I am an employee in the private sector

🚧 Challenge: when you return to work, it is possible that this will not happen naturally, e.g.

• the consequences of the brain injury may interfere with
  • your work rate
  • the quality of your work.
• your work-life balance may also be disrupted.

💪Opportunity: a reintegration measure that is often used is the partial performance of tasks in the workplace. This is called a ‘progressive return to work’.

• Your employment contract is partially suspended due to illness and you can resume some tasks in the workplace.
• This allows you to build up your workload gradually.

⚠️Be aware that returning to work part-time does not mean you return to work 50% or half-time.

• It is important to build this up slowly.
• For example, you can start with a limited number of hours per week.
• It is best to discuss the exact arrangements with your employer

There are several possible scenarios.

• You return to your previous job with your former employer .
• You return to your previous role with a new employer .
• You return to a different or adapted job with your former employer: working with your employer , your occupational doctor and your doctor/rehabilitation team , you explore whether there are other opportunities for you within the same company.
• You return to a different or adapted job with a new employer .
• You can start voluntary work. This can help you (re)discover possibilities and your abilities. It can be a valuable use of your free time and part of your search for paid work.

You are partly responsible for your return.

Fortunately, it is a shared responsibility, in which you yourself are central and different players support you.

• What do you want?
• What do you think is feasible?

🚧Challenge: you yourself may not be able to properly assess the impact of your brain injury in the workplace.

• It sometimes takes time to get this clear.
• You may also overestimate your own abilities. You sometimes long so strongly for a life like your life before the brain injury that you want to go too fast or take on too much.

💪Opportunity: this is why it is important to discuss your work-focused assistance needs with your treating doctor.

• Your treating doctor and treatment team can help you return to work.
• If you follow work-focused rehabilitation, rehabilitation goals are linked to your work goal.
• Your treating doctor often has a lot of information about your functioning that is meaningful for the occupational doctor and your employer

Depending on how you return to work, through an informal or a formal reintegration route, the steps to be taken and who takes them are fixed. In a formal reintegration route, the steps and those responsible are more fixed than in an informal reintegration route. For example, in a formal reintegration route, the occupational physician (or prevention advisor-occupational physician) is the central person. The doctor can support you and your employer where necessary.

You are not alone.  Many professionals can help you: each with their own expertise.

🤝Together: these people need each other to walk the right path with you and find a good solution together.

🚧Challenge: it can be unclear who exactly takes on what role or what you can turn to whom for.

💪Opportunity: Key Players in the Return-to-Work Process:

• Attending Physician/Team at the Hospital or Rehabilitation Center:
  • Establishing your care plan and necessary treatment (e.g., multidisciplinary rehabilitation).
  • Prescribing your disability.
  • Providing information on the impact of your brain injury.
  • Offering back-to-work guidance in a medical report to assist your workplace in evaluating your return or determining necessary support.
  • Collaborating on planning for a potential return to work, considering factors like reduced endurance capacity.
• Advisory Doctor and Return-to-Work Coordinator of the Health Insurance Fund:
  • Assessing your work incapacity and advising on potential return-to-work options or retraining.
  • The return-to-work coordinator facilitates communication among professionals and supports the advisory doctor.
• Occupational Physician:
  • Determines your medical fitness for your job as per your employment contract.
  • Evaluates options and considerations for (re)entering the workforce.
  • Identifies necessary adjustments to support you.
  • May conduct a pre-return-to-work examination.
• Employer:
  • Understanding your rehabilitation process and the impact of your brain injury on work performance is crucial.
  • Information sessions or personal discussions can help raise awareness among employers and colleagues.
  • Trade Union and Committee for Prevention and Protection at Work (CPBW):
  • Offer guidance on resuming work effectively.
  • Provide assistance if returning to your current employer is not feasible.
• Employment Services Mediators (e.g., VDAB, GTB, GOB):
  • Assist in returning to your current job or finding new employment.
  • Specialized services like GTB aid individuals with disabilities in securing and maintaining employment.
  • GOB offers job coaching services to facilitate reintegration with employers.

⚠️ Note: Positive advice from the health insurance fund's advisory doctor is required for starting a GOB pathway while receiving incapacity benefits.

Returning to work, due to the invisible effects of a brain injury such as fatigue or stimulus hypersensitivity, often presents a complex process.Once you are back at work, maintaining your position can be an even greater challenge.

Know that there are several individuals who can assist you:

• Your employer or someone from the human resources department.
  • In an ideal scenario, there is a disability manager who will help monitor your process on the job.
• Your occupational physician (or prevention advisor-occupational physician).
  • You can schedule an appointment with your labour doctor.
  • Together, you can discuss the course of your (partial) return to work and address your concerns.
  • Your occupational physician can also make an assessment of necessary aids and adjustments to your workstation.
• Work mediator and/or specialised job coaches, e.g., from VDAB, GTB, or GOB.
  • If a work mediator follows up with you, you can contact this mediator if you are in danger of dropping out or are worried that you will not be able to keep up your resumption of work.
• Specialised job coaches from Specialised Training, Guidance and Mediation Services (GOB) can support you and your employer in the workplace.
  • They can carry out an environmental and workplace analysis on the shop floor.
  • They will then map out in detail how to adapt the workplace if necessary, what support from whom could be valuable, and how to plan your tasks.
  • The job coach can pick up various concrete tasks with you. For example, the job coach can detect obstacles, train you certain skills step by step, or inform your colleagues about the impact of your brain injury in the workplace.
• Together with the treatment team, you can practice certain tasks you need to take up on the job separately.

🔀There are several options:

• you can share your thoughts about returning to work with the rehabilitation team .
• you can start a 'return to work' programme through the health insurance.
• you can schedule an appointment with a 'return-to-work coordinator' and/or advisory doctor from the health insurance company. This person can help you to find suitable guidance for your return to work.

💡Tips and tricks: check the website of your health insurance company and contact them to discuss your questions.

🤝Together

• You can contact your occupational doctor to discuss if, when and how you can practically return to work.
• You can also contact your supervisor to discuss the possibilities of returning to work. The emphasis is on finding a solution that satisfies both you, as employee , and the employer. 

💡Tips & tricks that can help you prepare for your return to work.

• 💡Tip 1. Try and get a good understanding of your own abilities and challenges.
  • You can write this down and review it with your friends and family .
  • It can also be valuable to share this information with your doctor/rehabilitation team or the work mediator from the employment service supporting you.

• 💡Tip 2. Keep a folder containing all the information about (the impact of) your brain injury.
  • You can review this folder yourself repeatedly.
  • You can also take the folder with you when visiting key professionals, such as the occupational doctor , the advisory doctor of the health insurance or the work mediator from the employment service.

• 💡Tip 3. Understand that the path back to work is not straightforward or clear.
  • It can be a journey, intertwined with processing and accepting the consequences of your brain injury.
  • A journey in which many professionals are actively involved.

• 💡Tip 4. Bring someone along to important appointments, such as an appointment with your employer or with the occupational doctor .
  As much as you want to arrange everything yourself, taking someone with you can be very useful.

💪Opportunity: the healthcare professional can support you to be prepared for the interview and attend the appointment with you.

• You will feel more confident because that person recognises and acknowledges your challenges and has the experience to explain it to others.
• Good support will ensure that results of the interview provide a better match to your specific situation.
• The occupational doctor can look after your well-being.
  • This doctor ensures that you can safely return to work.
  • Sharing relevant information about.

⚖️ Legislation: Starting from October 1, 2022, the occupational physician or a nurse assisting the doctor is required to reach out to you after four weeks of work incapacity. This contact aims to provide you with information regarding potential return-to-work options.

Scheduling an appointment with the occupational physician (or prevention advisor-occupational physician) can be part of an informal reintegration process, either as a pre-return visit or an assessment upon resuming work.

• During this meeting, the occupational physician will discuss your health status and job responsibilities.
• If feasible, the occupational physician may propose adjustments to your work setup to your employer.
• This discussion does not constitute a fitness-for-work evaluation, and the employment doctor does not complete a health assessment form at this stage.
• An examination upon returning to work is mandatory for employees subject to compulsory health monitoring after being absent for at least four consecutive weeks due to illness, accident, or childbirth.
• With your consent, the occupational physician may collaborate with your treating physician and/or the advisory doctor from your health insurance fund.This examination must occur between your first day back at work and your tenth working day.

You have the option to arrange an appointment within a formal reintegration process.

• You, either independently or with your treating physician, have the authority to initiate this process.
• Subsequently, the occupational physician informs your employer about the commencement of this program.
• Contrary to an informal appointment, in this formal setting, the occupational physician provides a documented decision to both you and your employer. Additionally, there are legal timeframes within which a response regarding your return to work is anticipated.

The occupational physician (or prevention advisor-occupational physician) has several tasks,

including checking whether you are medically fit to perform your duties (again).

• As the occupational physician does not have a treatment or care relationship with you, there is no direct access to your medical data.
• The treating doctor may only share information with the occupational physician with your consent.
• You can share the reports you receive from your treating doctor/team with the occupational physician yourself.
• Know that the occupational physician needs this information to correctly assess whether you can return to your job.
• This information can also help the occupational physician advise you on what adjustments can help you stay at work.

Yes, if you are affiliated to a union.

💪Opportunity:

your local militant can advise and inform you about the possibilities of resuming work with your own or another employer.
the militant, if you want, sometimes joins a discussion with your employer.

🤝Together: you can also visit your union secretariat, for a free career counselling session.

A career counselor will work with you on your career question.
This system works through career guidance vouchers.

💡Tip: Every employee is entitled to career cheques every six years.

The advisory physician of the health insurance fund has several tasks: checking, informing and advising.

• The advisory doctor assesses your medical history, your functional capabilities and the expected course of your recovery.
• The advisory doctor judges whether you, as an employee, meet the conditions for recognition of incapacity for work and thus qualify for incapacity benefit (or sickness benefit).
• The advisory doctor of the health insurance fund has an advisory role in work resumption and judges whether a work resumption route is compatible or appropriate to your medical situation. Thus, this doctor may allow partial work resumption while retaining (part of) your incapacity benefit.
• Partial work resumption means doing your former tasks, part of your former tasks or new tasks.

💡Tip: check your health insurance fund's website and contact the back-to-work coordinator to discuss your questions.

Yes, under certain conditions you can resume work part-time and keep (part of) your benefit.

💰Benefit: if you resume work and want to keep (part of) your benefit, you need the permission of your health insurance fund's advisory doctor.

• Depending on your health insurance fund, there are special documents to request this.
• After that permission, you may do adapted work.

🚧Challenge: resuming 'part-time' does not have to be directly half-time.

• For you, it may be appropriate to start with a more limited number of hours.
•  you can also do voluntary work during your incapacity for work.
  • For this, you do not have to ask permission from the advisory doctor of your health insurance fund.
• However, we recommend that you inform the advisory doctor. This doctor will check whether volunteering is compatible with your health condition.

💡Tip: discuss the number of working hours and work content with your treating doctor, work doctor and employer.

💡Tip: you can ask your health insurance fund for a brochure on (part-time) work resumption.

If you start working as an employee, your disability benefit through the health insurance fund decreases depending on how many hours you resume work.

1. 💰Benefit: if you resume work part-time, through the system of adapted work, you will retain (depending on the number of working hours) all or part of your benefit.

Your health insurance fund can check and calculate for you whether and how much your disability benefit drops.
You must apply for the adapted work to your health insurance fund.
Pending the decision, you may start adapted work.
You have to make sure that the necessary application documents reach the health insurance fund at least one working day before you start.

2. 💰Benefit: if you resume work full-time, resume work as you did before your disability or if you resume unemployment, you will no longer receive disability benefits.

In that case, notify your health insurance fund.
Depending on your health insurance fund, there are special documents to indicate this.

Yes, but...

1. 💰Benefit: if your workplace accident is not yet consolidated, you can partially resume work with financial intervention from the industrial accident insurer.

Your temporary incapacity for work is then no longer complete, but partial.
The compensation you receive from work accident insurance is then equal to the difference between your wages before the accident and your wages when you return to work.

2. 💰Benefit: If the workplace accident is already consolidated and your work disability is recognised by the health insurance fund, you can resume work part-time through adapted work.

You can resume work (partially) through an informal or formal reintegration route.

Yes, but...

During partial work resumption, you can only take holidays according to the effective working regime at that time, which means based on the number of hours agreed during the partial resumption of work.

During the first year of your work incapacity, your sick days are considered as days worked, and thus, you also accrue holiday entitlement. If you have not taken your holidays by the end of the year or cannot provide proof of this, your benefit for the month of December will be withheld in full.

The health insurance fund assumes that you will still take your remaining holidays during the month of December.

For more information on the calculation of your holidays and holiday pay, contact your employer, the National Office for Annual Holidays, or the FPS Social Security.If your work incapacity has been recognized for more than 12 months, the days of illness are no longer equated for the calculation of your holiday entitlement. As a result, you may only accrue a limited number of days' holiday in gradual employment after a longer period of work incapacity.

🚧 Challenge: if you can no longer perform your previous job due to your brain injury or see no opportunities with your current employer , there are several people who can support you:

• the occupational doctor of your current employer.
• the mediator of a specialised employment service.
• the doctor/rehabilitation team.

💪Opportunity: it is important to consider what you want to achieve in terms of work.

• What job seems suitable to you?
• Would you like to retrain?

🚧 Challenge: finding suitable work and a suitable employer , requires searching, patience and sometimes luck.

💪Opportunity: thanks to a job exploration (or job trial), you can experience

• the job
  • what does a specific job actually involve?
  • what are the demands and expectations for that specific job?
  • what are possible adaptations?
• yourself
  • what are your strengths and weaknesses?
  • what are your interests? What is your attitude to work?
  • what is a realistic/feasible work schedule for you?
• During a job interview, it is good to focus on why you are suitable for a specific job.
  • Talk about the impact of the brain injury on your work performance.
  • Talk about ways to make this specific job possible for you.

You are not obliged to inform your employer about your health or your medical history.

• For instance, you are not obliged to tell them you have a brain injury.
• Sharing this information can, however, make your employer more understanding of any necessary adjustments to your job or working environment.

It is a personal choice, where you can identify the pros and cons for yourself.

However, you are obliged to tell your employer everything that is important to perform your job.

•  For instance, you have to mention things that might challenge you performing a certain job. For example, if you need adjusted working hours, or if you cannot perform certain tasks associated with the job, you must mention this. You can consider the challenges you are experiencing and what would be helpful for you to perform the tasks.

🚧Challenge: it sounds easy in theory, but in practice there is often a thin line between what you say and what you don’t.

• Also consider emotional and behavioural consequences.
• Maybe you are uninhibited, anxious, inflexible, more irritable ... .
• This can create annoyance and helplessness in you and your colleagues/manager, but if you share this, it can also create a connection.
• It is best to discuss these consequences thoroughly.

💪Opportunity: think carefully beforehand about what you want to share with whom and how.

• For example, do you send an e-mail to all your colleagues or do you inform one colleague in detail? That colleague can be your confidant and your on the job mentor.
• It can be useful to rehearse such a conversation in advance with someone from the rehabilitation team or write such an e-mail together.
• If you have been able to talk about your brain injury several times, you will find a way to talk about it that suits you.

No, this is a personal choice.

💪Opportunity: if you return to work after a brain injury, you can be open with your employer, your supervisor and/or your colleagues by informing them about (the impact of) your brain injury.

However, this is not an obligation.
Explaining in an understandable language what (the impact of) your brain injury on the job is for you can help them to understand you better.

This will give your employer, supervisor and/or colleagues a better idea of what has changed for you and what is difficult. You can inform them about:

• things that will help you function well at work, such as working with earplugs as a solution to overstimulation.
• what they can do to support you, such as issuing assignments in writing.
• why certain adaptations are helpful for you, such as taking some time off during your lunch break to really unwind instead of chatting with your colleagues.

🤝Together: sharing the invisible consequences of a brain injury (e.g. reduced long-term concentration, hypersensitivity to stimuli or fatigue) can help your employer to think about options:

• how can you still continue to work with your brain injury?

A fixed-term employment contract, the employer can terminate without compensation.

An employer is prohibited by law (discrimination law 10/10/2007) from terminating an employment contract of indefinite duration because of (long-term) illness.

However, the employer can still dismiss you during your period of illness for other founded reason(s).
Since April 2014, the founded reason(s) must be explicitly stated on your dismissal letter.
The dismissal must meet certain conditions to be legally valid.

It is possible for you to be absent for long periods of time due to the brain injury and still remain on your employer's payroll. Your employment contract is then suspended due to illness.

If you are affiliated to a trade union, they can support you with possible questions.

⚖️ Legislation: after you go through a formal reintegration process and are permanently unfit for the agreed work, your employer can still terminate your employment contract. A parliamentary procedure is now under way to separate a dismissal due to medical force majeure from a formal reintegration process.

To answer this question, it is important to know what 'consolidation' means.

• Consolidation is a medical decision that means your brain injury and its consequences are considered stable and no more change is expected in your functioning.
• Until consolidation, you receive temporary disability (90% of your salary).
• After consolidation, permanent disability (percentage of economic disability) is paid.

💰Benefit: in case of partial resumption of work before consolidation, the wage difference will be topped up by the occupational accident insurance (so that you have no loss of wages).

However, this is a temporary arrangement until consolidation.
After consolidation, you can e.g. partially resume work through the health insurance fund, through an informal or a formal reintegration route.

🚧Challenge: appropriate timing to resume work after your brain injury remains a personal decision.

🤝Together:

• Be sure to discuss your questions and concerns with your treating doctor/team. 
  • That way, you are well informed and can choose whether to resume work (partially) before or after consolidation.
  • Since this is a workplace accident, the occupational accident insurance advisory doctor also follows you up.
• the advisory doctor follows up your insurance file.
  • this doctor estimates the impact of your brain injury on your work opportunities.
  • This doctor translates this assessment into a degree of permanent disability.
  • this doctor assesses the need for help and aids.
• Contact the Fedris social worker for further information. Fedris has developed some brochures to inform you as a victim.

💰Benefit: you report your incapacity for work to your health insurance fund.

• The health insurance fund will then check whether you are entitled to benefits and whether the conditions are met.
• The decision of your health insurance fund's advisory doctor to recognise your incapacity for work is not an end point.
• That is, it is not because you are incapacitated for a period of time that it remains recognised over time.

You are entitled to full, accurate and timely information.

🤝Together: sometimes it is useful to pass on written information to other services.

• This can only be done with your consent.
• Physicians and therapists can consult each other, they have shared professional secrecy.
• Everything must be transparent to you.
• Your medical records are kept carefully and securely in the healthcare facility.