Public Safety Professionals and Brain Injury

With proper care and management from a medical professional, most public safety professionals recover well and return to their regular duties following a traumatic brain injury (TBI). However, for some officers, TBI symptoms can last for months or years—affecting their ability to return to duty.

Accommodations and education on TBI may help with recovery

Medical professionals have treatments available to help support an individual’s recovery from a TBI. They can also provide a handout with instructions on accommodations that may help with a public safety professional’s return-to-duty. Suggested accommodations from a medical professional might include limited time driving (especially within the first few days) and avoiding intense physical activity. TBI symptoms often change during recovery. A medical professional should adjust an individual’s accommodations as symptoms improve or if new symptoms appear during their recovery.

Return-to-duty may be a gradual multi-step process

Public safety professionals are often involved in intense physical activity, operating vehicles, and high-stress situations. These activities may worsen TBI-related symptoms and increase the chance of another TBI. To help public safety professionals return to duty safely, experts from Ohio State University have created a multi-stage return-to-duty protocol that medical professionals can use for public safety professionals recovering from a TBI.

Graduated TBI Return-to-Duty Protocol

Stage 1: Relative Rest

• Light physical and leisure activities that do not make symptoms worse
• No work
• No exercise or physical training
• No weapons fire
• No driving

Stage 2: Symptom-Limited Activity (e.g., light duties)

• Increase physical and cognitive activities that do not provoke symptoms (e.g., take a walk, light reading/computer work as tolerated)
• No work
• No resistance or defensive tactics training or weapons fire
• No driving until dizziness or visual symptoms have resolved

Stage 3: Light activity (Public safety professionals can return to work at this stage with symptom-based limitations)

• Increase physical activity (e.g., longer walks, elliptical, or stationary bike) and work with symptom-based limitations
• No alternating shift work or shifts exceeding 8 hours
• No resistance or defensive tactics training or weapons fire

Stage 4: Moderate activity

• Increase physical activity (e.g., running, resistance training as tolerated) and work-related duties (e.g., technical reading, computer work, cleaning weapons)
• No alternating shift work or shifts exceeding eight hours
• No defensive tactics or weapons fire

Stage 5: Intensive activity (Public safety professionals can undergo return-to-duty screening with a medical professional)

• Participate in normal training activities within a supervised environment
• No alternating shift work or shifts exceeding 8 hours

Stage 6: Return to full duty when approved by a medical professional

It is important that a public safety professional does not speed through a Return-to-Duty Protocol. Medical professionals will generally move an individual to the next stage when they do not have any new symptoms at the current stage. If symptoms worsen or new symptoms arise, a medical professional will advise on whether to stop at the current stage of the protocol or move down to the previous stage.

Where to find care after a TBI

Some individuals may need weeks, months, or longer before they are able to work. Others may not be able to return to work due to long-term disability or persistent symptoms. Explore our resources for living with a brain injury.

Compassionate answers. Real support. Every step of the way.

Contact the National Brain Injury Information Center at 1-800-444-6443 or braininjuryinfo@biausa.org to speak to a specialist about:

• Help with care needs
• Legal and financial resources
• Services in your community