Wounded Warriors in Higher Education

Presentation for Postsecondary Institutions

U.S. Department of Education

Office for Civil Rights

Washington Association on

Postsecondary Education and Disability

April 20, 2011

Office for Civil RightsU.S. Department of Education

This presentation provides general information and does not represent a complete recitation of the applicable law and OCR policy in this area.

It does not address specific issues of compliance because determinations of

compliance depend on specific facts on a case-by-case basis. The language used in these slides is approved for the purposes of this

presentation only and should not be used for other purposes.

Lives of Hope, Promise, and Dignity

They’ve served their country with honor. Now what?

• Going to college may be the next step in their transition.

• You can honor these heroes by helping them understand that their new disabilities don’t have to get in the way of a college education.

Educational Benefits

• Every year, hundreds of thousands of American warriors use the Montgomery G.I. Bill and other benefit programs to help pay for college.

• Qualifying for these benefits is an inducement for volunteering for military service.

• For more information, see www.gibill.va.gov/GI_Bill_Info/benefits.htm

Educational Benefits

• Over 1.5 million American warriors have earned these benefits in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF).

• Many have been wounded.

Our Role as OCR

• Among other things, OCR is responsible for ensuring that colleges afford everyone an equal educational opportunity without regard to disability.

• A wounded warrior may be a person with a disability entitled to protection under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act, both of which OCR enforces.

Your Role as College Representatives

• Colleges may be unaccustomed to serving the large numbers of warriors with disabilities arising from OEF/OIF.

• Warriors with disabilities may be confused about the differing disability evaluation systems of the military, VA, and colleges.

• You can help by providing accurate information at critical points to ensure warriors with disabilities have the maximum opportunities to pursue their education.

Key Considerations re Wounded Warriors

• They often are:– New to their disabilities, without prior history

of IDEA/Sec. 504 eligibility.– Unaware of rights and procedures.– Unaware of how to overcome barriers.– Lacking information from high school about

disability or accommodations.

More Key Considerations re Wounded Warriors

• Psychological processes for accepting disability status may take time.

• Given their military background, some warriors may equate disability with “weakness.”

Demographics of Wounded Warriors from OEF/OIF

• Most are male

• Most are under 25 • Most are enlisted personnel: E-1 to E-4

(e.g., Army private to Army corporal or specialist)

• Injury survival rate of approximately 91%

Warriors with Disabilities

• Not all “wounded warriors” are people with disabilities under Federal disability rights laws.

Relevant Disability Rights Laws

• Section 504 of the Rehabilitation Act of 1973

• Titles II and III of the Americans with Disabilities Act of 1990

• Fair Housing Act

Section 504 and the ADA:Whom does the law protect?

• A person with a disability is one who:– Has a physical or mental impairment that

substantially limits a major life activity

or– Has a record of such an impairment

or– Is regarded as having such an impairment

Service-Connected Conditions

• If a mental or physical impairment acquired during OEF/OIF substantially limits one or more major life activities, and it is not a temporary condition, the impairment is a disability.

Examples of Service-Connected Conditions

– Loss of limb

– Severe burns

– Post Traumatic Stress Disorder (PTSD)

– Traumatic Brain Injury (TBI)

– Blindness, low vision

– Deafness, hard of hearing

– Polytrauma (any combination of the above)

– Substance abuse (§504/ADA do not protect current users of illegal drugs)

Multiple Disabilities are Common

• Injuries/disabilities are a complex mix of co-morbidity.– One survey demonstrated that 44% of soldiers reporting

loss of consciousness associated with combat injuries (4.9% of the whole survey cohort) met the criteria for PTSD

– The presence of TBI is strongly associated with the presence of PTSD

– Some have multiple incidents of TBI– Substance abuse often occurs along with other

conditions, like TBI

Military and VA v. § 504 Coverage

• The standards used by the military in determining disability for separation and benefit purposes, as well as the standards used by the VA to review disability claims, are different from the definition of disability in Section 504 or the ADA.

Definitions of Disability

Military VA ADA / § 504A service connected, physical (or mental) impairment which renders a member unfit to perform duties of the assigned military specialty

A mental or physical disease or injury resulting from or aggravated by military service.

1. A physical or mental impairment,

2. A history or record of such an impairment, or

3. Regarded by others as having such an impairment.

How is disability measured?

Military VA ADA / § 504Present level of severity in terms of impact on present military specialty and being unfit for duty

Whether the disease or injury affects a person’s ability to seek or engage in work. (unrelated to performance of military duty)

Whether the impairment substantially limits one or more major life activities of the individual.

How is disability measured?

Military VA ADA / § 504Present level of severity in terms of present military specialty – uses VASRD* -- must have a rated impairment and be unfit for duty

*VASRD-VA Schedule For Rating Disabilities

Rating schedule used to assign a percentage of disability based upon the impact of the disease or injury on a person’s ability to work. (i.e. , totally disabled, 70% disabled or 30% disabled) (based on VASRD)

Impairment must substantially limit a major life activity (ex:, caring for one's self, walking, seeing, hearing, speaking, working).

A person is either “disabled” or not – no percentages.

Is treatment of temporary impairments by Military, VA, and ADA different? YES!

Military VA ADA / § 504Temporary Disability Retired List for soldiers rated at 30% or more and impairment is too unstable for rating purposes—can be retained on TDRL for up to 5 years

Disability does not have to be permanent. Rating will change in time as a person’s condition improves/ worsens. Temporary condition resulting from military service may be a disability

Temporary conditions are generally not protected. Impairments that are episodic or in remission are protected if the condition would substantially limit a major life activity when active. The “regarded as” prong does not apply to impairments that are “transitory and minor.”

Accommodations – Basic Principles

• Colleges and students should use an interactive process to determine appropriate accommodations that meet students’ individual needs.

• Accommodations must be provided in a timely manner.

Accommodations

• Academic adjustments

• Other reasonable modifications to policies and practices

• Auxiliary aids and services

• Architectural solutions

Scope of Wounded Warriors’ Needs

• Wounded warriors may need accommodations in one area but not in others.

– Ex: A wounded warrior may not need any academic adjustments, but if he or she uses a wheelchair, physical access to a building or program access may be needed.

Some Typical OEF/OIF Disabling Conditions

Post Traumatic Stress Disorder (PTSD)

• PTSD is an anxiety disorder that develops in response to exposure from witnessing life threatening event(s) and feeling helpless or hopeless.

PTSD

• Wounded warriors with PTSD may experience “intrusive,” “hyperarousal,”and “avoidant” symptoms.

• Intrusive symptoms may include flashbacks and bad memories.

• Hyperarousal may include sleep disturbances, intrusive symptoms, and hypervigilance.

• Avoidant symptoms may include, poor concentration and memory, depression, self-imposed isolation or detachment, restricted emotions, and limited interest in popular activities.

Possible PTSD Academic Adjustments

• Reduced course load / early registration• Extra time for exams and assignments• Notetakers• Distance learning• Flexible attendance policies• Modified housing arrangements / tolerance

of unconventional sleeping & awakening hours

PTSD – Possible Approaches to Help Warriors

• Consider establishing:– Coordination between the campus and local mental

health resources, including the VA– Coordination with the VA on documentation needs– A transition back-to-college program run by the VA,

Disability Services Office (DSO), and the Veterans Service Office (VSO)

– A program to reduce drug and alcohol abuse among those with PTSD

– A wounded warriors support group

PTSD – Possible Approaches to Help Warriors

• Think about providing:

– Preplanned “safe places” for those with PTSD to go when they are experiencing an anxiety attack.

– Training for campus medical and security staff on PTSD.

Traumatic Brain Injury (TBI)

• Traumatic brain injury (TBI), occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.

• TBI has come to be known as the signature injury of the global war on terrorism, due to “blast injuries” such as those caused by the heavy use of improvised explosive devices (IEDs).

TBI

• In OIF and OEF, trauma to the brain is most likely to be the result of a blast injury or recurring smaller blunt force or penetrating insults to the brain, including burns and asphyxiation.

• TBI may have physical effects, behavioral effects, and cognitive effects which require accommodation.

TBI• Physical effects may include: headache, dizziness,

impaired vision or hearing, noise and light sensitivity, and fatigue.

• Behavior effects of TBI may include: impulsivity, lack of inhibition and motivation, difficulty in starting and completing projects.

• Cognitive effects of TBI include: slow information processing, poor attention span, easy distractibility, and difficulty shifting between tasks.

TBI

• Depending on the site and nature of the trauma to the brain, TBI may also manifest itself with serious mobility (gross or fine-motor skills) and sensory (vision, hearing, etc.) limitations and challenges.

TBI – Possible Approaches to Help Warriors

• Consider partnering with your local VA to offer classes teaching better use of:– technology such as PDA’s to stay organized– daily to-do lists– calendars – breaking large projects down into a series of

deadlines– coordinating and communicating with teachers

about deadlines

Acquired Deafness or Hearing Loss

• Common causes of acquired deafness or hearing loss among wounded warriors include:

– Blast injury to the ears or brain from IEDs and other combat-related sources.

– Use of firearms, tanks, etc.

Acquired Deafness or Hearing Loss

• Wounded warriors with hearing disabilities may need accommodations such as captioning on educational videos.

• Under Title II of the ADA, public colleges must give “primary consideration” to the requests of those with hearing disabilities when determining what types of auxiliary aid and services are necessary.

• Wounded warriors may not be familiar with American Sign Language (ASL) and may prefer other methods of communication.

Acquired Deafness or Hearing Loss

• Communication preferences of wounded warriors will vary by each individual’s degree of impairment and also by the setting and may include:– CART (Computer Assisted Realtime Transcription).

– Assistive listening devices for individuals who would benefit from amplification.

– Trained note takers.

Acquired Deafness or Hearing Loss

• Access to technology presents a different set of needs:– Distance learning may require captioning– Videotape or movie presentations may require

captioning– Alarm systems will need to meet architectural access

and safety code standards for persons with hearing impairments

– Auditory-based telecommunications systems such as telephone/voicemail may need TTY and text/graphic computer based alternatives

Acquired Deafness or Hearing Loss– Possible Approaches to Help Warriors

• Establish a campus support group to aid with challenges posed by acquired deafness.

• Offer opportunities for newly deaf individuals to interact with other deaf individuals and the hearing population.

Acquired Blindness or Low Vision

• Can come from blast injuries, brain trauma, or other causes.

Acquired Blindness or Low Vision

• Warriors who acquire blindness as adults may not know Braille and may have difficulty navigating their environments using tactile data and/or with nonvisual cues to achieve independence.

Acquired Blindness or Low Vision

• In addition to auxiliary aids, wounded warriors with acquired blindness or low vision may need many common accommodations such as extra time on exams.

• Again, under Title II, public entities must give “primary consideration” to the requests of the wounded warrior with a visual disability in determining what types of auxiliary aid and services are necessary for that student.

Acquired Blindness or Low Vision

• Potential auxiliary aids for wounded warriors who are blind or who have low vision: – Enlarged and high contrast print (note: low contrast may be

preferable for others, depending on nature of low vision)

– Colored overlays

– Audio books

– Readers or computer equipment to read written materials aloud.

Acquired Blindness or Low Vision

• Aids to mobility:– Reasonable service animal requirements– Detectable warning surfaces whenever required

for safety– Emergency evacuation planning, to the extent

done for others

Acquired Blindness or Low Vision - Possible Approaches to Help Warriors

• Consider offering special tours and orientation sessions for wounded warriors with vision impairments, though they may voluntarily choose to attend ‘standard’ tours and sessions instead.

• Think about offering wayfinding assistance, including tactile maps of evacuation and common routes.

• Think creatively about using new technologies, including talking landmark or global positioning systems for campus orientation.

The Built Environment for People with Mobility Disabilities

• In addition to classroom buildings, pay attention to the architectural accessibility of:– Housing– Assembly areas such as stadiums and

auditoriums

Mobility Disabilities - Housing

• If your college provides campus housing for students, it must provide comparable, convenient, and accessible housing choices to students with disabilities at the same cost as is available to others.

• Remember all areas -- consider bedrooms, kitchens, bathrooms, common spaces, etc.

Mobility Disabilities – Possible Approaches to Help Warriors

• Proactive steps– Addressing barriers without waiting for

complaints to be filed– Updating self-evaluation and transition plans to

identify and address barriers

Polytrauma

• Some wounded warriors will have “polytrauma” diagnoses. They will have multiple serious disabilities, sometimes including TBI, PTSD, amputations, hearing or vision loss, or severe burns.

• Colleges may need to be creative working with the polytrauma-wounded warriors to craft appropriate accommodations.

Personal Care Attendants

• Personal care attendants may be necessary to permit the wounded warrior’s full participation in college programs.

• Colleges are not required to pay for, assist in locating, or coordinating financial arrangements for personal care attendants.

Personal Care Attendants

• The VA, as part of its pension program, offers an Aid and Attendance benefit to help pay for personal care attendants for service members. In order to receive a pension from the VA, a service member must be 65 or older, or if under 65, permanently and totally disabled.

– This benefit is additional money for wounded warriors “who require the aid of another person in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting himself/herself from the hazards of his/her daily environment”

– It is also available to blind warriors and some with low vision.

Personal Care Attendants – Possible Approaches to Help Warriors

• Consider assisting wounded warriors in locating attendants.

• Think about assisting wounded warriors to prepare paperwork to qualify for VA financial support for attendant.

• Create appropriate on-campus housing policies for students with disabilities who have attendants.

Personal Care Attendants – Possible Approaches to Help Warriors

(continued)

• Consider:– Providing orientation for attendants on college

policies and expectations with regard to attendants and students with disabilities.

– Providing orientation for attendants on campus resources for medical emergencies.

Outreach to Wounded Warriors –Possible Approaches to Help Warriors

• Think about stepping up your on-campus voluntary outreach efforts to wounded warriors.

• Disability Service Offices can explore coordinating with campus Veterans Service Officers.

Outreach to Wounded Warriors –Possible Approaches to Help Warriors

• Consider implementing a wounded warriors outreach plan for the campus, bringing together:– VSO– DSO– Financial aid counselors– Admissions counselors– Wounded warriors support group members

Outreach to Wounded Warriors –Possible Approaches to Help Warriors

• Think about working with additional off-campus contacts, including:– Local\County Veterans Service Officer – Local VA– Local Vocational Rehabilitation Office– U.S. Department of Labor’s Transition Assistance

Program (TAP) vendor, such as an employment development agency

– Governors’ programs– Local military bases and family service centers

Other Outreach to Wounded Warriors –Possible Approaches to Help Warriors

• Consider inviting VA clients:

– to take “field trips” to your campus.

– to join adapted/accessible intramural athletic activities.

Other Possible Approaches to Help Warriors

• Consider offering faculty in-service and support about:– Common OIF/OEF disabilities.– How warriors view themselves and their

disabilities.– Available community resources.– Creative ideas to make the campus experience

successful.

Other Possible Approaches to Help Warriors

• Think about establishing a feedback system:

– A way of assessing whether wounded warrior’s challenges have been met and overcome.

– A network for warriors to raise and resolve common concerns with the college.

Contact Us

Office for Civil Rights

U.S. Department of Education

915 Second Avenue, Room 3310

Seattle, WA 98174-1099

Telephone: (206) 607-1600

TTY: (206) 607-1647

E-Mail: ocr.seattle@ed.gov

Website: www.ed.gov/ocr