Going Back to Work After Stroke
A stroke can be a life-changing event that often includes overcoming physical, cognitive or speech barriers. The right set of therapy goals can be an important part of overcoming some barriers. The decision to return to work can be an additional post-stroke goal. Making the decision to return to work, despite those barriers, as well as the process of finding the right job, is unique for each survivor.
Having the desire to return to the workforce is an important first step for survivors who are considering going back to work. Any discussion of employment has to consider stability of income for the stroke survivor and family. A loss of earnings and a large increase in debt is typical after stroke. A positive consideration is that the return to work provides psychosocial benefits for both survivors and their families. Having a job increases a survivor’s independence, sense of purpose and motivation to recover. Work broadens their social network and strengthens their connection with the community.
Each state offers different programs and resources to assist with getting back to work. The survivor may be referred to a state agency during rehabilitation or treatment. The sooner these resources are activated, the better the outcome. Most state agencies will have to go through a process to determine the survivor’s eligibility, so patience is required.
There are numerous paths to becoming employed. An agency can support you in identifying the best back-to- work path for you. Here are some of the questions a rehabilitation employment agency might ask:
1. Do you want to work at the same job with the same company as you did prior to the stroke?
Often the easiest way to return to work is with your previous employer. They know your strengths, skills and expertise. If this is your plan, the next question will be, “Can you still perform at the level required of you with minimal accommodations?” If so, that’s great, and likely offers the best outcome. However, the employer may want to set goals for bringing you back to your pre-stroke performance level. If you have a positive relationship with your employer, they may be more flexible about accommodations.
2. Do you want to work at the same job you did prior to the stroke, but with a different company?
You may benefit from consulting with a state-certified, rehabilitation employment agency job developer. They will assess your skills and may recommend training with modifications to help increase your employability and assist with the employment search.
3. Do you want to work at a job similar to, but less stressful than, the one you did prior to the stroke with either the same, or a different, company?
Some may want to work for their previous employer, but in a lower-level and less stressful position. Your experience with the company should be valuable to them. The new job may mean a pay cut, but you will be back in the workforce in a similar field. After time, you may be able to move up within the company, or seek advancement with a different employer to increase compensation.
At a different company in a similar field, existing skills and previous experience should make you a valuable applicant needing minimal training. Your previous experience should also increase your chances of a salary closer to what you made before the stroke. Although this choice may be difficult, the primary goal is getting back in the workforce with minimal downtime.
4. Would you be willing to train (through either a vocational institution or college) for a different job?
If this is the best option, it prompts a discussion of entering a new field at entry-level. Full retraining for employment can be time-consuming and expensive.
Survivor Steve Park takes a break from his job as placement specialist.
When entering any new career field, compensation is tied to your experience.
First, the rehabilitation counselor will help you identify your career interests and current abilities. The counselor will guide you through ability and aptitude assessments. Assessment results help to inform what training or retraining is needed for your newly chosen employment path.
If you are already on Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the Ticket to Work program provides training for employment through college or trade courses. This program also allows you to continue receiving SSDI benefits for nine months after you begin a full-time position. And if you are on Medicare, the Ticket to Work program offers 60 months of continuing health care after the start of employment.
5. Do you want to go back to work part time?
If your desire is to return to the workforce part time, the state agency can still help, but there may not be as many resources available. After working part time, you may choose to go back to the state agency and apply for additional guidance and resources as a person who is underemployed.
If you are drawing disability compensation through private insurance, Social Security Disability Income (SSDI), Supplemental Security Income (SSI) or another insurance program, let them know about your plans to work because having a job may impact your benefits.
Our list of questions is by no means complete. Many state agencies are set up to help those with full-time employment goals, but they can also benefit those seeking part-time employment. The Work Readiness Quiz offered on the Ticket to Work site is a good place to start.
Americans with Disabilities Act (ADA)
The Americans with Disabilities Act (ADA) protects against discrimination against qualified people with disabilities in all employment practices. A “qualified individual” is someone who, with or without reasonable accommodation, can perform the essential functions of the employment position the individual holds or desires.
Specifically, the ADA protects your right to work in an environment free from harassment related to your disability. It also protects your right to ask for reasonable accommodation. Reasonable accommodation is any change to a job, the work environment or the way things are usually done that allows you to apply for a job, perform job functions or have equal access to benefits in the workplace. Examples of reasonable accommodation include:
- removal of physical barriers
- modifying your workspace
- providing a quiet workspace
- helpful computer hardware or software
- time off for treatment of a disability
Essential functions of a job are the core duties that are the reason the job position exists. For example, in a call center, taking and placing calls is an essential job function. If an employee has a hearing disability, a reasonable accommodation might be a workspace in a quieter area or a special headset.
The best time to discuss any accommodations is after the job has been offered. The applicant is under no obligation to discuss disabilities with an employer before that.
Resources for Returning to Work
For more information about the ADA:
For deaf/hard of hearing callers:
1-844-234-5122 (ASL Video Phone)
1-800-514-0383 (TTY, for deaf/hard of hearing callers)
This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Stroke Association.