Returning to Work After Brain Injury: What to Expect & How to Prepare

Returning to work after brain injury may require relearning skills necessary to meet job demands and acclimating to the work environment. While this can take time, with the proper support and preparation survivors can achieve their goal of returning to their occupation more swiftly.

There are also various employment rights and benefits provided to individuals with disabilities or special needs to help make their return to work after TBI a smoother process.

This article will discuss helpful tips for returning to work after brain injury and how to access employment benefits to ensure a smooth transition.

Please use the links below to jump directly to any section.

• How can a TBI affect the ability to work?
• Helpful tips for returning to work after brain injury
• Understanding employment rights
• Accessing disability and social security benefits

How Can a TBI Affect the Ability to Work?

The return to employment after brain injury is a unique process for every survivor. The physical, cognitive, and behavioral secondary effects of TBI vary greatly. Depending on the type and severity of these effects, it may take survivors some time to learn how to manage them effectively to meet the demands of a specific job.

Some secondary effects of a TBI that can interfere with employment include:

• Muscle weakness
• Fatigue
• Vision impairments
• Lack of coordination
• Foot drop
• Behavioral problems, such as aggression
• Challenges with emotional regulation or personality changes
• Short-term memory impairments
• Cognitive difficulties such as limited attention and concentration

While these effects can pose different challenges for returning to work after a TBI, they can often be managed with a combination of compensation tactics and restorative techniques.

For example, one secondary effect of TBI that may occur when the areas of the brain responsible for movement are affected is foot drop. This condition impairs the ability to lift the front portion of the foot, causing the toes to drag on the floor.

When a survivor with foot drop returns to work, they may have difficulties walking efficiently and safely around the workplace. Foot drop can also increase the risk of injury, especially in a fast-paced job that requires a person to walk excessively or climb stairs.

To help support the foot and ankle, therapists may suggest using a compensatory tactic like an AFO brace. However, while an AFO brace is helpful, it does not offer a permanent solution for foot drop. To address the root cause and improve the ability to lift the front of the foot, individuals must engage in restorative techniques and practice rehabilitation exercises.

Typically, an occupational therapist can provide individuals with the proper exercises and compensatory strategies to overcome the effects of TBI and maximize their independence to return to work and other daily activities.

Helpful Tips for Returning to Work After Brain Injury

To help ease the transition back to work after a TBI, it helps to strategize and prepare. Along with participating in therapy, occupational therapists may suggest practicing certain tasks at home first to help boost strength and confidence in the workplace.

To simulate working at home, individuals can:

• Try to concentrate on a specific project on a computer for as long as possible, gradually building up to a few hours or a full workday
• Focus on building physical endurance by practicing exercises and chores around the house
• Perform activities that involve planning such as cooking or grocery shopping
• Wake up at the same time every morning as if going to work

Practicing these tasks at home can help individuals prepare physically and mentally for the workload ahead. Since every job has different demands, try to find activities at home that best simulate tasks specific to one’s desired job. Simulating work at home can also help individuals cope with feelings of stress or anxiety that may arise in the workplace after a TBI.

Understanding Employment Rights After TBI

There are various resources available that focus on helping TBI survivors adapt in the workplace. Understanding what adjustments employers can make before returning to work after brain injury may help individuals feel more at ease and be better prepared.

For example, the Americans with Disabilities Act (ADA) prohibits employers from discriminating against individuals with disabilities. Under the ADA, employers are required to provide reasonable accommodations to all employees with disabilities. Although this law applies to companies with 15 employees or more, some states may have additional laws that apply to companies with fewer than 15 employees.

Some accommodations individuals can discuss with their employer include:

• Working shorter hours
• Returning to work gradually, maybe working from home at first
• Taking more breaks to reduce the risk of overstimulation
• Starting with a lighter workload
• Reassignment to a new role

Employers can also provide physical and technological aids, such as modified desks or chairs, wheelchair accessibility, and computer programs to help survivors acclimate to the workplace and stay on task. By providing proper accommodations, employers can help individuals improve their overall performance, which is beneficial for both the employer and the survivor.

A vocational rehab specialist or an occupational therapist can help determine which adaptations are needed and will benefit an individual the most. They can also provide more guidance and tips on how to access employment rights, disability, and social security benefits.

Accessing Disability & Social Security Benefits After TBI

Lack of employment due to brain injury can cause financial difficulty, which can increase feelings of stress and anxiety. Fortunately, many programs provide survivors with a source of income while they work toward recovery and find employment.

Individuals can receive these benefits either through Disability Insurance (SSDI) or Supplemental Security Income (SSI). It’s important for TBI survivors to apply for these benefits as soon as possible because it can take several weeks or months to process the claims and receive benefits.

According to the Social Security Administration (SSA), TBI survivors may qualify for benefits if they experience either:

• A. Disorganization of motor function in two extremities, resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities, persisting for at least 3 consecutive months after the injury.
• B. Marked limitation in physical functioning, and one of the following areas of mental functioning, persisting for at least 3 consecutive months after the injury:
  • Understanding, remembering, or applying information
  • Interacting with others
  • Concentrating, persisting, or maintaining pace
  • Adapting or managing oneself

Benefits typically don’t begin until 6 months after injury, and they usually cease once the individual finds employment. However, there may be other programs that make exceptions and continue to help survivors who are employed.

Additionally, individuals receiving Disability or Supplemental Security Income may be eligible for the Ticket to Work program. This program (available in all 50 states) provides TBI survivors with access to career counseling, vocational rehab, job placement, and training.

Other Social Security incentives from the Ticket to Work program may include:

• Trial Work Period (TWP): The TWP allows survivors to test their ability to work for at least 9 months. Individuals will receive full SSDI benefits as long as they report their work activity. This makes it ideal for TBI survivors just beginning to return to work.
• Expedited Reinstatement (EXR): If a survivor is unable to work again within the 5 years after their EPE ends, they can request reinstatement of SSDI benefits without filing a new application.
• Continuation of Medicare Coverage: After the Trial Work Period ends, Medicare coverage will continue for 93 consecutive months.

Accessing disability and social security benefits after brain injury can help provide a sense of comfort and ease during recovery. Returning to work shortly after a brain injury can be counterproductive and interfere with recovery. Therefore, it’s important to take the time to heal and prepare to return to work with the appropriate resources.

Preparing to Return to Work After a Traumatic Brain Injury

Returning to work after brain injury is a unique process for every survivor. While it can take time and patience, with the proper resources and preparation individuals can have a smoother transition back to work.

We hope this article helped guide you through the process of returning to work after brain injury and encouraged you to reach your goals.