Return to Work: Managing the Return to Work Issues After a Concussion
Elizabeth M. Pieroth PsyD, ABPP

$3.95 		Professional Case Management
June 2012 
Volume 17  Number 3
Pages 141 - 142
 
  PDF Version Available!

ABSTRACT
As case managers are well aware, traumatic brain injury (TBI) is a leading cause of disability. Each year 1.7 million people suffer TBIs (Faul, Xu, Wald, & Coronado, 2010). In 2003, the direct costs of medical care and indirect costs (e.g., productivity) of TBI were estimated at $60 billion in the United States (Finkelstein, Corso, & Miller, 2006). Much of the literature on return to work issues after brain injury has focused on patients who suffer moderate to severe brain injuries, even though about 75% of TBIs each year are concussions or mild traumatic brain injuries (Centers for Disease Control and Prevention, 2003). The rate of individuals who successfully return to work after an mild traumatic brain injury varies in the literature and no clear picture has emerged. However, as the treatment of concussed patients has evolved over the years, we now have a better understanding on how to address the barriers that prevent a patient from returning to employment after a concussion.Research has well documented that the majority of individuals suffer a concussion recovery quickly and without any residual deficits. Most concussed individuals fully recover within 2 weeks and return to school, work, and other responsibilities without residual symptoms (Bleiberg et al., 2004). However, some individuals can struggle with physical and/or psychological symptoms long after the typical recovery period. These symptoms tend to fall under a few general categories: headaches, vestibular dysfunction, sleep disturbance, psychological/mood disturbance, or malingering. Each of these will be discussed briefly.Headaches are the most commonly reported symptom after concussion (Lovell et al., 2006). However, headaches are not diagnostic for concussion and can be due to many unrelated causes (e.g., sinus infections). It is important to distinguish lingering headaches from concussion and those due to other etiologies. In addition, individuals with prolonged headaches after a concussion may actually

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