A concussion is a mild traumatic brain injury caused by a blow to the head, neck or upper body and may include symptoms such as a headache, dizziness, nausea or loss of consciousness. Unfortunately, some people go undiagnosed, or misdiagnosed and continue to experience memory, attention deficits, poor emotional control, and other lasting symptoms, which prevent them to returning to work months after their injury.

Returning to work after a physical injury is difficult and with a concussion, the experience is complicated further by the interfering cognitive and psycho-emotional symptoms. Often folks are returned to work too quickly without the appropriate supports in place, or healthcare providers are waiting for the employee to recover before recommending a return to work plan.

The following are some tips for case managers and employees when returning to work following a concussion:

1)    Once the initial 3-4 week acute injury phase has passed, don’t wait until the employee has “recovered” before returning to the workplace. Instead, discuss opportunity for modified duties as the employee learns to manage their symptoms while being exposed to increasing physical and cognitive demands.

2)    Understand that this RTW plan may take longer than a standard 4-6 weeks, as unlike physical injuries, the complexity of symptoms experienced by someone with a concussion may necessitate more time.

3)    Consider psychological treatment for co-existing mental health conditions like depression and anxiety that may be associated.

4)    Determine workplace accommodations required, prior to the employee returning to the workplace to reduce risk of being overwhelmed.

5)    Ensure all cognitive, perceptual, and physical limitations are being accommodated, by involving an occupational therapist.

6)    Consider a gradual return to work experience to build tolerance to the physical and cognitive demands of the job.

7)    Promote good communication between the employee, the employer and the case manager/therapist to ensure a dynamic return to work plan that is flexible to change with the employee’s needs.

8)    Consider allowing the employee to seek quiet/dark space periodically through their shift to reduce the sensory overload they may be experiencing. If employee is sensitive to light allow a visor or sunglasses to be worn.

9)    If computer work is involved, symptoms of headaches and nausea can be aggravated. Allow for gradual exposure and breaks for sustained monitor work. Avoid scrolling tasks and instead read full page before scrolling down to next section.

10) Daily communication is required with the employee to assess if the accommodations are helping and to come up with possible solutions to help manage any other aggravated symptoms.

Marnie Courage, OT Reg (MB)
Owner/ Managing Director
Enabling Access Inc.
marnie@enablingaccess.ca
www.enablingaccess.ca