title: Minimizing the effect of TBI-related physical sequelae on vocational return.
abstract: This article evaluated the common physical sequelae that affect return to work (RTW) after traumatic brain injury (TBI). We performed a Medline search and evaluation of current TBI rehabilitation texts. The information presented is a combination of published literature and clinical guidelines. The limitations faced by many patients with TBI can best be overcome through clever job search, job redesign, and community linkages with business and industry that are willing to partner in helping the patient with TBI regain employment. The physician plays a key role in communicating suggestions to the vocational specialist. The comorbidities described represent challenges to successful RTW. These problems are recurrent, long-term, and clearly affect job procurement, nature of job, level of required support, and likelihood of job retention. Conversely, these challenges should not be viewed as impenetrable obstacles. With appropriate supports such as compensatory strategies, job coaching, assistive technology, medical management, and job restructuring, successful RTW is viable option. Physicians must focus on employment outcomes in real jobs and not settle for volunteer work, sheltered work, or assessment and planning. Individuals should be placed in real work for real pay. Through close collaboration between the survivor of TBI, the physician, the vocational specialist, and community resources, successful employment for survivors of TBI is possible and must be prescribed a high value.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Richmond VAMC, 1201 Broad Rock Boulevard, Attn 117, Richmond, VA 23249, USA. shane.mcnamee@va.gov
authors.forename: Shane
authors.initials: S
authors.lastname: McNamee
authors.forename: William
authors.initials: W
authors.lastname: Walker
authors.forename: David X
authors.initials: DX
authors.lastname: Cifu
authors.forename: Paul H
authors.initials: PH
authors.lastname: Wehman
mesh_terms: D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation*; D004651:Employment; D006801:Humans; D038223:Post-Concussion Syndrome / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational