Getting back to work


The early stages following an injury can be the most difficult. Your family and employer may focus on your physical recovery as this is what they can see and understand. If you also have a brain injury, this can cause cognitive, emotional and behavioural difficulties which are generally poorly understood by the person who has suffered the injury, as well as those around them.

Returning to work may be the first situation in which an injury survivor finds they are challenged. The work environment for most people is challenging, demanding and complex in nature. It is often the first place where difficulties arise. Due to poor understanding of traumatic injury these difficulties are not always attributed to the person’s accident or injury and in some cases the injury survivor leaves their job as they cannot cope or find themselves in situations where they are no longer able to meet the standards of work required of them.

One of the most significant and commonly reported symptoms following an injury is fatigue. The impact of this is often underestimated and can be the key issue when returning to work. It is vital that fatigue is managed and that a person paces and plans their return to work according to their abilities. Fatigue needs to be managed in order to optimise cognitive performance. A person’s fatigue levels are the main determinant in outlining a graded return to work as it is essential to manage this and avoid extreme fatigue.

Another key focus of vocational rehabilitation following an injury will be to provide the employer with education about the injury survivor’s difficulties and how these can be managed and accommodated. The vocational rehab practitioner will introduce compensatory strategies to enhance their performance at work. Intervention needs to be flexible and an ongoing process to monitor the person’s performance, address any difficulties or concerns that arise for the injury survivor and the employer and to provide advice about when will be the correct time to increase work demands.

No two injury survivors will have the same needs with regards returning to work. Vocational rehabilitation is not prescriptive or a one size fits all approach.

Useful information when considering returning to work

  • Keep your employer up to date and informed of your progress. You may not know when you are returning to work, but it is useful to keep communication lines open.
  • Make an appointment to discuss your return to work with your GP. A GP is responsible for writing a Fit Note (new terminology for a sick note) that outlines when you can return to work. This can be reviewed and adjusted according to your presentation. They can recommend a graded or phased return, as well as part time hours if this is the most suitable thing for you. They may seek external advice from other professionals who are providing you with treatment.
  • You will need a Fit Note to be eligible for relevant benefits you may be entitled to. Your employer will also need it to support them following their sickness and absence policies. Make sure you are aware of your sickness and absence policies at your place of work. Employers may ask that you be assessed by their own occupational health service.
  • Get in touch with your local rehabilitation service and ask to be assessed by an occupational therapist who may provide further advice regarding return to work and what you may need to do. Returning to work is a valid rehabilitation goal.
  • Contact your local Job Centre and speak to a Disability Employment Advisor who can also provide support if you are to be off work for a significant time. They can also help you to plan a return to work and consider what you may need to support this return, for example by getting you assessed by Access to Work.

Access to Work grants

The UK government provides Access to Work grants that can pay for practical support if you have a disability, health or mental health condition. A grant can help you:

  • start working
  • stay in work
  • move into self-employment or start a business

The grant is not for business start-up costs. How much you get depends on your circumstances. The money doesn’t have to be paid back and will not affect your other benefits.



Key points:

The correct timing of return to work is essential. Returning too early can result in a delay in recovery and further stress due to work place demands.

Survivors should seek advice in relation to returning to work, initially from a GP.

Injury survivors and employers often need support at work in the early stages of recovery.

Work will be one of the most complex and demanding tasks and environments a person with a traumatic injury will find themselves in. Do not assume that they will not experience difficulties.