IME / PPI Ratings / FCE

Independent Medical Examinations (IMEs) are examinations performed by an evaluator on a patient not in the care of the examinee, for the purpose of clarifying clinical and case issues. 

IMEs are an important component of the workers’ compensation system that are often conducted for injured workers as a means of determining causality, extent of injury and the proper medical treatment necessary. Causality is a very important component in the evaluation as it can determine whether an injury was truly work related or perhaps the result of a personal medical condition. This can have a tremendous ramification on the compensability of the claim. The objective non biased evaluations are also often used to clarify other disability or liability associated cases that may or may not end up in litigation, but are often used to settle wage replacement benefit claims, paying medical bills, and as a safeguard against fraudulent suits. An independent medical examiner often is called to testify before the workers compensation board or as an expert witness. Using a certified or experienced examiner is critical in these situations.

Comprehensive Care employs physicians who are certified in performing IME’s and understand the importance of good communication and timely reporting. We ensure that your experience in dealing with our clinic is as efficient and helpful as possible. Being a dedicated occupational medical clinic allows us a better understanding of workers compensation and the unique requirements of our clients, case managers, or insurance carriers.  In addition to performing the IME, our physicians can provide depositions and expert testimony for cases that go through litigation.

A Permanent Partial Impairment (PPI) examination is often done in the workers compensation setting when a patient has reached their Maximal Medical Improvement (MMI) and there is a level of impairment that still exists. In the process the examiner will utilize information from a thorough functionally based history, physical examination, take broadly accepted clinical results, and integrate them into the American Medical Associations Guides to the Evaluation of Permanent Impairment to determine a corresponding impairment value, thus producing a transparent, clearly stated and reproducible PPI rating. 

Utilizing Comprehensive Care for your PPI ratings provides a benefit to all involved parties by minimizing conflict and improving decision making.

A Functional Capacity Evaluation (FCE) is a systematic process utilized by health professionals to assess an individual’s physical capacities and functional capabilities.

  • The FCE compares an individual’s performance level to the demands of a specific job, work activity or occupation.
  • The FCE establishes the physical demand level an individual can perform safely.
  • The FCE is useful in determining any necessary job modifications to prevent further injury or ability to return to pre-injury duties safely.
  • FCE’s can provide objective information regarding functional work ability in the determination of occupational disability status.
  • FCE’s are used to predict the potential ability to perform work following acute rehabilitation, work hardening/conditioning programs.

The Functional Capacity Evaluation assesses the individual’s flexibility, strength, balance, coordination, cardiovascular condition and body mechanics. An effective FCE determines whether there is a match between the individual’s functional capabilities and the physical demands of his/her specific job functions.

Typically, the FCE focuses on a job goal rather than on individual aptitudes, interest and temperaments.

There are two types of FCE’s:

  • Baseline FCE: An objective assessment of the individual’s physical abilities to perform a variety of tasks related to the physical demands of work
  • Job Specific FCE: An evaluation of the individual’s physical abilities to function within the parameters of the essential functions of an identified occupation. Work simulation is often an integral component of the evaluation.

Our physical therapist certified in FCE’s will perform this evaluation. The evaluation usually takes up to 4-5 hours depending on the individual’s needs. The procedure involves filling out pain and function questionnaires and completing physical tasks that have been selected by the therapist that will best meet the individual’s needs. The therapist will then analyze the data collected from the session to reflect specific objective information regarding functional work ability and/or determination of occupational disability status.

Who Should Be Referred?

  • Individuals who have achieved maximum medical improvement (MMI) but continue to have issues related to returning to work.
  • Individuals who need quantification of their physical capacities for determination of disability status.
  • Individuals who need to quantify ability to safely return to pre-injury duties.