Life-changing injuries

Returning to work or education after acquired disability or injury

Before injury, people we spoke with worked in a variety of different careers and jobs. Some were able to return to these jobs, with reduced hours or doing slightly different tasks. Others were no longer able to do the same job and either changed career, did voluntary work, returned to education, remained unemployed or took early retirement. Most of those currently unable to work hoped to return to work in the future.
 
The length of time off work varied, depending on the type and severity of people’s injuries. Vocational rehabilitation programmes, occupational therapists, psychologists, Access to Work or similar charity schemes supported people’s return to work. Vocational courses allowed people to experience a structured work environment before returning to their job or finding a new position. People were supported to try different types of work, such as working in a supermarket or office, often unpaid, to see if they could do the job. Raymond’s wife organised for him to do a paper round, which he thought his colleagues would find amusing.

The psychologists Wesley worked with helped him to get a job.

The psychologists Wesley worked with helped him to get a job.

Age at interview: 30
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
How soon after your injury did you start to work again?
 
Few years. Yes. I think my first job, what did I do when I come out of hospital? I think it might have been, might have been Waitrose, near the station. But that was it, I think it was Waitrose, because I had, I was going to a special psychology place in [head injury clinic] who you were in contact with. Yes, it was through two psychologists there how I got the job in Waitrose. They came to the interview with me there and they came up with, he’ll work twenty hours a week for nothing. And I didn’t even know about this. This psychologist just suggested it. So I think I ended up working 80 hours for nothing. 
 
And why do you think that they organised that for you?
 
So Waitrose could get 80 hours free labour out of me for nothing.
 
Do you think that was the only reason for it?
 
No, probably not. It was probably so you know, they could see if I was any good at the job. If they liked me, and if I actually liked the job. And then after that I actually got a job out of them. It was only part time; I think 16 hours a week, just pushing trolleys. But from that I was there about three, three and a half years. I kept saying, “Look, you know, can you give me more hours. Can you give me better job?” Within in, and you know, from that I learnt all the different sections. I worked on the fruit and veg for about a year, and year and a bit. 

 

People faced different challenges returning to work. Those with brain injury talked about fatigue, problems with stamina and memory, sensory overload, concentration and mobility, and talking more than they did before injury. Going back to work was described as “scary” (Raymond) for some as it differed from the safe environment of rehabilitation hospitals. Open plan offices could be busy and distracting and travelling to and from work exhausting.

Pain medication helped people with physical problems to do their jobs. People with spinal cord injuries said they needed to prioritise their health over their workload because it took longer to recover from health problems.

Simon B thinks it’s important to find a way back into the world of work, but it’s important to...

Simon B thinks it’s important to find a way back into the world of work, but it’s important to...

Age at interview: 42
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
So I’ve always found working self-employed or flexible hours for me, personally the best way to work, because I don’t mind working long hours, as long as I can work them flexibly. So, not easy and for me it was little stages, you know, one day a week, two days a week, three days a week and just building up to it. Maybe that’s just me I don’t know. I mean for others it might be easier just to go back and work full-time and get on with it. I have friends that have worked full-time from very soon after their injury and still work full-time to this day. I think you have to be very mindful that you don’t put your body at risk of working too much. You do have to, you do have to compromise again because there’s no point working full-time if your body starts falling apart and you pick up pressure sores and don’t take care of yourself, so you do have to manage that Again it’s another thing to manage. It’s a never ending list of things to manage to be frank, but yeah, stages. 
 
Stage return. I would certain encourage people not to return full-time straight away, maybe part-time, or if they lose their job, start volunteering. Or start finding a way back into the working world. Because it brings, it brings a whole new life to you. If you’re not stuck, if you’re stuck indoors seven days a week because of disability and not leaving the house, you’re probably depressed because you’re stuck indoors as much as you’re depressed because you’re disabled. So to have something to get your teeth back into is, is important, I think. So I found that although work can be quite demanding and quite hard, I think it’s, in many ways, something that I’m really glad I’m engaged in. Because everyone needs something to get out of bed for. And for me, I like my job, so I don’t mind getting out of bed for it.

 

Some people did not always realise just how their injury might affect them and felt, looking back, they had unrealistic expectations trying to go back to work as soon as they could.

Ed went back to work before he was ready. He was getting very tired and frustrated, so he got...

Ed went back to work before he was ready. He was getting very tired and frustrated, so he got...

Age at interview: 42
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
I actually, I returned to work some two weeks after the accident, generally thinking that I was fine. In actual fact I got a little bit bored being at home and so I naturally thought it’s time to get back into it. I did in actual fact try to log in remotely about two days after coming out of hospital, which would have been four days after the accident. And for one reason or another I just, it just wasn’t working. I couldn’t get it to work. I couldn’t understand. I was getting very sort of, sort of frustrated and angry with the situation and then it ended it locked me out, sort of gave up, in sort of a bit of a huff.
 
But to those around me that were witnessing it wasn’t all together all there up top really. But anyway, I subsequently, back to, I returned to work after two weeks and on, on sort of reduced hours. However, those reduced hours were still, I’d get up, at just after, you know, quarter past five or so, sort myself out, walk up to the bus stop, get the bus, then still I’d go to the gym for an hour, even though it was far lighter, mainly because of concern over putting too much stress on my facial fracture, and popping my plate. 
 
But over a period of two months I was starting to find, even though I wouldn’t admit to myself, but it was painfully clear to others around me, especially my wife, that I was getting more tired progressively earlier in the week. So, instead of hitting that wall probably on a sort of Thursday, Friday, I start to hit it on a Wednesday, sometimes a Tuesday, sometimes, you know. 

 

Returning to work gradually was sometimes beneficial. People worked for one or two days a week and began with basic tasks like filing and photocopying. Strategies, such as going into the office early when it was quiet, or telling their colleagues about their problems, helped. Bryan had a support worker who helped him with his job. Dave had started his own business because “the flexibility offered by working independently was attractive”.
 
Having a supportive, flexible and understanding employer was also very important to people. Some employers tried to understand how injuries affected their staff and were accommodating about sick leave and payments.

Jack was given sick leave and sick pay during the period of his recovery.

Text only
Read below

Jack was given sick leave and sick pay during the period of his recovery.

HIDE TEXT
PRINT TRANSCRIPT

If you are working at the time of the accident or the time of your limb loss your employer will give you time off work so that's sorted. You've got enough time to learn how to walk and then get back into work slowly. Because I don't know of any employer's that wouldn't be willing to help in that respect. In terms of money, in the short term your employer may or may not pay you but then you've got statutory sick pay, which is not a lot but it's something. There will be ways to earn money. Hopefully you have a great family support network, which is obviously going to help you so use everything you've got – be it family, your work, the government – use them as much as possible to help you get that mobility and get that fitness and then see where it takes you, see what happens. I've not set out to do anything, this has all happened, it’s all just to kind of fallen into place like this. Like getting and being with my girlfriend that's again it just happened, the whole education thing it just happened. I was working at the time, my employer was brilliant to me' they paid me full pay for six months; they helped me get back to work slowly. Even being at work the guys who I worked with you know they didn't mollycoddle me and all that kind of stuff. They just were quite brutal with me actually if I'm perfectly honest. That helped me personally. 

Others had less positive experiences. After Jane returned to work she was signed off on sick leave and eventually “let go”. Others told us that employers found it difficult to understand brain injury with its hidden effects. Christopher thought that having no visible sign of injury meant employers expected the “pre-injury you to go back to work” and this was not always the case. Kenneth described feeling “written off”.

Bridget told her new employer about her injury and that because of her insurance she could work...

Bridget told her new employer about her injury and that because of her insurance she could work...

Age at interview: 56
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT
I think at that stage I then started applying for jobs, and I was offered a job. It was a firm of legal aid solicitors. I think they only had about 80 staff and they offered me the job. In the interview I didn’t tell them about my accident. I had got a very, obviously, very viable reason for wanting to change. And it wasn’t until they offered me the job that I then told the director about my accident and that they didn’t need to pay me, and that I, because I had the insurance, and anyway they agreed to that happening and I was there for three months. And eventually they did ask me to leave, and they said, basically, it was, there were some very good things about me, in that I … when they had a particular personnel issue or problem, I would be able to talk them through and how to work it and do it. But then, you know, someone would walk in the door and I couldn’t remember who they were, you know, it was that. And I was being ridiculed basically and they just felt it wasn’t, and so they decided to recruit...I was the first person on personnel they’d ever had. I mean it had always been done by the partners. So they then decided to recruit and employ somebody.
 
So I then went and did voluntary work in Oxfam for a long time. Local Oxfam. And so it was...I just wanted to be back at work, I wanted to be, no probably not back at work, I just wanted to be with other people and doing things, and, you know, because I had a very full life before and then suddenly to be at home all the time, which you know, I didn’t need to work, but I really didn’t want to not work. So that was it. 

 

Colleagues could be supportive in different ways. Jack said his didn’t “mollycoddle” him, Brian’s bought him a wheelchair and Sam said his got used to seeing him “whizzing around in a wheelchair. Jane said her colleagues patronised her by talking to her in a particular way when she was unwell with her brain injury, but failed to realise that she had recovered.

Initially Raymond did not want to tell his colleagues about his problems, but when he did they...

Initially Raymond did not want to tell his colleagues about his problems, but when he did they...

Age at interview: 44
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
Did people then find out or did you tell people then?
 
No, but I was much more willing to tell close confidants of mine at work what had happened to me. And also explain to them you know why I was having certain problems in certain areas and then, low and behold, I didn’t get sympathy, I got support you know, it’s amazing.
 
How did they support you?
 
I didn’t question me so much anymore. I got trusted a lot more, which makes you feel good as well when that happens, when people trust you. 

 

Sam felt a bit of a ‘spectacle’ on his first day back. His health wasn’t great, but he dealt with...

Sam felt a bit of a ‘spectacle’ on his first day back. His health wasn’t great, but he dealt with...

Age at interview: 29
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
I felt a bit of a spectacle the first day but everyone’s like, you know, everyone, I’m sure they were all briefed to like, don’t crowd him and shit, and you know, I had an office with one of my mates and, you know, just bit by bit you’re just going to get back into it. Go to the pub. And you know, you just get back to it, and people get used to seeing you kind of whizzing around in a wheelchair. And you know, it was just not really that bad.
 
It was difficult to get used to the, I was so tired to start with, you know, because your body’s just fucked and you have to sleep more than you would have before and I used to sleep about four or five hours a night and go out every night, and go to work and just be tired and be like, yeah, I’m young and invincible kind of thing. And then you kind of need to sleep and you’ve been off work and you’ve been sleeping quite a lot and all of a sudden I was back to sleeping like six or seven hours. And I was just shattered, and I was sleeping at the weekends and working. 
 
I started off going back three or four days a week and then very quickly I just didn’t want to be different to other people, I wanted, and the work was overlapped anyway, so I just went back full time. And yes, I was tired, that was the main thing and my health wasn’t great. And I got bladder infections and stuff like that, but all the things you worry about you end up dealing with.

 

 
Sometimes people were unable to return to work as their injuries were too severe. Others were looking for employment but found it difficult to get, or hold on to, a job. People with brain injury told us they were unsure about whether or not to tell potential employers about their injury because of a lack of understanding about brain injury. They felt that their injuries had a negative effect on their careers and future prospects. Jane said she was “devastated” at losing her job and felt a loss of identity that she thought her boyfriend shared. She said “I still find now that I’m asked what am I? What are my goals? I have to admit I’m at loss right now. I still don’t really know. I’d like to get a permanent job”.

Joe went back to study after his injury but the university did not think he was able to keep up....

Joe went back to study after his injury but the university did not think he was able to keep up....

Age at interview: 53
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
You said that at university that you weren’t learning fast enough.
 
That’s what was said yes.
 
That was what was said. And did you agree with that?
 
No I did not. Because I think I did and I more than did what was required, but if you have studied and you have a doctorate. I don’t have a doctorate, but I’ve been where you’ve never been. I’ve seen things and I have a different view of the world that you don’t have, but I might not be a hundred per cent and your word is more, your word is going to be taken over mine, so… And that was just what, what took place really. So I just say, well, you know, I don’t beat up myself about it. Sometime walking away is not really such a bad thing you know.
 
It sounds like what you’re saying is that you had lots of life experience but your university sort of didn’t value that as such?
 
No they didn’t value that, because, you see, what is valued is the degree, the Master’s Degree paper. Not the knowledge or experience. Now my knowledge and experience, if that was to be taken into account, I could be earning. But it was not, so and there are some people that are of, that is just their way of thinking. For instance like, if you’re working in Jamaica, and you’ve a Diploma and Degree you get the job, no experience or nothing, you just get the job. It’s just actually they prove my Degree and you get a job. Here in England it’s the same thing, Degree and Diploma and you get a job. Not experience.

 

 
Wesley thought his injury hindered his career progression. He thinks people should try to do what they’re good at after injury and not just take the first job that comes along. Juri’s injury causes him difficulties when it comes to job interviews.

The fight Juri was in when he sustained his injury is on his record. He has to discuss it with...

The fight Juri was in when he sustained his injury is on his record. He has to discuss it with...

Age at interview: 27
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
Every time I get a CRB back now at the end of it, as in like, it doesn’t affect me when looking for a job, but sometimes, usually I say it beforehand. If not nobody ever said anything to me. Because this is at the end that I got into a fight I would have I would have had charges pressed against me, if it weren’t for my eye injury.
 
Okay and that comes back every time you apply for a CRB check?
 
Yes. I wanted to do like I don’t know what, I complain and try to get it off of my CRB, but then they went to the Courts because I used to go and watch like the cases going on and talking to a detective. She said to me, “If it’s not affecting your employability. Don’t do anything for you.” So I didn’t want to go against it, what the detective said, you know. Maybe she was a bit subjective in what she said, because she’s part of the Police Force, but still you know, maybe she was really telling me something good, and I said, “As long as it’s not affecting me, I won’t do it.” I don’t like it though. But because it’s not really what happened you know, it’s not as if it’s written there as if I were meaning something. Because I got angry with them. That is another thing that taught me to be more diplomatic.
 
So having this on your CRB checks doesn’t affect your employability?
 
No.
 
Okay. Has anyone ever discussed it with you in an interview or...?
 
No. Usually I say to them before, after they give me the job, but before they get my CRB back.
 
And what do you tell them?
 

I had a fight when I was younger and the police thought it was my fault as well and it comes up not as in a record, a criminal record, but as in, there is are the last column, that says the last part of it says like, ‘Other things’ or something like that. And even when the police once stopped me on my motorcycle and they said to me, they look at me laughing or something like that you know, because, jokingly, you know, because I don’t look like the type of person who would do something like that, and what was written there was very harsh towards me, against me because of the way I behaved when I was in the interrogation room. 

Some people said they felt glad to be alive and accepted they would no longer be able to return to the same kind of work. Not going back to work could offer people the opportunity to explore new options and re-evaluate their lives. They began to think about what was important to them in life and said their views on their career and work-life balance changed. As DJ said, the “injury was not the end of the world”. People were also able to work in environments that they found more comfortable. For example, Jack was able to wear shorts in his new job and this was important to him after his leg was amputated. Christopher realised he no longer had to live in London because since leaving his job he can work anywhere. Some of the people returned to university and felt that studying gave them something to focus on whilst they were recovering and adapting to their impairments.

Rob went back to college after he lost his sight. He chose to go to a mainstream institution and...

Rob went back to college after he lost his sight. He chose to go to a mainstream institution and...

Age at interview: 24
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
Yeah. And what has the staff been like at college?
 
Fantastic. Yeah, I’ve got a learning support worker and she’s basically my scribe and yeah, she really, really helps me a lot. The teachers are really great with me. I mean, I chose to go to a school that’s not geared towards disabled people and geared towards visually impaired. It’s just a standard college and I mean they’re obligated to make the work accessible for me and give me the same education as everyone else going there. And they’ve done that, they’ve made it totally accessible for me.
 
And why did you choose that school, you know, that college as opposed to somewhere that may have had more experience or may have been geared towards people who’ve had various needs?
 
Yeah, there are, there are specific like blind colleges and everything like that and, in a way, it would be okay to go to them and again be with people who are going through the same sort of thing as me and it’d probably be a bit easier to access the work, but I want to do it the same as everyone else. I mean I can access the work. I mean through everything I’ve got, I can access the work. I don’t need specialist, like Braille forms or anything like that, and the subjects I’m doing, the subjects I’m doing are quite audible. So I’m doing English literature at the moment, and that’s like, it’s like a massively audible subject. I mean everything can be, all the books and texts can be converted to audio and everything else is like discussion and yeah, it’s no diagrams or anything like that. So it’s really, really easy for me to access. Science would be something I think I would struggle with, with the diagrams and I’d possibly have to go to a more specialist school for that.

 

If paid employment was not possible (or financially worthwhile as salaries could interfere with insurance or compensation payments), people often worked as volunteers' gardening, working in injury-related charities or church. This work could help increase confidence, provide a structure and purpose to their day, and the opportunity to meet other people.

After his injury, Simon A realised he could use the story of his recovery to motivate others.

After his injury, Simon A realised he could use the story of his recovery to motivate others.

Age at interview: 46
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT
And do you see your brain injury as a problem or a journey?
 
Sometimes it’s a problem. I think the key is, you have to develop strategies to cope with it. You have to know your limitations, and know, like, for instance, certain aspects of my abilities, I’m actually better at now than I was before, before I know how, I know what my, I know what I can’t do, and I really focus all my energy on things that I’m good at.
 
And what kinds of things are they?
 
Well what I do now is, in work, I’m much better at motivating than I was before. Because I use my, the terrible adversity that I went through. I show, for instance I show the before and after pictures of my personal, physical rehabilitation to some of the elite athletes that I’m responsible for coaching. And I can completely change a session, with the approach that these, these athletes can have to their training. And they need stimulating and they need motivating, to move on to a different level.

 



Last reviewed October 2015.

Copyright © 2024 University of Oxford. All rights reserved.