Job Accommodations for People with Brain Injuries

Job Accommodation Network - Fact Sheet Series
Acomodaciones en el Empleo Para Personas con Lesiones Cerebrales

The brain can incur several different types of injuries depending on the type, amount, and position of force impacting the head. The impact may affect one functional area of the brain, several areas, or all areas of the brain. These factors determine what types of accommodations are effective.

The following is a quick overview of some of the job accommodations that might be useful for employees with brain injury. For a more in depth discussion, access JAN's publications at
media/atoz.htm. To discuss an accommodation situation with a consultant, contact JAN directly.


  • Reduce distractions in the work area
  • Provide space enclosures or a private office
  • Allow for use of white noise or environmental sound machines
  • Allow the employee to play soothing music using a cassette player and headset
  • Increase natural lighting or provide full spectrum lighting
  • Reduce clutter
  • in the employee's work environment
  • Plan for uninterrupted work time
  • Divide large assignments into smaller tasks and steps
  • Restructure job to include only essential functions


  • Make daily TO-DO lists and check items off as they are completed
  • Use several calendars to mark meetings and deadlines
  • Remind employee of important deadlines via memos or e-mail or weekly supervision
  • Use a watch or pager with timer capability
  • Use electronic organizers
  • Divide large assignments into smaller tasks and steps
  • Assign a mentor to assist employee with determining goals and provide daily guidance
  • Schedule weekly meetings with supervisor, manager, or mentor to determine if goals are being met


  • Provide picture diagrams of problem solving techniques, e.g., flow charts
  • Restructure the job to include only essential functions
  • Assign a supervisor, manager, or mentor to be available when the employee has questions


  • Allow the employee to tape record meetings
  • Provide type written minutes of each meeting
  • Use notebooks, calendars, or sticky notes to record information for easy retrieval
  • Provide written as well as verbal instructions
  • Allow additional training time
  • Provide written checklists
  • Provide environmental cues to assist in memory for locations of items, such as labels, color coding, or bulletin boards
  • Post instructions over all frequently used equipment

Gross Motor Impairment:

  • Modify the work-site to make it accessible:

    - Provide parking close to the work-site
    - Provide an accessible entrance
    - Install automatic door openers
    - Provide an accessible restroom and break room
    - Provide an accessible route of travel to other work areas used by the employee
  • Modify the workstation to make it accessible:

    - Adjust desk height if wheelchair or scooter is used
    - Make sure materials and equipment are within reach range
    - Move workstation close to other work areas, office equipment, and break rooms

Vision Impairment:

  • Provide written information in large print
  • Change fluorescent lights to high intensity, white lights
  • Increase natural lighting
  • Provide a glare guard for computer monitors
  • Consult a vision specialist particularly


  • Reduce or eliminate physical exertion and workplace stress
  • Schedule periodic rest breaks away from the workstation
  • Allow a flexible work schedule and flexible use of leave time
  • Allow work from home
  • Implement ergonomic workstation design
  • Provide a scooter or other mobility aid if walking cannot be reduced

Work Effectively with Supervisors:

  • Provide positive praise and reinforcement
  • Provide written job instructions
  • Write clear expectations of responsibilities and the consequences
  • Allow for open communication to managers and supervisors
  • Establish written long term and short term goals
  • Develop strategies to deal with problems before they arise
  • Provide written work agreements
  • Develop a procedure to evaluate the effectiveness of the accommodation


  • Provide praise and positive reinforcement
  • Refer to counseling and employee assistance programs
  • Allow telephone calls during work hours to doctors and others for needed support
  • Provide sensitivity training to coworkers
  • Allow the employee to take a break to use stress management techniques to deal with frustration

Attendance Issues:

  • Provide flexible leave for health problems
  • Provide a self-paced work load and flexible hours
  • Allow employee to work from home
  • Provide part-time work schedule

Issues of Change:

  • Recognize that a change in the office environment or of supervisors may be difficult for a person with a brain injury
  • Maintain open channels of communication between the employee and the new and old supervisor to ensure an effective transition
  • Provide weekly or monthly meetings with the employee to discuss workplace issues and productions levels

Resources Specifically for People with Brain Injuries

Brain Injury Association of America
1608 Spring Hill Road
Suite 110
Vienna, VA  22182
Direct: (703)761-0750

National Brain Injury Information Center
Brain Injury Information Only
Toll Free: (800)444-6443

National Resource Center for Traumatic Brain Injury
P.O. Box 980542
Richmond, VA 23298-0542
Direct: (804)828-9055

Updated 8/18/08.

This document was developed by the Job Accommodation Network, funded by a contract agreement from the U.S. Department of Labor, Office of Disability Employment Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Labor. Nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Department of Labor.

Posted on BrainLine October 7, 2008.

This document was developed by the Job Accommodation Network, funded by a contract agreement from the U.S. Department of Labor, Office of Disability Employment Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Labor. Nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Department of Labor.

Comments (12)

Reading all those comments made me sad :-(. I have a TBI from dying 4 times during our twins birth . I thankfully was revived successfully and am almost "me" after 3 years.Although I have a very bad memory now and who knows if I know accounting anymore but I'm on the search for a entry level position and hoping it goes well.

No clue how to handle me. I was in Iraq and now have TBI, PTSD and depression...still they require MORE from me. Maybe I should speak up but am afraid of the response and image I will face.

It is 2am and I am up again with another migraine from my injuries/PTSD. Reading all these comments to include yours... its nice to know I am not alone. I am currently struggling with an employer who hired me knowing I have disabilities but is now trying to find a way to get rid of me because it is to difficult to accommodate me. It is sad that people have lost compassion for those of us who want to work hard and try so desperately to find our new normal. Thank you

Education is KEY. It is so helpful to hear the truth about these matters. People NEED to see the rawness of heroes. In sharing your story, you will help others not feel alone, in turn, relieving some of your feelings of isolation. Any time I have seen someone become vulnerable with one or a group of people, there is a sense of relief. So, be bold and be better...
Much luck on your journey!

We definitely do need a greater awareness of people with brain injuries or autism, etc.   It has made it a living hell to maintain employment and work with temp agencies, because of them not hiring someone who understands disabilities/GIFTS.

It is so good to know I am not alone. I was a school counselor and got upset twice. I wasn't written up, but now, I am virtually unhireable in the Tennessee Shelby County Schools district. Negative words spread, without understanding.

Only someone with a TBI or someone living with them would ever truly understand what a day in our life is really like. It's beyond tough! I take one hour at a time. I'm a suffering middle school teacher...screaming kids, loud noises, bright lights, too much stimuli and major multi-tasking - I need the medical insurance, as I also am fighting cancer. Hang in there, everyone!

Employers don't understand brain injuries or the day to day symptoms that you deal with and they really don't care. You have to go through great lengths to get documentation from employer because in their minds as they stated "I would assumed" you would be better in two weeks"- it's now been 3.5 months - like who would want to make this up - I wouldn't wish it on my worst enemy

I let the people at my job know what happened to me years ago. Just so they knew and could maybe try to understand why I am the way I am. And just in case my seizures ever acted up which they probably wouldn't as long as I took my meds. And all it got me was to have to get a Dr note that it was ok for me to be working. And then the real kick in the face. I got written up for getting upset once or twice and referred to EAP (Employment Assistance Program) so I could talk to some lady and let her know all my business so she could sent me up with a counselor for me to go get help. People just don't understand TBI's and don't really care to.

I asked for a reduction at work and it became more stressful with the way that they were treating me than with the symptoms. I'm still struggling and my supervisor's response was to come up with a plan.

This list is very helpful.

My employer terminated me rather than providing any accommodation. And I was injured on the job. 

need more public awareness of existence of brain injured people trying to make it in the world and training for agencies assisting the people with brain injury problems and deficits.