I agree witht he other postings here. Also keep in mind that type of disability being sought. The world of disability evaluation in the private insurance arena is opening up to functional capacity evaluators as a result of recent federal court cases. Evidence submitted by physicians is being looked at in a more negative light than in the past.

If the case has to do with long-term disability, get a copy of the policy (or ask the requesting party) a couple of questions: is there a form you need filled out after this evaluation. If there is then write the report in terms expressed on the form.

Next, if this is a long term disability evaluation, is the person being compared to their ability to work in any capacity in a job described by the DOL or by a job analysis? The difference here is major. If it is the DOL then you need to consider the DOT and COJ data; if it is based on a ja then get one. The policy will guide you here.

Each month I review a recent court case. About 40% of them are ERISA federal cases. The others are either state cases or EEOC federal ADA cases. You may want to join us on the first Thursday of each month at 2 p.m. eastern to analyze a case. The broadcast is recorded and you can listen later, too.

We perform several FCE's, typically 2-3 per week for ferderal disability cases.  The recommendations I make are dependent on the referral sources.  Typically, the PCD/GP needs to fill out a form for SSID and need us to perform some testing.  If a person demosntrates positional tolerance of at least sitting, hand function looks good, and they can demonstrate at least sedentary physical demand, our referral sources have asked us to state what we recommend, ie vocational rehabilitation.  We are part of a large health system so patients hafve access to many other referral sources.  If a client demosntrates poor reliabilty of pain and disability which may be due to perceptions of disability or low effort say due to fear avoidance, we have also been asked to flag that and make recommendations ie: seeing a pain psychologist to be able to deal with those issues.  We also have some referrals outside of the health system that refer and they don't want any of that because they don't want to deal with it.  If it is recommended by another healthcare provider, they have to follow up with it and they would rather not, as they do not have ther resources.  Doesn't make it right, so we don't make recommendations but we try to deal with it as ethically as possible in the best interest of the patient.  It really depends on the relationship you should be devolping with your referral sources.

I think often that a comprehensive summary may be what is needed in these cases, but also feel that recommendations may help the reader make the next step decisions. In future cases, I would be a good idea to clarify what the referral source wants-that way you know you have answered any questions they may have. You can make up and print out a form for referral sources to check mark what questions they want answered and provide some blank lines for them to write in specific questions. Particular questions for disability cases may be; what modifications to the work environment may help the prospective worker, and or what specific limitations a prospective worker may encounter in a work environment. Clarifying the referral questions first will help you avoid any second guessing, and may help you avoid going in a direction that is not needed!