CONTEXT SEED — LONG-TERM FUNCTIONAL / PSYCHOLOGICAL / EDB JO...

Prompt

CONTEXT SEED — LONG-TERM FUNCTIONAL / PSYCHOLOGICAL / EDB JOURNEY This conversation should focus primarily on the psychological, functional, occupational, and institutional reality of my situation, and on the possibility of EDB as a sustainable endpoint. Do NOT make the financial/benefit modelling the centre of the discussion unless I specifically bring it back into the conversation. BACKGROUND I have a formal Autism Spectrum Disorder diagnosis and have been working with the same therapist since around the time of my diagnosis. She knows my history and functioning longitudinally and is now unconditionally supportive of me pursuing the EDB pathway if that is what I ultimately decide is appropriate. I am also considering/expecting discussion with my NP, who I expect may be supportive as well, although I have not yet pursued that discussion. I have a long history of working extremely hard to remain functional and employed. I am highly masking and have described myself as being able to “fake 80%” — I can often appear considerably more capable than my underlying sustainable capacity actually is. My occupational pattern over many years has repeatedly looked like: work → accumulating exhaustion/depletion → progressively worse functioning → “super crash” / burnout → serious intervention and/or leave → recovery → return to work → repeat. This is not a one-time crisis. It is a longstanding recurring pattern. THE CENTRAL FUNCTIONAL PROBLEM My current concern is increasingly about executive-function capacity and sustainability rather than simply whether I can technically perform a job. I experience significant executive-function impairment, particularly around: - task initiation; - initiating and organizing ordinary life activities; - maintaining executive capacity outside structured work; - cognitive/mental depletion; - recovery from sustained demands; - maintaining functioning across multiple areas of life simultaneously. My perception is that this has continued to deteriorate over time despite treatment. Treatment helps. I am not saying treatment does nothing. It provides meaningful benefit, but it has not stopped the underlying pattern of deterioration or restored sustainable overall functioning. The central problem is that I can push myself very hard to succeed at work while increasingly failing to function adequately in the rest of my life. The compensation strategy itself has become part of the problem. I can mobilize enough capacity to perform at work, but the cost can be that there is insufficient executive/mental capacity left for ordinary life, relationships, recovery, household responsibilities, and other non-work functioning. Eventually the depletion feeds back into work itself, causing another burnout and absence. Therefore the question I am increasingly trying to answer is not: “Can I force myself to keep working?” It is: “Can I sustainably live this way?” I am concerned that another decade of proving that I can push myself through work may simply reproduce the same cycle. CURRENT OCCUPATIONAL ENVIRONMENT I work a demanding rotating refinery/operations schedule involving 2×12-hour day shifts, 2×12-hour night shifts, followed by 4 days off. An important nuance is that my current operations role may actually be more compatible with my AuDHD functioning than some jobs that appear easier from the outside. The operations environment can provide periods of sensory and social reprieve, relative autonomy, focused work, and opportunities to regulate. Those features may be part of how I have managed to remain employed despite my difficulties. A conventional daytime/social/office environment could potentially be MORE damaging rather than less damaging because of: - continuous social interaction; - open-office or sensory exposure; - interruptions; - meetings; - task switching; - ambiguous priorities; - prolonged executive-function demands; - fewer opportunities to withdraw and regulate. Therefore “find an easier office job” is not automatically an appropriate answer to my situation. I have tried other positions and may be willing to try other possibilities again, partly to exhaust reasonable alternatives. But I also recognize that a different occupational environment could impose different and potentially greater functional demands. IMPORTANT DISTINCTION I do not want the discussion to reduce this to: “I have AuDHD, therefore I cannot work.” The important issue is functional impairment. The meaningful question is: What can I actually do, how reliably can I do it, under what conditions, for how long, and what happens to the rest of my functioning when I sustain those demands? My history suggests that I can perform at a high level through extraordinary compensation, but that this performance may not represent sustainable occupational capacity. A key concept to preserve is: ABILITY TO PERFORM ≠ ABILITY TO SUSTAIN. I can sometimes perform the work. The question is whether I can sustain employment without repeatedly sacrificing the rest of my functioning and eventually reaching another burnout/absence. EDB CONTEXT My employer's Extended Disability Benefit (EDB) is administered by Sun Life. The plan's structure is important psychologically and institutionally: - During the first 12 months, the relevant test is essentially whether impairment prevents me from performing the essential duties of my own occupation. - After 12 months, the test becomes broader: whether impairment prevents me from performing the essential duties of any job in any setting for which I am qualified, subject to the plan's applicable income threshold. Therefore I understand that the second stage is potentially the much harder institutional hurdle. I expect that Sun Life could ask why I cannot transition to another occupation if I cannot continue my current operations role. I do not want to approach that question defensively or dishonestly. I want to understand it properly. The appropriate evidence would need to focus on actual functional limitations and sustainability rather than simply diagnosis. Potentially important evidence includes: - longitudinal executive-function deterioration; - task-initiation impairment; - inability to sustain functioning across work and non-work life simultaneously; - repeated burnout/crash cycles; - repeated periods of absence/recovery; - the extraordinary compensatory effort required to maintain work performance; - treatment that helps but has not restored sustainable functioning; - the difference between short-term performance and long-term sustainability; - actual experience with different work environments/positions; - the possibility that more socially or cognitively demanding environments may be less sustainable than the current operations environment. THERAPEUTIC / CLINICAL CONTEXT My therapist has been with me since diagnosis and knows the longitudinal history. After a recent very good session, she is unconditionally supportive of me pursuing EDB if that becomes the appropriate pathway. I expect my NP may also be supportive, although that discussion has not yet happened. I want clinical support to be based on honest functional assessment, not on simply trying to obtain approval for a desired outcome. I also do not want to exaggerate or manufacture incapacity. If I am capable of something, that should be acknowledged. If I have a good day, that should be acknowledged. If I can perform something briefly but cannot sustain it, that distinction should be documented. The goal is an accurate longitudinal picture. POTENTIAL PROCESS I expect this could be a long process. There may be: - shorter TDB leaves; - treatment and reassessment; - attempts to return; - attempts to adapt work; - potentially trying other positions; - further deterioration or inability to sustain the arrangement; - eventually a longer TDB period; - EDB application/adjudication; - requests for additional medical information; - possible vocational/functional assessment; - possible disagreement about alternative occupations. I am not trying to manufacture a six-month leave merely to “test” disability. I am interested in understanding what happens if medically appropriate periods away from work reveal that my functioning does not recover sufficiently for sustainable employment. The eventual question is whether the longitudinal evidence supports EDB. THE DEEPER GOAL The desired endpoint is not simply: “Get approved for disability.” The deeper goal is to determine whether there is a sustainable life available to me that does not depend on repeatedly sacrificing my overall functioning in order to maintain employment. EDB, if medically and institutionally justified, would represent a possible endpoint to the work → depletion → burnout → absence → recovery → return cycle. The goal is not to stop contributing or to give up because work is difficult. The goal is to stop treating repeated collapse as the price of remaining employed. I want to approach this carefully, honestly, and methodically. I want to understand: 1. what my actual functional picture appears to be; 2. what evidence would demonstrate it accurately; 3. what parts of my history strengthen or weaken an EDB case; 4. what barriers AuDHD/neurodevelopmental disability may encounter institutionally; 5. how Sun Life/employer/vocational adjudication may interpret my ability to perform versus my ability to sustain; 6. what a legitimate “any occupation” analysis would look like; 7. what reasonable alternatives should actually be explored; 8. how to distinguish genuine exploration of alternatives from repeatedly forcing myself into environments that are likely to reproduce the same failure; 9. how to document the process honestly without exaggeration; 10. and ultimately whether EDB is a realistic, medically and functionally defensible endpoint. The tone should remain compassionate but intellectually honest. Do not automatically assume EDB will be approved. Do not automatically assume it will be denied. Help me examine the situation from both my lived reality and the perspective of clinicians, disability insurers, vocational assessors, and the employer. Most importantly, preserve the distinction between: - diagnosis and disability; - ability and sustainability; - occupational performance and whole-life functioning; - temporary recovery and durable capacity; - “I can push through this” and “I can live this way indefinitely.” The central question is whether continuing to force employment is actually preserving my life/functioning, or whether it is repeatedly consuming the capacity required to have a life outside work.