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Understanding the purpose of an Functional Capacity Evaluation (FCE) is important because it will provide insight as to where the particular injury case is moving. The FCE will give the Maryland workers compensation attorney an idea as to the next step in the case and what to prepare for.
At a certain point in the injured workers treatment the physician will indicate there is no further treatment options. This means that the injured worker has reached maximum medical improvement or what is referred to as MMI. Once MMI is reached there are a couple of different paths the ordinary Maryland workers comp case takes. See definitions page.
Ready for a Rating
If the injured worker is ready for a rating their Maryland workers compensation attorney will set them up for an Independent Medical Evaluation for the purpose of a rating. The rating will help assist the attorney determine what is a fair amount of compensation to be paid. The rating will provide a percentage impairment based on any permanent problems the injured worker is left with after treatment. If the injured worker is not able to perform at the physical capacity they once could, or if it is unknown as to what capacity they can perform the compensation lawyer may choose to have an FCE done prior to obtaining a rating. Obtaining the FCE prior to having a rating performed is the preferred method among many Maryland workers compensation attorneys because often the FCE will suggest further treatment. Further treatment means the injured is not ready for a rating and has not reached maximum medical improvement.
Functional Capacity Evaluation (FCE)
A functional capacity evaluation is a day long, or half day long evaluation performed by a medical doctor or physical therapist to determine the physical capabilities of the injured worker. If it is unknown what the injured worker can physically tolerate or if there is no clear picture as to what the injured worker can tolerate than a FCE will be necessary.
How is it performed
The functional capacity evaluation is performed utilizing multiple physical agility tests. Some examples: are lifting weight from the floor to the knees, to the waist, and to shoulders, length of time an injured worker can walk, run or jog, distance the injured worker can carry items of particular weight, how long can the participant sit, stand, stoop, kneel, and squat, and many other tests.
The injured body part will determine the tests that are performed at the functional capacity evaluation. For shoulder injuries one should expect to perform more tests involving lifting, pushing, pulling and carrying. Leg/knee injuries often lead to an FCE that will include the injured worker performing more tests involving walking, standing, squatting, and kneeling. Back injury participants can expect the tests may be a combination of lifting items and length of time the participant can stand, sit, or walk.
What injured Maryland Workers need to know about Functional Capacity Evaluations
The particular provider that is performing the evaluation will also be looking for inconsistencies in the injured workers response. The purpose of the test is to push the participant to perform up to the point the pain becomes the terminating factor. On occasion the injured worker will emphasize the pain more so than expected considering the nature of the injury. FCE providers are wise to this so they will perform tests that seem to be focused on one part of the persons body but would ordinarily cause pain in another part of the body. An example using a low back injury: the provider may indicate that they are testing the flexibility of the leg and knee but are really testing the flexibility of the low back. The participant who earlier indicated excruciating pain in the low back has no pain response in their low back because they believe it is their knee that is being testing when the leg test is actually to inquire as to back pain. Instances like this occur occasionally and can damning to the compensation case.
Along with tricks the providers may use to consider inconsistencies the injured worker must consider providing full effort throughout the test. When the FCE participant gives up or throws the towel in too soon on a particular test then he or she will be seen as not providing full effort and the test will be deemed not reliable. An example of testing for reliability: The participant will be asked to walk on a treadmill with a heart monitor attached. As pain increases the heart rate should increase, if it does not then there is an indication of exaggerated pain. Repeated over exaggerations can lead to “low reliability” function capacity evaluations.
Because the FCE report may indicate “inconsistent efforts” or “low reliability” it will could be deemed inaccurate and cause problems in obtaining compensation for the injured worker. Valid FCE reports are not only essential for the Maryland workers compensation attorney to obtain just compensation but also to continue obtaining benefits to which the injured worker may be entitled.
What happens after the functional capacity evaluation is performed
If the report issued reliable results and consistent effort then there are a few options for the injured worker depending on their functional limitations.
A. If Tested at the functional capacity needed to return to their job the injured worker may have the option of returning to their old occupation and with the same employer. Very often this is not an option because the employer has already replaced the injured worker position. The injured worker can then decide to fight for vocational rehabilitation benefits or if the benefits are voluntarily provided may pursue the job search while receiving compensation. Another option is for the injured worker to perform the job search without the assistance of a vocational counselor however no weekly compensation would be paid.
B. If tested at a function capacity that is below the requirements needed to return to their job the injured worker will have similar options to those that are provided in circumstance A. If the employer is willing to accommodate the injured workers restrictions then he or she may return to their employments. With only some restrictions outlined in the FCE this is often the best solution all parties. It gets the worker back to work which will prevent further compensation payments by the workers compensation insurance company. It also helps prevent future job loss because of the limitations that would otherwise lead to further compensation payments. Another option is for the injured worker to receive vocational rehabilitation benefits and job counseling.
C. Occasionally the functional capacity evaluation will suggest further treatment. Suggested further treatment often includes a course of work hardening which is only indicated if the worker is not already at full capacity, and the Evaluator thinks further efforts can get the injured worker to a higher capacity. The purpose is to make the worker qualified for more jobs. Work hardening is an aggressive course of physical therapy that is usually attended to daily for anywhere from two weeks to two months. The goal is to increase the participant/injured workers capacity. If work hardening is prescribed then the injured worker may choose to attend the work hardening program, move the case towards permanency or argue for vocational rehabilitation. Vocational rehabilitation is likely not the best option.
If the report is deemed unreliable the injured worker may ultimately end up losing their right to vocational rehabilitation benefits, compensation benefits or the chance of being rehired by their employer. The case may have to move directly to permanency.
Contact Mr. Rodabaugh, an experienced Maryland workers compensation attorney!