Returning to work after a brain injury

Ipek Tugcu explains what employers need to consider when helping to reintegrate an employee with a brain injury back into the workplace

Unfortunately, there is no single manual which will outline a list of steps to rehabilitate someone with a brain injury – it doesn’t work like that. A brain injury doesn’t always display symptoms, react to therapies or evolve how you may expect it to. You may not even be sure whether it’s the injury causing difficulties, or something completely unrelated. And yet, having an employee with a brain injury does not have to mean the end of the road. A successful working relationship is possible, provided that both parties are willing to work together and employers are open to learning and adapting. 

Identifying limitations and needs

An employer must first understand their employee’s condition, difficulties and requirements. They should speak with the employee directly about this, but could also (where appropriate and with consent) consult their family or treating neurologist. Ideally, employers should speak to the employee and arrange an independent occupational therapy assessment, designed to identify relevant limitations and how they can be best addressed. 

Considering suitability of the role

Employers are under a duty to consider alternative employment for existing employees who are unable to continue in their previous role. For returning or new employees, employers should consider the following:

  • Can the person do the job? If not, can the role be adapted to suit them?
  • Do working hours/workload/tasks need to be changed?
  • Does the employee need more time off or more time to complete their tasks? 
  • Is extra/different management needed?

Making reasonable adjustments

Little changes can go a long way. The problem is that often, employers don’t know what changes are needed. Input from the employee and an occupational therapist can be hugely helpful. Reasonable adjustments should be made to allow an employee to carry out their tasks independently. This could include: 

  • Equipment or aids, for example to help mobility or to assist with duties (a larger monitor, single-handed keyboard, dictaphone, etc.). 
  • Arranging a quiet place to work – as fatigue and sensory overload are common consequences of brain injury
  • Adopting flexible working hours or allowing them to work from home. Even allowing an employee to avoid commuting at rush hour can have a huge impact on their ability to work 
  • Creating a daily routine which provides stability, to help with memory or anxiety
  • Providing training in what is expected of them, or with assistive technology given to them

Relationships with colleagues

Brain injury can impact someone’s mood, patience and interactions with others. While it’s important that the employee’s needs are considered, employers also owe a duty to all of their employees to provide them with a safe working environment. Therefore, employers should consider:

  • Working with the employee to identify how much they want their colleagues to know about their injury. Training can be given to colleagues on the impact of the brain injury and what could help (or trigger) the employee;
  • Setting up a ‘buddy’ system, meaning the employee has one person as their contact point for any help. This can provide reassurance and stability. The buddy can answer questions, identify difficulties, coordinate needs and support the employee in raising issues if a difficulty arises;
  • Adopting and implementing clear guidelines. A direct approach is often sought by those who suffer from a brain injury, who may find it difficult to read between the lines. It’s important that the employee understands what is expected of them, and what is unacceptable;
  • Adopting safeguards to protect the employee and others against triggers that may cause harmful behaviours. For example, alcohol at social work events can lower inhibitions and cause undesirable behaviours for anyone, but for those with a brain injury, this can be amplified and can cause additional risks such as seizures. It’s important to be clear and consistent in your approach of dealing with any unacceptable behaviour. Careful notes should be made and shared with the employee following verbal discussions. 

Ipek Tugcu is an associate solicitor at Bolt Burdon Kemp