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.

Steve Park on the bow of a ship

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

Americans with Disabilities Act

A Guide for People with Disabilities Seeking Employment

How to File an Americans with Disabilities Act Complaint with the U.S. Department of Justice

For more information about the ADA:

Equal Employment Opportunity Commission (EEOC)

1-800-669-4000 (voice)

For deaf/hard of hearing callers:

1-800-669-6820 (TTY)

1-844-234-5122 (ASL Video Phone)

Email: info@eeoc.gov

Department of Justice (DOJ)

1-800-514-0301 (voice)

1-800-514-0383 (TTY, for deaf/hard of hearing callers)

Social Security:

The Employer Assistance and Resource Network on Disability Inclusion (EARN)

Vocation Rehabilitation by State

Office of Disability Employment Policy, United States Department of Labor

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.​

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Stroke Rehabilitation

Making the Best Decisions at Discharge After Stroke

The type of rehabilitation and support systems a survivor receives at discharge can strongly influence health outcomes and recovery. In this, the first part of a two-part series on stroke rehab, we offer guidance for the decision-making process required when it’s time to leave the hospital.

What to Expect from Outpatient Rehab

After stroke, about two-thirds of survivors receive some type of rehabilitation. Outpatient therapy may consist of Several types of therapy. Whether a patient is referred to inpatient or outpatient therapy depends on the level of medical care required.

What to Expect in Stroke Rehab

Following a stroke, about two-thirds of survivors receive some type rehabilitation. In this second of our two-part series, we want to alleviate some of the mystery, fear and anxiety around the inpatient rehab part of the stroke recovery journey.
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AHA-ASA Resources

The Support Network

When faced with challenges recovering from heart disease or stroke, it’s important to have emotional support. That is why we created a network to connect patients and loved ones with others during their journey.

Caregiver Guide to Stroke

The Caregiver Guide to Stroke is meant to help caregivers better navigate the recovery process and the financial and social implications of a stroke.

Stroke Support Group Finder

To find a group near you, simply enter your ZIP code and a mile radius. If your initial search does not pull up any groups, try

Tips for Daily Living Library

This volunteer-powered library gathers tips and ideas from stroke survivors, caregivers and healthcare professionals all over the country who’ve created or discovered adaptive and often innovative ways to get things done!

Stroke Family Warmline

The Warmline connects stroke survivors and their families with an ASA team member who can provide support, helpful information or just a listening ear.

Let's Talk About Stroke Patient Information Sheets

Let's Talk About Stroke is a series of downloadable patient information sheets, created by the American Stroke Association, that presents information in a question-and-answer format that's brief, easy to follow and easy to read.

Request Free Stroke Information Packets

Fill out this online form to request free information about a variety of post-stroke topics.
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Stroke & Parts of the Brain

When Stroke Affects the Occipital Lobe

Our occipital lobe, the smallest of the four lobes of the cerebral cortex, controls how we visually interpret our world.

When Stroke Affects the Cerebellum

The cerebellum contains 80 percent of our neurons. Its job seems to be to make things better. We talked with neuroscientist Jeremy Schmahmann about how stroke affects the “little brain.”

When Stroke Affects the Parietal Lobe

The parietal lobe helps us make sense of sensory information, like where our bodies and body parts are in space, our sense of touch, and the part of our vision that deals with the location of objects.

When Stroke Affects the Frontal Lobe

Of the four lobes that make up the cerebral cortex, the frontal lobe is the largest. It plays a huge role in many of the functions that make us human — memory, language, movement, judgment, abstract thinking.

When Stroke Affects the Temporal Lobe

The temporal lobe has several functions, mainly involved with memory, perception and language.

When Stroke Affects the Brain Stem

The brain stem serves as a bridge in the nervous system. It sits at the top of the spinal column in the center of the brain. When a stroke happens there, it can cause a few different deficits and, in the most severe cases, can lead to locked-in syndrome.

When Stroke Affects the Thalamus

The thalamus can be thought of as a "relay station," receiving signals from the brain’s outer regions (cerebral cortex), interpreting them, then sending them to other areas of the brain to complete their job.
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