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independent medical exam indiana

Functional Capacity Exam (FCE)

Related terms include “Physical Capacities Evaluation” (PCE), “Functional Capacity Assessment” (FCA) or “Work Capacity Evaluation.”

A Functional Capacity Evaluation/Exam (FCE) is a series of tests designed to measure physical strength, ”range of motion”, stamina, and tolerance to functional activities, including lifting and carrying and will begin with an in-depth questionnaire.

In a workers’ compensation claim, the results of Functional Capacity Evaluation are typically used to develop return-to-work plans, as the basis of an offer of alternative employment, or as the foundation for a feasibility development plan (work-focused rehabilitation). An evaluator SHOULD ONLY use tests that have to do with the specific individual’s diagnosis and return-to-work goals or job demands.

These tests can be used to evaluate work tolerance and work restrictions, if necessary. The exam is used to determine the extent of the employee’s residual or permanent disability. Do your best, be honest, and remember there’s no right or wrong answer.

P.S. I can safely guess that you WILL NOT be jumping rope.

How can I receive the form that lets me get an Independent Medical Examination (IME)?

 

If you have not received a form that lets you get an independent medical examination (IME), but you have been released from the worker’s compensation doctor, then you can contact the worker’s compensation insurance carrier and ask about it.

If you find out that you are not eligible for an independent medical examination (IME) through the Board, then you can seek one at your own expense and try to use your doctor’s report as leverage to get your benefits reinstated. Obviously, this would only happen if the doctor’s report is favorable to you.

If you do seek an IME, make sure you select a doctor with an excellent reputation or the Board may discount your doctor’s opinion.

What Injured Workers Need to Know About Independent Medical Examinations

 

You have a right to an independent medical examination (IME). You may request an IME if you feel you were returned to work too soon and/or if you feel you would benefit from additional medical treatment.

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To make this request, you still need to mark the Report of Claim Status/Request for Independent Medical Examination (Form 38911) accordingly. This form will be mailed to you from the insurance carrier at the time your temporary total disability (TTD) benefits are terminated. This may coincide with the time that you are also released by the doctor at maximum medical improvement. Please note that you only have seven (7) days from the date of receipt to return the completed form to the Worker’s Compensation Board of Indiana.

The Board will then review your request, consider your medical treatment and prognosis, and then likely schedule you for an IME with a doctor they have chosen. If they schedule you for an independent medical examination, the doctor they send you to will only evaluate whether you need additional medical treatment and whether you should be working given your condition. This doctor, however, will NOT do the following:

  • Prescribe your medication
  • Discuss future medical needs
  • Give you a permanent partial impairment rating

Here is a list of items you need to take to the independent medical examination:

  • Original X-Rays, MRI’s, CT Scans, or any other radiology film
  • Any medical records for related treatment with your personal doctor(s)

If a nurse case manager (or rehabilitation manager) has been assigned to your case, he or she is not permitted to attend the independent medical examination scheduled by the Board.

The outcome of your examination will carry a lot of weight in the direction of your case. In other words, if the IME doctor decides that you can return to work and you need no further treatment, it will be difficult for you to prove otherwise since this is a doctor that was personally selected by the Board. Likewise, if the IME doctor indicates that you need more treatment and/or that you should remain off work, the Board will likely stand behind their doctor and order that your worker’s compensation benefits be reinstated.