PTSD accommodations at work

What PTSD accommodations can you ask for at work?

The Americans with Disabilities Act (ADA) reaches employers with 15 or more employees. The examples below come from the PTSD page of the Job Accommodation Network (JAN), grouped by what each one changes at work.

These are examples to start a conversation with your employer. In its reasonable accommodation guidance, the Equal Employment Opportunity Commission (EEOC) says, "The employer may choose among reasonable accommodations as long as the chosen accommodation is effective." It also says, "An employer does not have to eliminate an essential function, i.e., a fundamental duty of the position."

Your workspace

Noise-canceling headsets or earbuds, a white noise or environmental sound machine, and fans. Sound-absorbing panels or other noise abatement, cubicle doors, shields or shades, folding partitions or room dividers, a monitor mirror, or a modified workspace. Alternative lighting, such as full-spectrum or natural lighting, simulated skylights and windows, and odor control.

Instructions and planning

Written instructions, recorded directives, messages or materials, and verbal cues. Calendars and planners, timers and watches, checklists, reminders, and a color-coded system. Color-coded manuals, outlines and maps, visual schedulers, electronic organizers, task separation, and task identification.

Training and support

Additional training time, training refreshers, or changes to how training is given. A job coach, on-site mentoring, a support person, or a professional organizer.

Breaks and schedule

A modified break schedule, periodic rest breaks, or uninterrupted "off" work time. A flexible schedule, or telework (working from home).

How the job is organized

Job restructuring, task rotation, or moving marginal (non-essential) tasks to someone else. Adjusted supervisory methods.

Is PTSD a disability under the ADA?

The regulation at 29 CFR 1630.2 lists post-traumatic stress disorder by name. Paragraph (j)(3)(iii) says "it should easily be concluded that the following types of impairments will, at a minimum, substantially limit the major life activities indicated", and its list names "post-traumatic stress disorder" among the impairments that "substantially limit brain function".

JAN puts the starting point this way: "The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more 'major life activities,' (2) has a record of such an impairment, or (3) is regarded as having such an impairment." Under 29 CFR 1630.2(o)(4), an employer "is not required to provide a reasonable accommodation to an individual who meets the definition of disability solely under the 'regarded as' prong".

Under 29 CFR 1630.2(j)(1)(iv), "The determination of whether an impairment substantially limits a major life activity requires an individualized assessment." Paragraph (j)(3)(ii) adds that "the individualized assessment of some types of impairments will, in virtually all cases, result in a determination of coverage" and that "the necessary individualized assessment should be particularly simple and straightforward."

Do you have to tell your employer you have PTSD?

To get an accommodation, your employer has to be told that a change is needed for a medical reason. The EEOC's guidance puts it this way: "the individual or his/her representative must let the employer know that s/he needs an adjustment or change at work for a reason related to a medical condition".

It adds that "as a general rule, the individual with a disability...must inform the employer that an accommodation is needed." That rule is about getting an accommodation. Beyond it, and apart from a medical inquiry the regulation allows, one that is "job-related and consistent with business necessity," whether to tell your employer anything is your choice.

Medical information your employer gets through its medical inquiries has rules of its own. Under 29 CFR 1630.14(c)(1), it "shall be collected and maintained on separate forms and in separate medical files and be treated as a confidential medical record." Supervisors and managers may be told about "necessary restrictions on the work or duties of the employee and necessary accommodations".

First aid and safety personnel may be told, "when appropriate, if the disability might require emergency treatment." Government officials investigating compliance "shall be provided relevant information on request." Under (c)(2), the information "shall not be used for any purpose inconsistent with this part."

Certicare is a telehealth service where leave and accommodation paperwork is completed and signed by a state-licensed provider after an evaluation. If your employer asks for documentation, that's the paperwork a provider can complete, where the evaluation supports it. There's usually no appointment, and a provider may follow up for more detail before deciding. Turnaround is usually within 24 hours after we have everything needed.

Completing our intake form starts the review; it does not guarantee a signature, and if the review does not support your request you are refunded in full.

How do you ask for a PTSD accommodation?

There's no required form of words. Under the EEOC's guidance, a request can use "plain English." It doesn't have to mention the ADA or use the phrase "reasonable accommodation," and it doesn't have to be in writing.

What the request needs is the link between a change at work and a medical condition. Who can make the request, what happens after you ask, and how quickly your employer should respond are covered in our guide to requesting a reasonable accommodation.

What documentation can your employer ask for?

Your employer may ask for documentation when "the disability and/or the need for accommodation is not obvious." Under the EEOC's guidance, it describes the impairment, its "nature, severity, and duration," and the functional limitations.

It also shows how the accommodation you asked for addresses your limits at work. The same guidance adds that "the employer may require only the documentation that is needed to establish that the disability necessitates a reasonable accommodation."

The same guidance gives examples of who can provide it: "Appropriate professionals include, but are not limited to, doctors (including psychiatrists), psychologists, nurses, physical therapists, occupational therapists, speech therapists, vocational rehabilitation specialists, and licensed mental health professionals."

Your own provider can write the documentation. A state-licensed provider reviews your answers and, where the evaluation supports it, completes and signs the paperwork your employer asked for. The decision on the accommodation stays with your employer.

What if your employer says no?

Your employer may offer a different accommodation that's effective instead of the one you asked for. That's a choice the EEOC's guidance allows the employer. It also says, "If more than one accommodation is effective, 'the preference of the individual with a disability should be given primary consideration.'"

One limit on an employer's duty is "undue hardship." The EEOC defines it as "significant difficulty or expense and focuses on the resources and circumstances of the particular employer in relationship to the cost or difficulty of providing a specific accommodation." When no accommodation is possible, read when an employer can't accommodate restrictions.

EEOC charge deadlines, the ADA's bar on retaliation, and what to do after a denial are covered in our guide to requesting a reasonable accommodation.

For leave as an accommodation, see our guide to ADA leave.

You don't need to have the accommodation worked out before you start. Answer the intake questions, and a state-licensed provider completes and signs the paperwork your employer asked for, where the evaluation supports it.