Symptoms of Substance Abuse/Chemical Dependency:

Smell of alcohol on breath or in perspiration
Red-faced and/or prominent capillaries over cheeks and nose
Bloodshot and/or glassy eyes, excessive use of eye drops to conceal it, wears sunglasses indoors
Constricted or dilated pupils
Sweating when otherwise comfortable
Self-medicating, has medical problems and does not seek help, but rather treats self
Memory lapses, can’t account for whereabouts
Slow, slurred, or pressured speech
Avoids close contact or interaction with others, avoids eye contact
Lying
Erratic behavior patterns, mood swings, inappropriate affect (laughing when others are crying)
Tremors, hands shake
Does not answer when on call or does not return pages
Misses work frequently or is late frequently
Defensive and/or minimizing regarding alcohol and/or drug consumption, denial
Persistent financial, marital, or familial problems
History of alcohol or substance abuse in family
Excessive use of fragrance and/or breath spray to conceal substance use
Possession of alcohol or drugs at work (in desk, purse, locker)
Alcohol in car or empty alcohol containers in car on a regular basis
Known to frequent bars/clubs on a regular basis
Frequently associates with known alcohol or substance users/abusers
Low or elevated self-esteem
Poor impulse control, hasty, impatient
Easily agitated, irritable

Psychiatric Conditions:

Self-medicating, has medical problems and does not seek help, but rather treats self
Erratic behavior patterns, mood swings, inappropriate affect (laughing when others are crying)
Low or elevated self-esteem
Poor impulse control, hasty, impatient
Easily agitated, irritable
Psychosomatic, hypochondriasis
Paranoia
Insomnia, hypersomnia
Anxious
Depressed, flat affect
Manic affect
Distorted thinking, delusional, hallucinations, disconnected thoughts
Isolative, withdrawn
Denial, minimizes having problems
Suicidal ideation or previous attempt
Pattern of extreme risk-taking behavior
Misses work frequently or is late frequently
Reputation of bizarre or otherwise extreme behavior
Passive-aggressive and/or manipulative behavior

Disruptive Behavior

Abrasive interpersonal style of interaction
Passive-aggressive and/or manipulative behavior
Appearance of never being happy or satisfied
Apathetic, pessimistic, believes things will never improve
Bizarre, unusual behavior
Often grandiose, elevated self-esteem
Is threatening, verbally abusive
Often overreacts
Very low tolerance for others, while expecting others to have great tolerance for him/her
Often acts with disregard for rules and consequences, feels entitled to do so
Often complains and is often complained about to authorities for rude or otherwise unacceptable behavior
Denies wrongdoing and refuses to make changes in behavior

Physical Limitation

Appears unable to see when others have no difficulty
Weak or restricted grip (hand shake)
Tremors, hands shake, deterioration of fine motor skills
Unsteady gait
Frequent loss of balance, diminished equilibrium
Cannot raise arms above head, bend and touch toes, etc
Muscle, bone, nerve or tendon damage

*Any of these symptoms alone do not constitute impairment, but when taken in combination can be a reliable indicator.  Patterns of behavior are what is important, not single, isolated events or episodes, unless they are so extraordinary that they endanger the professional or others.  Also, it is not uncommon for a professional to simultaneously have more than one impairment type.