The percentage of psychological injuries being seen among service members returning from Iraq and Afghanistan is surpassing that of previous conflicts in our nation’s history. Post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and major depression are described as the “signature injuries” of the current conflicts. Because of the hidden nature of these injuries they can be more difficult to treat and diagnose and may remain with the veterans for the rest of their lives.1
One treatment being used to reduce the symptoms of the disorders is assisting the injured in finding employment. Research shows that employment transition assistance provided an almost identical effect on the reduction of symptoms as did medication—and without the potential drawbacks of addiction or side effects that may result.
The numbers of those transitioning out of military service with disabilities are alarmingly high. Nearly 2 million American service members have been deployed in the current conflicts and already 686,000 have transitioned out of the service. The percentage of those experiencing PTSD, depression, and TBI has grown exponentially. Improvements in body armor and medical technology, along with faster medical evacuation, have helped save the lives of many combatants. But those same advances, paired with the intense destructiveness of IEDs (improvised explosive devices), result in even more long-lasting, disabling injuries. Projections suggest that 17 to 20 percent of our veterans display symptoms of TBI. Research indicates that nearly 20 percent of those fighting in Iraq and 11 percent of combat veterans in Afghanistan are reporting mental health problems. A study by the RAND Corporation estimated that a third of all of deployed service members have PTSD, major depression, or TBI. The VA corroborates that, reporting that 37 percent of the veterans seen in VA health-care facilities following deployments have received mental health diagnoses.2
A transition to post-deployment employment can provide the following psycho-social benefits to an individual with hidden disabilities:
• Employment helps restore feelings that the veteran can master problems and cope with life’s stresses and demands.
• A job helps increase socialization and discourages withdrawal, as the individual has to report for work and interact with coworkers or clients.
• Work can provide an anchor to an individual who might be questioning the meaning of life.
• Employment provides financial benefits to the individual and society.
Barriers to Transition
Transitioning out of the military with a hidden disability likely is more difficult than it is to do so with a physical disability because of a number of barriers that surround the former. The first is the determination process for psychological disabilities. Documenting and proving the war-related nature of a psychological injury is not always easy. Documenting the symptoms of hidden disabilities is particularly arduous and ratings boards are quite cautious, wary of individuals attempting to fake the symptoms. The determination of a rating is critical because it will affect the type and amount of benefits the veterans (and family members) receive for the rest of their lives. Other benefits, such as Social Security or from a state government, also may be affected by the rating. Thus, it is not uncommon for veterans to find themselves in the position of having to challenge a VA or military disability rating in order to receive benefits.
Another barrier is the fact that people without disabilities do have fears, uncertainties, doubts, and misconceptions about all disabilities—especially hidden ones such as PSTD, depression, and TBI. That is the stigma of mental illness. One aspect of it is that non-disabled people fear they could suffer the same sort of injury and end up with that very disability themselves. Hidden disabilities are especially anxiety-provoking in that way because of the lack of understanding one may have about those illnesses, the way the symptoms may vary over time, and the discomfiting fact that the individual may look “normal” but still be disabled. The possibility that one could incur a head injury tomorrow and end up like that person (someone with TBI) can be a terrifying thought for some people. The non-disabled may choose to avoid people with those disabilities to avoid having to experience such fears.
Managers, customers, supervisors, or teachers experiencing those types of fears, uncertainties, or doubts will generally try to avoid someone with hidden disabilities and will not extend offers for employment, help them at school, or work with them on the job. It is clear that such misconceptions can affect hiring decisions: the current unemployment rate for all Americans is around 10 percent, but for people with all types of disabilities the rate is 14.5 percent.3
The numbers are much higher for those with hidden disabilities, with some reports suggesting rates ranging from 40 percent to as high as 90 percent. In a survey from the Society for Human Resource Management, for example, nearly half of the employers who responded (46 percent) said they believed that PTSD and other mental issues would be a problem in hiring veterans. Among those who actually worked with veterans, however, just 13 percent reported problems with people with PTSD in their organizations.4
In addition to those barriers, returning veterans with disabilities may also face a transition hurdle in the form of misconceptions and feelings about service members. Unlike in some past conflicts, most Americans today express support for the troops. But frequently their hiring actions belie such professions of support. Hiring managers may not understand military terminology or the military hierarchy described in a résumé. Others may have misconceptions about those who have served in uniform and how well their skills and training might transfer to the civilian environment. A hiring manager may think, say, that a transitioning Marine’s personality would be too rigid to work in a casual office environment. The manager may also have trouble looking past the Marine’s youth to see the leadership experience and technical skills the Marine gained in the Corps that go far beyond age.
In fact, concerns and misconceptions about military service in general seems to translate into lack of employment opportunities for veterans—regardless of the presence or absence of a disability. According to the Bureau of Labor Statistics, the unemployment rate in November 2010 for veterans who served in the current conflicts was almost a full point higher than non-veterans (10.0 percent to 9.1 percent).5
Overcoming Hiring Hurdles
Finding employment in today’s tight marketplace can be tough for anyone, and it can be even more difficult for veterans with hidden disabilities because of the fear, uncertainties and misconceptions about psychological disabilities and the military. But members of the military and people with disabilities can offer a number of benefits to employers. Transitioning veterans should determine what benefits they bring to the workplace, when and how to discuss those disabilities, and understand how the disabilities can be accommodated on the job. With that information in hand, an individual will be better able to address any employer’s concerns and make a stronger case why they should be hired. That process, along with a step-by-step guide to getting a job as a transitioning veteran with a disability, is described in the employment chapter in Returning Wars’ Wounded, Injured, and Ill: A Reference Handbook, a book co-edited by the author.
By virtue of having served in the military, almost every service member has, to some degree, acquired the following traits and skills: Loyalty, selflessness, respect for procedures and authority, discipline, leadership at a young age, an accelerated learning curve, training in new technology, working in teams and in diverse environments, performing under pressure, and the ability to overcome adversity. Those with military experience may regard those attributes as insignificant. They are, after all, part of everyday life, traits shared by just about everyone else in uniform. But in the private sector those traits are often not so common, and they are highly desired by business leaders and managers. Even in this tough job market managers complain about how hard it is to find people possessing those traits, and how much they want to find and hire people who have them.
Transitioning service members bring other benefits to an employer, as well. One is the government-paid relocation costs for the first transition out of service. If an employer wants a veteran to move to a new area for his first civilian job the military usually will pay for that—which could save an employer thousands of dollars. Many employers promote their hiring of veterans and people with disabilities in the media, thereby enjoying the positive public relations that derive from those policies.
Companies working to obtain federal government contracts not only appreciate the insider knowledge that a veteran may have, those contracts can contain incentives to encourage their hire. Likewise, virtually all federal jobs (and some state and local positions, too) give veterans a preference in the hiring process. Additional information about hiring people with disabilities is at www.earnworks.com. In addition, companies that hire people with disabilities and make accommodations can accrue tax benefits and credits by doing so. The IRS has a Web page relating to that at http://www.irs.gov/businesses/small/article/0,,id=185704,00.html. The more a veteran acquaints himself with such policies and procedures, and the better prepared he is to discuss them openly with a potential employer, the better his chances of landing the job.
The perceived high cost of accommodating disabilities in the workplace is often cited by employers and managers in not making job offers. But the costs are just that—a perception, not a reality. In a Department of Labor study of more than 1,000 employers that made accommodations, nearly half of them (46 percent) spent nothing on the accommodation. Of those that did spend money, the average outlay was $500. Almost all of the employers that spent money commented that the benefits and results they gained from the hire more than made up for the expense.7
A great many accommodations for hidden disabilities can be made at no cost; most involve altering a schedule, providing memory aids, or removing some distractions from the workspace. The Department of Labor site mentioned above—www.askjan.org—provides additional information in this arena. Again, a veteran should investigate potential accommodations before an interview and be prepared to discuss how inexpensive they can be for the employer. In my experience, the only real limitations in the employment of people with disabilities are in the minds of those who prejudge another’s abilities.
Determining when to discuss a disability with a potential employer can be difficult: Raise the issue too soon and the employer might be turned off before learning fully about your abilities. Raise it too late and the employer might feel like he has been set up. Although it is illegal to deny employment because of a disability, it can and does happen. And when it does, it can be very difficult to prove discrimination. Authors Dale Brown and Richard Bolles (Job-Hunting for the So-Called Handicapped or People Who Have Disabilities) have seen how disclosure can leave a candidate vulnerable to discrimination. They recommend making workplace accommodations for disabilities part of the negotiations for all aspects of the job.
In addition to discussing disabilities, transitioning veterans also often need to explain military service to prospective employers who have never served in the military and know little about it. The first place this may turn up is in writing a civilian résumé. Résumé-writing is an art and a skill that even many professional writers have trouble mastering. Someone who has been in uniform for 20-plus years may never have written a résumé. A number of books and Web sites offer sample résumés and provide guidance on writing them.
Keep in mind that military jargon, acronyms, and terminology may confuse civilian résumé-readers or interviewers. To avoid that, work with a friend or a counselor to translate your military experiences into language that a potential boss will understand and appreciate. Every military installation has a transition office, which is a good source for consultation. Similar information can be found online at www.turbotap.org or www.taonline.com. Service members also should visit the military-to-civilian skills crosswalk page at http://online.onetcenter.org/crosswalk/MOC/, which can be of help in explaining one’s military occupational classification (MOC) skills and experience in civilian terms. The Department of Labor also has veterans’ employment representatives around the country to help with the process (see www.taonline.com/VetReps).
Many transitioning veterans with hidden disabilities find that it is easier to start their own businesses rather than deal with the fears, uncertainties, and misconceptions of potential employers. Resources for entrepreneurial types is available at the Small Business Administration’s Web site for veterans (www.sba.gov/vets) and by accessing the SBA’s SCORE program—local counselors for small businesses ( www.score.org). Veterans Business Outreach Center Loans are available from the Small Business Administration’s “Patriot Express” program, http://www.sba.gov/content/express-programs.
The Stay-In Option
Throughout most of America’s military history, the idea of a badly wounded warrior going back into uniform was inconceivable. Now service members are allowed the opportunity to continue to serve, even with disabilities. That recent turnabout is due in a large part to cultural and societal changes in the military, increased interest from military and civilian leaders, the need for an all-volunteer force to fight a long and ongoing war, and new understandings of disability and improvements in accommodations technology.
Most injured veterans may not be able to return to their previous roles, but many can serve in other capacities. For those who have built their lives in the military and have strong personal connections with their branch, the opportunity to continue serving is a welcome change in policy and practice. Because of the stigma and fear of hidden disabilities, it may be difficult to gain re-entry, however, and it may involve some negotiating and even a fight to return. But with determination on the part of the veteran, and accommodations from the military as an employer, it remains an attractive alternative.
Employment can be—and in many cases should be—an integral part of the treatment program for veterans with psychological disabilities. The process of finding the right employment can be long, tedious, and at times maddening. The resources listed here can provide needed assistance, or point the way to other avenues of approach. The aim is to open doors for our nation’s wounded warriors as they make the transition into the civilian world.
1. Terri Tanelian and Lisa H. Jaycox (editors), Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery (Santa Monica, CA: RAND Corporation, 2008).
2. http://www.rand.org/content/dam/rand/pubs/reseach_briefs/2008/RAND_RB9336.pdf. Also, Karen H. Seal et al, “Trends and Risk Factors for Mental Health Diagnoses among Iraq and Afghanistan Veterans using Department of Veterans Affairs Health Care, 2002-2008,” American Journal of Public Health, 2009, 99 (9): pp. 1651-1658.
3. “Persons with a Disability: Labor Force Characteristics – 2009,” http://www.bls.gov/news.release/disable.nr0.htm
4. “Employing Military Personnel and Recruiting Veterans – Attitudes and Practices,” SHRM Poll, 23 June 2010, http://www.shrm.org/surveys
6. “For-Profit Colleges: Undercover Testing Finds Colleges Encouraged Fraud and Engaged in Deceptive and Questionable Marketing Practices,” (Washington, DC: Government Accountability Office, GAO-10-948T, 4 August 2010) http://www.gao.gov/new.items/d10948t.pdf. See also, http://help.senate.gov/newsroom/photos/gallery/?id=9d444d71-ec6e-492d-9953-082bf0ecacd6 and http://help.senate.gov/imo/media/doc/Education%20Report.pdf.
Educational Aid: Promise and Peril
Once discharged, a former service member has access to a number of benefits—many of them through the VA—to help with the transition process. Some of the benefits have time limitations, so transitioning veterans should explore the programs and benefits as quickly as possible to take full advantage of them.
The best-known of those benefits is the GI Bill. Education and training can give veterans additional tools to improve their transition into the civilian sector. Choosing this path provides access to a wide range of benefits under the GI Bill of Rights. Since its passage in 1944, the GI Bill has helped hundreds of thousands of veterans obtain college degrees, advance in their careers, and improve their lives in many ways.
The passage of the Post-9/11 GI Bill in 2009 increased the educational benefits available to veterans by helping to defray the cost of tuition and fees at a wider range of educational institutions and training providers. Educational benefits also are available through other programs, and some are even available for the children and spouse of a totally disabled service member.
Because of the kind of guaranteed income involved, many schools and training programs have made great strides in reaching out to veterans and making them feel welcome. Most of those programs are legitimate and have improved the experiences for transitioning veterans. Some colleges have hired counselors and created campus organizations to offer advice and academic guidance, often from a veteran—someone who has gone down the same path.
Many for-profit learning institutions (such as Kaplan, Strayer, or the University of Phoenix) have intensified their programs for veterans and invested heavily in recruiting them and their GI Bill benefits. Those for-profit schools have experienced enormous growth. At a time when enrollment at nonprofit and public schools is shrinking, for-profit institutions grew 225 percent to become a $29 billion industry, and now educate 10 percent of all post-secondary American students. Those schools achieved that kind of growth by offering convenient hours and options for working students (including more online and distance-learning opportunities) and focusing on providing what employers want from graduates of training programs.
The rapid growth of such programs has also generated some concerns. Some statistics suggest that students of these programs incur higher default rates on their student loans than students of nonprofit and state schools. Some of the institutions have been accused of misleading applicants as to the opportunities and salaries that are available to them upon graduation. A number of the schools are criticized for what is seen as overaggressive recruiting—the targeting of those who can least afford it—to promote over-priced programs that leave students with little to show from their classroom time except a pile of debt.6
In August 2010, Senators James Webb (D-VA) and Dick Durbin (D-IL) asked the VA and the Department of Education for detailed information on the tuition paid to those programs and the benefits veterans derived from them. The Education Department currently is considering new “gainful employment” legislation that will cut off federal aid to education programs with high student-debt levels and poor loan-repayment rates.
The for-profit education programs may offer an attractive and affordable road for veterans to obtain an education conveniently and effectively, but anyone interested in any school or training program should remember the Latin caution “caveat emptor”—let the buyer beware. Conduct due diligence on any program (and competing programs) before signing up with a college or training program. Collect as much factual information (not marketing materials) about the costs, graduation rates, and career placement on every program that sounds appealing. If possible, compare a program that sounds promising with similar programs at other schools, if others are available in the area: Studies of for-profit, nonprofit, and state schools found a great variety of costs for the same types of programs or degrees in the same area.
Returning veterans with disabilities who have an interest in advancing their education can also receive help in accommodating those disabilities—even hidden disabilities—in the classroom. Most college campuses are disability accessible because of federal law. Most campuses have student services to help someone with disabilities navigate through the campus and its resources. The Association on Higher Education and Disability (www.ahead.org) is the central clearinghouse of information for those offices. The Job Accommodation Network (www.askjan.org) can also provide guidance and suggestions on dealing with disabilities in the classroom and on campus.