medical evaluation

Your doctor may recommend a Functional Capacity Evaluation. If so, you are probably wondering what this means, and how it could impact your claim.

FCE (Functional Capacity Evaluation) is a type of evaluation done to see if an injured worker has recovered enough from their injuries to go back to work. They are like physical therapy sessions where you are asked to perform a series of tasks, and one session can take up to three or even four hours. The tasks can vary, but you may be asked to lift weights, stretch, walk, bend, and other exercises to see how your physical condition is.

An FCE is generally nothing to worry about. However, you should know some things going in.

Why Are They Needed?

At some point, your doctor will need to decide if you are able to go back to work. However, though they know a lot about your medical condition, they are not trained to assess your physical abilities to perform certain tasks, which is why the FCE is done by another professional.

The person who performs the evaluation will record your performance and send it back to your workers’ comp doctor for analysis. In many cases, doctors will decide whether you are capable of resuming normal or modified work activities based on the evaluation.

However, the FCE is not a simulation of a normal day in your workplace. It has a set of physical exercises that, in some cases, have nothing to do with your work. As a result, it is possible to score well on the FCE, but not be able to resume your work.

Can I Lose My Benefits?

If the FCE determines you are capable physically to perform a variety of tasks, and your doctor clears you for work, then yes, you will no longer receive workers comp benefits. The problem is, if you go back to work, and are unable to perform your regular activities because your condition hasn’t improved yet, you’ll most likely need to be given another position that can accommodate you.

However, if you’re employer does not have such a position available, unfortunately, it is possible to lose your job. This is why it’s so important to educate your doctor on the particularities of your job. When they receive the FCE, tell them if the activities you were asked to perform don’t resemble in any way the physical strain your job normally poses.

What Can You Do?

You have the legal right to refuse to perform any task the FCE therapists asks you to. To protect your rights even more, you can take a friend with you and have them record the session.

It is also a good idea to speak with a St. Louis workers compensation attorney, who may accompany you to the meeting, and intervene if needed. Additionally, a lawyer can help you fight to keep your benefits until you’re fully recovered.

At some point in the workers’ compensation process, your employer may ask you to take a functional capacity evaluation (FCE).

A function capacity evaluation will assess your physical capabilities post-injury. If you are well enough, you may be able to come back to work. Even if you are not, the result can help you and your St. Louis work injury lawyer fight for your workers comp benefits. Here is what you need to know about these tests.

What Are They?

A functional capacity evaluation is a test given to injured workers to understand the extent of their injuries. If you receive one, your ability to do things like walk, lift objects, and complete other physical activities will be tested.

Why You Might Receive One

There are many reasons why you might get an FCE. The following are a few of the most prevalent.

Disability Eligibility – One benefit you might receive is for disability, which is given to those that cannot complete regular work activities. An FCE can prove your physical condition.

Medical Needs – FCEs can tell you and your lawyer if you will incur extensive medical costs when caring for your injuries.

Returning to Work – At some point, your damages may subside and you will be eligible to come back to your job. FCEs can tell your employer if that is possible.

Who Will Give It to You

Two professionals might administer an FCE. The first is your company doctor, provided that they have a certification to do so. If they do not, the company doctor will outsource the task to another medical professional that does have a certification. Often, this person’s official position is as an FCE Technician.

What to Expect from an FCE

At first, the technician will likely ask you a series of questions about your job, injury, and health history. Once they have an idea of who you are and what your damages are, they may  explain how to describe your pain. That usually means using a specific type of language to tell them where you’re hurting and how badly. Lastly, they will likely have you complete regular job functions such as standing, walking, pushing, reaching grasping, balancing, bending, and more. As you complete these tasks, they will take notes on how you look and when you feel pain.

How They Affect Workers’ Compensation Cases

If you receive an FCE soon after your injury, the results can inform you and your lawyer on how much compensation you deserve. If your abilities are compromised, they will likely entitle you to more benefits. Additionally, those results can tell you about how much money you’ll need to spend on physical therapy going forward. Lastly, an FCE can tell your employer whether or not you can come back to work. If you do well in the test, you may return to your old position or start working in a light-duty capacity. In these situations, your compensation would typically stop.

Now that you understand FCEs, you have a general idea of what to expect if you receive one. No matter what the results are, they are generally a positive thing for you. If you perform well, that means your health is improving. If you do not, you may be able to raise the sum of the benefits you are entitled to.

Speak with an Experienced Workers Compensation Lawyer

Call 24/7 :: (314) 361-4300

Once you claim workers’ compensation, you have an obligation to seek the proper medical care to make your injuries better.

If you are hurt at work, then you are likely eligible to have your medical costs and lost wages covered by workers’ compensation insurance. In the state of Missouri, any company who has employees must be insured by workers’ compensation insurance in order to cover any workers who are injured while they are engaged in their work-related activities. If you are hurt at work, regardless of whose fault it is, your medical costs and any money that you lost due to being out of work are compensated for under workers’ comp.

What are Your Obligations?

Workers’ compensation differs from personal injury in that it doesn’t matter who is at fault for the injuries. The worker can be wholly responsible for their injuries and still be entitled to gain coverage to get back to work. But that does not mean that the employee does not bear any responsibility for their injuries.

Once you claim workers’ compensation, you have an obligation to seek the proper medical care to make your injuries better and to document not only how they happened, but the extent of your injuries. The insurance company will want proof that the injury was sustained while engaged in work-related activity, how long your injury will take to heal, and also that you were injured in the first place. The only way to prove those facts is to seek medical attention immediately when you have been hurt.

Responsibility to Mitigate Your Injuries

If you are eligible for workers’ compensation benefits and are receiving them, then you do have an obligation to mitigate those injuries. This means that you have to make every effort to make your injuries better. In the same respect, you have a responsibility not to make them any worse. So if you skip an appointment, don’t follow your doctor’s orders, or refuse treatment that will ameliorate your injuries, then you may be giving the workers’ compensation insurance company cause to either stop your payments or to deny your claim. 

What if Surgery is Recommended?

Although surgery can come with risks, if surgery is recommended and it will help to make your injury better and return you to the full capacity you had before you were injured, then the insurance company might be able to insist that you have surgery or deny you coverage going forward. Since workers’ compensation is based around the notion that it is there to help a worker heal and get back to work, having a treatment that would aid the worker to return them to full capacity may be required.

If You Don’t Want to Have Surgery

If you are worried about surgery and there is a chance that it might not make you better, then you have to decide for yourself what it best. If you are fearful that the surgery might make things worse or the success rate is not very good, then it is important to hire a St. Louis workers’ compensation attorney to plead your case if your benefits should be withheld due to failure to mitigate your injuries. They can help you with an appeal if you are denied coverage.

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Free Missouri Workers’ Compensation Consultation!

In Missouri, if you hurt yourself while you are work and performing under the scope and authority of your employment duties, then you are generally entitled to workers’ compensation benefits. Workers’ compensation is insurance coverage that is meant to cover an employee in the event that they are hurt while working.

There are very specific things that you have to prove to collect workers’ compensation benefits. The first is that you were engaging in work-related activities.

The Next Step

If you can prove that you were engaged in a work-related activity when injured, you must then show that you were in fact injured and to what extent. To do so, you have to seek medical attention to document what happened and to verify that you not only were hurt, but also how severely you were hurt, what your prognosis is, and what type of treatment you will likely need to recover from your injuries. 

The extent of your injuries will determine what benefits you are entitled to. For workers’ compensation, you are eligible to receive economic damages for medical costs and lost wages. If the injury is severe enough, you are also eligible to collect temporary disability or – in extreme cases – permanent disability payments. If you collect temporary disability benefits, you will get a portion of your salary while you are unable to work. The aim is for you to heal and return to work as quickly as you are able to do so.

What is an IME?

An Independent Medical Examination is when the workers’ compensation insurance carrier demands that you be evaluated by another medical professional. If the insurance company either believes that your injuries aren’t real, that they aren’t as severe as you claim, or even that they weren’t related to work activities, then they might require you to see another physician. It is their obligation to pay for the evaluation. However, you generally do have to comply, or they can deny your benefits going forward.

So What If the IME and My Physician Disagree?

If your physician and the IME come to a different conclusion, then the insurance company might try to deny you coverage, cut your benefits and demand that you return to work. However, you do have the right to appeal the IME’s diagnosis. In some cases the IME can be overridden, and your benefits will not be discontinued.