At a recent weekly staff meeting, human resources manager Zetta Ferguson noticed that one of her employees wasn't sitting at the conference table.
She encouraged the employee who was sitting against the wall, Corey Michael McGee, to join the rest of the group at the table, but he declined. After the meeting, McGee explained: "I sit against the wall where I'm safest. Or in my mind I feel I'm safest."
An Army veteran who was struck by an improvised explosive device and gunfire in Fallujah, Iraq, McGee says post-traumatic stress disorder and some remaining effects of his injuries stay with him in some ways in the workplace, but "it's gotten a lot better over the years."
Many employers have not delved deeply into how they might address PTSD, a relatively new issue, but they could face it more frequently as more veterans return to the workforce.
About 2.4 million members of the military have been deployed in the past decade in Iraq and Afghanistan, and tens of thousands are returning home. The influx is expected to continue until 2016.
The U.S. Department of Veterans Affairs estimates as many as 11 percent of veterans of the war in Afghanistan and 20 percent of Iraqi War veterans are afflicted by PTSD, which can generate both sympathy and fear.
Employees with the disorder may face problems arising from anxiety or have limited ability to perform certain tasks. At the same time, some employers may overreact, and veterans often don't want employers or co-workers to assume they have a condition resulting from combat.
Ferguson, an HR manager at the Atlanta Veterans Affairs Medical Center in Decatur, Ga., is experiencing the challenges firsthand. It sometimes takes creativity to address McGee's needs while capitalizing on his strengths and maintaining his privacy, she said. She decided, for example, to invite employees to sit wherever they wanted to avoid singling McGee out.
"Nobody wants to feel like they don't fit in," said Ferguson, a veteran herself.
PTSD can often rise to the level of a disability protected under the Americans with Disabilities Act, which calls for employers to make reasonable accommodations for employees to do their jobs, said Jennifer Sandberg, a partner at labor and employment law firm Fisher & Phillips. Administrative charges of PTSD discrimination filed under the ADA totaled 593 in fiscal year 2011, and have increased every year since 2006, according to data from the U.S. Equal Employment Opportunity Commission.
Some who suffer PTSD have problems with memory, concentration, organization or sleep — all of which can affect their work, according to a Department of Labor website for employers.
PTSD affects about 7.7 million adults, according to the National Institute of Mental Health.
A variety of accommodations can help people with PTSD, including flexible work schedules, schedule reminders and checklists, rest breaks or white noise machines, according to America's Heroes at Work, a Department of Labor website that addresses employment challenges of returning veterans with traumatic brain injury and PTSD.
"We want to make sure we return the favor, basically the debt that we owe to them to help find them placement in the workforce — give them all the tools that they need and assist them," Georgia labor commissioner Mark Butler said.
Leander Hines, a reservations agent for Atlanta-based Delta Air Lines, has a service dog he brings into work that serves as a medical alert dog and helps him with PTSD.
A retired Army criminal investigator, Hines says he suffered a traumatic brain injury from an IED explosion more than five years ago.
At Delta's reservations center in Dallas-Fort Worth, "when I'm on the phone with somebody that's just negative, she'll stand up under my desk and I'll just realize that I need to step back," Hines said. "She knows that I'm angry, so she'll pretty much turn a circle and jump up on me, redirect me."
Atlanta VA medical center trauma recovery program director Bekh Bradley said employers should not assume veterans have PTSD.
"No veteran wants to come in under suspicion that because they're a veteran they have PTSD," Bradley said.
He encouraged employers to learn more about PTSD. Though some people affected by PTSD may worry that they'll be seen as "crazy," "they're really not crazy — they're just having a response that is not adaptive to their current environment," Bradley said.
He said some veterans may go out of their way to avoid traffic because in combat they learned to be very cautious about things on the side of the road that could be improvised explosive devices.
Many companies don't have specialized programs to address PTSD in the workplace and depend on existing resources such as employee-assistance programs to help.
An employee is not required to disclose any disability to his or her employer, Sandberg said. But some employers become too anxious about the possibility of an employee with PTSD, she said.
"What is typically a challenge for employers is that they worry this person might be violent when that might not be the case at all," Sandberg said. "Don't assume the worst and try to take action when you've had no signals" that cause concern.
And even when there are employees with PTSD, it's probably not a good idea to tell other employees unless there is a business reason, Sandberg said.
Ferguson, who has plenty of exposure to veterans while working at the VA, said rushing to conclusions about veterans with PTSD can get employers in trouble. "Could a vet with PTSD go off? Of course," she said. "Could a non-veteran go off? Of course."