Return to Work after Brain Injury

Returning to work after suffering from a brain injury can have a variety of outcomes. One person may be very successful and jump right back into their previous role with a minimal to no difficulties. Another might experience a slower process that involves gradually increasing the number of hours and days worked in a given week, and may require modifications to their role.  Someone else might find the return to work very challenging and require adjustments to expected tasks, need to pace themselves with frequent breaks, and have to use compensatory strategies to manage their memory and attention deficits.

What are the steps in a return to work after a brain injury?

There is no specific protocol to follow for either the individual returning to work after a brain injury or the rehabilitation team providing support. In addition to considering the specific type of work a person is returning to, there are many other factors that must be evaluated when developing a return to work plan including:

  • areas of deficit/severity of injury
  • individual strengths
  • level of insight
  • ability to self-monitor
  • tendency to become overwhelmed
  • cognitive overload
  • fatigue
  • pain issues
  • emotional/mood challenges

In some cases, a work hardening program may be helpful to gradually reintroduce tasks that require specific types of thinking and brain work. This can be helpful in terms of identifying potential areas of difficulty and provide an opportunity to zone in and practice these skills and trial compensatory strategies outside of the actual work environment.
For some, returning to their original job may not be the best option. Vocational testing can help with identifying areas of strength and weakness, and then determining other types of employment that are fitting. In some cases, this may then require returning to school and retraining in an entirely different field. In other situations, someone may be able to shift positions and remain in the same line of work. 

Struggles with a return to work after brain injury

An individual with brain injury might find themselves in a position where they are intellectually and/or physically capable of doing the job, yet find themselves dealing with mood issues, fatigue, attention and/or cognitive overload to the point where they are struggling to complete job tasks or meet specific requirements. This is where pacing strategies and task modifications can be helpful in terms of allowing someone to continue working in some capacity, yet at a level that is manageable for them.

Individuals returning to work after a brain injury may also experience problems when dealing with family and friends who do not understand the invisible deficits and symptoms, such as fatigue and being easily overwhelmed or cognitively taxed. They might be judgemental or view a person as lazy or just making excuses. This can create a tremendous amount of stress on families and relationships, and psychological counselling may be helpful for all involved.
Generally speaking, having a strong rehabilitation team when returning to work after a brain injury can be extremely beneficial. Speech-Language Pathologists are often significantly involved in the return to work process. Other team members typically include: Occupational Therapists, Psychologists, Physiotherapists, Rehabilitation Support Workers, and Case Managers. These team members take on different roles and levels of support as their client travels through the process of returning to work.


Amanda Brown is a Speech-Language Pathologist with nearly a decade of experience in providing assessment and treatment to clients in the clinic and community settings. Amanda enjoys working with clients of all ages and applies a strong client-centred approach to her therapy, balanced with family/team collaboration.