Referral Source Question
Tue, 06/22/2010 - 12:26pm
I recently performed a FCE on a client referred by her attorney, to assess her status post treatment for an auto accident. One of the referral source questions was: "Expected work time endurance given back pain and for expected work life duration". I know the FCE is a valuable tool for assessing current functional status, but do not feel it can predict a client's future status.
So,
1) What would be an appropriate way to answer this question? This will likely go to litigation per the client's attorney, and I don't want to negate the whole report by stating that an FCE can not predict the future...
2) Is there any research that suggests for how long FCE data are likely to remain valid/reliable? In other words, I can assess a client's current status quite well utilizing FCE protocols, but does that really show how he/she will be tomorrow, 6 months from now, etc. as it does not control for future possible gains due to a home exercise program, nutritional/health status, or any other factors that may affect her future functional capacity.
Thanks!
Fri, 06/25/2010 - 12:36pm
#2
Work Life Duration
I think you are absolutely right in observing that determining how long someone's career will last prior to an inability to continue due to an injury or illness is outside of the scope of an FCE alone. This sounds to me more like a prognosis question (an MD's field of expertiese) or Future Cost of Care. Future cost of care is topic covered in a course offered by RMA, but may not be feasible for you to persue a specialty in this if you will only see one or two in your career. If you are from Canada, this may not be the case. If from the states, or something you agree with, you may consider;
"Although an FCE using best practice rationalle is the most accurate means of estimating an individuals ability to work on a reliable basis, the many complexities (age, culture, health, vocation, climate, etc.) makes an estimation of "work life duration" a question that falls outside of the field of expertiese of this evaluator. Therefore, this question may be better answered by a professional that specializes in this fied."
First, its great that you are really paying attention to the referral question. You have a much high chance of delivering high-level results if you insist on the referrer being clear.
Second, I agree with Jim: you can answer the first part of the question but not the second. Assuming that the referrer really means work-day endurance, you can use your skills to assess her ability to perform over the day which you evaluate her. Since the question hinges on endurance, remember to take as much time as you can in both standardized and distraction-based work sim activities to gather data about sustained tolerances and general endurance.
Does the attorney have a job goal against which you can evaluate or is this a residual ability eval?