During the disability

Reach out to your employee/colleague during their absence.

There is no definitive answer on how frequently to make contact. However, there are three key moments where active listening is crucial:

Initiate contact with the individual at the start of their absence.
Maintain regular communication with the individual or a trusted loved one (partner, family member, or close friend) throughout their absence.
- Encourage the individual to communicate directly with their immediate manager and/or colleagues.
- Take the time to actively listen or schedule another conversation to ensure attentive listening.
Just before their return, collaborate on determining their capabilities, preferences, and work-related possibilities and challenges.
- What tasks are manageable upon return?
- What areas are still challenging or not feasible?
- What forms of support are needed?
- How can the manager or colleagues provide assistance?

💡Tip: If you are unsure about your role or responsibilities, seek guidance from the social secretariat or occupational health service for information and support.

👉 Click on a question for further insights and guidance.

An acquired brain injury (or ABI) is an umbrella term for all injuries to the brain that occur at the earliest six months after birth.

🚧Challenges:

a brain injury can have several causes and often disrupts the course of one's life. Because of that disruption, a person's life has changed and there is a time before and a time after the brain injury.
the term 'acquired brain injury' refers only to the cause, and says little about the nature and severity of the consequences.

A brain injury can

be the result of an external cause, such as a traffic accident or a fall down the stairs. This is called a traumatic brain injury.
also occur because something goes wrong inside the brain, for example a blood vessel ruptures or a clot gets stuck in the brain's bloodstream (causing a stroke). This is called a non-traumatic brain injury.

The impact of the brain injury can be broad, people may have challenges at different levels, e.g. at the level of

functioning, e.g. someone may suffer a loss of strength in the limbs or experience difficulties swallowing.
activities, e.g. someone may have communication difficulties or the brain injury may affect their mobility.
participation, e.g. it might be hard(er) for someone to combine different roles (such as employer, partner and friend) or it might be hard(er) to combine work activities with other live domains (such as home and hobby).
external factors, e.g. added value of stimulus-low working space or supportive relatives.
personal factors, e.g. how to cope with the challenges.

No.

Just as every person is different, every brain injury is different and therefore the consequences of each brain injury are also different.

Depending on

the severity, location and extent of the brain injury, the consequences will differ for everyone (from mild to very severe). Moreover, not every person faces all the consequences.
- For example, one might be in a wheelchair and communicate fluently, while another person with brain injury can walk independently and needs more time to perform certain tasks.
personal factors, such as, age, the consequences can have a different impact.
- For example, the impact of a brain injury is different for a young person with young children compared to an older person who has a partner that needs care.
the employment, meaning the task demands and working environment, the consequences can have a different impact.
- For example, it can be easier for someone to fulfil routine tasks compared to performing new tasks under time pressure.

🚧Challenge: often, people with a brain injury may have difficulty coming to terms with change.
Opportunity: they need time and repetition to master (new) tasks.

They can use tools to compensate for the consequences, such as,
- using a paper diary or a calender in their mobile phone to make sure they arrive at an appointment on time.
- using checklists or post-it notes to make sure they do not forget any tasks.
- putting things in a fixed place to make sure they find their way smoothly. .

🚧Challenge: it may be difficult to realise exactly what the consequences are:

What is going well?
What could they do better or differently?

💪Opportunity: be open to feedback or support the person if they can't figure it out themselves.

There is no one answer to this question.

The duration of the (impact of) the brain injury and when the person can return to work depends on many factors. Consider, for example:

the degree or severity of the brain injury: this can vary from mild to very severe.
the consequences of the brain injury.
how these consequences are reflected in the workplace:
- what is expected of the person in the workplace?
- what are the requirements of the tasks?
- are the consequences mainly physical or more cognitive or emotional?
the amount of time needed for rehabilitation and whether this is compatible with a return to work.
the options for adapting the work with you, as the employer , or with a new employer.

🚧Challenge: in order to return to work, people need a variety of skills including cognitive, social, communication and physical skills. These are often affected after a brain injury.

Returning to work is a personal journey and requires time, energy and effort.

There is no ready-made solution.
The person often builds up the reintegration slowly: they start with a few hours and if that goes well, they work more hours.
The danger is that people with a brain injury might overestimate their ability and want to return to their previous level of functioning quickly.
A flexible, progressive schedule should be drawn up by mutual agreement.

💪Opportunity: rehabilitation that focuses on the skills people need in the workplace, so-called vocational rehabilitation, can be an important step in returning to work.

🤝Together: the doctor or someone from the rehabilitation team can provide a preliminary plan. In close consultation with the employee and the work mediator :

look for possibilities and limitations in function
look for adjustments to tasks and/or the working environment
suggest new possibilities.

There is no ready-made answer to this question.

Immediatly after a brain injury occurs, there is the acute phase: the person's medical condition is not yet stable and the focus is on survival.
This is followed by the rehabilitation phase. The person's medical condition is stable and they may start rehabilitation.
Once the person is no longer undergoing rehabilitation and little improvement can be expected, we speak of the chronic or long-term phase.

Most progress occurs in the first few months after the brain injury. Two years post-onset, gradual, less noticeable progress is still possible. The significant progress the person achieves in the beginning and the slower progress later on are both valuable for the person.

🚧Challenge: hardly anyone goes back to being the person they were before the brain injury.

It is not always easy for the person themselves to understand exactly what the consequences are:

What is going well?
What can be done differently?

💪Opportunity:

Some people are open to feedback or ask for help when they cannot manage on their own.
It can be common for others not to appreciate the extent and implications of the challenges they’re facing and recommendations about returning to work. These people need more guidance from others.

💡Tips & tricks: a brain injury has an impact. Some people do not fully realise what is going on themselves.

It is difficult to answer this definitively.

During an absence from work, there are generally three moments of contact where it is important that you, as an employer , actively listen to the employee :

at the beginning of the absence,
during the period of illness and
when returning to work.

💪Opportunity: it is important that you, as an employer , maintain good contact with your employee during the absence period.

If there is an absence or return to work policy within the organisation, then it is clear who contacts the employee, when and how often.
Some organisations do not have such a policy (yet). This can make it more difficult if you have an employee on long-term sick leave or who is unwilling/unable to return to work.

🚧Challenge: if someone is incapacitated after a brain injury, this can – depending on its severity – immediately result in a lengthy period of disability. There may also be a period when your employee is in a coma and you cannot contact them directly. In this case, try to keep in touch with the employee’s friends and family and inform them that you are there as an employer if they have any questions.

🤝Together: if you, as an employer , are not sure what is expected of you when one of your employees is on long-term sick leave, you can ask the health service or occupational doctor for support.

💡Tips & tricks

If possible, let the employee speak for themselves.
Show interest in the employee’s well-being or that of their friends and family .
Avoid making the employee or their friends and family feel that the contact is intended as a check on the disability.
Gather information. Keep the employee and the nature of the absence in mind.
Take time to listen or call back at a later time.
Avoid negative reactions, such as hinting at prejudice or using an inappropriate tone of voice.
Have your absent employee call their supervisor directly, rather than sending an e-mail to the human resources department.
It is important to reassure the employee and/or their friends and family and be genuinely interested in the conversation.

No, not really.

🚧Challenge: every brain injury is different; every person is different and every impact on communication is different.

💪Opportunity: adapt your communication to the person's needs. If the person has difficulty understanding verbal language or expressing themselves, the following communication tips can help:

Don't talk about the person, but to the person.
Opt for a quiet environment: choose a quiet and calm room and talk 1-on-1. If necessary, have a friend or family member join in, someone who knows the person well and can give communication tips or offer support.
Support what you say with gestures, pointing, drawing or written words.
Structure what you say: speak in short sentences, avoid complicated terms, write down the most important points.
Check that you are in agreement: maintain eye contact and regularly check that you are understanding each other correctly. For example, you can ask the person to summarise the information.

No.

Terminating an employee due to illness is not permissible.

When an employee requests to return to work after a period of illness, the feasibility depends on the severity of the brain injury and their progress post-rehabilitation. As an employer, it is advisable to allow the employee sufficient time.
Dismissal during a period of illness can be considered under specific conditions, ensuring that the illness itself is not the sole reason for termination. Discrimination based on a health condition is strictly prohibited.

🚧Challenge: A brain injury can significantly impact an employee's ability to work, potentially leading to long-term incapacity.If it is mutually agreed that reintegration options are limited, you may explore the possibility of terminating the employment contract for medical reasons. However, termination can only occur after completing a formal reintegration process.

⚖️Legislation: The regulations were revised in the Royal Decree of September 11, 2022. Moving forward, 'dismissal due to medical force majeure' will be distinct from the reintegration process, emphasizing a stronger focus on reintegration. Specifically, 'dismissal due to medical force majeure' will follow a separate procedure.

💰Financial Impact: If an employee is incapacitated for an extended period, the initial incapacity period is covered by the employer. Subsequently, reimbursement may be provided by the health insurance fund or industrial accident insurer for the employee.

Financial impact

If an employee is incapacitated for an extended period, the initial incapacity period is covered by the employer.

Subsequently, reimbursement may be provided by the health insurance fund or industrial accident insurer for the employee.

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