medium-size nonprofit. My boss and I have worked together for many years and have always had a great relationship. Over the past year I've been dealing with a health problem, and my doctor is pushing me to have surgery. I keep putting it off because it could mean being away from work for as long as three months. I can't afford three weeks without a paycheck, let alone three months, and the amount of paid time off we can accumulate is limited. My boss has urged me to have the surgery and says, “We'll work something out.” How can I get him to give me a more concrete explanation of how exactly we'd work this out? I think he doesn't want to be backed into a corner, but am I just supposed to trust his intent?

Karla: You know what would make this whole situation easier? Short-term disability insurance. Many employers and a handful of states use it to provide income to workers temporarily disabled by illness or injury unrelated to work, or to cover workers recovering from childbirth when parental leave isn't available. But since you don't mention it, I assume it's not available to you.

I want to believe your boss wants only the best outcome for you. But you need to “work something out” with him before you go under the knife so you don't spend your recovery worrying about finances, and he doesn't worry about you taking advantage of his patience. Present him with some ideas, and let him tell you the minimum he can commit to. These could include:

• Letting you work from home once your doctor says it's safe to do so.

• Granting you an advance on your salary or allowing you to take more paid leave than you've accumulated (both of which you would have to earn back over time).

• Asking colleagues to donate excess paid-leave days through an anonymous, voluntary process.

If your boss isn't willing to commit to any of those, you may have to resort to begging family, friends and strangers for loans or donations, or waiting until you've built your savings. Just remember: The longer you have to wait for your surgery, the longer you may be out of commission afterward.

Ideally, you can use this experience — and, hello, your position as COO — to push for formal paid-leave benefits (short-term disability coverage or unlimited sick leave banking) for your entire organization. Although the federal Family and Medical Leave Act protects many workers' jobs for up to 12 unpaid weeks, it would be nice if no one — inside or outside the C-suite — had to make bleak calculations about whether unpaid recovery time is a luxury they can afford.

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Thanks to Suzanne Goulden, director of total rewards and analytics at the Society for Human Resource Management.

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Karla Miller, of South Riding, Virginia, offers advice on surviving the ups and downs of the modern workplace.