Returning to work after spinal cord injury – what you need to know

Determining when to return to work depends on the severity of your injury, the nature of your job and your overall recovery progress. It is essential to follow the advice of your treating doctors, who will assess things such as mobility, pain levels and physical limitations. There are also other factors to take into account, such as your ability to manage your incontinence and how you are coping mentally.

When you feel ready to start thinking about returning to work, it’s important to approach the process gradually, with a clear plan in place.

Start by speaking with your medical team to ensure that you’re fit to return and to understand any limitations or adjustments that you may need. Notify your employer and request a meeting to discuss your return to work plan, which may include a phased return, adjusted duties, or flexible hours.

It is likely that you will be considered as disabled under the Equality Act 2010, and so you have the right to request reasonable adjustments. It is helpful to involve Occupational Health or HR to assess what support can be put in place.

It is important to avoid pushing yourself too hard or too quickly, as this can risk setbacks in your recovery. It is also important to avoid downplaying your condition or adjustments that you would find helpful out of fear of being a burden.

If you were not employed at the time of your injury and would like to join the workforce, it is often helpful to start by looking at voluntary roles to give you a flavour of what you might like to do and what type of role would suit your particular circumstances.

Volunteering often helps boost self-esteem, without the pressure of being formally employed.

It may be beneficial to obtain input from a vocational rehabilitation expert. There are also charities such as the Spinal Injuries Association (SIA) and Back Up who can help with seeking employment.

Some people use spinal cord stimulators after spinal cord injury. A spinal cord stimulator is designed to help manage chronic pain, not to limit mobility, and for many people it significantly improves quality of life and function.

Using a spinal cord stimulator should not prevent you from returning to work, depending on your overall health and the nature of your job. However, certain factors should be considered, such as avoiding heavy lifting, repetitive bending, or exposure to strong magnetic fields, which could interfere with the device.

A spinal cord injury will be considered a disability if it meets the definition set out in the Equality Act 2010. The legislation defines a disability as a:

“physical or mental impairment that has a substantial and long-term adverse effect on a person’s ability to carry out normal day to day activities”.

A spinal cord injury that results in ongoing mobility issues, chronic pain or reduced function, lasting or expected to last 12 months or more, will typically qualify.

There is a duty on employers to make ‘reasonable adjustments’ to facilitate a return to work and avoid any substantial disadvantages you may suffer at work. This goes beyond simply levelling the playing field for a disabled individual.

Learn more about the Equality Act and reasonable adjustments here.

You may be entitled to a range of welfare benefits in the UK, depending on how your condition affects your daily life and ability to work.

These include:

• Attendance Allowance to help with care needs;
• Carer’s Allowance to help people caring for individuals with a spinal injury;
• Employment and Support Allowance (ESA), which can help when someone is left unable to work as a result of a disability;
• Personal Independence Payment (PIP), which is a tax-free benefit to help with extra costs of living as a result of long-term disability (over 12 months);
• Statutory Sick Pay (SSP), which helps in the event that a spinal injury leaves you unable to return to employment for more than three consecutive days;
• Universal Credit (UC), is a benefit for people of working age who are either on a low income or are left unable to work due to disability or long-term illness.

Each benefit has specific eligibility criteria, so it’s advisable to seek advice from a welfare rights advisor or use government resources to determine what support you can claim.

Motability can also be a valuable source of support with maintaining independence and mobility, which in turn can help with a return to the workplace.

Through the Motability Scheme, eligible people receiving a qualifying mobility benefit, such as the higher rate of the mobility component of Personal Independence Payment (PIP) can lease a car, wheelchair accessible vehicle (WAV), scooter or powered wheelchair. The scheme covers insurance, servicing breakdown assistance and maintenance, reducing both the financial and practical burdens of vehicle ownership.

Motability can make it significantly easier to attend medical appointments, commute to work, or carry out daily activities with greater freedom and comfort, especially when tailored adaptations are needed to make the vehicle accessible and safe to use.

You may also be eligible for support through Access to Work, a government initiative which helps people get or stay in work if they have a physical or mental health condition or disability. Access to Work could give you a grant to help pay for things like specialist equipment or software; travel costs (if you cannot use public transport); or physical changes to your workplace.

By law, your employer must make reasonable adjustments to help you continue working as before, as far as possible.

Employers should work collaboratively with you, and where appropriate, occupational health professionals to assess specific needs and implement reasonable adjustments that enable you to perform your role effectively and safely.

The adjustments you require at work will depend entirely on your personal situation. However, there is a common range of solutions available for employers to reasonably adjust their workplace to your needs.

These changes could include:

• installing ramps;
• installing automatic doors;
• providing accessible toilets;
• providing height adjustable desks and ergonomic chairs;
• ensuring clear walkways;
• installing wider doorways;
• providing accessible parking spaces.

If you experience incontinence, key changes could include:

• ensuring easy and discrete access to accessible toilets, ideally located close to your workstation;
• providing discrete personal storage for incontinence products and changes of clothes;
• providing access to shower/ wash facilities;
• providing a private space for changing clothes or managing personal hygiene;
• allowing flexible breaktimes to accommodate urgent needs.

Whilst, understandably, it may be difficult to talk to your employer about these types of issues, open, confidential communication is essential so your employer can understand what you are going through and what changes can be made to help. Helpful information is also provided by the Equality and Human Rights Commission in their guidance for employers.

Read the EHRC guidance here.

Employers could also potentially make working time adjustments to support you manage to manage your condition while remaining productive at work. For example:

• allowing a later start time to enable bowel irrigation to be performed before coming into the workplace;
• reduced hours, part-time working, or compressed hours that allow you to work your full-time hours over fewer days;
• working from home;
• provision for regular rest breaks;
• allowing time off for medical appointments or treatment;
• implementing a phased return to work after further periods of absence.

Employers can also make changes to workplace policies and practices to ensure inclusivity and compliance with The Equality Act. This could involve:

• updating absence management policies to account for the need for more frequent medical appointments or extended recovery periods, without penalising the employee unfairly;
• reviewing flexible working policies to offer remote work or adaptable hours;
• reviewing health and safety procedures to ensure accessibility and emergency evacuation plans as appropriate;
• offering training for managers and staff on disability awareness help provide a more supportive environment.

Embedding these changes into official policies helps normalise adjustments, promotes equal opportunities, and ensures an employee feels valued and protected in their role.

It is important to keep lines of communication open with your employer as your needs may change. For example, recovery after a spinal cord injury can take up to two years so until this point is unlikely that you will be aware of the final extent of your injuries. Rehabilitation and therapy can also assist some elements of your condition and so your needs may change over time, impacting the adjustments you need.

If an employer says they cannot meet your needs, they must show that the adjustments required are not reasonable based on factors such as cost, practicality, or the size and resources of the business.

If you believe your employer is failing to meet their obligations, you may wish to raise the issue formally through your company’s grievance procedure. You can also seek advice from ACAS, a trade union, or a solicitor specialising in employment law as you may have grounds for a discrimination claim or be entitled to alternative support such as ill-health retirement or benefits.

Find out more about your employer’s obligations and your legal options.

If over time, adjustments become unfeasible due to significant changes or deterioration in your condition, a more in depth discussion may be needed. This could involve exploring alternative roles within the organisation, changing duties or adjusting work hours further. If no suitable solution can be found, medical retirement, ill-health dismissal or access to long term disability benefits may need to be considered.

Throughout this process your employer must handle the situation with sensitivity and fairness, following proper procedures and seeking medical evidence where appropriate.

It is essential that you know when you’re ready to return to work. Many people find themselves returning too soon because they underestimate the impact their symptoms have on their ability to work, which can be damaging to their confidence.

To try and ensure you’re prepared you can practice your journey to and from work, along with the types of skills that you will be using at work, for example, sitting at a desk and working on a computer.

It can also be helpful to meet up with colleagues before returning to work, to reconnect socially.

It is imperative to seek support from those around you regarding your return to work. Building a supportive network at work, whether through colleagues, HR or disability support groups, can provide emotional encouragement and practical advice.

A couple of charities we work with, who offer support for people living with spinal injury include:

• The Spinal Injuries Association
• The Cauda Equina Champions Charity

Open communication with your employer about your needs and limitations is essential to ensure appropriate adjustments are made.

Developing a realistic schedule that includes rest breaks can help you manage fatigue and pain levels. Staying organised and prioritising tasks can also reduce stress and physical strain.

It may also be beneficial to work with occupational health professionals who can assess your environment and recommend tailored solutions.

Whilst you should try and be positive about your return to work, it is also important to be realistic; a spinal cord injury often leads to significant changes to the way people work.

You may not be able to travel as you once did, and you might not be able to work as long hours. Whatever it might be, you must be willing to accept things may be different.

If you’re unable to return to work after a spinal cord injury, it is important to know that there is support available to help you adjust financially and practically. As mentioned above, there are benefits that you may be eligible for.

If you were employed before your injury, you should check if your employer provides permanent health insurance (sometimes called group income protection), which can cover a significant proportion of your salary, often for an extended period of time. If your employer does not offer this type of benefit, it might also explore options like ill health retirement or settlement through your employer’s insurance or occupational pension scheme, if they have one.

While not being able to return to work can be a significant emotional and financial adjustment, there are resources and pathways available to help you maintain independence and plan for the future.

If you feel unable to return to work, you should seek advice before making any decision. This includes checking whether you are eligible for ill-health retirement or Permanent Health Insurance (PHI).

Find more information about how we can help with PHI.

Additionally, if your spinal injury was the result of an accident or negligence, you may be entitled to compensation should you not be able to return to work.

Compensation is calculated to take into account any loss of earnings as a result of a spinal injury that wasn’t your fault, so if your career has been halted as a result of a spinal cord injury you are not left in financial difficulty.

Whether your injury was the result of an accident or medical negligence, our specialist spinal injury solicitors are here to help.