I am an employee in the Flemish government

🚧 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 the work-focused help request with your treating doctor.

The occupational physician, reintegration officer of your department or agency and the Career and Wellbeing team can support you.
They can help monitor that the steps you take towards work are feasible and that the work is appropriate.

🤝Together

• Good relationships with your manager and colleagues are crucial.
  • Informing them about the consequences of your brain injury can enhance their understanding and support in the workplace.
  • Maintaining contact with your employer during your absence helps keep the communication line open and ensures your employer is updated on your recovery process.
  • Share information that makes you feel good.
  • Establish agreements with your employer to facilitate your return to work in the best possible conditions. This can be done through an informal or formal reintegration process. In both scenarios, the occupational physician assesses your medical suitability for a job. The doctor can support you and your employer where necessary.
• Your loved ones often have a good understanding of your progress and can provide valuable insights into the appropriateness of resuming work.
• Your treating doctor/team can assist you in your return to the workplace.
  • If you participate in vocational rehabilitation, rehabilitation goals are linked to your job goal.
  • They often possess valuable information on your performance that is meaningful for the occupational physician and your employer.
• There is also a reintegration officer and a Career and Welfare team that you can contact for additional help, guidance, or coaching during your reintegration.
  • 💡Tip: in some (large) companies or organizations, there is a team or employee specialized in returning to work after a (long-term) absence. You can contact this person for extra help, guidance, or coaching during the reintegration process. Be sure to inquire about this with your employer's HR department.

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).
  • completes the illness certificate from the Flemish government, 
  • 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 (IDEWE):
  • 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.
• Career and Wellbeing Team: Both you and your employer have the option to seek additional assistance, guidance, and coaching from this team to facilitate an informal reintegration process.
• Reintegration Officer from your department or agency: This individual can assist you with your reintegration process.

💁Meer weten? Bekijk de informatie van de Vlaamse overheid over re-integratie bij de Vlaamse overheid.

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 you and your work.
• You can engage a reintegration coach or career coach to support you in your return to work.

Certainly, you have the option to apply for part-time work.There are two part-time work schemes available:

• 'Part-time work due to illness': In this scheme, a temporary work schedule between 50% and 100% is implemented if the examining doctor believes you can eventually return to full-time work.
• 'Part-time work due to disability or chronic illness': This scheme allows for a temporary or permanent adjustment of the work schedule to 50%, 60%, 70%, or 80%. This gradual approach helps in building up your resilience. Returning immediately to full-time work after a brain injury is less common.

💰Salary: Transitioning back to work through part-time arrangements will impact your salary. Details on these consequences can be found in the following question.

💡Tip: It is advisable to discuss the number of working hours with your treating doctor, occupational physician, and employer.

This varies based on the specific part-time arrangement in place.

• For working part-time due to illness: 
  • Your salary, seniority, vacation days, holiday pay, end-of-year bonus, and (supplementary) pension remain unaffected.
  • Each day of part-time absence due to illness contributes towards your sick quota of 666 working days.

• When working part-time due to disability or chronic illness:
  • Your salary is adjusted: You receive a salary corresponding to your work percentage along with a 30% salary bonus based on the amount you would have earned at full-time.
  • For instance, if you work at 50%, you will receive 65% of your full-time salary; at 80%, you will receive 86% of your full-time salary.
  • Your vacation days will decrease proportionately.
  • However, your holiday pay, seniority, pension, and sick leave remain unaffected.

⚖️ 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 the DCPA 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.

You can always submit a request to (partially) resume work.

If you wish to resume work part-time, approval from Medex or the insurer is required, depending on the department or agency you work for.

🚧Challenge: To accurately estimate your percentage of permanent disability, it is crucial that the advisory doctor of the industrial accident insurance is well informed about the progress of your part-time return to work.

💪Opportunity: It is essential to report what is going well. Additionally, it is important to discuss the things that are more challenging.
After all, many consequences of a brain injury are not visible, but they have a significant impact on your (remaining) work options.

💡Tip: If you have specific questions about returning to work after a work-related accident, schedule an appointment with a Fedris social worker.

Certainly,

this is contingent upon the specific part-time arrangement in place.

Engaging in part-time work due to illness does not impact your vacation days or holiday pay.

However, part-time work due to disability or chronic illness results in a proportional reduction in your vacation days.

Additionally, working part-time due to disability or chronic illness influences your holiday pay.

If you find yourself unable to continue in your previous job due to a brain injury or if you do not see opportunities with your current employer, several individuals can provide support:

• The back-to-work coordinator and the advisory doctor from the health insurance fund
• The occupational physician (or prevention advisor-occupational physician) at your current workplace
• The mediator from VDAB or GTB (Specialized Mediation Team)
• Your treating doctor/team

🚧Challenge: It is crucial to determine your work goals.

• What type of work do you find suitable?
• Are you considering retraining?

💪Opportunity: Discovering fitting employment and a compatible employer requires exploration, patience, and sometimes a bit of luck.

• Engaging in a career exploration (or job trial) allows you to experience the nature of specific work, its requirements, expectations, and how your brain injury may impact it.
• This process provides insight into your options, needs, and challenges.
• Through this exploration, you can identify your strengths and weaknesses with a brain injury, understand your interests and work preferences, and determine a feasible work routine.

During job interviews, it is beneficial to emphasize why you are well-suited for the position. When discussing your brain injury, focus on its implications for work performance and strategies to facilitate your success.

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?

If you have utilized your sick leave entitlement, the possibility of a medical pension may be considered.

• This entails an early pension for medical reasons available to statutory employees of the Flemish government.

When your sick leave quota has been exhausted, your supervisor can request the Medex pension committee to conduct an assessment.

• The pension committee evaluates and determines whether you can return to work during the assessment, are fit for your current position, are unfit for your current position, are eligible for temporary early retirement, or are permanently unsuitable for any role.
• If deemed permanently unsuitable or temporarily retired prematurely, you may be placed on a (temporary) medical pension.
• Other decisions may also lead to eligibility for a medical pension in due course.

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.

💰 Salary: Your salary will be maintained both during temporary disability and after consolidation (permanent disability).You have the option to request to (partially) return to work at any time. If you intend to resume work part-time, approval from Medex or the insurer is necessary, depending on your department or agency.

🚧Challenge: Determining the right timing to return to work following your brain injury remains a personal choice.

You notify your illness to the medical oversight organization, Mediwe vzw.

💰Salary: Your salary will be maintained throughout your illness until your sick leave quota is depleted.

• Find out here what occurs once your sick leave quota is exhausted.
• You disclose your disability to your health insurance provider.
• Subsequently, the health insurance fund will assess your eligibility for benefits and verify if the necessary conditions have been fulfilled.