Co-authored by Tania Fuschino, Acclaim Ability Management Inc. and Mackenzie Klauck, Ontario Brain Injury Association, June 2025
Brain injuries can happen suddenly and change a life in an instant—whether from a fall, a medical event, or a sports-related impact.
When talking about brain injuries, it’s important to understand the broad term that covers them all: acquired brain injury, or ABI. An ABI refers to any damage to the brain that occurs after birth and is not related to hereditary conditions, developmental disabilities, or degenerative diseases like Alzheimer’s or multiple sclerosis.
ABIs are generally divided into two categories: traumatic brain injury and non-traumatic brain injury.
A traumatic brain injury (TBI) happens when an external force injures the brain—this could be the result of a fall, a car accident, or a hit to the head, like taking an elbow during a basketball game. Concussions are the most common form of TBI. In contrast, non-traumatic brain injuries are caused by something internal, such as a stroke, a brain tumor, or oxygen deprivation.
Together, these two types of ABIs affect thousands of individuals and families every year, each with its own challenges and recovery paths ahead.
The Scope of Acquired Brain Injuries Across Canada
Every 3 minutes, one person in Canada sustains a TBI.
According to Brain Injury Canada1, approximately 4% of the population lives with a non-TBI, and over 18,000 TBI-related hospitalizations occur each year. On average, 573,000 cases of concussions2 are documented annually in Canadians aged 12 and older, with 150,000 of those cases occurring in Ontario. These figures are expected to rise by 20313, with TBI becoming the most common neurological condition affecting Canadians.
Research from the Ontario Brain Injury Association’s (OBIA) Brain Injury Impact Survey4 reveals that 19% of individuals reported sustaining an acquired brain injury (ABI) in the workplace or while performing job-related duties. The impact on employment was significant—over 77% indicated a change in their employment status following their injury, and 81% shared that they were no longer able to work.
In Canada, the nationwide direct cost5 of care following TBIs alone is over $650 million per year, with affected individuals out of work for an average of 42 days costing $580 million in 2023. This means the total cost associated with TBIs is over a whopping $1 billion each year.
For businesses, the impact of ABIs extends far beyond direct healthcare costs. Lost productivity, extended employee absences, and the challenge of safely reintegrating employees into the workforce can cause significant strain. Many workers returning from an ABI often experience lingering cognitive, emotional, and physical symptoms6 that may affect job performance—ultimately requiring tailored accommodations or gradual return-to-work plans. Without proper support systems in place, employees may struggle with fatigue, memory issues, and decision-making, increasing the risk of re-injury or long-term disability.
This burden is exacerbated by the fact that many individuals lack access to comprehensive rehabilitation, leaving them to navigate the complex aftermath of brain injuries without adequate support. As a result, proactive workplace strategies—including education, early intervention, and structured return to work plans—are critical in fostering a sustainable and inclusive work environment.
As the prevalence of ABIs continues to rise, integrating data-driven insights into workplace health and safety strategies is essential for reducing financial strain, supporting employee recovery, and improving long-term workforce outcomes.
Return-to-Work Accommodation Trends: Living with, Mild, Moderate & Severe ABIs
Returning to work after an ABI presents unique challenges that vary depending on the severity and type of injury. In the workplace, where cognitive function, multitasking, and sustained attention are critical, employees with ABIs often require extended recovery periods and workplace accommodations. Understanding return-to-work trends for different types of brain injuries across industries is essential for creating more supportive and sustainable reintegration strategies.
Concussions and Other Traumatic Brain Injuries
Concussions and mild TBIs are the most common ABIs and can result from falls, motor vehicle collisions, or sports-related incidents, with concussions being the leading ABI in the workplace over the past decade.
While symptoms like headaches, dizziness, and cognitive fatigue may subside within weeks, research indicates that nearly 20-25% of individuals7 experience persisting post-concussion symptoms that can last several months, and even years. As a result, a tailored reintegration approach is required for the individual to sustainably return to work.
For instance, in the education sector, where teachers are tasked with managing student interactions and engaging in constant communication, lingering cognitive impairments can delay a full return to hours and duties. A trend in this sector has been the adoption of gradual return-to-work plans, allowing educators to start with reduced hours and progressively increase their workload as they manage symptoms of ABI.
In one specific case, a secondary school teacher who sustained multiple brain injuries, found that the rigid structure of standard phased return-to-work plans was inadequate for their unique recovery needs. Despite multiple attempts over several years to resume full-time teaching, each effort was unsuccessful. It wasn’t until a highly individualized approach was adopted—one that allowed for small, structured increases in workload over the span of more than a decade—that the teacher was finally able to return to a full-time schedule. This case highlights the importance of long-term support, flexible planning, and a recognition that recovery timelines can vary dramatically from person to person.
Employees recovering from moderate or severe TBIs often face more pronounced cognitive, emotional, and physical challenges. These injuries can result in permanent impairments, affecting memory, executive functioning, and emotional regulation, making full-time work difficult or even impossible in some cases. Return-to-work trends for moderate to severe TBIs often involve role modifications, with fewer cognitive demands. A recurring challenge in the workforce is the availability of brain-injury-specific accommodations, leading to gaps in support for those recovering from TBIs across different industries, particularly education.
Non-Traumatic Brain Injuries
Non-TBIs often cause long-term neurological effects8 such as cognitive difficulties, physical impairments, and emotional/behavioural changes . Employees recovering from these conditions may frequently require workplace accommodations that address both mobility and cognitive challenges.
In the education sector, this might include assistive technologies, reduced instructional hours, or collaborative teaching arrangements to lessen cognitive strain9. One emerging workplace trend is the use of structured cognitive rehabilitation programs that help employees regain job-related skills before transitioning back into full-time roles. However, as reported by individuals who have sustained brain injuries, systemic challenges like inadequate HR assessments or lack of specialized return-to-work support continue to hinder successful reintegration. To address this, some organizations are beginning to implement brain-injury-informed return-to-work frameworks10 that incorporate input from neurologists and rehabilitation specialists.
ABIs are invisible injuries. By embracing flexible work arrangements, cognitive rehabilitation strategies, and expertly crafted return-to-work plans, industries like education can create more inclusive environments that promote long-term recovery and job sustainability. For many individuals, the cost of care following a brain injury or serious health condition can be overwhelming, making employee recovery and reintegration into the workforce even more challenging. Organizations like the Workplace Safety and Insurance Board (WSIB), an agency of the Ontario government, can help make a difference, but are not accessible to all workers as not all employers offer WSIB benefits.
Additionally, many ABIs occur outside of the workplace, leaving a large portion of individuals without access to WSIB support altogether. In these cases, after-care programs play a crucial role in ensuring long-term success, offering continued therapy, workplace accommodations, and structured reintegration programs that help individuals regain their independence and contribute meaningfully to their workplaces and communities.
Recovery is not just about physical healing—it’s also about finding new purpose and adapting to a changed life. The following case study shares the story of a man who sustained a TBI in his early 40s, and how he navigated his transition from a full-time, high-level career to a volunteer role that gave him a new sense of purpose. Now in his 60s, his journey highlights the crucial need for workplace accommodations, and the value of support and structure in the reintegration process.
From Career to Purpose: A Journey Through an Acquired Brain Injury
Working as a Director of Information and Communication Technology (ICT), a role he had hoped to maintain until retirement, this individual had a lot of people relying on him for guidance. Unfortunately, the moderate-to-severe TBI he sustained dramatically changed his life trajectory. Despite his dedication and passion for his work, the cognitive and memory impairments that followed the injury made it impossible for him to perform at the level required for such a high-stakes position. The memory difficulties he faced made it challenging to keep track of daily interactions and provide the same expertise he once could to his staff.
As a result, he was forced to retire prematurely, a decision that left him feeling frustrated and disheartened.
However, his story does not end there. With the help of his support team, he found a sense of purpose through volunteering. He was placed in a role where he interacted with office colleagues, receiving vital assistance to help him stay organized and on track. This role, while not a return to his former career, provided a crucial outlet for his skills and helped him regain a sense of accomplishment.
His journey underscores how reintegration into the workforce isn’t always successful, yet individuals can still find fulfillment and resilience in other aspects of life. It highlights the importance of redefining one’s sense of purpose while also calling for greater understanding and support from workplaces in addressing the unique challenges of those with ABIs.
While he could not return to his previous position, he continues to find fulfillment in volunteering. His story is a testament to resilience, but also a call for action: organizations must better understand the human experience of an ABI and offer support that helps individuals reintegrate, whether into the workplace or other meaningful aspects of life.
This is where organizations like OBIA play a critical role. Through education, awareness, and direct support, OBIA enhances the lives of Ontarians living with an ABI, ensuring they have the resources and community connections needed to adapt, rebuild, and move forward—whether that means finding new purpose or improving overall quality of life.
Transforming Workforce Reintegration and After-Employment Care
Returning to work after an ABI is rarely straightforward. While some individuals living with the effects of brain injury can regain stability in their roles with the right support, others face barriers that make traditional reintegration more challenging.
Acclaim Ability Management understands that returning to work after an ABI is more than a process — it’s a deeply personal journey. That’s why a thoughtful, data-informed approach is taken to develop return-to-work plans that honour the cognitive, physical, and emotional realities of recovery. Through attentive case management, Acclaim works closely with employers, healthcare providers, and rehabilitation specialists to create structured, step-by-step reintegration plans that support both the individual and their workplace. These plans are built around the person’s evolving abilities, ensuring expectations are realistic and recovery remains the priority. From modified duties to gradual return schedules and tailored accommodations, Acclaim’s goal is to help individuals with ABIs return to work in a way that feels manageable, meaningful, and sustainable.
Backed by real-time data and industry insights, Acclaim’s reintegration process emphasizes early intervention, proactive case management, and focuses on an individual’s abilities. Instead of applying a one-size-fits-all model, Acclaim develops dynamic, adaptable solutions that evolve with each individual’s progress. This expertise not only helps transition back into the workforce but also provides employers with the tools and knowledge to foster a more supportive work environment.
While some support is available through government programs, many individuals living with an ABI do not have access to the kind of private rehabilitation and care services offered through systems like WSIB. OBIA’s Return to Work program helps bridge this gap by providing education and guidance to both employees returning to their pre-injury workplace and the employers supporting them. This no-cost program includes self-paced online training tailored for employers, including supervisors, managers, HR professionals, and organizational leaders. The training covers key topics such as understanding ABIs, recognizing common symptoms, implementing effective accommodations, addressing mental health in the workplace, and navigating potential setbacks during the return-to-work journey.
To further support the return to work process, employees can access tailored education and may be eligible for occupational therapy and social work support for up to 6 months. This program is funded in part by the Opportunities Fund for Persons with Disabilities, with services provided to each individual valued at over $4,000 CAD.
By supporting both employers and employees, the Return to Work program aims to improve outcomes for workers, enhance employee retention rates and build employer’s capacity to hire and support persons with disabilities.
Moving Forward with the Right Support
No two ABIs are the same, and the solutions provided should reflect that reality.
With an individualized return-to-work plan that includes the right accommodations and support, an individual’s path coming back to the workplace may unfold differently. The stories shared are a powerful reminder that return-to-work plans are not one-size-fits-all solutions.
Acclaim’s data-driven case management ensures that return-to-work strategies are tailored, sustainable, and responsive to the unique challenges of brain injury recovery. At every stage of the journey—from navigating a return to work to adjusting to life with a brain injury—organizations like OBIA are essential. OBIA supports individuals who may not have access to insurance or WSIB by providing education, advocacy, and direct services. Whether someone is working toward reintegration into the workforce or rebuilding purpose in other meaningful ways, OBIA is there to help people adapt, reconnect, and move forward.
If you or someone you know is looking for guidance and resources on navigating the return to work process following an ABI, reach out to OBIA’s team today to learn more about the Return to Work program and additional support available.
If your organization is seeking a partner to build effective, brain-injury-informed return-to-work plans, connect with Acclaim’s dedicated team today. They’ll provide support to both employers and employees with compassionate, customized case management that makes reintegration possible and sustainable.
References
- Brain Injury Canada – Statistics
- Statistics Canada, 2024 – Concussions happen at home too – February 9, 2024
- Brain Canada Foundation, 2024 – $1.1 million for new brain injury research in Canada – June 20, 2024
- OBIA – Brain Injury Impact Study
- Grillo Law, Lexology – How Much Traumatic Brain Injury Costs in Canada
- OBIA – Brain Injury Information
- Institute of Behavioural and Functional Medicine – The impact of post-concussion syndrome
- Brain Injury Canada – Non-traumatic brain injury (nTBI) – 2024
- ,10. Brain Injury Canada – Returning to work following an acquired brain injury – 2019
