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Accommodating Employees with Post-Traumatic Stress Disorder


By: Department of Labor

Transitioning service members and veterans experiencing the effects of Post-Traumatic Stress Disorder (PTSD) may face day-to-day difficulties-particularly in the workplace. However employers can play a vital role in these individuals' recovery by recognizing the challenges associated with PTSD and making reasonable accommodations to help ensure workplace success.

People with PTSD may experience some of the limitations discussed below, however they seldom will develop all of them. In addition, the severity of the condition and, subsequently, the degree of limitation will vary among individuals. Even within the same individual, there may be factors that exacerbate symptoms (e.g., additional stressors, health concerns, interpersonal issues, etc.) and other factors that are more restorative (e.g., social support, professional treatment, balanced participation in recreational/pleasurable activities, good health habits, etc.)

Employers should be aware that not all people with PTSD will need accommodations to perform their jobs, and many others may only need a few accommodations. The following is only a sample of the accommodation possibilities available. Employers should also know that unless the employee reveals, or makes available information, that they have been diagnosed as having PTSD, the employer will not necessarily know whether the condition is present in any given individual.

Questions to Consider:

  • What limitation is the employee with PTSD experiencing and how does it affect his or her job performance?
  • What specific job tasks are problematic as a result of their limitations?
  • Are there aspects of the work, physical environment, or social environment that exacerbate the employee's symptoms?
  • What accommodations are available to reduce or eliminate these problems?
  • Has the employee with PTSD been consulted regarding possible accommodations?
  • Once accommodations are in place, would it be useful to meet with the employee with PTSD to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  • Do supervisory personnel and employees need training regarding PTSD?
  • Has the employee sought care or treatment for PTSD or a similar condition and, if so, has the employee continued to follow up and comply with the recommended care (provided this information is known)?

Accommodation Ideas:

Memory:
  • Provide written instructions
  • Post written instructions for use of equipment
  • Use a wall calendar
  • Use a daily or weekly task list
  • Provide verbal prompts and reminders
  • Use electronic organizers or hand held devices
  • Allow the employee to tape record meetings
  • Provide written minutes of each meeting
  • Allow additional training time

Lack of Concentration:
  • Reduce distractions in the work environment
  • Provide space enclosures or a private space
  • Allow for the use of white noise or environmental sound machines
  • Allow the employee to play soothing music using a music player and a headset
  • Increase natural lighting or increase full spectrum lighting
  • Divide large assignments into smaller goal-oriented tasks or steps
  • Plan for uninterrupted work time

Time Management/Performing or Completing Tasks:
  • Make daily "TO-DO" lists and check items off as they are completed
  • Divide large assignments into smaller tasks and steps
  • Schedule weekly meetings with supervisor, manager or mentor to determine if goals are being met
  • Remind employee of important deadlines via memos or e-mail

Disorganization:
  • Use calendars to mark meetings and deadlines
  • Use electronic organizers
  • Hire a professional organizer or organizational coach
  • Assign a mentor to assist the employee

Coping with Stress:
  • Allow longer or more frequent work breaks
  • Provide backup coverage for when the employee needs to take breaks
  • Provide additional time to learn new responsibilities
  • Restructure job to include only essential functions
  • Allow time off for counseling
  • Assign a supervisor, manager or mentor to answer employee's questions

Working Effectively with a Supervisor:
  • Give assignments, instructions or training in writing or via e-mail
  • Provide detailed day-to-day guidance and feedback
  • Provide positive reinforcement
  • Provide clear expectations and the consequences of not meeting expectations
  • Develop strategies to deal with problems

Interacting with Co-workers:
  • Encourage the employee to walk away from frustrating situations and confrontations
  • Allow employee to work from home part-time
  • Provide partitions or closed doors to allow for privacy
  • Provide disability awareness training to coworkers and supervisors

Dealing with Emotions:

  • Refer to employee assistance programs (EAP)
  • Use stress management techniques to deal with frustration
  • Allow the use of a support animal
  • Allow telephone calls during work hours to doctors and others for needed support
  • Allow frequent breaks

Sleep Disturbance:
  • Allow the employee to work one consistent schedule
  • Allow for a flexible start time
  • Combine regularly scheduled short breaks into one longer break
  • Provide a place for the employee to sleep during break

Muscle Tension or Fatigue:
  • Build in "stretch breaks" during the workday
  • Allow private space to meditate or do yoga
  • Allow time off for physical therapy or massage therapy
  • Encourage use of the company's wellness program

Absenteeism:
  • Allow for a flexible start time or end time, or work from home
  • Provide straight shift or permanent schedule
  • Modify attendance policy (e.g., count one occurrence for all PTSD-related absences, or allow the employee to make up the time missed)

Panic Attacks:
  • Allow the employee to take a break and go to a place where s/he feels comfortable to use relaxation techniques or contact a support person
  • Identify and remove environmental triggers such as particular smells or noises
  • Allow the presence of a support animal

Headaches:

  • Provide alternative lighting
  • Take breaks from computer work or from reading print material
  • Practice stress-relieving techniques

Additional information about PTSD and employment can be found on the America's Heroes at Work Web site: www.AmericasHeroesAtWork.gov.

This fact sheet was developed in cooperation with the U.S. Department of Labor's (DOL) Office of Disability Employment Policy, the Job Accommodation Network, the Veterans' Employment and Training Service, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, and the Defense and Veterans Brain Injury Center.