To get an FCE or not?
This is probably not the first question that you ask yourself. In the 10 years that Ohio Diagnostic Services has been performing FCE’s and talking to Nurse Case Managers, we are often confused by the reasons we are given as to why an injured worker is not a candidate for an FCE. These are just a few of the reasons we are given:
1. We are not here to recommend treatment.
An FCE is not treatment. It is a diagnostic tool, just like an X-ray or MRI, for you and the physician of record to decide if the functional abilities determined in the FCE will safely allow the injured worker to return to work.
2. We are waiting for an additional allowance.
As long as there is an allowed diagnosis, the injured worker will not perform any differently for the FCE if an additional ICD-9 code is added to the claim.
3. We are going to get an IME.
How many IME’s have actually helped you send an injured worker back to work in a timely manner? If an IME is an absolute must, an FCE should be done prior to that exam. This will give the IME physician a complete and accurate picture of exactly what the injured workers' functional abilities are.
4. I’m not sure if the injured worker is ready for one yet.
Allow us to make that determination for you. If at any time an FCE is not the right thing to do, Ohio Diagnostic Services will contact you and tell you the reason it is not appropriate at this time. So please, never be hesitant to refer for an FCE.
I have an FCE. What do I do with it?
Depending on the type of FCE performed, there may be different conclusions that may be reached.
If it is a Job Specific FCE, the injured worker will either be able to fufill all of the requirements of the job description or will not. Depending on the functional abilities, you may have a couple of choices:
1. If the injured worker can fufill all of the requirements, he or she is able return to work in the pre-injury position.
2. If the injured worker cannot fufill all of the requirements of the job description, it may be possible to send him or her back to work in a modified transitional position. **Remember this may be only temporary and should absolutely result in the injured worker returning to his or her pre-injury position.
If the FCE is referred as a baseline, there are many options that you could consider.
You will be able to use the results to assist you and the physician of record in:
A Job Search Program
Determining Maximum Medical Improvement (MMI)
Work Conditioning/Hardening Program
Vocational Rehabilitation
Social Security / Disability
If the injured worker is unable to work at all, you will need to determine whether or not further treatment is needed. The Therapist that performed the FCE will be happy to discuss this with you if you prefer.