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Neuro Landscape Blog - A Brain Injury Blog by Dr. Mark J. Ashley, CEO, Centre for Neuro Skills
Neuro Landscape
A Brain Injury Blog by Dr. Mark J. Ashley, CEO
Centre for Neuro Skills

Month: <span>November 2018</span>

Next Steps in Worker’s Compensation for Treating Brain Injury

Monday, November 5th

(Note:  This is part one of a two-part series on issues affecting worker’s compensation, brain injury rehabilitation, and appropriate patient care).

The ultimate goal for the person with a traumatic brain injury (TBI) who participates in a comprehensive postacute rehabilitation program is to return to a productive life after discharge. Many times that involves returning to work. If the person sustained a brain injury in the workplace, he/she enters into the worker’s compensation continuum of care treatment system and is entitled to certain benefits that aim to reduce medical and living costs.

However, the public health care options available do not offer much in the way of treatment for TBI or stroke patients, as those options provide people with a considerably smaller chance at returning to higher productivity.

A collaborative report from the California Traumatic Brain Injury Advisory Board states, “For those significantly or profoundly impacted by this injury, reintegration into the community is overwhelming due, in part, to limited services and insurance coverage for critical medical and social rehabilitation. Moreover, persons with TBI often need help with community reintegration multiple times and at different junctures, because of the complexity of their injury and changes in their medical condition, living arrangement, or caregiving situation. (2010)” 1

Centre for Neuro Skills (CNS) has a legacy of success in the worker’s compensation industry and has helped thousands of people to return to productive lives. Since our inception in 1980, we’ve focused on community integration through an individualized, goal-oriented approach to therapy.

Postacute TBI rehabilitation that incorporates various therapeutic disciplines, including occupational therapy and vocational rehabilitation, can simulate real-world work environments, assisting people in re-learning skills for independent living. Through neurobehavioral therapy and behavior analysis in postacute care, clinicians can individualize the treatment needs of each person – increasing their participation in rehabilitation and community activities. This enables them to practice skills needed for independent living and provides them with a greater chance of a productive life post rehabilitation.

Can the benefits of postacute rehabilitation continue long-term?

A 2016 research study, led by Grace Griesbach, Ph.D., National Director of Clinical Research for CNS, investigated whether benefits of postacute rehabilitation for TBI are sustained after discharge from a full time comprehensive postacute rehabilitation program.

In the project, moderately to severely injured people with TBI who participated in a full-time comprehensive postacute rehabilitation program were interviewed one year after discharge. “In the analysis of employed and unemployed subjects, it was revealed that 43.75% had an occupation of equal position to that before an injury. Those that were working also showed positive levels for social participation, cognitive function, and social satisfaction,” the paper states. Additional analysis revealed that as many as 66% returned to some form of paid employment.

These findings support the durable outcome and beneficial effects of postacute TBI rehabilitation long-term, it noted, “concluding that individuals with a good rehabilitation outcome are more likely to regain their former occupation and quality of life.” 2

Do these findings also conclude that access to health insurance is vital for TBI recovery? I’ll address that topic in part two of this blog, Next Steps in Worker’s Compensation for Treating Brain Injury, which explores cost savings, reporting, data collection, and public health care options that are currently available.


  1. California Traumatic Brain Injury Advisory Board, Advancing California’s Traumatic Brain Injury Service System, Department of Mental Health, May 2010.
  2. Charan Singh, Sarah Finley, Sharon Umphress, Craig Persel, Grace S. Griesbach, Outcome After Post-Acute Rehabilitation in Traumatic Brain Injury Patients, Vol. 97, Issue 10, e100, Archives of Physical Medicine and Rehabilitation, October 2016. Accessed at: