Returning to work post Brain Injury

Not everybody who has sustained a brain injury will be experiencing the same difficulties or challenges. We often see Clients with hidden effects of a brain injury and it may not be immediately obvious that they are experiencing these difficulties. However, effects following a brain injury such as difficulties with processing, multi-tasking, concentration difficulties, memory recall, sleep disturbance, difficulties dealing with noisy environments may affect the ability to return to the same job as prior to the brain injury, or affect being able to seek and sustain new employment.

Whilst not everyone can return to employment after brain injury, for many it is a realistic and important goal as part of a goal orientated rehabilitation programme. It may also depend on the neuro-rehabilitation or vocational rehabilitation which has been received which may assist them to return to work following a brain injury.

I have experience working as a Case Manager with Clients who have had lengthy periods off work. Whilst Clients have been away from the structure of working, and work colleagues this can often lead to anxieties and lack of confidence, and fear for the future. Therefore, it can be a very anxious time for many. Having previously assisted clients who had sustained a brain injury a driving force for many was to return to work and boosted their confidence during the rehabilitation process. If given the right support and understanding, careful planning, and good communication many people do make a successful return to work.

Sometimes Clients want to return to work when their physical injuries have progressed without realising that their cognitive difficulties and fatigue may still be significant and not show their full extent until they have returned to work. Cognitive fatigue can be common following a brain injury and can be disabling. Some Clients may not initially appreciate the benefits of a guided, and graduated return to work. It is far better for a Client to have a successful and graduated return to work, than to have unrealistic expectations which could lead to further absence from work. An unsuccessful return to work may affect a person’s self- image, well- being and satisfaction in life.

Returning to work… What you can expect from your employer:

Your employer should be kept in the picture with regards to your recovery and abilities. Regular communication is essential. Not all employers are as motivated as others to provide this support. Often it is worrying for an individual to share medical information, as you might be concerned that it will be used against you. However, the reality in the majority of cases is that it will provide best results for you (and protection of your rights) if you are willing to share medical information with your employer and update them regularly.

Your employer should keep all your medical information confidential (although they may need to share it with, for example, your line manager or other members of HR on a “need to know” basis). Usually you can agree what you are happy to be shared but you should try to be as open as possible in order for your employer to assist you with your return to work. They may also require information related to your health if it may put yourself or others at risk. i.e: inability to drive, machinery usage, medications, development of seizures, etc.
If you are working with a Case Manager, NHS rehabilitation team, they should support you, and communicate with your employer to assist with your vocational rehabilitation.
If there is an Occupational Health department available they should be involved with your return to work programme. They can also provide early, and ongoing support as required.

Your employer has a legal requirement to make reasonable adjustments to the workplace or your terms and conditions of employment under the Equality Act 2010 on the basis that your brain injury amounts to a disability. Things that might be reasonable include a graduated return to full working hours, different role, flexible/reduced hours, regular meetings to monitor return to work, any equipment needs to assist you in the workplace. What amounts to reasonable adjustments will be different for every person and every workplace. Your employer is also under a duty not to discriminate against you because of any disability, or because of something arising from a disability. The term “discrimination” covers a number of issues, but generally means that you must not be treated less favourably than someone without a disability.

Regular meetings should be encouraged for all parties to ensure a team approach for return to work. Problems and difficulties can be identified early and further adjustments may be required. For example working hours may need to be reduced or more flexibility with hours may be required until the employee has settled back into their role, or the workload may need to be adjusted during the return to work programme.
It may be helpful to provide Headway leaflets (Headway.org.uk) to your employer on the specifics relating to brain injury.

Your employer may suggest the involvement of the Access to Work Scheme prior to returning to work. (To receive support from Access to Work you must have a disability or health condition that means you need an aid, adaptation or financial or human support to do a job. For example, special computer equipment or travel costs because you cannot use public transport.)