Working with a brain injury

🔀 An employee can reintegrate in various ways. Key considerations include:

• Is the reintegration process formal or informal?
• Can the employee return to their previous role with or without adjustments?
• Is partial return to work an option?

⚖️ Legislation: Effective October 1, 2022, significant changes are introduced to the reintegration trajectory for disabled employees (Reintegration trajectory 2.0).

• The new scheme applies immediately to ongoing reintegration processes without transitional measures.
• The rules concerning medical force majeure remain unchanged pending further legislative developments.
• Reintegration can occur through either an informal or formal process, subject to approval from the health insurance fund's advisory doctor.

In an informal reintegration process, there are no set administrative procedures or deadlines. The focus is on collaboration between the employee, employer, and occupational physician to find a mutually satisfactory solution, promoting a comfortable return to work.

🤝 Collaboration: Trust among the treating physician, occupational physician, employee with an acquired brain injury, and employer is essential for the success of an informal reintegration process.In a formal reintegration process, there is a documented administrative procedure initiated by either the employee or employer. The prevention advisor-occupational physician makes decisions based on the individual's ability to resume work, potentially with adjustments or alternative tasks.

Can the employee return to their previous position with or without adjustments?

• Yes, returning to the previous position may be feasible with government support if necessary adjustments are made.
• 💰 Support: If returning to the previous role is not viable, the employee can transition to a new adapted position tailored to their abilities and limitations due to a brain injury. Employment support measures are available from the government to address efficiency loss or reduced resilience.

Can the employee partially resume work?

• 💪 Importance: Partial return to work is crucial for employees with brain injuries.
• Partial resumption of work is not an entitlement but a gesture of goodwill from employers.
• Reasonable adjustments should be provided, and if deemed unreasonable, employers can refuse them. If full return is not possible, seeking additional assistance or guidance is recommended. Varying work volumes allow employees to pace their return according to their recovery process. Health insurance fund approval is required for partial return, with notification necessary at least one day before resuming work.

No.

The decision to disclose a brain injury rests with the employee and/or their loved one, as it is a personal choice.

Medical certificates do not disclose specific health conditions due to medical confidentiality regulations.

🤝Together:

• If the employee or their loved one chooses to share this information, discussions can be held regarding whether it can be shared with colleagues and/or management.
• The occupational physician will not disclose a diagnosis but will provide work-related advice based on medical information.
• Even in the case of a new employee, there is no obligation for the applicant to inform the employer about a brain injury. It is expected that the applicant assesses the feasibility of work with their health condition and communicates any concerns to the employer.

The consequences of a brain injury at work vary depending on:

• the severity, location and extent of the brain injury,
• the person’s personal characteristics,
• the (physical, socio-emotional, cognitive) content of the job,
• the (physical, cognitive) working environment,
• colleagues, ... .

Common invisible or less visible consequences of a brain injury that may affect a return to work are:

• cognitive consequences, such as slower thinking, problems with planning and organisation or mental fatigue
• consequences related to personality, emotions and behaviour, such as not taking the initiative, being hyperactive, feeling socially isolated or a reduced level of self-awareness

💡Tips & tricks
Remember that every brain injury is unique and not all consequences will apply to a particular person with a brain injury.
The person may also have visible consequences from the brain injury. Examples include a loss of arm strength, difficulties with coordination or reduced mobility.
 

💪Opportunity: the employee has to find a balance between what they can do and what needs to be done.

You engage in discussions with the occupational physician (or prevention advisor-occupational physician) regarding task specifics and working conditions.

What are the obligations for you as an employer?

• Give utmost consideration to the recommendations of the occupational physician.
• Adhere to the collective reintegration policy and the right to reasonable adjustments for individuals with disabilities.
• Clearly explain the reintegration plan and provide justification if adapted or alternative work options are not feasible.

🔄 What options are available?

• Whether aware of an employee's brain injury or not, you can initiate a reintegration program through the occupational physician (or prevention advisor-occupational physician).
• This request can be made after a minimum interruption of 3 months of the employee's incapacity for work, or sooner with a doctor's certificate indicating definitive unsuitability for their assigned tasks.
• In an informal reintegration process, collaborate with the employee and potentially the occupational physician to develop a return proposal. Schedule a meeting with the occupational physician to plan the return to work, discussing adjustments to task content, work environment, or schedule as needed.

🤝 Collaboration: Ensure effective communication with the occupational physician by providing insights into task specifics, working conditions, concerns, and considerations for the employee's safe return considering their brain injury.

• The occupational physician will evaluate the employee's medical suitability for their role and translate health information, such as the brain injury, into practical work-related advice.
• This information can guide adjustments to make the position suitable.In a formal reintegration process, it is essential to justify any inability to provide alternative or adapted work options.

⚖️ Legislation: The revised reintegration trajectory (reintegration trajectory 2.0) aims to facilitate the return of employees unable to perform their designated tasks. The occupational physician may decide on various outcomes based on medical assessments and considerations outlined in the legislation.

While feasible, the follow-up process is tailored in collaboration with the employee.

🚧 Challenge: The employee's needs and inquiries play a pivotal role in shaping the follow-up process.

The frequency of occupational physician monitoring for your employee is influenced by the severity of the acquired brain injury and job responsibilities.

💪 Advantage: Continuous follow-up is often beneficial as individuals with brain injuries struggle to assess the impact of (part-time) work on their capabilities and challenges.

• Factors like fatigue, self-assessment accuracy, or changes at home are aspects that employers should monitor.
• Studies indicate a higher risk of premature job discontinuation for individuals with brain injuries, underscoring the importance of ongoing monitoring by both the occupational physician and treating physician.
• Timely intervention is crucial in case of difficulties.

Engaging a job coach from GOB can offer on-site support, helping prevent permanent employee dropout.

Not without the consent of the employee with a brain injury.

If the employee gives permission to the doctor and to you , then theoretically this is possible.

In practice, direct consultation with the doctor happens very rarely.
This is due to medical confidentiality and the person's right to privacy.

⚠️Note: an employee is not obliged to share their health condition with their employer .

🤝Together: working with the occupational doctor you can discuss your concerns and questions. The doctor knows about:

• the health condition and the job requirements,
• the terms and conditions of employment, working relationships and environment.

The occupational doctor cannot share information about the health condition with you.

However, the occupational doctor can translate this information into work-related advice about opportunities and areas of concern in the workplace.