Supporting the Employment Success of Veterans with TBI

1
Supporting the Employment Success of Veterans
with TBI PTSD

• JAN Webcast
• November 5, 2008
• Michael Reardon Kendra Duckworth
• Office of Disability Employment Policy Job
  Accommodation Network
• U.S. Department of Labor

2
Invisible Wounds of War

• Signature injuries of the Global War on Terror
• Nearly one in five veterans of the Iraq and
  Afghanistan wars is currently suffering from
  depression or stress disorders
• 19 of troops say they might have experienced a
  TBI, usually as the result of a powerful roadside
  bomb
• Source RAND Corporation, 2008

3
Effects of TBI/PTSD

• Both can have similar symptoms and behaviors,
  which can include
• Headaches
• Vertigo
• Balance problems
• Anxiety
• Sleep disturbance
• Short-term memory deficits
• Poor concentration
• Poor decision-making difficulties

4
Impacting Employment

• TBI/PTSD symptoms can sometimes cause
  difficulties as service men and women transition
  back into civilian life especially in the
  workplace
• Simple workplace supports can help wounded and
  injured veterans succeed on the job
• Employment can play a major role in recovery

5
Defining TBI PTSD

• Traumatic Brain Injury (TBI) A blow or jolt to
  the head or a penetrating head injury that
  disrupts the function of the brain.
• Post-Traumatic Stress Disorder (PTSD)
• An anxiety disorder that can develop in response
  to exposure to an extreme traumatic event (e.g.,
  military combat, violent personal assaults,
  terrorist attacks, natural or man-made disasters,
  or horrific accidents). The event, directly
  experienced or witnessed in another person,
  involves actual or threatened death, serious
  injury or threat to one's physical integrity.

6
Employer Education

• What employers need
• To know the facts about TBI and PTSD
• Support and education concerning how to assist
  returning service members with TBI and PTSD in
  their transition

7
Dispelling the Myths

• True or False?
• All TBIs are severe.

8
Dispelling the Myths

• False
• TBI is an umbrella term that spans a wide
  continuum of symptoms and severity
• The large majority (80) of combat head injuries
  sustained in Operation Iraqi Freedom and
  Operation Enduring Freedom are mild concussions
  as opposed to severe, debilitating TBI
• Of those, another 80 will have a full recovery

9
Dispelling the Myths

• True or False?
• All employees with PTSD will have violent
  outbursts that disrupt the workplace.

10
Dispelling the Myths

• False
• People with PTSD do not necessarily pose a direct
  threat to themselves or others
• PTSD develops differently in different people and
  most symptoms will decrease over time
• Employees who manage their symptoms through
  medication or psychotherapy are very unlikely to
  pose a threat
• Employers can mitigate vulnerabilities to stress
  by providing a job accommodation.

11
Dispelling the Myths

• True or False?
• All employees with TBI or PTSD will need
  significant, expensive job accommodations.

12
Dispelling the Myths

• False
• Not all people with TBI and/or PTSD will need
  accommodations
• Workplace supports are generally simple and
  inexpensive to implement
• By employing a veteran with TBI or PTSD,
  businesses can contribute to his/her recovery and
  experience bottom line benefits from an
  experienced veteran employee

13
An Educational Initiative

• The U.S. Department of Labors (DOL) response

14
Goals

• To help returning service members and veterans
  with TBI/PTSD succeed in the workplace
• To increase awareness of TBI/PTSD employment
  issues among employers, the workforce development
  system, service branches, key military support
  systems, VSOs and One-Stop Career Centers
• To create and raise awareness of resources that
  assist employers with accommodations for
  transitioning service members and veterans with
  TBI/PTSD

15
Partners

• Joint leadership by ODEP VETS
• Collaboration with other DOL agencies
• Input and cooperation from partner federal
  agencies
• Department of Defense
• Department of Veterans Affairs
• Defense Centers of Excellence for Psychological
  Health Traumatic Brain Injury
• Defense Veterans Brain Injury Center
• Department of Health and Human Services
  Substance Abuse Mental Health Service
  Administration
• Department of Education
• Department of Transportation
• Employer Support for the Guard Reserve
• National Institute of Mental Health
• Social Security Administration
• Small Business Administration
• Uniformed Services Branches
• Others

16
Target Audience

• Audience
• Employers
• Reached Through the Following Channels
• Workforce development community
• Federal government agencies
• Disability organizations
• Veteran military organizations
• Business human resource organizations
• Public policy organizations
• Trade organizations
• Media outlets

17
Toll-Free Assistance

• Job Accommodation Network (JAN)
• 800-526-7234 (voice) or 877-781-9403 (TTY)
• Offers free, personal assistance to employers on
  issues related to veterans with disabilities,
  including
• Reasonable job accommodations
• Workplace productivity enhancements
• Information regarding the ADA other disability
  legislation
• Much more

18
AmericasHeroesAtWork.gov
www.AmericasHeroesAtWork.gov
19
Web Site Features

• Common employer questions about returning service
  members with TBI and/or PTSD
• Fact sheets and reference guides on TBI PTSD as
  they relate to employment
• Web-based training tools on making workplace
  accommodations for employees with TBI/PTSD
• Promising practices for helping those with
  TBI/PTSD succeed at work
• Veterans employment success stories
• Links to additional TBI, PTSD and veterans
  employment
• resources

20
Resources Web Page
21
Common Employer Questions

• Americas Heroes at Work provides answers to the
  most common employer questions about returning
  service members with TBI and/or PTSD, including
• What is a TBI? What is PTSD?
• What are the symptoms of TBI? of PTSD?
• Are all TBIs severe?
• What should employers expect from a person with
  PTSD? Will they have violent outbursts?
• There's a lot of negative stigma associated with
  PTSD. How can employers separate myth from fact?
• What should employers expect from National Guard
  and Reservists who return to their jobs with TBI
  and/or PTSD?

22
Common Employer Questions (cont.)

• Additional examples of common employer questions
  
• Are TBI and PTSD conditions that are exclusive to
  veterans?
• Are TBI and PTSD considered disabilities under
  the ADA?
• Are employees with TBI and/or PTSD required to
  disclose their disability to employers?
• What promising practices can DOL recommend to
  employers who might be hesitant to hire a veteran
  with TBI and/or PTSD?
• What should employers do if they suspect an
  employee is struggling with the effects of TBI
  and/or PTSD?
• Why do veterans make great employees?
• How can employers find and hire a disabled
  veteran?
• What are the tax incentives for hiring a disabled
  veteran?

23
Fact Sheets Reference Guides Web Page
24
Fact Sheets Reference Guides

• Frequently Asked Questions About TBI Employment
  
• Frequently Asked Questions About PTSD
  Employment
• Dispelling the Myths About PTSD
• Accommodating Employees with TBI
• Accommodating Employees with PTSD
• Promising Practices Job Coaching Mentoring
  Training, Supervision Other Natural Workplace
  Supports Customized Employment
• Dos and Donts for Hiring Managers
• Tips for Communicating with People with TBI/PTSD
• Employers and the ADA Myths and Facts

25
Accommodating PTSD and TBI

• Questions to consider
• What limitations is the employee with TBI and/or
  PTSD experiencing and how do these limitations
  effect the employees job performance?
• What specific job tasks are problematic as a
  result of these limitations?
• What accommodations are available to reduce or
  eliminate these problems?
• Has the employee with TBI and/or PTSD been
  consulted regarding possible accommodations?
• Do supervisory personnel and employees need
  training regarding TBI or PTSD?

26
Accommodations for TBI

• Lack of Concentration
• Reduce distractions in the work environment.
• Provide space enclosures or use of private
  spaces.
• Allow the employee to wear a headset and listen
  to soothing music.
• Increase natural lighting.
• Divide large assignments into small goal oriented
  tasks or steps.
• Plan for uninterrupted work time.

27
Accommodations for TBI

• Accommodations for Memory Deficits
• Use notebooks, calendars, or sticky notes to
  record information for easy retrieval.
• Provide written as well as verbal instructions.
• Allow additional training time.
• Provide written checklists.
• Provide environmental cues to assist in memory
  for locations of items, such as labels, color
  coding, or bulletin boards.
• Post instructions over all frequently used
  equipment.

28
Accommodations for TBI

• Accommodations for Fatigue
• Reduce or eliminate physical exertion and
  workplace stress
• Restructure the job to include only essential
  functions
• Allow a flexible work schedule and flexible use
  of leave time
• Allow work from home
• Implement ergonomic workstation design
• Provide a scooter or other mobility aid if
  walking cannot be reduced

29
Accommodations for PTSD

• Coping with Stress
• Allow the employee to take breaks for stress
  management.
• Provide backup coverage for when an employee
  needs to take a break.
• Provide additional time to learn new
  responsibilities .
• Restructure the job to include only essential
  functions.
• Allow time off for counseling.
• Assign a supervisor, mentor or team member to
  work with the employee.

30
Accommodations for PTSD

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

31
Accommodations for PTSD

• Dealing with Anger and Emotions
• Encourage the employee to walk away from conflict
  and take a break.
• Provide positive praise and reinforcement.
• Allow phone calls or emails to support persons
• Refer to Employee Assistance Programs (EAP) and
  Veteran Centers
• Maintain open communication.
• Schedule weekly or monthly meetings with the
  employee to set goals and review progress.

32
Accommodations for PTSD

• Working Effectively with Supervisors
• Giving assignments, instructions or training in
  writing
• Communicate via email
• Provide detailed day-to-day guidance and feedback
• Provide positive feedback and reinforcement
• Provide clear expectations and consequences
• Develop strategies to deal with problems before a
  crisis occurs

33
Helpful Tips for Hiring Veterans with TBI and/or
PTSD

• Follow these helpful hints to guide you through
  the hiring process
• Do learn where to find and recruit veterans with
  TBI or PTSD
• Do learn how to communicate with persons who have
  TBI or PTSD
• Do provide reasonable accommodations that the
  qualified applicant will need to compete for the
  job
• Do treat an individual with TBI or PTSD the same
  way you would treat any applicant or employee
  with dignity and respect
• Do know that among those protected by the ADA are
  qualified individuals who have TBI or PTSD
• Do understand that access includes not only
  environmental access, but also making forms
  accessible to people with cognitive or
  psychological disabilities
• Do train supervisors on making reasonable
  accommodations

34
Success Stories Web Page
35
Helpful Links Web Page
36
How You Can Help Veterans with TBI/PTSD Succeed
in the Workplace

• Hire veterans with TBI and/or PTSD
• Educate your employees and HR staff about TBI
  and/or PTSD
• Learn more about promising practices, workplace
  accommodations and employment supports
• Share information about Americas Heroes at Work
  with other employers
• Provide feedback on employer/HR professional
  needs and concerns regarding TBI and/or PTSD
• Help identify veteran employment success stories

Email us at AmericasHeroesAtWork_at_dol.gov
37
How You Can Help Veterans with TBI/PTSD

• Hire veterans with TBI and/or PTSD
• http//www.americasheroesatwork.gov/links2.htmlti
  tle2
• Hire Vets First http//www.hirevetsfirst.gov/
• EARNWORKS Veterans Initiative
• http//www.earnworks.com/veterans/index.asp
• VAs Vocational Rehabilitation and Employment
  Program
• http//www.vba.va.gov/bln/vre/emp_resources.htm

Email us at AmericasHeroesAtWork_at_dol.gov
38
Contacts

• Ron Drach
• U.S. Department of Labor
• Veterans Employment Training Service
• 202-693-4749 - drach.ronald_at_dol.gov
• Michael Reardon
• U.S. Department of Labor
• Office of Disability Employment Policy
• [phone] - reardon.michael_at_dol.gov