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RE: FCE - Cycler - 09-08-2009

no sparkey........ .where did you get that notion. How would Methadone maintenence patients get to the daily clinic ??? Methadone is a very cheap and effective pain medication used widely now in chronic non-malignant pain practices and while all recommendations are NOT to attempt to drive for the first few hours after a dose because patients tend to dose off unexpectedly, it's fine otherwise.

We are talking about the Federal DOT rules that prohibit issuing a medical clearance for a commercial driver CDL if they test positive for methadone. That's not you.


RE: FCE - sparkey - 09-09-2009

Okay maybe I was reading it wrong. Sorry I was just confused and thought you said that on Methadone you should not be driving. I just know I do not get tired on it and do not even notice I am on it after I take it. It is a great pain reliever when you get the right doseage. I am seeing the doctor today and feel I need to just have alittle more prescribed to function on a daily basis as the pain is still not under control. I know I will never be 100% pain free but we are getting there slowly so that I can function on a daily basis without being in bed due to pain.


RE: FCE - Cycler - 09-09-2009

The DOT may recognize the usefullness of Methadone for chronic non-malignant pain but associates it's use with detox/methadone maintenance programs which is a high risk population. While methadone is well tolerated by chronic pain patients there is no real chance that the DOT will revers itself on the matter.

The DOT drug testing rules for controlled substances are a hold -over from the 70's post Vietnam drug era, which is why the NIDA 5 panel drug test still looks for PCP an essentially non-existent drug anymore. This hold over is also why the NIDA 5 panel drug test for truck drivers DOES NOT test for semi-synthetic opiods such as percocet, oxycontin/codone, vicodin, hydromorphone etc which are actually the most abused narcotics and tend to show up in the non DOT forensic testing of truck drivers in post accident ER evaluations when there is loss of conciousness etc and need to know. Go figure.

.....and you want the Gov to run your health cars system?????


RE: FCE - Cycler - 09-09-2009

Actually I believe "the system " works pretty darn well considering all the interested parties that have a stake in the outcome. I think any system of any sort in any field that works as planned 97 % or better is about as good as it can be done.

Much of what I see from posters on this forum with endless tales of woe could hardly be considered work related regardless of how the legal system has or has not ruled on it. Also the fact that all that could be done was done but the medical outcome was less than hoped for and leading to the not unexpected difficulties of establishing permanent disability does not condemn Workers Comp but it IS unfortunate. Contrary to what is often posted, delays in diagnosis or treatment is not generally associated with poorer outcomes. In fact quite the opposite in Spine medicine where to do less is often better in the long run from my reading of the literature. Again, my opinion only.....



"Actually friends, this happened to me. No matter how you look at RTW, there is never a GREAT result for the IW. The sysem is screwed up so much that every IW is Guilty, and NEVER proven innocent. Ramble Ramble Ramble. LOL!!! JMHO!
[/quote]


RE: FCE - Bad Boy Bad Boy - 09-09-2009

I like honest Opinions too.

Medications affect each and every person in a different way... Opinion

FCE's are not always a fair assesments... Opinion, As it only will show, what a person can tackle in a limited amount of time per task.. Being said, on 25% of on FCE is showing what one can truely due and perform on for a couple of hours or even maybe 15 minutes. As it is my honest opinion. The facts are very true. Now like me, I am at prime strenght in the start of an FCE for some reason, as time pass on through it, I become much weaker, heart rate goes way up and proves this. But, your rated at what you were able to do, and at the peak instead of off peak. This is why I then paid for my own FCE, that was computer Operated. I studied up on it, and did get a well based explained FCE while leaving out human judgement. An FCE is like anything else, each tester will give a different assesment of such test. If 20 FCE's were performed by 20 different people, there will be 20 total different reports. But go to 20 computer operated FCE's, and the results will be close to the same each time.


RE: FCE - freebird - 09-09-2009

chrischris Wrote:To take or not to take your meds is up to you; depending on your circumstances. I do believe that if you DON'T take your meds, tell the examiner that you didn't, but you have them with you to take as soon as the exam is complete. There should be no fear in taking this exam for any IW who truly wants to return to work. It is also a help to the IW especially if he/she has several doctors with varying opinions about RTW and/or RESTRICTIONS. Also keep in mind,
Functional Capacity Evaluations Can Identify Workers Comp Malingering Don't jump me! It's true, and you all know it, that there are people who just don't want to RTW. They have their own reasons and I am not judging. It could be how they have been treated by ER since on WC. It could be that the ER doesn't communicate with them, or show any interest in them returning. It could be that the EE is AFRAID that once released back to work, the ER is just waiting to fire the employee. Again, I say there are lots of reasons. For me, it could be that I have such a bad psychological injury along with my physical injuries, that if my restrictions allow an alternate position, the ER will do everything they can to get rid of me and cause additional psychological injury. Actually friends, this happened to me. No matter how you look at RTW, there is never a GREAT result for the IW. The sysem is screwed up so much that every IW is Guilty, and NEVER proven innocent. Ramble Ramble Ramble. LOL!!! JMHO!

The Waddell Test was used in my FCE Examination to see if I was malingering or faking during a 2 day Fce. I PASSED; Not a faker.
This pisses off a lot of IW's especially the ones that are excused of faking.
http://library.findlaw.com/1999/Aug/1/129419.html


RE: FCE - Cycler - 09-09-2009

Of course that would assume that FCE's are a valid test of anything and have been standardized and subjected to rigorous scientific scrutiny and independently validated since so much is riding on the results.

Would it surprise you to know that that is not the case or that the medical community (Doctors) have generally held FCE's to be of no predictive or clinical value ?

If you feel it is important to give your best non-medicated effort as a true indication of your overall functional ability then who could argue with that? It is what is best for you and your circumstances.

Bad Boy Bad Boy Wrote:I like honest Opinions too.

Medications affect each and every person in a different way... Opinion

FCE's are not always a fair assesments... Opinion, As it only will show, what a person can tackle in a limited amount of time per task.. Being said, on 25% of on FCE is showing what one can truely due and perform on for a couple of hours or even maybe 15 minutes. As it is my honest opinion. The facts are very true. Now like me, I am at prime strenght in the start of an FCE for some reason, as time pass on through it, I become much weaker, heart rate goes way up and proves this. But, your rated at what you were able to do, and at the peak instead of off peak. This is why I then paid for my own FCE, that was computer Operated. I studied up on it, and did get a well based explained FCE while leaving out human judgement. An FCE is like anything else, each tester will give a different assesment of such test. If 20 FCE's were performed by 20 different people, there will be 20 total different reports. But go to 20 computer operated FCE's, and the results will be close to the same each time.



RE: FCE - Cycler - 09-09-2009

the signs described by Dr. Gordon Waddell many years ago and updated and commented on by him from time to time do not describe malingering behavior and he has said so many many times in print. They are misused by biased IME Drs. to support their bought and paid for position in the hopes that the other side doesn't know any better, which is generally true from my experience. Google the term and read for yourself.


"The Waddell Test was used in my FCE Examination to see if I was malingering or faking during a 2 day Fce. I PASSED; Not a faker.
This pisses off a lot of IW's especially the ones that are excused of faking.
http://library.findlaw.com/1999/Aug/1/129419.html
[/quote]


RE: FCE - freebird - 09-09-2009

Cycler Wrote:the signs described by Dr. Gordon Waddell many years ago and updated and commented on by him from time to time do not describe malingering behavior and he has said so many many times in print. They are misused by biased IME Drs. to support their bought and paid for position in the hopes that the other side doesn't know any better, which is generally true from my experience. Google the term and read for yourself.


"The Waddell Test was used in my FCE Examination to see if I was malingering or faking during a 2 day Fce. I PASSED; Not a faker.
This pisses off a lot of IW's especially the ones that are excused of faking.
http://library.findlaw.com/1999/Aug/1/129419.html
[/quote]
Whatever the case, This is how I was graded in 2008 when I took my FCE as far as faking goes.


RE: FCE - Cycler - 09-10-2009

BBBB;

I've dug a little deeper into the FCE lit and found some older papers that do support your experience that pain meds effect the behavior and therefore the outcome of an FCE in certain circumstances on high dose short acting pain meds so I would modify my statement on always. I still like my position from a theoretical standpoint but your outcomes demonstrate that one size does not fit all.


Freebird.

Cool. and that's a very informative link and scary if I was the IME doc .....