“Is a psychological disorder the same as a psychological disability? Is it not possible to have a disorder and not be disabled?”
Unquestionably. Under the Americans with Disabilities Act, the following psychological disorders are considered potentially disabling conditions:
- Major Depressive Disorder
- Bipolar Disorder (Cf. Manic Depressive Disease)
- Panic Disorder
- Obsessive Compulsive Disorder
- Schizophrenic Disorders
- Personality Disorders
- Drug and/or Alcohol Abuse Recovery
Under the Americans with Disabilities Act, the following psychological disorders are not considered potentially disabling:
- Disorders of Sexual Behavior
- Compulsive Gambling
- Current Drug and/or Alcohol Abuse
The disorder is considered disabling if it interferes with major life activities such as learning, concentrating, performing manual tasks, or interacting with others. The employer may ask for medical documentation of the disorder for purposes of disability determination. Employers may discipline a worker for violating workplace policy even if the misconduct is related to the individual’s disabling psychological disability.
Research in social and organizational psychology at Temple University indicates that the presence of a psychological disorder does not necessarily imply a disability. That is, many individuals with psychological disorders within the categories considered potentially disabling are, in fact, able to work, work effectively, and do not require a change in workplace accommodations in order to function.
Among the changes to accommodate psychological limitations are:
- Leaves of absence
- Change in work hours to accommodate treatment
- Physical modification of the workplace such as soundproofing, etc.
- Job reassignment
Arguably, one of the complicating factors in determining the disabling impact of a psychological disorder is that of motivation. There are compensated schizophrenic individuals who very much want to be part of the workforce if they can be assured access to see their doctors for medication and psychotherapies. Additionally, many depressed individuals are decidedly less functional when not exposed to productivity, daily variation in schedule and social interactions that the workplace permits. Conversely, there likely will always be individuals who seek to avoid work and other responsibilities of life. Ultimately what must be determined is the fine discrimination among the existence of a mental disorder, its disabling impact and whether removal from the workforce is facilitative of recovery or perpetuating of dependency.
In those cases in which the individual is concurrently dealing with a physical disorder, the psychological complaints may arise not only as a consequence of the physical complaints but as an expression of fear regarding the chronicity of complaints.
The individual may fear:
- worsening of their physical condition,
- that their physical complaints are not seen as severe as the patient feels them to be, or
- that the physical complaints are inaccurately diagnosed and
- that a return to the workforce will impede any further attention to these physical complaints.
The concept of disability becomes not only social and cultural but based upon the individual psychological factors which operate on the specific patient.
Dr. David B. Adams is the clinical director of Atlanta Medical Psychology and is in his 24th year of clinical practice, diagnosing, treating, and providing 2ndOpinions on disorders resultant from and contributing to work-related injuries, including anxiety, mood and somatoform disorders. Dr. Adams is a Fellow of the American Psychological Association, the Academy of Psychosomatic Medicine and the American Academy of Pain Management. Licensed in Pennsylvania, Florida, North Carolina and Georgia, Dr. Adams is the author of greater than 70 scientific articles and textbook chapters on the interaction between psychological factors and work-related injuries. He is the Executive Director of the American Academy of Doctors of Psychology, an international search engine of psychologists. Dr. Adams delivers a weekly seminar to physicians, nurses, employers, insurers, and attorneys on the psychological aspects of disability management. Dr. Adams can be reached at 404.252.6454 (E-Mail: firstname.lastname@example.org)