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Getting Back to Work after a Spinal Cord Injury

By Matt Lalande in Spinal Cord Injuries on August 23, 2021

Getting Back to Work after a Spinal Cord Injury

Undeniably, numerous challenges exist for people with spinal cord injuries who decide to take these first “steps” back to life – with work being one of them. Moreover, once on the job, disabled people often have to contend with additional obstacles, both physical and emotional. Many buildings and transportation systems are now accessible, but some still are not; coworkers often take the time to understand stand the needs of disabled colleagues, but some may be too uncomfortable or insensitive to even approach them. And while getting ready each morning and commuting to and from work can be a hassle for anyone, the time and effort involved are especially pronounced for those who need the help of a PCA and/or a wheelchair.

Getting back to work (if you are able) after a spinal cord injury will not be the first thing you are thinking about after your spinal cord injury, but in the long run – many people with SCI’s actually want to get back to work since it can certainly contribute to one’s self-worth, independence and productive living. Making the transition back to work is a process that requires a lot of guidance, patience, and planning. During this process, you’ll have to think about your personal and career goals, and you’ll need to make important decisions about your future. You’ll also want to gather information, to set and achieve goals, and to solve problems with as much information as possible. In addition, you’ll need to understand how to advocate for yourself. In this article, our spinal cord injury lawyers write about:

  • the challenges and opportunities in returning to work;
  • the role of vocational rehabilitation and
  • important laws in Ontario protecting and affecting persons with disabilities

Taking time to Adjust to your New Life after a Spinal Cord Injury

After a spinal cord injury, we understand that it can difficult to take in the reality of your situation. There’s no doubt that most spinal cord injury victims experience severe emotional reactions after an SCI that which require long-term psychological adjustment -and- getting back to work is the last thing on your mind.

In our experience, most people with new spinal cord injuries have no idea where to begin. Victims often wonder how they’ll handle the strain of rehab and recovery – especially the financial hardships. They’re still being acclimated to their injuries and the changes in their lives – which sometimes takes months if not years and during this time, it would be highly premature for them to think about their future in terms of returning to work. Most newly paralyzed people are unable even to imagine the prospects of job hunting, let alone going on an interview. In the early days after injury, victims are still learning how to manage a curb or just put on a jacket or socks from a wheelchair.

However, when a person is emotionally and physically able to start thinking about a return to work but unsure where to turn or how to approach a return to work, our spinal cord injury lawyers, through retained occupational therapists, will assist as best we can with connecting you with trained vocational therapists and psychological counselors (if necessary) who will explore your goals and employment expectations step by step – to ensure comfort in your decision and help with everything you need in your search for return to work.

How can I Return to Work after a Spinal Cord Injury?

Returning to work after a spinal cord injury can mean many different things. For example, it can mean that you return to your old job where only minor accommodations are needed. These changes might include rearranging your desktop space or ergonomic reorganization of your entire workspace. Your return to work might also mean that your employer will make more extensive changes to your work environment, and perhaps buy special equipment to enable you to function independently at work. In some cases, you might need to take on different job responsibilities or a new type of job if you want to stay with your employer.

For other people, returning to work means finding a new career path different from the kind of work done before the spinal cord injury. Most people with spinal cord injuries need time before they are ready to return to work. During the relatively short inpatient rehabilitation stay, your schedule no doubt was (or is) filled with many retraining and rehabilitation activities, with a focus on regaining your function and strength.  As a part of your rehabilitation, you may speak to a vocational rehab advisor who will discuss with you the possibilities and hope of a someday return to work.

Although you might receive vocational rehabilitation services while you’re an inpatient, our spinal cord injury lawyers can and will refer you to local vocational specialists when you’re ready and cleared by your doctor to return to work.

What can Vocational Rehabilitation do for me?

Vocational rehabilitation (VR) helps people with spinal cord injuries return to work by defining feasible employment goals and by helping the inured person with spinal cord injuries work toward those goals. In general, a vocational specialist offers vocational counseling and guidance as well as job search and placement assistance when you are ready. Vocational rehabilitation specialists, in Ontario, are mostly specially trained occupational therapists which help people with disabilities become self-sufficient.

Vocational rehabilitation professionals can help you by:

  • assessing the impact of the injury on the individual;
  • determining work abilities;
  • identifying employment interests and goals;
  • identifying strategies to meet these goals;
  • recommending vocational training;
  • offering advice about assistive technology and adaptive equipment;
  • providing training and referrals to resources that make the return employment possible and
  • providing other services that support achievement of education and employment.

Vocational rehabilitation professionals can refer you for career skills training, assist with job placements, recommend worksite accommodations, and enhance employers’ understanding of your needs. They also coordinate special services with technical schools and colleges if you need more training or education in order to advance your career.

Am I Eligible for Vocational Rehabilitation Services?

If you have been hurt in a motor vehicle accident you will be able to fund the services of a vocational specialist through your accident benefits. In Ontario, a victim of spinal cord injury is entitled to $1M in medical, rehabilitation and attendant care benefits for life.  Rehabilitation benefits, covered under sections 14 to 20 of Ontario’s Statutory Accident Benefit Schedule, are the most common of all the benefits available to motor vehicle accident victims under Ontario’s no-fault accident benefits regime. Medical and rehabilitation benefits provide you with the modalities needed to restore your health and return to work and society. Accident victims are entitled to what is “reasonable and necessary” in terms of rehabilitation treatment. Vocational rehabilitation would fall into what is reasonable and necessary rehabilitation to assist a spinal cord injury victim back into society.

What is a Vocational Evaluation?

At the beginning of the vocational rehabilitation process, your occupational therapist might suggest a vocational evaluation to help define your goals and abilities. This evaluation includes interest and aptitude tests and vocational counseling to determine job interests and abilities. It also considers your interests and achievements before your injury, specifically in the areas of education and work, and your current interests and functional abilities.

During the evaluation, your vocational professional will most likely ask you to complete a number of standard tests. For example, academic achievement tests may be given to assess your basic reading, math, and spelling skills; a career interest test may be given; and other tests may be given to assess your functional and skill levels. These are not tests of “intelligence or aptitude”; they are simply used as a tool to understand better who you are and how best to design a VR plan to meet your needs. After you have completed all of the tests, the VR professional will write a brief report about your used as a tool to understand better who you are and how best to design a vocational rehab plan to meet your needs. After you have completed all of the tests, the VR professional will write a brief report about your test results, your interest areas, and his or her observations. He or she will also recommend steps you will need to take to achieve particular education and employment goals.

Getting ready to return to work after a spinal cord injury

When you’re ready to return to work, your vocational rehabilitation professional can assist you in the job application process. He or she can help you:

  • set a job goal;
  • write your resume;
  • conduct a job search;
  • prepare to “network” with other people who may be able you find you a job;
  • complete application forms;
  • assess your own and employers’ expectations and;
  • gather career and disability information.

Making Changes That Let You Work

In many situations, even minor accommodations to a work environment can make the difference between being employed and being unemployed. Technology can also dramatically increase your employment opportunities.

Just as able-bodied people take advantage of technology, people with disabilities today can use technology such as cellular phones with headsets, computers with voice-recognition and dictation software, and dictaphones to work productively. Using technology (and particularly during covid) people with disabilities and spinal cord injuries can also work from home.

It’s important that you examine your assistance and accommodation needs carefully. Vocational rehabilitation professionals and occupational therapists can advise you about assistive technology and how to structure your work environment so that it works for you. They can analyze your job functions and tasks, and reasonable accommodations at your workplace. In addition, they can help you think about related issues, such as how you will get to and from work and your need for personal assistance in the workplace. Your VR counselor can assist you in this process and can help you convey your needs to potential employers.

For people with spinal cord injury, several types of accommodations can help improve opportunities to succeed in the workplace. These types include: accessible workplace facilities, modified workstations, assistive technology, modified work schedules, and job restructuring.

Accessible Workplace Facilities

Accessible workplace facilities will be needed if you use a wheelchair or have difficulty walking or climbing stairs. These accommodations need not be expensive. They can include:

  • designating extra-wide parking spaces near the workplace;
  • designing an accessible route from the parking lot into the building;
  • installing ramps to building entrances;
  • leaving floors bare or installing low-pile carpeting;
  • removing obstructions in hallways and walkways;
  • making doorways wide enough for wheelchairs;
  • installing automatic door openers or lever doorknobs;
  • installing elevators with wheelchair level controls;
  • providing wheelchair-accessible restrooms, lunchrooms, break rooms, and training areas;
  • making copiers, fax machines, and other office equipment accessible.

Modified Workstations

Modifying your workstation can help a person with a spinal cord injury work more efficiently and productively. Your vocational rehabilitation counselor can work with occupational therapist who can advise you about needed modifications. Some modifications might require buying new items, but sometimes only small changes to existing furniture or equipment are needed.

Examples of workstation changes include:

  • rearranging files or shelves so you can reach them;
  • relocating your desk or table to make it accessible;
  • situating your desk in a way that allows face-to-face communication;
  • raising your desk on wood blocks to accommodate your wheelchair;
  • using a desktop turntable organizer to keep items within reach.

Assistive Technology

As mentioned above, assistive technology can help you perform work functions and to work more productively. Examples of assistive technology you might use at work include: Typing splints or mouth sticks, specialty keyboards, large trackballs or joy-stick style mice, speech recognition technology, voice-activated computer software, voice-activated speaker phones, large button telephones, automatic dialing systems, and telephone headsets, page turners and book holders.

Modified Work Schedules

In today’s work world, many people with and without spinal cord injuries have modified work schedules to accommodate their individual needs. Changing your work schedule can make a big difference in your ability to get to and from work and in your efficiency throughout the day. Work schedule changes can include: working on a flexible schedule (flex-time), sharing a job with another person, working at home, scheduling short, frequent rest breaks to avoid fatigue and working part-time.

Job Restructuring

Job restructuring is another type of accommodation for people with spinal cord injuries. When a job is restructured, nonessential functions are changed or reassigned to another employee in exchange for a task that you can do more easily.

Should I tell prospective employers about my disability?

One of the most frequently asked questions is whether your spinal cord injury should be disclosed when you apply for work.  Your resume is generally not the place to disclose disability issues. Some people choose to mention their disability in their job, or for example, they let the employer know that they are members of a wheelchair sports team.

Our occupational therapists tell us that spinal cord injury victims should always keep in mind that communication with potential employers should emphasize strengths and skills, not weaknesses. Employers expect that the job applicant can perform the essential functions of the job. Their understanding of spinal cord injury and disability may be very narrow and limited, and they may only focus on the limitations of the disability. Therefore, you need to be able to advocate for yourself and convince them that you can perform the job for which you are applying. Barriers can be overcome if accommodations are made to your workspace. You have the responsibility of communicating that you will be successful in the job.

As you make plans to return to work, it’s important to know about laws that protect you and give you rights or support you as a person with a disability. In Ontario, the Ontario Human Rights Code protects individuals from discrimination in a range of common activities, including employment. Discrimination refers to unequal treatment that results in a disadvantage to an individual based on stereotypical assumptions about their presumed characteristics, rather than on their actual abilities or circumstances.

Human rights legislation prohibits discrimination in a variety of social activities including employment, provision of goods and services, and provision of housing.  In the employment context, human rights laws affect:

  • an employer’s advertising, recruiting and hiring practices.
  • an employee’s job requirements and tools necessary to perform the work.
  • the physical layout of the employer’s premises.
  • the employer’s workplace policies, procedures and practices involving hiring, promotion, compensation, benefits, attendance, leaves of absence, hours of work, dress codes, work performance, discipline and dismissal.

What are some prohibited grounds of discrimination?

Discrimination will only exist if the distinction is based (either in whole or in part) on one or more of the statute’s prohibited grounds of discrimination. Human rights legislation prohibits discrimination in the context of employment on the basis of:

  • Race.
  • Colour.
  • Disability, including physical or mental disability.
  • Religion or creed.
  • Place of origin, nationality or citizenship.
  • Family status.
  • Marital status.
  • Sex.
  • Sexual orientation.
  • Age.

Whare are some Forms of Discrimination?

Simply speaking, discrimination is divided into three different forms. The steps required to avoid discrimination and the remedies awarded depend upon the form that the discrimination takes. The three forms of discrimination are discrimination arising out of workplace standards that create an adverse effect, either directly, indirectly or systemically; harassment and reprisal. 

Direct Discrimination – arises when the employer adopts a standard that is discriminatory on its face.

Indirect discrimination – is more subtle than direct discrimination. It arises when your employer adopts a standard that seems neutral on its face but has an adverse effect on someone.

Systemic discrimination  – arises out established practices or patterns of behavior that have perpetuated a negative impact upon the hiring, employment or advancement of a particular group. It is based upon stereotypes, prejudices and assumptions about whether members of a group are incapable of performing a particular job.         

Harassment  – is broadly defined as unwelcome conduct that detrimentally affects the work environment or leads to adverse employment related consequences for the victim

Reprisal  – is an action, or threat, that is intended as retaliation for an employee who comes forward with a complaint of discrimination, or who otherwise seeks to enforce their human rights.

Do all Ontario employers have a duty to accommodate?

Yes, where an employer’s standards create an adverse effect on an employee based on a prohibited ground, the employer has a duty to accommodate the employee to the point of undue hardship. Accommodation generally refers to changes the employer can make to the workplace or the employee’s working conditions to avoid or alleviate the discriminatory effects of the workplace standard. Accommodation is an individualized process that involves multi-parties. The scope of the duty to accommodate will vary depending upon the characteristics of the workplace, the specific needs of the employee and the circumstances in which the impugned decision was made.

The employer’s duty to accommodate ensures that:

  • Each person is assessed according to their own abilities, rather than presumed characteristics.
  • Employees who are otherwise fit to work are not unfairly excluded where working conditions can be adjusted without undue hardship.

The duty to accommodate arises in the context of direct, indirect and systemic discrimination, but not in harassment or reprisal scenarios. After your accident and once the employer is aware of your need for accommodation, the employer has a duty to determine how you can be accommodated through changes to the workplace or the employee’s working conditions, without undue hardship to the business.

Remember, it’s important that you and your family advocate

As with therapy and other medical rehabilitation services, vocational rehabilitation requires your active input and participation. Vocational rehabilitation professionals and occupational therapists can give you a lot of support and connect you to helpful resources, but remember, it’s important that you  actively take part in the process…when you are ready.

In addition, like your therapists, vocational rehabilitation professionals can provide you with information, advice, and training, but they cannot make decisions for you and your family. You are the ultimate decision-maker, planner, goal setter, and goal achiever! As you work toward your goals, you must take responsibility for getting what you need to be successful at school or work. You must be clear about your goals, ask for help, be persistent, and not get discouraged. It might take a while before you get to where you hope to be, but the better you understand your own goals and the resources available to you, the closer you will be to meeting these goals.

Have you or a loved one suffered a spinal cord injury?

If you or a loved one has suffered a spinal cord injury, our Hamilton spinal cord injury lawyers can help. Our Hamilton personal injury law firm understands after representing many truly amazing clients with spinal cord injuries, that SCI’s are a truly devastating life changing injuries with profound consequences to individuals and their families. If your SCI was caused by the negligence or carelessness of someone not paying attention, contact us today. You may have recourse for compensation – and given that the costs involved in the management of SCI’s can be enormous – we can ensure that you and your family are protected financially – for life.

Call us today, no matter where you are in Ontario at 1-844-LALANDE or local in the Hamilton / GTA / Niagara areas at 905-333-8888 today. Alternatively, you can send us an email through our website and we will get back to you as soon as possible.

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Research courtesy of T. Bellamy – Vocational Rehabilitation of Severely Handicapped Persons, Jain Holmes – Vocational Rehabilitation and to Ross Rehabiltiation – continuing education and litigation reports, Return to work after spinal cord injury: factors related to time to first job – https://pubmed.ncbi.nlm.nih.gov/21383761 and



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