Facilitator’s Guide ADA Trainer Network, Module 3j

©Northeast ADA Center, 2012

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Non-Obvious Disability in the Workplace:

An Overview

About this module

Goal: To enable participants to build practices, behaviors and/or policies that recognize both obvious and non-obvious disabilities. Format: PowerPoint presentation Time: 30 minutes Potential audience: Job-seekers with disabilities, employers, recruiting/staffing professionals, disability service providers, employers/business leaders, educators Materials needed:

Hard copy of presentation optional. Offer to send text version to those who need it after the session.

Facilitator’s Tips for this module

The issue of non-obvious disabilities in the workplace has caught the attention of many stakeholders: employers, policy-makers, HR professionals and diversity practitioners. In our prior ADA TN offering, the program dealing with non-obvious disability was frequently requested. There are a variety of reasons for this:

1. an emerging awareness of the definition of disability, 2. the passage of the ADA Amendments Act and 3. the fact that more people with non-obvious disabilities are in the workplace due to

better diagnostic capabilities and treatments. It is likely that this module will be one of the more requested modules in the ADA TN offering.

This module provides a brief overview of this topic from a legal, practical and human perspective. It is, for the most part, given in a lecture format. We begin with the special dynamic of non-obvious disability and then move to examining statistics and accommodation options for major types of non-obvious disabilities.

Other modules may have some material that overlaps with this module, such as “Talking to an Employer about a Disability” or the modules dealing with hiring issues. If the “Non-Obvious Disability in the Workplace” module will be delivered with any of these other modules, facilitators may wish to move quickly through material that’s already been covered or eliminate some slides.

Facilitator’s Guide ADA Trainer Network, Module 3j

©Northeast ADA Center, 2012

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Here are a few “Do’s” and “Don’ts” to consider when facilitating this module: Do:

Keep the presentation moving forward.

Stay within the 30 minute timeframe

Refer participants with questions about particular situations involving workers with non-obvious disabilities to the 800 949 4232 TA number for the ADA Centers.

Don’t:

Let go unchallenged misperceptions of people with non-obvious disabilities. As discussed in the module, people with non-obvious disabilities can be subjected to unfounded myths and fears about their disabilities in ways that people with obvious disabilities may not.

Gently but firmly question participants who are making blanket statements, such as: “Everybody has a disability these days!” “My sister has MS and she’s not whining about it—she’s still working full-time!” or “We can’t hire people with PTSD because they’ll go postal.”

Many times, participants will want the facilitator to comment on specific cases refer participants with specific cases to either the ADA Center TA line (800 949 4232) or ask them to see you after the session.

Facilitator’s Guide ADA Trainer Network, Module 3j

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Facilitator’s notes for each slide

Facilitator’s Notes (Slide 1) This is the title slide for this module. Explain that this module will give a brief overview of the issue of non-obvious disabilities in the workplace. Please note: There are different words to refer to non-obvious disabilities. Though the words “hidden disability” have sometimes been used, we have avoided this wording because it indirectly implies that the person needs or wants to hide their disability. The word non-apparent has also been used. Though this is a respectful and acceptable wording, most employers and other stakeholders have become familiar with the words “non-obvious” disability. Hence, the topic of this module will be more clearly communicated.

Facilitator’s Guide ADA Trainer Network, Module 3j

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Facilitator’s Notes (Slide 2) Change this slide to reflect your regional information. Trainers, be sure to advise participants that this training is not intended as legal advice.

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Facilitator’s Notes (Slide 3) This slide introduces some major concepts around non-obvious disabilities in the workplace. We have had the ADA since 1990. Many employers and other stakeholders “get it” when it comes to applying ADA accessibility, non-discrimination and accommodation rights for people with obvious disabilities, such as those who use wheelchairs. They struggle, however, to understand what these concepts mean when they apply to people with non-obvious disabilities. The three points on this slide introduce the importance of understanding issues surrounding non-obvious disability. These points will be expanded upon throughout this module.

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Facilitator’s Notes (Slide 4) Building upon the last bullet of the prior slide, these five points focus on the dynamic of non-obvious disability in the workplace. Disclosure may be a choice. The amount of explanation you will need for this bullet will depend on what other modules you used to make up your program. Do not go into lengthy explanations here; the disclosure issue is again touched upon in slide 11. For now, make sure participants understand that people with non-obvious disabilities are not obligated to disclose that they have a disability unless they are requesting an accommodation. An employer should not feel that the person is “hiding” their disability if they do not disclose until they request an accommodation. Greater social stigma. Some types of non-obvious disability may carry greater social stigma and, hence, be subjected to significant discrimination. It’s important to always question automatic assumptions around particular types of non-obvious disability. Point out the following myths around people with various types of non-obvious disability, for example:

People with mental illness are more likely to be violent at work (Truth: People with treated mental illnesses are no more likely than others to commit acts of violence in the workplace)

Workers with diabetes frequently have “black outs” where they can no longer function and pose a danger to others (Truth: Diabetes symptoms are usually effectively managed)

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Workers with seizure disorders will be likely to have seizures while on the job (Truth: Many seizure disorders can be effectively treated with medication)

Co-workers should always be informed when a fellow employee has AIDS/HIV so that they can take precautions against contamination (Truth: Co-workers cannot be told if someone discloses a disability, per the ADA. Further, AIDS/HIV is not contagious in normal workplace interactions.)

“But you look just fine!” People with non-obvious disabilities may be subject to others questioning the legitimacy of their condition. When the disability condition does not appear to impact “normal functioning,” others may too quickly assume that the person is weak or a complainer. Blame the person. Similarly, others may be more likely to blame the person for their disability and, hence, may feel this person is less “deserving” of accessibility and accommodation. Confusion about accommodation. Generally, employers have a better understanding of accommodations for people with obvious disabilities, such as sensory or mobility disabilities. They may, however, have less understanding around accommodations needed by people with non-obvious disabilities.

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Facilitator’s Notes (Slide 5)

This slide provides a list of examples of non-obvious disabilities. This list is not exhaustive. If time allows, ask participants to name examples of other types of non-obvious disabilities. Please note: If participants give examples of disabilities which are not likely to be covered under the ADA (e.g. a broken ankle, a sinus infection, etc.), you may need to provide some additional information about what is considered a disability under the ADA.

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Facilitator’s Notes (Slide 6) This is the first of five slides that pose multiple choice questions to participants. Go over these slides quickly, without spending a lot of time discussing possible answers. Give participants about 30 seconds to make a guess before giving the correct answer. Slides 6 – 10 are animated with a fly-in. This means that the slide you first see while on “slide show” mode in PowerPoint will not be the complete slide. As you advance the slide again, the source for the answer will appear. This was done for two reasons: 1. To hide the correct answer allowing participants to guess; 2. To highlight the source for the correct answer. The correct answer to the question posed in slide 6 is D. One in four. According to the National Alliance on Mental Illness and the US Dept. of Health & Human Services., this amounts to about 57 million people in our country. This does not mean that 57 million people are newly diagnosed each year. Rather, this means that during any given year, about one-quarter of our population will have had a mental health disorder. One in 17 of these people will have had a serious mental illness.

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Facilitator’s Notes (Slide 7) Give participants a few seconds to think through what might be the correct answer. The correct answer is B: Depression. This slide has animation; the reference for this statistic will appear by advancing the slide. This answer will be a surprise to most participants. It demonstrates the importance of understanding that employers need to be able to accommodate people with a variety of disabilities, not just obvious disabilities.

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Facilitator’s Notes (Slide 8) The answer to this is A: Arthritis. There are several types of arthritis; the most common is osteoarthritis. About 50 million Americans have been diagnosed with arthritis by a doctor. Though arthritis becomes more common as we age, it is not restricted to older people. Arthritis has many different causes and manifestations. This slide has animation; the reference for this statistic will appear by advancing the slide.

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Facilitator’s Notes (Slide 9) The correct answer is D: 50%. About one in two Americans has a chronic illness diagnosis. Common types of chronic illness include diabetes, arthritis, heart disease, stroke and cancer. This slide has animation; the reference for this statistic will appear by advancing the slide.

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Facilitator’s Notes (Slide 10) The correct answer is C: 30%. This number is an estimation. It is difficult to get accurate statistics about the prevalence of conditions such as Post Traumatic Stress Disorder (PTSD) and traumatic brain injury (TBI) for a number of reasons: these conditions may not be present until long after the event that caused them; the military, though improving, has not always provided the screening and diagnosis systems needed; and veterans themselves may not be willing to come forward with these types of disabilities. This means that employers who want to “do the right thing” and hire returning veterans need to have in place effective ways to ensure that veterans can retain jobs when working with these disabilities. This slide has animation; the reference for this statistic will appear by advancing the slide.

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Facilitator’s Notes (Slide 11) After seeing the statistics in slides 6 – 10, participants may be wondering why so many people in our country have nonobvious disabilities. This slide gives some reasons for this in this increase. Without spending too much time on this slide, provide a brief overview of these points.

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Facilitator’s Notes (Slide 12) This slide gives a brief overview of some ADA legal considerations around nonobvious disabilities in the workplace. If you have included a module in your program that has already touched upon these issues, you will can to through these points very quickly. The first point on this slide expands upon a point made earlier. For people with non-obvious disabilities, disclosure is often a choice. The remaining points go through inquiry and disclosure issues for three employment stages.

The law places strict limits on employers when it comes to asking job applicants to answer medical questions, take a medical exam, or identify a disability. For example, an employer may not ask a job applicant to answer medical questions or take a medical exam before extending a job offer.

At the second stage (after an applicant is given a conditional job offer, but before s/he starts work), an employer may make disability-related inquiries and conduct medical examinations, regardless of whether they are related to the job, as long as it does so for all entering employees in the same job category. The last point refers to disclosure and inquiry after employment has started. If the employer has a reasonable belief that an employee might need an accommodation, the employer can make a private inquiry. For example, if an employee who is hearing impaired will be attending a training or a meeting, the employer can ask the employee about what accommodations they might need in order to participate in that event.

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Facilitator’s Notes (Slide 13) This slide continues the discussion of legal issues and nonobvious disability by focusing on the accommodation process. Again, how much time you spend on this slide will depend on whether you have already covered this material in another module. People with nonobvious disabilities will need to disclose the disability to their employer if they are requesting an accommodation. This disclosure can be made to several different people within the organization, such as a manager, HR professional, supervisor. As stated previously, when an employee requests an accommodation, the employer may collect medical information. Employers must maintain separate confidential files for medical information. During the interactive accommodation process, people with non-obvious disabilities may want to clarify who will be told of a change in the work. Remember that a co-worker can only be told of an accommodation if they will be directly impacted by an accommodation. If this happens, the employer can let the person know that there will be a change in the way that the employee does there job, but they cannot share why the change is occurring as doing so would amount to a disclosure of disability. Employers are often concerned about what to tell co-workers who feel that employees who are given accommodations are receiving special treatment. If asked, an employer can say that it is complying with the law by providing a change in the workplace for a specific individual. But, it

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is important that employers provide clear policies to all employees around the availability of accommodations in compliance with the law. This information can be communicated in an employee handbook, on a website detailing company policy, at orientation, in posted signs, or in the information that goes out with paystubs so that everyone is aware of it. Employers should include all laws under which an employee might ask for a change in the work environment (i.e. ADA, FMLA). Employers should also stress that they value employee privacy and therefore will not share with co-workers why any one employee was granted an accommodation. It’s important that direct managers and supervisors are provided with this information to give to the people they manage. Please refer your audience to their regional ADA Center if there are complex questions about this issue during the training. The last bullet on this slide goes into the following slides which focus on brainstorming possible accommodations for different types of non-obvious disabilities. Creativity and flexibility are the hallmarks of a good accommodation process. Many times, the only accommodations that are considered are those of work-leave and/or re-assignment. Try to think of other accommodations first—accommodations that will keep the person engaged in the job as much as possible.

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(Slide 14)

(Slide 15)

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Facilitator’s Notes (Slides 14, 15 & 16) Slides 14, 15 and 16 give brief case scenarios around people with nonobvious disabilities and workplace accommodations. As with other slides, there is fly in animation on these slides. Here is how slides 14 – 16 are facilitated:

1. First, present the slide without the accommodation suggestions. 2. Briefly read the case study (in red text on the left). 3. Let participants brainstorm some possible accommodation options given what is

known about this individual’s disability and their job. It is understood that these will just be guesses. In real life, more would need to be known about the condition, the person and the job in order to make this decision. The purpose of this exercise is just to get participants thinking about the wide range of options for different types of nonobvious disabilities.

4. After about a minute of brainstorming, advance the slide several times until all the possible accommodation options for this case are given. There are between 4 – 6 accommodation options given for each case.

5. Point out the Job Accommodation Network resource link that is given on the slide. The Searchable Online Accommodation Resource (SOAR) is given on the slide.

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Facilitator’s Notes (Slide 17) National Network: Please insert your centers contact information into this slide.

Conclude by reminding participants that the training materials were produced by the Northeast ADA Center in collaboration with the ADA National Network. Remind them of the free and confidential technical assistance and other services available from your local ADA Center and from the ADA Centers throughout the country. Mention the ADA TA line: 800-949-4232.