How to Handle Psychiatric Disabilities in the Workplace: Balancing Issues of Behavior, Direct Threat, and Reasonable Accommodation Common Psychiatric Conditions ..Depression ..Bipolar Disorder ..Anxiety/Panic Disorders ..Post Traumatic Stress Disorder ..Personality Disorders ..Obsessive Compulsive Disorder Behavior Issues ..Disruptive behavior ..Erratic or inconsistent behavior ..Control of anger and emotions ..Non compliant behavior ..Workplace violence ..Threats (verbal or written) ..Psychological ..Physical Attack (property, personal injury) ..Suicide ..Homicide Inappropriate Behaviors ..Yelling and screaming ..Throwing objects ..Bizarre behaviors ..Fighting (verbal or physical) ..Threats by e mail ..Pounding fists or objects on desks or walls ..Slamming Doors ..Profanity What is My Obligation? ..Primary responsibility to provide a safe workplace ..Intervene swiftly ..Clear consequences for inappropriate behavior ..Zero Tolerance When to Intervene ..When the employees behavior affects job performance ..When the employees behavior affects co workers ..When the employees behavior effects business ..When the employees behavior is a direct threat to self or others What About Reasonable Accommodations ? ..An employer must make reasonable accommodation to enable an otherwise qualified individual with a disability to meet such a conduct standard in the future, barring undue hardship. Because reasonable accommodation is always prospective, an employer is not required to excuse past misconduct. ..Yes, you can discipline for violating conduct standards. ..More on this later …. How Much Do I Have To Do ? ..Obligated to provide a Reasonable Accommodation to an employee with a known disability ..An employer is obligated to make an accommodation only to the known limitations of an otherwise qualified individual with a disability. ..it is the responsibility of the employee with a disability to inform the employer that an accommodation is needed to perform essential job functions or to receive equal benefits and privileges of employment. ..An employer is not required to provide an accommodation if unaware of the need. Stolav. Joint Industry Board ..The employer was not “on notice”of the employees mental disability even if they were aware of the employee’s misconduct in the workplace. ..“The employer is obligated to accommodate only those disabilities that are obvious, or called to its attention by the employee” …back to Reasonable Accommodation ..Reasonable Accommodation-any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. ..Qualified Person with a Disability-A qualified individual with a disability is a person who meets legitimate skill, experience, education, or other requirements of an employment position that s/he holds or seeks, and who can perform the "essential functions" of the position with or without reasonable accommodation Accommodation Ideas ..Time off or a modified work schedule ..Physical changes to the work environment ..Modify workplace policies ..Adjusting supervisory methods ..Reassignment What is Undue Hardship ? ..an employer is not required to make an accommodation if it wouldimpose an "undue hardship" on the operation of the employer's business .."Undue hardship" is defined as an "action requiring significant difficulty or expense" when considered in light of a number of factors. These factors include: ..the nature and cost of the accommodation ..the overall financial resources of the facility making the reasonable accommodation; the number of persons employed at this facility; the effect on expenses and resources of the facility; ..the type of operation of the employer, including the structure and functions of the workforce ..the impact of the accommodation on the operation of the facility. ..Direct threat Work Safety Issues and Direct Threat ..Direct Threat means "a significant risk of substantial harm to the health or safety of the individual or others that cannot be eliminated or reduced by reasonable accommodation. ..The determination that an individual poses a "direct threat" must be based on an individualized assessment of the individual's present ability to safely perform the functions of the job ..considering a reasonable medical judgment relying on the most current medical knowledge and/or the best available objective evidence. ..the employer must identify the specific behavior that would pose a direct threat. ..An individual does not pose a "direct threat" simply by virtue of having a history of psychiatric disability or being treated for a psychiatric disability Conduct Issues ..an employer may discipline an individual with a disability for violating a workplace conduct standard even if the misconduct resulted from a disability ..provided that the workplace conduct standard is job-related for the position in question and is consistent with business necessity ..if it would impose the same disciplineon an employee without a disability. ..An employer must make reasonable accommodation to enable an otherwise qualified individual with a disability to meet sucha conduct standard in the future, barring undue hardship. Because reasonable accommodation is always prospective, an employer is not required to excuse past misconduct. What About Medication ? ..Medication monitoring is nota reasonable accommodation. ..Employers have no obligation to monitor medication ..The employer should focus on the employee's conduct and explain to the employee the consequences of continued misconduct in terms of uniform disciplinary procedures. It is the employee's responsibility to decide about medication and to consider the consequences of not taking medication Can I Ask About Prescription Medication ? ..In limited circumstances, Employers may be able to demonstrate that itisjob-related and consistent with business necessityto require an employee to report when he/she are taking medication that may affect their ability to perform essential functions. ..Under these limited circumstances, an employer must be able to demonstrate that an employee's inability or impaired ability to perform essential functions will result in a direct threat ..Employees in positions affecting public safety EEOC ENFORCEMENT GUIDANCE: DISABILITY-RELATED INQUIRIES AND MEDICAL EXAMINATIONS OF EMPLOYEES UNDER THE AMERICANS WITH DISABILITIES ACT (ADA) Can I Ask For Documentation? ..Request Documentation ..Describe why you need this information, i.e., to verify the existence of a disability and the need for accommodation. ..Describe the type of information that you need in the documentation. Under the guidelines, you can ask for the following types of information: ..that the employee has a covered disability under the ADA (an impairment that substantially limits a major life activity), ..functional limitations that the person experiences that are due to the disability, and suggested accommodations in the workplace ..If the information provided by the professional still does not clarify the situation for you, you may ask the employee to meet with a professional of your choice to verify the disabilityand/or need for accommodation. Medical Inquiry ..A medical inquiry or examination is job-related and consistent with business necessity when: ..an employer has a reasonable belief, based on objective evidence, that an employee's ability to perform essential job functions will be impaired by a medical condition, ..an employer has a reasonable belief, based on objective evidence, that an employee will pose a direct threat due to a medical condition, ..an employee asks for a reasonable accommodation and the employee's disability or need for accommodation is not known or obvious ..required in positions that affect public safety, such as police and fire fighters. EEOC Enforcement Guidance: Disability-Related Inquiries and Medical Examinations of Employees under the Americans with Disabilities Act (ADA) Medical Inquiry ..Does the employee have a physical or mental impairment ? ..What is the impairment? ..Is the impairment long-term ,chronic or permanent? ..If notpermanent, how long will the impairment likely last? Medical Inquiry ..Does the impairment affect a major life activity? ..Caring for self ..Interacting with others ..Memory ..Thinking ..Learning ..Sleeping ..Concentrating ..http://www.jan.wvu.edu/media/medical.htm Accommodation Solutions Computer Repair Technician who has Bipolar disorder ….. An individual with bipolar disorder had difficulty concentrating and was unable to complete work assignments effectively and in a timely manner. What are accommodations? Solutions Text Box: White noise Headphones Scheduled interruptions Real Estate Broker who has a personality disorder …. An individual became irrational during a business meeting. He was not able to finish the meeting and was removed from the meeting. He later revealed that he is a personality disorder and recently relapsed due to the stress of losing his mother. What are accommodations? Solutions ..Referral to EAP ..Administrative leave ..Flexible scheduling for treatment ..Mandatory improvement plan ..Reprimand ..Reassignment Rehabilitation Counselor with OCD A rehabilitation counselor with obsessive compulsive disorder had to complete case reports. The counselor had difficulty meeting deadlines. What are accommodations? Solutions ..Case checklists ..Written work agreements ..Clear expectations of responsibilities ..Clear consequences of not meeting performance standards Secretary who has Depression What are accommodations? A secretary had difficulty working with her supervisor after disclosing she was being treated for depression and had limitations in working overtime. Solutions ..A monthly schedule (with weekly updates) indicating potential overtime needs ..Allow telephone calls during work hours to doctors and others for needed support ..Allow the presence of a support animal ..Allow the employee to take breaks as neededBuddyI like cats Sales Representative with Agoraphobia A sales representative was reprimanded for arriving to work late because she had difficulty traveling during peak traffic times. What are accommodations? Solutions ..Change in start time ..Work from homepart of the week Sales Representative with PTSD An individual with post-traumatic stress disorder returned to work on the third floor of an office building following a burn injury. The individual had difficulty evacuating from the building due to anxiety. What are accommodations? Solutions ..Provide office close to exit ..Implement buddy system ..Distribute clear and concise policies and procedures in writing ..Practice emergency drills ..Work directly with EAP ..Solicit and implement feedback from employees Interactive Process ..Talk to the employee with the disability ..Remember your obligation to provide a reasonable accommodation ..Reasonable for the employer ..Effective for the employee ..Obtain appropriate medical information ..Discuss accommodation options ..Call JAN Questions ? (800) 526-7234 (V/TTY) (800) ADA-WORK (V/TTY) http://www.jan.wvu.edu Contact (800) 526-7234 (V/TTY) (800) ADA-WORK (V/TTY) http://www.jan.wvu.edujan@jan.wvu.eduPlease call, e-mail, or visit us on the Web!