Your Plan for Long Term Disability Benefits and a Functional Capacity Evaluation
One of the best ways to establish your functional restrictions and limitations is a functional capacity evaluation. However, all to often, long term disability carriers use functional capacity evaluations as a basis to deny claims.
Many long term disability carriers will deny claims on the basis there is no objective basis for the physical restrictions and limitations assigned by your physician. The long term disability carrier will request a functional capacity evaluation to determine the validity of your subjective complaints and prove you can work.
What is a functional capacity evaluation?
A functional capacity evaluation is a 3 to 5 hour comprehensive evaluation used to determine your current physical ability to sit, stand, walk, lift and carry. Your mobility, strength, endurance, sensation, hand function and gross/fine motor coordination will also be evaluated. Part of the testing will determine your consistency of effort and, long term disability carriers can deny claims on the basis that you failed to give full effort during the course of the functional capacity evaluation.
Test for malingering During The Functional Capacity Evaluation
The functional capacity evaluator will perform a Waddell’s test. The Waddell’s test is a group of signs that are part of a physical examination and are divided into 5 groups:
1. Regional disturbance;
4. Tenderness; and
For example, in the simulation test the evaluator will press down on your head. If you complain of back pain while the functional capacity examiner is pressing down on your neck, that’s a sign of a non-organic response. If you have 3 or more positive signs on the Waddell’s testing, it’s positive for symptom magnification. The long term disability carrier will accuse you of exaggerating your symptoms.
The functional capacity evaluator will also be looking for inappropriate description of symptoms which can include:
• Whole leg pain;
• Whole leg numbness;
• Whole leg giving out;
• Tailbone pain; and
• The failure of medical treatment and no pain free periods.
Psychometrics testing in the FCE
You may be given a battery of psychometric testing to assess your perceived pain and disability. The lack of consistent findings can suggest a non-organic influence that has more to do with illness behavior than physical disease. The testing can include:
• Ransford pain drawing;
• Numeric pain rating scale;
• McGill pain questionnaire;
• Dallas pain rating questionnaire;
• Waddell’s testing; and
• Oswestry pain questionnaire.
As a long term disability attorney, I seriously question whether the psychometric testing is a legitimate part of a functional capacity evaluation and would suggest that you refuse to take any psychometric testing. You should, fully, otherwise cooperate with the functional capacity evaluation.
Getting the long term disability benefits you deserve
If you’ve been scheduled for a functional capacity evaluation, you are, most likely, being set up for a claims denial.
You should first check your policy to see if whether or not the long term disability carrier even has the right to a functional capacity evaluation. If the policy doesn’t allow for the functional capacity evaluation, I would strongly recommend that before going you consult with a long term disability attorney and see if they agree with you. You shouldn’t subject yourself to testing that is not permitted under the long term disability policy.
If you’ve been scheduled for a functional capacity evaluation, it’s time to contact long term disability attorney, Nancy Cavey, who will help determine the best course of action for you.
Contact her today at 727-894-3188 for a no obligation consultation about your rights to long term disability benefits.