Return to Work – Yes You Can!

Brain Injury Association of Ohio’s TBI Summit Panel Discussion

By Jeff Buffer, MA, CRC, BWC Vocational Rehabilitation Supervisor

I had the opportunity to participate in the Brain Injury Association of Ohio’s TBI Summit held at OSU’s Fawcett Center last month.  The conference’s goal was to help persons with traumatic brain injury (TBI), their families, and providers learn strategies that can help with community and work re-entry during recovery from a brain injury. The summit included information about brain injury treatment, services and therapies that can assist with those goals.

Brain injury survivor panel member

BWC’s Nurse Director Mary Charney, BSN, RN, and I co-presented in a panel titled, Return to Work-Yes You Can! Kara Moore, an Ohio Health speech and language pathologist, also joined us. Kara shared tips for working with employers of persons with a brain injury and she shared her perspective as a brain injury survivor after a motor vehicle accident and the challenges she experienced during her return to work.

Some tips she shared included following advice from doctors and therapists as to how much a person can do when they first attempt to go back to work after a brain injury, and letting the employer know about issues the worker with a brain injury is having and how they might be addressed. This could include being assigned a lighter work load initially or having a coworker help with more complex tasks.

Kara also talked about going back to work gradually and taking frequent rest breaks as needed. She mentioned types of job site modification that can be done to help with symptoms of a brain injury, such as changing the type of overhead or desk lighting in a work setting.

Preventing injuries, case management

Mary, who has extensive health-care experience in occupational medicine, presented on the importance of BWC’s injury prevention programs as they relate to reducing the number of brain injuries. BWC’s Division of Safety and Hygiene offers statewide safety awareness campaigns for slips, trips and falls, safety education and training programs, and safety grants that assist employers to purchase equipment designed to reduce workplace hazards.

She also discussed the importance of medical case management and care coordination, especially during the acute phase of care and rehabilitation. Patients with catastrophic injuries see multiple specialists and are faced with many complex decisions.  It’s the catastrophic case manager’s role to help the patient navigate confusing and complex health instructions and appointments and ensure the lines of communication remain open between the patient, family, providers and others involved in the case.

Medical management’s goal is to return every injured worker back to his or her optimal level of function, maximum quality of life and return him or her to work when possible.

Vocational rehabilitation in workers’ compensation

My presentation, drawing from over 30 years of vocational rehabilitation experience, included eligibility for services, when a person with a TBI might be ready to participate, and which services are considered the most effective when working with persons with brain injuries and employers. We discussed Information about being ready for vocational rehabilitation services for persons with brain injuries, plus the challenges they face, including a lack of understanding by employers and coworkers about brain injuries and accommodating the TBI employee’s needs.

Services that make a difference

Other challenges include identifying providers who have a knowledge of working with persons who have a brain injury. Some positives included vocational rehabilitation can develop specialized plan services to meet the TBI worker’s unique needs, and these services can focus on the whole person.

Services that help persons with a TBI include vocational case management and employment services such as a work trial, situational assessment, employer-based work adjustment or job coaching services.  Return-to-work (RTW) incentive services such as a gradual RTW plan or employer incentives for when a person’s productivity might be limited initially can be helpful. Other employment-based services such as on-the-job training, job modification, ergonomics and tools/equipment may also assist the worker.

In addition, supportive services such as adjustment to disability counseling and living maintenance can make a big difference when a person with a TBI is attempting to RTW in a vocational rehabilitation plan. It’s rewarding when all parties work together for one common goal to return a worker with a TBI back to the job.

Jackie Stanton, Ph.D., CRC, a case manager for Metro Health Rehabilitation Institute of Ohio’s Work Matters Program, facilitated the panel. The audience asked good questions about the information presented, and the current director of the BIAO, Stephanie Ramsey, (former BWC medical services director), commented that the presentation was well received and included needed information.  The attendees were persons with brain injuries, their families and providers – including psychologists, therapists and nurses, as well as case managers.

Focus on survivor’s strengths

Overall, the panel emphasized the importance of everyone working together as a team, including the person with a TBI, their family or support system(s), their employer and coworkers, doctors, psychologists, case managers, vocational providers and therapists.  It’s also important to focus on a patient’s strengths, and what they can do after a TBI, as this keeps the person engaged in the overall medical and vocational recovery process.

The more a person with a TBI learns about their new level of functioning after a brain injury, the more prepared they are to get back to activities of everyday life including employment.

Note: Here is a short video about an injured worker describing his experiences with a TBI who is back to life.

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