When dealing with a workers’ compensation claim, you need to consider the value of your case. You may have heard the term “Functional Capacity Evaluation” (FCE) but are unsure of its relevance to your workers’ compensation settlement, especially when dealing with medical appointments, insurance paperwork, and lost wages.
FCE helps determine your maximum medical improvement (MMI), a critical factor in reaching a settlement. You might be closer to achieving MMI than you think, and the FCE can provide valuable insights into your physical capabilities and limitations.
To fully grasp its impact on your case, it’s essential to delve deeper into the purpose and implications of this evaluation. By better understanding the FCE’s significance, you can make informed decisions and advocate for your workers’ compensation settlement.
What is an FCE?
A Functional Capacity Evaluation (FCE) is a test that helps determine the physical strength and limitations of injured workers. It’s like a detailed checkup but more focused on how well someone can do work-related tasks.
This evaluation usually occurs when the worker is close to or has reached Maximum Medical Improvement (MMI), which means they’re as recovered as they’re likely to get.
FCEs are often requested by the employer’s insurance company or a workers’ comp attorney to determine whether an employee can return to their job or needs work modifications. They can also determine whether ongoing medical care or future medical treatment is necessary.
The results of this evaluation can be a significant factor in a worker’s claim. This test can influence injured workers’ benefits, including medical and wage loss benefits, so it’s crucial for any workers’ compensation case.
Components of a Functional Capacity Evaluation
An FCE is an objective assessment to get a clear picture of the injured worker’s capabilities. Here are some typical components of an FCE:
- Strength testing: Measures how much weight a worker can lift, push, or pull safely.
- Range of motion assessment: Checks flexibility by seeing how well a worker can bend, stretch, or reach.
- Endurance tests: Determines how long someone can do a specific task without getting tired.
- Balance and coordination: Evaluates the worker’s stability when performing tasks.
- Job-specific tasks: Simulates activities that match the worker’s job duties, like typing for office employees or lifting for manual laborers.
Role of FCE in Workers’ Compensation Settlement
The role of an FCE in a workers’ compensation settlement is pretty important. The results of this evaluation can influence how much compensation an injured employee receives.
For example, if the FCE shows that an employee has limited physical abilities and can’t do their regular job duties, it could increase the settlement amount to cover lost wages or the need for ongoing medical treatment.
Insurance companies use Functional Capacity Evaluation (FCE) results to decide whether an employee is ready to return to their job, needs modifications, or should receive additional benefits.
An authorized treating physician or other medical professionals, like a physical therapist, often rely on FCE results to recommend physical therapy or further treatment to support recovery.
The Impact of FCEs on Workers’ Compensation Settlements
An FCE can greatly impact a workers’ comp settlement as they report the physical abilities and limitations of injured workers.
Everyone, from insurance companies to workers’ comp attorneys, relies on these results to determine everything from disability benefits to whether workers can return to their old jobs or need something less strenuous.
Determining Impairment Rating
One key way FCEs affect workers’ compensation claims is by helping to determine an impairment rating.
This rating, expressed as a percentage, reflects the level of permanent disability a worker has after reaching MMI and indicates how much the injury impacts their ability to perform regular job duties. A higher impairment rating usually means that the employee has more severe limitations.
The FCE evaluation results clearly show the workers’ physical abilities and the amount they can lift, carry, push, or pull.
Impact on Disability Benefits
The impairment rating determined by an FCE can affect the disability compensation a worker receives. If the rating shows a significant loss of physical abilities, the workers’ compensation insurance carrier may offer more benefits. These could include ongoing payments, more extensive medical benefits, or even lump-sum payouts in some workers’ comp settlements.
The insurance company will use the FCE to decide the type of disability benefits, such as whether the employee is eligible for permanent partial disability or permanent total disability. The impairment rating can also determine how much the insurance company needs to cover in future medical care.
Return to Work Potential
FCEs are important in deciding whether an injured worker can return to their original job or needs modifications. The evaluation can show if the employee is fit enough to handle the physical job demands.
If not, the FCE results can suggest modifications, like lighter tasks or a part-time schedule. But if the FCE shows that the employee can’t return to their previous job, it can affect the workers’ comp settlement by highlighting the need for more benefits or even job retraining.
Vocational Rehabilitation
Sometimes, an FCE might suggest that an injured worker needs vocational rehabilitation. This change happens if the worker’s physical abilities no longer match their job requirements.
Vocational rehabilitation means getting new training or education to qualify for a different job. It’s an important consideration in workers’ compensation cases because it can lead to a more suitable job placement.
Other Factors Influencing a Workers’ Compensation Claim
When dealing with a workers’ compensation case, it’s not just the Functional Capacity Evaluation that decides the final outcome. Several other things come into play that can affect your workers’ comp settlement.
From a comprehensive medical assessment and treatment history to the negotiation skills of your workers’ comp attorney, these factors can either increase or decrease your final settlement amount.
Medical Records and Treatment
Medical records are like the backbone of any workers’ comp case. They provide proof of the work injury, document all medical expenses, and show how well (or poorly) you’re recovering. Doctors’ notes, therapy reports, and treatment plans help paint a clear picture of the injury’s impact on your life.
Without solid medical documentation, proving the seriousness of the worker’s injuries becomes very difficult, which can affect the settlement amount. The insurance company will look closely at your medical history to see if any ongoing or future treatment is needed, and they’ll consider that in their offer.
Lost Wages and Earning Capacity
Lost income and future lost wages are huge considerations in a workers’ comp settlement. If you’ve been out of work for a while because of your workplace injury, that’s a direct loss of income. Your workers’ comp settlement should cover what you’ve missed out on and any future earnings you might lose if you can’t return to your regular job.
The insurance company usually calculates this work comp by looking at your wage history and determining how long you will likely be out of work. If your injury means you’ll need to switch to a lower-paying job, that can also affect your future earning capacity and increase your compensation.
Pain and Suffering
Pain and suffering are considered non-economic damages, unlike lost wages or medical bills. They cover the emotional and physical toll the injury has taken on you.
While pain and suffering are not always part of a typical workers’ comp settlement, they can sometimes be included, especially if the work-related injury leads to long-term disability or big changes in your quality of life. This permanent impairment can add to the total amount you receive.
If you believe your pain and suffering should be considered, you should talk to a workers’ compensation attorney, who can help you understand your options. They can ensure every aspect of your case is accounted for in the final settlement.
Negotiations and Legal Representation
Negotiations are where having an experienced attorney can make a huge difference. Your lawyer will negotiate with the insurance company to ensure the settlement offer is fair and covers all your needs.
An experienced lawyer will use your case details to push for a better deal. This objective evidence includes the Functional Capacity Evaluation results, medical records, and other findings. Reaching a fair settlement also depends on how well your attorney can argue your case against the insurance company.
Secure Expert Legal Counsel
Handling a workers’ comp claim on your own can be overwhelming, especially when trying to recover from a workplace accident. You don’t have to go through it alone.
At Rosenfeld Injury Lawyers, our team has experience with these cases and knows what it takes to secure a fair workers’ comp settlement. Whether dealing with the insurance company or gathering the necessary medical records, we’ve got your back.
Call us at (888) 424-5757 or fill out our contact form for a free consultation.