1. JAN FAQs Mental Health Impairments in the Workplace
Melanie Whetzel, M. A., CBIS
Lead Consultant, Cognitive/Neurological Team
Sarah Small, M.S., CRC
Consultant, Cognitive/Neurological Team

2. Common Mental Health Impairments
Addiction
Anxiety
Bipolar Disorder
Major Depression
Obsessive Compulsive Disorder (OCD)
Panic Disorder
Post-Traumatic Stress Disorder (PTSD)
Seasonal Affective Disorder (SAD)

3. Limitations Mental Health Impairments Concentration Sleep Disturbances
Memory
Organization
Time Management
Stress / Emotions
Panic
Sleep Disturbances
Attendance
Coworker Interaction
Working Effectively

4. Disclosure
We have an employee who didn’t disclose during his interview. Now 6 months later he is finding it difficult to work the night shift he was hired for and is asking for accommodations.
Do we have to accommodate?

5. Solution
The employer would need to get more information from the employee to determine if a disability or medical condition is involved and start the interactive process. The next step would be to get medical information and consider accommodations that may be effective.

6. Medical Documentation
A state agency employee answers consumer questions by phone. He states he can no longer work the phones even for the two hours/day he is required because of the stress caused by the phone calls.
We have documentation of stress from the urgent care doctor who saw the employee last night. Can we request more information, from a more appropriate source?

7. Solution
JAN suggested looking at what it is about the phone calls in particular that causes or exacerbates the stress. Does he need training? Mentoring? More visual resources to refer to? Would color-coding help? Soft music? Breaks?

8. Questions

9. Service Animals
An employee brings his service animal to work without giving the employer notice. When asked, the employee stated that the employer can only ask two questions and can’t require medical documentation.
What kind of documentation can employers ask for related to a service animal?

10. Solution
The employer explained that under the ADA, they have the right to request documentation or demonstration of the need for the service animal (when the need is not obvious) and that the service animal is trained appropriately and will not disrupt the workplace. They also provided the JAN publication on service animals and suggested the employee call JAN for more information.

11. Service Animals
When an employee asks to bring in her new support dog, she states that she has trained the dog herself and that there is no documentation to show that.
Can we require service and support animals in the workplace to be behavior/training certified?

12. Solution
The employer allowed the employee to bring in the service animal on a trial basis to see if the animal is effective, well-behaved, and does not pose an undue hardship.

13. Questions

14. Reassignment
An employee who found it very difficult to talk to (sometimes irate) customers on the phone asked for a reassignment to an admin position that required only internal phone contacts. She was asked to interview before a panel of evaluators.
We require employees who are interested in other positions to interview for them. Are we required to forgo that for people with disabilities? Is that fair?

15. Solution
After consulting with JAN, the supervisor better understood how reassignment worked as an accommodation and with the help of the HR department determined if the employee was qualified for the admin position.

16. Performance and Conduct Standards
An employee is written up after several verbal warnings for inappropriate conduct. She is placed on a thirty-day plan of improvement and warned that if the behavior doesn’t stop within the stated time period, she will be let go. The employee decides to disclose her disability and ask for accommodations to assist her in responding more appropriately to co-workers.
How do we manage a Performance Improvement Plan (PIP) when in a counseling session the employee relates the performance issues to a disability?

17. Solution
The employer puts the PIP on hold until they receive medical documentation and can put accommodations into place, but does not rescind the discipline that occurred before the disability was known. Once accommodations are put into place, the employer starts the PIP.

18. Questions

19. Direct Threat
We have recently hired an employee who just disclosed that he has PTSD.
What do we do now?

20. Direct Threat
What constitutes a direct threat?

21. Direct Threat The employer must be prepared to show that there is:
significant risk of substantial harm;
the specific risk must be identified;
it must be a current risk, not one that is speculative or remote;
the assessment of risk must be based on objective medical or other factual evidence regarding a particular individual; and
even if a genuine significant risk of substantial harm exists, the employer must consider whether the risk can be eliminated or reduced below the level of a "direct threat" by reasonable accommodation.

22. Solution
Once the employee disclosed that he has PTSD, the employer starts the interactive process and asks him what accommodations he needs to help him in the workplace.

23. Questions

24. Modified Schedule and Leave
An employee originally accommodated with a 12-week leave for depression asked for an 8-week extension which the employer provided. Now that it is time for the employee to return to work, the employer receives a doctor’s note stating the employee is not ready to return, and no date is provided by which the employee will be able to.
How much leave is too much for an employee who needs extended leave for mental health issues? What constitutes hardship?

25. Do employers have to grant indefinite leave as a reasonable accommodation to employees with disabilities? Although employers may have to grant extended medical leave as a reasonable accommodation, they have no obligation to provide leave of indefinite duration. Granting indefinite leave, like frequent and unpredictable requests for leave, can impose an undue hardship on an employer’s operations. Indefinite leave is different from leave requests that give an approximate date of return or give a time period for return.

26. Hardship
The chronic, frequent, and unpredictable nature of absences may put a strain on the employer’s operations for a variety of reasons, such as the following:
an inability to ensure a sufficient number of employees to accomplish the work required;
a failure to meet work goals or to serve customers/clients adequately;
a need to shift work to other employees, thus preventing them from doing their own work or imposing significant additional burdens on them;
incurring significant additional costs when other employees work overtime or when temporary workers must be hired.

27. Solution
The employer requests information from the doctor about a firm return date. When none can be given, the employer determined they could no longer provide the leave and keep the position open.

28. Questions

29. Telework
An employee with acute anxiety asks to work from home as often as possible. The commute to work has become very difficult.
We don’t have to accommodate employees because of their issues getting to work, do we?

30. Solution
The employer worked through the interactive process and determined that the employee was having panic attacks when caught in rush hour traffic. A compromise was offered that allowed the employee to work from home at times but was also offered a flexible schedule so that she didn’t travel in peak traffic.

31. Modified Policy
An employer refuses to engage in the accommodation process that involves a request from an employee with epilepsy for a change in the attendance policy due to seizures. The employer says that everyone wants more flexibility and this employee is no different. “We aren’t in the business of giving employees special treatment.” 
How do we explain to employees who work the regular schedule why we have allowed an employee with a disability to have a flexible one?

32. Solution
The employee provided information gained from a consult with JAN that shows how a modified workplace policy can work to help him with his attendance. The employer then called JAN himself to find out more.

33. What to tell employees
An employer may not disclose that an employee is receiving a reasonable accommodation.
An employer may respond to a question from an employee about why a coworker is receiving what is perceived as "different" or "special" treatment by emphasizing its policy of assisting any employee who encounters difficulties in the workplace.
Employers might find it helpful before such questions are raised to provide all employees with information about various laws that require employers to meet certain employee needs), while also requiring them to protect the privacy of employees.
As long as there is no coercion by an employer, an employee with a disability may voluntarily choose to disclose to coworkers his/her disability and/or the fact that s/he is receiving a reasonable accommodation.

34. Questions

35. Resources: Employees with Mental Health Impairments
Employers' Practical Guide to Reasonable Accommodation Under the Americans with Disabilities Act (ADA) 
The ADA: Applying Performance and Conduct Standards to Employees with Disabilities

36. Contact Mental Health Impairments
(800) (V) & (877) (TTY)
AskJAN.org &
(304) via Text
janconsultants via Skype