Traumatic brain injury linked to long-term work disability

Having a traumatic brain injury, no matter how serious, is associated with a greater likelihood of qualifying for work disability up to five years later, according to a study published February 11, 2026, in Neurology^®, the medical journal of the American Academy of Neurology. The study does not prove cause and effect, it only shows an association.

"Traumatic brain injury can result in disability that may make it difficult to return to work, yet being employed is essential for maintaining quality of life and financial stability," said study author Andrea Klang, MD, of Uppsala University in Sweden. "While most traumatic brain injuries are mild, recovery can still be incomplete. For severe brain injuries, there can be lasting symptoms. Our study found no matter the severity, traumatic brain injury was associated with a higher likelihood of a person qualifying for work disability."

For the study, researchers used Swedish national registries to identify nearly 100,000 people with traumatic brain injury who were treated in a hospital or in a specialized outpatient care visit and nearly one million people without brain injury. Participants had an average age of 39.

Researchers divided those with traumatic brain injury into three groups. People in the highest group, 1% of participants, had the most severe brain injuries, requiring surgery. Those in the middle group, 6% of participants, had been hospitalized three or more days but with no surgery. Those in the lowest group, 93%, were hospitalized no more than two days or not at all.

Participants were followed for five years. Researchers determined which participants had medically certified work disability, verified by a physician as a reduction in work capacity due to illness or injury. They measured the likelihood of people moving to and from work disability, which was defined as having a sick leave longer than 14 days or receiving disability benefits.

Compared to those without brain injuries, all three groups of people with traumatic brain injuries had a higher likelihood of having work disability during the five years of follow-up, with an average duration of 1,201 days on disability for people in the highest group and 526 days for people in the lowest group.

Over five years, 72% of the people in the highest injury group, 67% of those in the middle group and 45% of those in the lowest group had at least one period of work disability compared to 26% in the non-injury group.

After adjusting for factors just as age, education and occupation, researchers found that one month after injury people in the highest injury group had a 43% chance of work disability, people in the middle group had a 29% chance and those in the lowest group had a 6% chance, compared to a 0.5% chance for people without brain injuries.

After similar adjustments, researchers found that five years after injury people in the highest group had a 13% chance of work disability, the middle group had an 11% chance and the lowest group a 7% chance, compared to a 4% chance for people without brain injuries.

Researchers also found that for all groups, older age was associated with a higher likelihood of work disability. In the middle and lowest groups, female sex as well as psychiatric and substance use disorders were also associated with a higher risk.

"Our findings emphasize a need to offer long-term, individualized rehabilitation to all people with traumatic brain injuries to address any impairment," said Klang.

A limitation of the study was that it looked only at people in Sweden and results may not be the same for people in other countries.

The study was supported by the Swedish state under the Agreement on Physician Education and Research, a national partnership between the government and regions supporting clinical research and medical education.