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Firefighter Disability - It May Not be What You See

What do you think of when you hear the word disability? Most likely the word disability creates an image of any number of conditions that are visible but disabilities are also those not visible

As a clinical psychologist my definition of what constitutes a disability has expanded beyond what I could see, to include what was not seen, and not always evident. So, before continuing with the reading, take a moment and think about what you know about disabilities, how are you influenced by what you understand about disabilities and about your biases related to the term “disability”.

This article is not meant to be a legal discourse about disabilities and what an employer should and should not do legally. It is a discourse on what a disability is and how you are affected by your understanding of disability. What is a disability? How do we define disability? My hope for this article is to provide information that is neither readily evident nor acknowledged about the psychological side of disabilities. Most of what is written about disabilities are related to the legal violation of the rights of individuals with disabilities.

From the perspective of the law, both federal and state, disability is a legal term, and as such can have some variance from law to law. The Americans with Disabilities Act (ADA) defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activities. This definition also includes people who have a record of impairment or who are regarded as having a disability (ADA, 2013). Having a record of impairment means that you were impaired in the past, but are no longer struggling with the affects of that impairment, such as someone who had a heart attack, received treatment, but no longer experiences the symptoms associated with the heart condition. A person regarded as having a disability refers to someone who may not have a disability, but is considered to have a disability. For first responders the repeated exposure to trauma, and other stressors may contribute to an employer treating him or her as having PTSD, without the individual having an actual diagnosis of PTSD (NAMI, 2013).

Disabilities can be visible and invisible. Disabilities may be acquired or developmental. Visible disabilities would be noticeable and may include someone who uses a service dog, a hearing aid, in a wheel chair, on crutches, or other such visible conditions. Invisible or hidden disabilities included conditions that are medical, psychological and cognitive. These disabilities can hinder a person in a variety of ways and creates challenge for the person who has the disability and to the people around that person. Others may not understand the cause of the problem, if they cannot see evidence of it in a visible way. Disabilities that fall within these categories include, medical issues such as heart attack or diabetes, mental health disorders such as severe depression, PTSD, Bipolar, cognitive challenges such as dyslexia, ADHD, and other intellectual disabilities. Regardless of whether the disability is visible, invisible, acquired or developmental the presence of the disability affects interactions between people who have a disability and those around them.

When the disability is visible then the disability is often the first thing that other people see and react to. Often assumptions are made regarding what that individual can and cannot accomplish. If it is an invisible disability such as depression, ADHD, or dyslexia that become evident because of decreased performance or an admission, other assumptions follow such as the individual is stupid, lazy or making excuses or trying to cheat.
Having a disability does not mean not able, not able to work, not able to learn, not able to socialize, and etc. The reaction of individuals encountering someone who is disabled often originates in assumptions and stereotypes held by people about the legitimacy of the disability and capabilities of someone who is disabled. For people with a disability, they often feel that they are defined by their disability and that other people see the limitations of their disability. For people with an invisible disability, they often must decide whether or not to reveal their disability. This decision often carries a complex mix of emotions. When faced with your own or other’s disability it is important to let go of the stereotypes and assumptions and accept them as they are.
In a work environment, the employer or supervisor must to some extent accommodate the abilities of the individual and not the “inabilities” or “disabilities” under the law (EEOC, 2013). In the general societal standard, a cruel and imprecise measure of the individual’s ability to integrate into society, a different thought process must be in place either through exposure or experience with those who “look different or act different”. It is important for members of a community or a work environment to shift their attentions from the negative connotations to which we have become accustomed and move to a stance toward the positive aspects of those with disabilities.

Lets look at an example of two scenarios from the perspective of the individual with a “hidden disability” and the supervisor who over sees this individual. The first scenario will look at Chris and the second scenario will look at Paul.

Chris is a 27 year old Caucasian woman, who has worked as a firefighter for 5 years. She wants to become a Lieutenant in her department. Chris knows from years of frustration in school and her experience in becoming a firefighter that she has a learning disorder. She has struggled her whole life with dyslexia and ADHD. Once she was diagnosed schools and her early employers made accommodations for her, which included more time for tests, a quiet environment, delivery of information through verbal, tactile and visual means, and assistance in organizing and scheduling information. With these accommodations Chris has been quite successful.
When she tested for the fire service, after many failed attempts she finally asked if she could have more time for the written test because of her dyslexia. She provided documentation from her doctor and the testing agency agreed. She excelled and has been a firefighter for 5 years. Her current employer does not know that she struggles with learning disabilities. She has ben able to complete her academy and all the learning tasks of the fire service through hard work, and sleepless nights. She did not want to ask for help, or to be seen as “stupid” or “lazy” with her officers, so by long hard and stressful work she has done quite well.
Now, she would like to test for Lieutenant. She knows that she does not test well and that she needs to vary the delivery of the study materials (verbal, tactile and visual), but she has not shared this with anyone else. She is afraid to ask for accommodations for the upcoming promotional exam, because she doesn’t want to have her efforts diminished because she was helped. She has heard her officer talk about people who ask for accommodations for learning disorders and she recognized that he holds many of the stereotypes related to learning disabilities that she encountered growing up.

Chris’ officer has talked about people asking for accommodations as being unfair to the people that don’t get those accommodations. It makes sense to him that most of the buildings they inspect have ramps and/or elevators so people in wheelchairs can access the offices. But, he doesn’t understand ADHD or dyslexia and thinks those disorders are excuses when people fail to perform. He believes that if they just worked hard enough they could pass. He doesn’t understand the invisible disabilities and views people with visible disabilities as being less abled.

Chris’ request could go several different ways. In the scenario I just described the actual outcome was the officer refused to acknowledge her request, she tested without accommodations and did poorly. And since providing her officer with the information about her disability, he has started finding fault with her performance, when there was none before. She has tried to talk to her officer but she feels he has shut her out and she is now feeling isolated. She has contacted the EEOC to see if she can sue to force the department to provide accommodations for her disability as it falls under the definition of disability.

A more positive outcome for this scenario would have been for the officer to listen her request, and to ask questions about what her disability was and how it affected her, and how the accommodations would help compensate for the disability. He then could have made advocated with the department to make the accommodations so she would have a chance at success.

Paul has been a firefighter paramedic for 16 years. For the past year he has had his fair share if stress. He has two teen daughters, and a two year old. Money is a bit tight and his wife who also works is feeling the strain of juggling motherhood with work, and is putting pressure on Paul to do more, around the house and at work. Paul is exhausted. For some reason, the past year, Paul seems to be on every bad call. And on top of that he has been working with a partner with whom he has almost daily conflicts.

Paul hates life right now. He can't sleep, he wakes up in a sweat after nightmares he has trouble remembering, he doesn't enjoy anything. He doesn't go out with the guys from the firehouse anymore, he's not late to work but no longer comes in early, he has had a spotless record but the past year he has been talked to repeatedly about his short temper. At home, he isolates himself by sleeping late, and a never-ending list of chores he says, have to get done. But the reality is he doesn’t get much of anything done. Paul is experiencing a high level of stress in multiple areas of his life. As you may have started to realize, Paul is struggling with a number of symptoms that are consistent with depression, and PTSD.

Paul’s officer recognized that Paul was struggling with depression and/or PTSD. His officer was verbally supportive, and encouraged Paul to seek help through the EAP. Paul went to the EAP who evaluated him and referred him to a Psychologist, who diagnosed Paul with major depressive disorder and PTSD nos (which means he has some of the PTSD symptoms, but not enough to be diagnosed). The psychologist recommended medication with weekly psychotherapy, as well as a hiatus from the job. When he reported back to his officer and HR department, they were not fully supportive. They determined that his diagnosis was not enough to take any type of disability leave. They said that he could take unpaid time, but he did not qualify for disability or light duty. He can’t afford to go on unpaid leave. He now talks about how all he thinks about is quitting the job, but he can’t afford to do that nor can he retire because he does not have enough years on the job to receive his full benefits. He is currently just hanging on and is feeling more and more despair, along with feeling that he is under greater scrutiny. He does have a mental health disability, and does meet the definition set forth under the ADA definition.

These two scenarios are examples of hidden disabilities that are protected under the ADA. They also are examples of how biases about disabilities affect both the individual with the disability and those around them. For a better understanding of various disabilities and supportive attitudes and behaviors toward individuals affected by a disability access the American Psychological Association site, NAMI, the state labor and industry site, Job Accommodation Network, the Americans with Disability Act and the EEOC site. All these sites provide comprehensive information on disabilities. Some are focused more on the human interaction and psychology while others are focused on the legal aspect.

By M2 Resource Group, Inc
EMS & Fire Subject Matter Expert Witness; Litigation Support; Psychological Testing & Counseling
ABOUT THE AUTHOR: Dr. Beth Murphy PsyD
Dr. Beth Murphy, PsyD retired as a firefighter after 12 years of service to pursue and complete her Doctorate in Clinical Psychology. She is a practicing clinician with a focus on workplace stress, PTSD, Cancer Survivors and TBI. Her population focus is on police and fire agencies, as well as military personnel. Her study focus for her dissertation was women firefighters and stress. She has presented material at Washington State Psychological Association annual meeting, the International Society for Traumatic Stress Studies annual meeting, the international Association of Fire Chiefs (IAFC) and the Fire Department Instructors Conference (FDIC) on Suicide Prevention for Firefighters. She is the CEO and President in M2 Resource Group, Inc.

Copyright M2 Resource Group, Inc

Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer.For specific technical or legal advice on the information provided and related topics, please contact the author.

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