Employees with Post Traumatic 

Stress Disorder 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

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Updated 03/23/10. 
Practical Solutions • Workplace Success 

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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction 

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Post Traumatic Stress Disorder (PTSD) 

What is PTSD? 

PTSD is a debilitating condition that can occur after exposure to a terrifying event or 

ordeal in which grave physical harm occurred or was threatened. Traumatic events that 

can trigger PTSD include violent personal assaults such as rape or mugging, natural or 

human-caused disasters, accidents, or military combat. Traumatic events most often 

associated with PTSD are 1) for men: rape, combat exposure, childhood neglect, and 

childhood physical abuse, and 2) for women: rape, sexual molestation, physical attack, 

being threatened with a weapon, and childhood physical abuse (National Institute of 

Mental Health, 2008). 

Many people with PTSD repeatedly re-experience the ordeal in the form of flashback 

episodes, memories, nightmares, or frightening thoughts, especially when they are 

exposed to events or objects reminiscent of the trauma. Anniversaries of the event can 

also trigger symptoms. Feelings of intense guilt are also common. Most people with 

PTSD try to avoid any reminders or thoughts of the ordeal (National Institute of Mental 

Health, 2008). 

In November of 2001, the New England Journal of Medicine reported that 44% of the 

adults surveyed experienced one or more symptoms of stress during the week of 

September 11, 2001 (Drazen, 2001). It is predicted that many children and adults will be 

diagnosed with PTSD as a result of the terrorist attacks against the United States at the 

World Trade Center, the Pentagon, and in Pennsylvania. Other unfortunate and 

traumatic events in recent American history that caused people to be diagnosed with 

PTSD include: the 1995 Oklahoma City bombing, the shootings at 1999 Columbine 
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High School in Colorado, the 1986 Space Shuttle Challenger explosion, and the 

Olympic Park bombing in 1996, and Hurricane Katrina in 2005. 

How prevalent is PTSD? 

The National Center for Post Traumatic Stress Disorder estimates 7.8 percent of 

Americans will experience PTSD at some point in their lives, with women twice as likely 

as men to have PTSD. About 30 percent of the men and women who have spent time in 

war zones experience PTSD. More than half of all male Vietnam veterans and almost 

half of all female Vietnam veterans have experienced clinically serious stress reaction 

symptoms. PTSD has also been detected among veterans of the Gulf War, with some 

estimates running as high as eight percent (National Center for Post Traumatic Stress 

Disorder, 2007). 

What are the symptoms of PTSD? 

According to the Anxiety Disorders Association of America, symptoms of PTSD can 

include: 

• Re-experiencing the event, which can take the form of intrusive thoughts and 

recollections, or recurrent dreams; 

• Avoidance behavior in which the sufferer avoids activities, situations, people, 

and/or conversations which he/she associates with the trauma; 

• A general numbness and loss of interest in surroundings; this can also present 

as detachment; 

• Hypersensitivity, including: inability to sleep, anxious feelings, overactive startle 

response, hyper vigilance, irritability and outbursts of anger. 

Symptoms usually begin within three months of a trauma, although there can be a 

delayed onset and six months can pass between trauma and the appearance of 

symptoms. In some cases years can pass before symptoms appear. In this case the 

symptoms are often triggered by the anniversary of the trauma, or with the experience 

of another traumatic event. Symptoms may vary in frequency and intensity over time 

(Anxiety Disorders Association of America, n.d.). 

PTSD and the Americans with Disabilities Act 

Is PTSD a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC, 1992). Therefore, some people with PTSD will have a disability under the ADA 

and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (EEOC, 1992). For more information about how to 
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determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm. 

Are employees with PTSD required to disclose their disability to their 

employers? 

No. Employees need only disclose their disability if/when they need an accommodation 

to perform the essential functions of the job. Applicants never have to disclose a 

disability on a job application, or in the job interview, unless they need an 

accommodation to assist them in the application or interview process (EEOC, 1992). 

Can an employer ask an employee with PTSD to submit to a medical 

examination? 

Yes, if the need for the medical examination is job-related and consistent with business 

necessity. Typically, employers will ask an employee with PTSD to submit to a medical 

examination (also called a fitness-for-duty exam) after the employee had an incident on 

the job that would lead the employer to believe that this employee is unable to perform 

the job, or to determine if the employee can safely return to work, and if any 

accommodations will be needed on the job (EEOC, 1992). 

Special note: Pre-job offer medical examinations or inquiries are illegal under the ADA. 

People with PTSD (or any disability) do not have to submit to a medical exam or answer 

any medical questions until after they are conditionally offered a job (EEOC, 1992). 

Do employees with PTSD pose a direct threat to themselves or others? 

People who have PTSD do not necessarily pose a direct threat to themselves or others. 

Employees who control their conditions through medication or therapy probably pose no 

current risk. Even if direct threat exists, employers should reducing or eliminating the 

threat by providing an accommodation (EEOC, 1992). 

How and when does a person with PTSD ask for an accommodation? 

An employee with PTSD can ask for an accommodation at any time when he/she needs 

an accommodation to perform the essential functions of the job. The employee can 

make a request verbally or in writing and is responsible for providing documentation of a 

disability (EEOC, 1992). 

Can an employer discipline an employee with PTSD who violates conduct or 

performance standards? 

Yes, an employer can discipline an employee with PTSD who violates conduct 

standards or fails to meet performance standards, even if the behavior being exhibited 

is caused by the employee's disability. However, an employer is obligated to consider 

reasonable accommodations to help the employee with PTSD meet the conduct or 

performance standards (EEOC, 1992). 
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Accommodating Employees with PTSD 

(Note: People with PTSD may develop some of the limitations discussed below, but 

seldom develop all of them. Also, the degree of limitation will vary among individuals. 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 possibilities available. Numerous other accommodation solutions may exist.) 

Questions to Consider: 

1. What limitations is the employee with PTSD experiencing? 

2. How do these limitations affect the employee and the employee’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the employee with PTSD been consulted regarding possible accommodations? 

6. 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? 

7. Do supervisory personnel and employees need training regarding PTSD? 

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 
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• Allow the employee to play soothing music using a cassette 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 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 for time off for counseling 

• Assign a supervisor, manager, or mentor to answer employee’s questions 

Working Effectively with a Supervisor: 

 

• Giving 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 
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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 

• Example: 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 

Diarrhea/Vomiting/Nausea: 

• Allow flexible bathroom breaks 

• Move employee to location where he/she can access the bathroom discreetly 

• Provide space for storing extra clothing or personal hygiene products 
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Headaches: 

• Provide alternative lighting 

• Take breaks from computer work or from reading print material 

• Practice stress-relieving techniques 

Transportation Issues: 

• Eliminate non-essential travel 

• Provide a driver 

• Allow extra time for travel 

• Allow the employee to bring a support person 

Situations and Solutions: 

An administrative assistant with PTSD works at a museum, which is currently under 

construction. Construction workers, who were strangers, caused the employee extreme 

anxiety. As an accommodation, a JAN consultant suggested temporarily relocating the 

employee’s work space away from the construction area. The museum also developed 

an ID badge for construction workers and required them to sign in at their job locations. 

A prison guard, recently attacked by an inmate, has PTSD and anxiety. The prison 

guard was fearful of returning to the worksite, even to discuss her return-to-work 

options. A JAN consultant offered the following suggestions: allow the employee to 

bring a support person or support animal to the meeting, move the meeting to an 

alternative location, or allow the employee to attend the meeting via telephone. 

An office worker who was stalked and harassed by a former employee now has a panic 

disorder. She is fearful of answering her office telephone. JAN suggested these 

accommodations to her employer: use telephone with a caller ID function and/or call 

blocking function, change the tone or frequency of telephone ringer to reduce panic 

reaction, route all calls through a switchboard or receptionist, and disable this 

employee’s direct extension to prohibit direct calls. 

A vocational school teacher with PTSD requested accommodations due to anxiety and 

flashbacks. She taught in a building separated from the main school, and she had 

difficulty dealing with large classrooms of unruly students. As an accommodation, JAN 

suggested training the teacher on special behavior management techniques and 

providing administrative support for student disciplinary actions. The school also 

provided the teacher a two-way radio, which allowed her to contact an administrator 

quickly when she needed immediate assistance in her classroom. 

A postal employee with PTSD requested accommodations to help him deal with 

recurring flashbacks. His flashbacks were triggered by the smell of gasoline and the 

noise from the mail truck. The employee tried wearing a respirator to give him a clean 

air supply. He also tried wearing headphones to reduce the noise from the truck, but he 
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still experienced stress and edginess. JAN suggested a position transfer as an 

accommodation. JAN also suggested allowing this employee to take a break when he 

experiences extreme anxiety and allow him to use relaxation and visualization 

techniques in a private space on the job. 

A veteran who is now an office employee has PTSD and anxiety. He is easily frightened 

when being approached unsuspectingly. This employee works in a structured cubicle 

environment facing his computer and cubicle walls, with his back to the cubicle 

entrance. He wants to be alerted when a coworker or supervisor walks into the cubicle 

behind him. JAN suggested using a monitor-mounted mirror, so he could see the 

entrance behind him. JAN also suggested placing a sensor mat at the entrance of the 

cubicle, which will make an audible alert when someone steps on it. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

American Academy of Experts in Traumatic Stress 

368 Veterans Memorial Hwy 

Commack, NY 11725 

Direct: (631)543-2217 

Fax: (631)543-6977 

info@aaets.org 

http://www.aaets.org 

The American Academy of Experts in Traumatic Stress® is a multidisciplinary network 

of professionals who are committed to the advancement of intervention for survivors of 

trauma. The Academy aims to identify expertise among professionals, across 

disciplines, and to provide meaningful standards for those who work regularly with 

survivors. 
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Anxiety Disorders Association of America 

8730 Georgia Avenue 

Suite 600 

Silver Spring, MD 20910 

Direct: (240)485-1001 

Fax: (240)485-1035 

http://www.adaa.org 

Resources for clinicians, researchers and other treatment providers in all disciplines. 

Resources for anxiety disorder sufferers, family members, and other interested parties. 

Fast facts, statistics, news releases and more for media professionals. Search for 

treatment providers near you. 

International Society for Traumatic Stress Studies 

111 Deer Lake Road, Suite 100 

Deerfield, IL 60015 

Direct: (847)480-9028 

Fax: (847)480-9282 

istss@istss.org 

http://www.istss.org 

The International Society for Traumatic Stress Studies (ISTSS) is the world’s premier 

trauma organization dedicated to trauma treatment, education, research and prevention. 

Through this organization, professionals share information about the effects of trauma, 

seeking to reduce traumatic stressors and their immediate and long-term 

consequences. 

National Center for Post Traumatic Stress Disorder 

Direct: (802)296-6300 

ncptsd@va.gov 

http://www.ncptsd.va.gov/ 

Strives to advance the clinical care and social welfare of America’s veterans through 

research, education, and training in the science, diagnosis, and treatment of PTSD and 

stress-related disorders. 

National Center for Victims of Crime 

2000 M Street NW 

Suite 480 

Washington, DC 20036 

Toll Free: (800)394-2255 

Direct: (202)467-8700 

Fax: (202)467-8701 

webmaster@ncvc.org 

http://www.ncvc.org/ 
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Purpose is to forge a national commitment to help victims of crime re-build their lives. 

PTSD Alliance 

Direct: (877)507-PTSD 

info@ptsdalliance.org 

http://www.ptsdalliance.org/home2.html 

A group of professional and advocacy organizations that have joined forces to provide 

educational resources to individuals diagnosed with PTSD and their loved ones; those 

at risk for developing PTSD; and medical, healthcare and other frontline professionals. 

Rape, Abuse, and Incest National Network 

2000 L St. NW 

Ste. 406 

Washington, DC 20036 

Toll Free: (800)656-4673 

info@rainn.org 

http://www.rainn.org 

When a victim calls, a computer identifies the caller's location by reading the area code 

and the first three digits of the phone number. Then, the call is connected 

instantaneously to the rape crisis center nearest the caller. If the line is busy, the call will 

be connected to the next closest member center. The local center answers the call as if 

it had come in directly, providing counseling and support. Every call is completely 

confidential. 

Sidran Institute 

200 E. Joppa Road, Suite 207 

Baltimore, MD 21286-3107 

Toll Free: (888)825-8249 

Direct: (410)825-8888 

Fax: (410)337-0747 

help@sidran.org 

http://www.sidran.org 

Dedicated to supporting people with traumatic stress conditions, providing education 

and training on treating and managing traumatic stress, providing trauma-related 

advocacy, and informing the public on issues related to traumatic stress. 
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References 

Anxiety Disorders Association of America. (n.d.) Post traumatic stress disorder 

(PTSD). Retrieved September 5, 2008, from 

http://www.adaa.org/GettingHelp/AnxietyDisorders/PTSD.asp 

Drazen, J.M., Curfman, G.D., & Campion, E.W. (2001). After September 11. New 

 England Journal of Medicine, 345, 1490. 

National Institute of Mental Health. (2008). Reliving trauma: Post-traumatic stress 

disorder. Retrieved December 22, 2005, from 

http://www.nimh.nih.gov/publicat/reliving.cfm 

Equal Employment Opportunity Commission. (1992). A technical assistance manual on 

the employment provisions (title I) of the Americans with Disabilities Act. 

Retrieved September 5, 2008, from http://askjan.org/links/ADAtam1.html 

What is posttraumatic stress disorder? A national center for PTSD fact sheet. (2007). 

Retrieved September 5, 2008, from 

http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_what_is_ptsd.html 
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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.