Employment & Training

For some people, returning to work after a traumatic brain injury can be difficult or impossible. But a good many people with traumatic brain injury do return to their old careers — or to new ones that bring fulfillment and a sense of self-worth.

Obstacles, often referred to in context with traumatic brain injury as environmental barriers, can make returning to work difficult — from stairs and long corridors to lack of transportation or the attitudes of other people. Existing laws can help overcome some of those barriers.

The Americans with Disability Act, which was passed in Congress in 1990, states that if a person has a condition that meets the definition of a disability — and this can include a brain injury — an employer is required to provide the individual with reasonable accommodations to perform his or her job.

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What Do I Tell My Employer?

Ask the Expert: What Do I Tell My Employer?
Sometimes it's best that you don't do the explanation yourself when trying to explain your TBI to your employer. Sometimes it's best if you work with professionals such as neuropsychologists to explain to your employer that you had an injury, that you have recovered to some extent from your injury, but you need some support in order to do your job properly. And what you need to do is explain to your employer that you are just not the same as you were before your injury. But that doesn't mean that you can't go to work and do your job and do a competent job. It just means that you need some assistance along the way. Some of those assists that you need might be very simple assists that are easily provided and easy accommodations which, under the law, your employer is obligated to give to you, such as providing you with notepads so you can take notes, such as providing you with a tape recorder so that when you go to a meeting you could record the information and listen to it back. Sometimes you might just need short breaks during the course of the day so that when you get cognitively fatigued you can recover and go back to work. Sometimes the accommodation might be instead of working a full day you might only work a half-day in order to accommodate your disability. Sometimes instructions, rather than being in writing, if you have problems with visual difficulties following your brain injury, those instructions can be communicated to you verbally. So there--sometimes if you have problems with loud noises, your environment could be moved to a more quiet space so that you can do your job. And if you have a problem with bright lights, maybe you could work in an area where there is more natural light than artificial light. These are easy accommodations that could be provided, but employers are not aware of them because they're not aware, first, of your injury and then not aware of the deficits that you have. So sometimes it's easy if somebody with the proper skill set comes in and explains it to your employer so that you get the help that you really need so that you can remain at work and do your job properly.

Advice for Young Adults with TBI Entering the Workforce

Advice for Young Adults with TBI Entering the Workforce
[Mariann Young] Advice for a kid entering the workforce starts even before they're ready to enter the workforce. [Mariann Young, PhD] [Clinical Psychologist – Rainbow Rehabilitation Centers, Inc.] The school has to become involved in this. There are transitioning planning. There are agencies within— every state has them whether they're rehab service agencies, social agencies, but kids that are severely injured are going to need that assistance and especially those that are making it with special education support and don't have the noticeable physical disabilities, but have cognitive limitations. They're going to need the added assistance whether through job coaching or someone that can—in fact— tell prospective employer— you know—they may not understand the first time around. And if you gave them a manual, that's not going to work. They may actually need someone to come and show— multiple times—but then they'll be a great employee once they learn that technique. If you are going to change— you know—the job it's going to take some time for them to learn that new job, or to accept that change. You know you're going to have to work. If they're frustrated, they may not accept it appropriately, but if you explain to them— you know— what's going on, they'll learn, they'll understand, and then you'll have a fabulous employee. But you're going to have to take the time. You may have to change the way you operate with them— the way you explain things to them and give them multiple ways of learning their position. But once they're there, you can depend on them.

How Can You Help People with TBI Return to Their Jobs?

How Can You Help People with TBI Return to Their Jobs?
[Dr. Heechin Chae] We don't want the person to fail while they recover. The last thing I want is we work towards goal, and they come back and say, "I got fired because I couldn't do my job." It's like, "Of course you cannot do your job. Actually it's failure on my part to not protect you because of this medical condition." I make sure we take them out, whether it be three months, two months, 90 days. Some of them say, "Doc, I'm going to be fired if I take three months off." Then I try to work with HR. What is the best way to really do this and not have the person fail before the person is ready? I really try to protect them and get them functioning better before they go back. They go back. We try to do an increment time and again communicate with the workplace to do this. The good news is that I think all workplaces I work with—they are very open to do this. Now in military setting it's basically working with command. The command, again thankfully because of the increased awareness of TBI, they're very willing to work with me. Actually I've been very surprised to find it's easier to work with command then some of the companies on civilian side. Command has been very receptive and easy to work with. I think that perception out there—I got to be there, otherwise I'm let go—is kind of wrong. I think that a lot of companies actually want their employees to get better. Actually all commands I know want their soldiers and sailors to get better. They actually really are committed to them. I will say work with these people to get them back to work but protect them before they're ready.

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