Employers Can Help Employees with Traumatic Brain Injuries Return to Work

Tasha Patterson@Work

Employers Can Help Employees with Traumatic Brain Injuries Return to Work

By Kerri Wizner, MPH, Assistant Director of Epidemiology, MDGuidelines; Justine Ahle, MS, Senior Analyst, MDGuidelines; Keemia Vaghef, PhD, Director of Analytic Consulting, Leave Solutions, Alight

More than 27 million cases of traumatic brain injury (TBI), a category that includes falls, motor vehicle crashes, and sports injuries, occur globally every year.1 Described as a silent epidemic, the injuries can be difficult to manage due to complex coding that affects claims and an outdated approach that may delay an employee’s return to work. While the data is daunting, there are things employers can do to prevent TBIs and support employees.

In the U.S., an estimated 18% of TBI cases (out of an estimated 350,000 per year) are work-related and commonly caused by falls, being struck, vehicle crashes, and assaults.2 Workers’ compensation programs show that 60% of work-related TBI injuries resulted in disability or death, and cost on average more than $150,000; one-third of severe work-related injuries involve TBI.3,4 Research indicates that upwards of 80% of injured workers may consider their TBI to have been preventable if there were more supervision or safety trainings. In other words, more investment in trainings could help avoid TBIs, and considering that 20% to 50% of these employees experience limitations three to 12 months after the injury, this is something to consider.5–8  

From a non-occupational perspective, an estimated 5.3 million Americans live with disabilities related to TBIs. A recent article also notes that the highest rate of injury occurs between the ages of 15 and 24 years old.9

The most common TBI symptoms include headache, nausea, fatigue, speech issues, dizziness, sensitivity to light or sound, memory or concentration problems, and mood swings. Employees with more severe cases may also experience seizures; fluids draining from the nose or ears; or unusual behavior, such as combativeness.10 Most people with concussions can go back to work in about two weeks, while people with more severe TBI may not be able to return to work for four months if ever.11

Nonmedical factors can affect if and when a person returns to the job after an injury. For example, people in professional and managerial positions more often return to work — and more quickly — after a TBI than those in manual labor jobs.12, 13 This response may be due to a higher educational level, early use of return-to-work supports, and more flexibility by employers that are interested in keeping the in-demand skill set of a manager. TBI is unique from other workplace disabilities because it combines physical and mental care and may become chronic despite the fact that it is not categorized as a musculoskeletal, mental, or long-term disability. You may see national headlines about sports concussions, but it has not been a focus of short-term disability (STD) discussions despite increasing prevalence.

Additionally, work satisfaction, future vocational outlook, and quality of life can affect time frames for someone who has a TBI and returns to work.14 However, it is difficult to predict who will go back to work because of individual characteristics such as personality, pain tolerance, and support systems, as well as TBI severity, impairments, and environmental factors like access to care.15

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