Returning to Work After a Brain Injury

Finding the right type of employment is key

It may take time, but many people living with brain injury can find their first job or return to work and have fulfilling careers. Talking to your or your loved one’s medical professional about starting or getting back to work is a good place to start. Medical professionals can fill out a form with Instructions on Return to Work. They may also refer you to a brain injury professional who can do tests to assess what type of employment may be a good fit for you or your loved one based on personality, skills, abilities, and interests. Many rehabilitation facilities (particularly transitional or community reentry programs) can help share employment options and help you build skills to enter or re-enter the workforce.

Below are examples of tools that may be useful. In general, these tests may help you decide if you are ready to work, as well as what types of jobs may best fit your personality, skills, abilities, and interests.

• Vocational Evaluation and Assessment: This process helps us understand if a person is ready to work after a brain injury. It looks at a person’s skills, interests, and abilities to find jobs that may be a good fit.
• Neuropsychological Assessment: This evaluation looks at how a brain injury may affect thinking, emotions, and behavior. It helps identify changes in memory, attention, problem-solving, and communication that can affect work-related activities.
• Functional Capacity Evaluation: This assessment measures a person’s physical abilities, such as lifting, standing, and moving. It helps determine what types of work tasks they can safely do.
• Job Analysis: This looks at the specific demands of a job and compares them to a person’s current abilities. It helps identify needed supports or ways to safely return to work.

Re-entering the workforce after a brain injury is different for each person

Your or your loved one’s ability to return to work depends on many factors, including:

• Severity of the injury and symptoms
• Tasks you are required to perform as part of a job
• Types of symptoms you are experiencing

Some people with a brain injury can return to work within a couple of days of their injury and may only need short-term support or accommodations during their recovery, like rest breaks during the day or earplugs to limit sensitivity to noise. Others may need weeks, months, or longer before returning to work. Some people may not be able to return to work (or the same type of employment) due to long-term disability or ongoing symptoms.

You may need more time off if a job requires:

• Working from heights, including climbing a roof or ladder, or the risk of falling
• Exposure to explosions, blasts, or projectiles
• Intense physical activity, such as running and heavy lifting
• Attention or concentration
• Driving
• Operating machinery or heavy equipment
• High-stress or safety risks, such as work with hazardous materials

These activities may make your symptoms worse or increase the chance of another brain injury during recovery.

Medical professionals may recommend that employers make changes to an employee’s tasks or schedule during their recovery. Examples include:

• Rest breaks, shortened work schedule, or a later start time
• Time to take short walks or other similar, light physical activity
• Temporary transfer to a position with tasks that don’t worsen symptoms
• Access to sunglasses, earplugs, or headphones if bothered by light or noise
• Reduced driving or physical activity
• Extended time to complete tasks
• Reduced screen time, such as on computers and tablets
• Limited or no use of machinery or heavy equipment
• Access to assistive technology to help perform tasks, like screen reading and magnification software

There are a few things to consider when asking for workplace accommodations.

While your medical professional may recommend an accommodation to help you return to work, under the Americans with Disabilities Act (ADA), only employers who have 15 or more employees are generally required to provide what are considered “reasonable” accommodations. Even so, some state and local laws may also require that employers with fewer employees provide reasonable accommodations. ADA considers a reasonable accommodation as:

“Any change to the application or hiring process, to the job, to the way the job is done, or to the work environment that allows a person with a disability who is qualified for the job to perform the essential functions of that job and enjoy equal employment opportunities.”

An employer is not required to put accommodations in place that may cause harm or challenges to the company or business. To set up reasonable accommodations, your loved one would need to:

• Share information about their disability with their employer. You can use this sample letter to help you get started. Your employer may request documentation about your disability from a medical professional, along with examples of requested accommodations.
• Send an email to their employer to request accommodations under the ADA. Providing examples of requested accommodations is recommended. In response, an employer may request documentation about their disability from a medical professional.

When possible, you and your employer should work together to develop a plan for accommodations that meets your needs. Check out additional advice from the ADA National Network and the Model Systems Knowledge Translation Center on workplace accommodations.

There is support available to help plan for your first job

Under the Individuals with Disabilities Education Act (IDEA), children living with disabilities who are age 14 are eligible to receive a plan from their school that helps them prepare for life after graduation. For some, this may mean planning to attend college, while for others, the plan may focus on helping them enter the workforce.

Reach out to organizations and people who have experience to help you through this process

Navigating the return-to-work journey after a brain injury can be overwhelming, but there are many resources available to help.

• State Vocational Rehabilitation (VR) Agencies: These programs are funded by both federal and state governments and help people with disabilities prepare for, find, and keep employment. They offer a range of services, including vocational evaluations, job coaching, and help with job placement. Find a VR agency in your state.
• The Job Accommodation Network (JAN): JAN is a free resource that provides expert guidance on workplace accommodations and disability employment issues. They can offer advice on specific accommodations that can help a person with a brain injury succeed in their job.
• Support Groups: Connecting with others living with a brain injury can be incredibly helpful. Support groups provide a safe space to share experiences, learn coping strategies, and receive emotional support from people who understand the challenges.

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

Contact the National Brain Injury Information Center at 1-800-444-6443 to speak to a specialist about:

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