Workers' Compensation Discussion Forums

FreeBird, all you had to do was ask, I have no problem explaining on how I do, or did things.

As I had said, my heart rate was not in the FCE report stating I could still perform very heavy work duties. My surgeon (Neurosurgeon) agreed with me on an FCE other then the Baseline ones I was given. (This was my request though to have another FCE) He wrote me the script for the FCE computer operated. As I said I did pay for it. My cost was $720.00, a good fair price. I'm sure a script would be needed in about any of the 50 States.

The difference from a Baseline and a Full FCE to determine ones work capibility... Big difference. Baseline was based on my work skills as when injured, and maybe some other stuff. A Full FCE I paid for will determine what you truly can do and perform. Baseline report was only 7 to 12 pages. The Full FCE was a detailed in full 45 pages. As you can see it was well worth every dime I spent for it. In Illinois and some other States a regular PT or OT can't perform an FCE, they can once they have been trained, schooled, and on the job training, then certified with the State to perform FCE's.

I hope this helps you... If not let me know.

Bad Boy Bad Boy Wrote:FreeBird, all you had to do was ask, I have no problem explaining on how I do, or did things.

As I had said, my heart rate was not in the FCE report stating I could still perform very heavy work duties. My surgeon (Neurosurgeon) agreed with me on an FCE other then the Baseline ones I was given. (This was my request though to have another FCE) He wrote me the script for the FCE computer operated. As I said I did pay for it. My cost was $720.00, a good fair price. I'm sure a script would be needed in about any of the 50 States.

The difference from a Baseline and a Full FCE to determine ones work capibility... Big difference. Baseline was based on my work skills as when injured, and maybe some other stuff. A Full FCE I paid for will determine what you truly can do and perform. Baseline report was only 7 to 12 pages. The Full FCE was a detailed in full 45 pages. As you can see it was well worth every dime I spent for it. In Illinois and some other States a regular PT or OT can't perform an FCE, they can once they have been trained, schooled, and on the job training, then certified with the State to perform FCE's.

I hope this helps you... If not let me know.

I n Louisiana, A PT or OT must be certified in this field.
I actually know someone who is a registered OT who went to upstate new york for a week to get this certification.
This OT is only certified to do a FCE in Louisiana at one location because of contract language.
He can be bought out buy another company but it will cost big bucks. Crazy crap but it is in the contract and that company paid for the schooling.

Anyway, I do not know what type of FCE I have taken but both had 2 parts; one was a 2 day FCE; The 2nd basically the same except we paused for 2 hours and finished both sections in one day.

Both with similar results. Sedentary with Restrictions and some sedentary light with many Restricitons. 20 lb occasional weight limit etc.
Big Back injury in 2003 requirng removal of Thoracic Disk replaced with titanium cage, plates, screws and bone fusion from rib removal where they went in from the front(T12 Vertebrate) to do this in 2006.

I have fought,studied to get what I have got so far.
I thought we had a settlement agreement but that was over 4 months ago.
Anyway, I will fight until the last straw; I am hard headed but also much smarter than I was 6 years ago. Heck, I am almost dangerously smart.

FB;
Any of your physicians, or any doctor you might see, including an DC, may write a Rx for you to have an FCE and you may pay for it out of pocket at whatever facility you choose in all 50 states. Yes, they are very expensive but may also be a very good investment in your settlement.

Freebird, can I say, you don't need to apply a quote from each post your addressing, if it was meant for me to read, I surely will know. Thank you.

Oh yes, the FCE's can be different in many ways. ! could be just what the Insurance Carrier is wishing for. Then there are Baselines which is most used in a work comp injury. A full FCE can be used to see where one fits into the work place being able to perform at what stages and what work classification. Sometimes some employers use it to see how fit a new hired person may be also. But, do to the cost only a select few employers go this far. But not a bad idea, and could be worth the cost later on.

A 2 day FCE is also good, so the person staging the program can get a better idea on the persons pain from the previous day.

When I done my last Insurance FCE, it took me 3 full months to ease the pain I suffered from it. Then it was a couple months after that is when I paid for the Full Performance FCE which was computer Operated. The computer program is set up by the operator, setting up your weight height and on and on. This way it knows when to have you stop say when your heart rate starts to go off scale and such. Pain will raise your heart rate also. I found there were less errors in the computer operated FCE. And yes when it was done stated Sedentary with Restrictions and made it clear I would be able to possibly work a 4 hour day at the most. I would have to say, knowing what I can and can't do, I found this to be very correct. But, I did try since 2004 to find employment, had only 1 interview, they notice I had a problem with my neck and turn my head, ask me what it was, I told them. They said I qualified for the job, but I was too much a risk to hire. I just couldn't hold it against them for telling me the truth. My second injury to my neck, was caused by a prank. That ruined my career. I have damaged nerves, and the C8 nerve is damaged for life.

Can I ask whats wrong with using Quote when I am addressing what you have said?
Just wondering.......... Not a problem at all...

Both of my FCE's were based on a software program. I thought that would be fairly standard protocol this day and time.

I was approved for SSDI in March 2006, received backpay back to date of injury except for the 6 months they keep.
Currently still on WC pay and SSDI at the same time with no offset in WC pay. Thats the reason I am in no hurry to settle except I would like to find a PM Clinic closer to home.
I currently have to travel 111 miles one way every month.
I could possibly change but since I am seemingly fairly close to settling, I do not want to rock any boats. I get 52 cents a mile so .....
My life is fairly stable; Pain Management monthly, pain meds for life and not being stupid in my every day life.

The last IME I had to go to the WC WHORE Doctor found me PTD. This was my 4th to this wc whore but he diagnosed it proper the last time IMO. Caught the WC IC off guard to say the least.

So, are we done with this thread now? Or is there anymore that anyone wants to know more, or have more questions?

Bad Boy Bad Boy Wrote:So, are we done with this thread now? Or is there anymore that anyone wants to know more, or have more questions?

Bad Boy,
With the exception of one, I think most fully respect what you've detailed. Right on, bud!

BBBB;

WHile I suppose we are done with this thread and that your experiences with your various FCEs is what any IW can expect, both good and bad, it really is a rehash of an older thread where I cautioned that FCE's have questionable validity issues and are generally held to be unreliable predictors of function by the medical community as a whole. Various courts have also questioned their ability to meet Frye and Daubert standards. Even the large insurance companies have published one the need for a more focused standard.
Consider these excerpts from the FCE literature as each "system" tries to outsell it's competition;
" As functional capacity is influenced by psychosocial as well as physical factors,
it is difficult to determine whether maximal effort is exerted in FCEs.The sensi-
tivity and specificity of a number of tests,including the PILE,were examined for
their ability to determine maximal effort (Lemstra, Olszynski, & Enright, 2004).
While specificity was reasonable, sensitivity was unacceptable as those giving
maximal effort may be incorrectly labeled as exerting submaximal effort (Lemstra
et al.,2004).Caution is therefore urged when labeling the efforts of individuals. "

or

"When lifting capacity results were compared with job requirements, those
workers who met the physical job demands were found to have significantly lower
injury rates than those workers who did not demonstrate the required physical
capacities (Harbin & Olson,2005).Strength testing alone,however,had no predic-
tive value for determining the incidence of work injuries.Therefore, the ‘physical
evaluation of potential employees is useful for injury prevention only if it can be
related to the physical requirements of the job’(Harbin & Olson,2005,p.306). "

..and yet FCE's of IW in situations such as your, the norm, are job non-specific, just a test with no context.

So the problem with an FCE is really that, with the exception of very narrowly focused job specific testing, the outcome has doubtful medical and legal validity and yet it has become a powerful tool in litigation, generally at the expense of the patient or injured worker. The testing is very expensive and so it's of no surprise that various vendors, usually physical therapists or exercise physiologists, compete vigorously for a place at the insurance industry trough and do not market their services to the patient community at all. Physicians, even Rehab Specialists who are arguably the most highly educated Professionals in the field of medical conditions and human performance are never found to be involved in the FCE industry and have generally disavowed their usefulness - curious.

I would want every patient to understand these issues and to have the knowledge to challenge a skewed or erroneous report as few would have the means to obtain their own competing FCE as you did.

In a nutshell, FCE's are bad science at this stage of their development and testee's and their attorney's should be better informed on the matter for their own protection than is currently the case. Maybe a Sticky topic on what every IW should know about FCE's ?

Wink Wrote:

Bad Boy Bad Boy Wrote:So, are we done with this thread now? Or is there anymore that anyone wants to know more, or have more questions?

Bad Boy,
With the exception of one, I think most fully respect what you've detailed. Right on, bud!

Cycler, after I paid for the computer operated FCE that Wink and I had talked about with each other in the past, that after I think he performed his, I performed mine. After that, I had worked with Work Comp Attorneys on FCE issues since that time. Where we (me and the attorneys) talked about what is, and can be debatable. In a hearing process. I do know my attorney has debated mine since then also.

Bad Boy Bad Boy Wrote:Cycler, after I paid for the computer operated FCE that Wink and I had talked about with each other in the past, that after I think he performed his, I performed mine. After that, I had worked with Work Comp Attorneys on FCE issues since that time. Where we (me and the attorneys) talked about what is, and can be debatable. In a hearing process. I do know my attorney has debated mine since then also.

Sorry to Quote you again,But this question is for you. Have you settled your WC claim (claim's) to date?