I still don't have a diagnosis yet after 14 months and back in October, WC sent me to one of their neurosurgeons who of course couldn't find anything wrong with me (based just on a MRI of my cervical spine and the EMG report). My attorney had this appointment set up where it would also count as my independent medical exam. I only saw this neurosurgeon one time and he is now recommending that I have a functional capacity exam. Could someone explain to me the difference between an independent medical exam and a functional capacity exam and how you can have either when you don't even have a diagnosis?

You should have a diagnosis code being billed to the workers' comp ins carrier. they're just not telling you what that is right now. If you go about it the right way, someone should help you obtain that information. maybe your attorney or by obtaining a copy of your medical records and billing info, if they'll give that to you. don't want you to make splashes/demands, just work on it.

Legal and financial issues complicate medical issues, always.

Your attorney will -- or, should answer those questions for you because things differ from state to state and he is your attorney. he's getting paid. Both sides have to show proof to a judge/ALJ. One way to do that is they do that by obtaining an IME (independent medical exam/evaluation). The IME will doctor fill out the FCE (Functional Capacity Evaluation) report. The IME doctor is usually paid for by the insurance company, with reimbursement for travel provided to you, usually. If your attorney is providing an IME it's at his choosing. You need to know who is paying the IME doctor bill. Your attorney or their insurance company? The IME doctor will examine/inquire/delcare/attest/document/record and make a report (and I'm not talking about a FCE report here-just a IMExaminer's report report ) on your health status for the purpose of providing the facts/evidence regarding his/her OPINION of your at-that-moment exam, your history & physical examinations, prior treatment and medical conditions, accidents, slip and falls, congenital abnormalities, so on and so forth and about anything they choose to inquire. you don't have to provide, but they'll make a note of that too, and can note what entrance you came off the highway from where you parked, assisted or unassisted into the building, and any tests he may have available to him, (usually more records than you're aware of that are usually provided by whoever pays for the exam) - your current health status as the examiner opines.

It's a very thorough exam to undergo by its nature. It's supposed to be done in an acceptable manner; meaning, you don't have to submit to any invasive procedures--check with your lawyer) - The IME report should be considered as EVIDENCE, good or bad. Most judges knows most IMExaminers. They've seen their reports before.

What did your MRI say? That's considered EVIDENCE, relied upon heavily in WC cases by plaintiff, defendant's, IMExaminers, judges/ALJs & doctors.

EMGs, well, they're not always on the money. They're good if it shows something-gives a doctor evidence or an idea what and how to treat. gives lawyers and judges something too. But if they're negative and you have complaints, it's not a good thing legally or medically.

It is what it is. Work has it demands. if you can't do it, you can't... that's bad enough.

Your IME visit is not for the purpose of treating you. don't get confused about the setting.

A functional capacity evaluation is a report of basically a doctor assessing your abilities of sit, stand, walk, climb, kneel, crouch, crawl, bend, overhead work, you know, about your functional abilities directed toward work settings.

It's due process. It takes time. It will not be easy to win. Be patient and be truthful about things and you should come out okay.

Thanks for the info, I'm going to email my attorney today and see if he knows the diagnosis code they're currently using. I know the old ones they were using back when I was seeing a physiatrist up until last February. At that point he stopped seeing me and said that he didn't know what was wrong with me and recommended that I see a neurosurgeon. It took until the end of October for the WC people to set me up to see a neurosurgeon and my attorney had it set up where this would also count as my IME and afterwards I would have a choice of seeing him as my treating physician or the doctor I had previously chosen from the WC list that they never got me into see. Apparently the MRI didn't show anything because the neurosurgeon told me that he only wanted to see me again IF it showed anything and he's not willing to see me now. This neurosurgeon who did the exam was not the least bit interested in finding out what was wrong with me. I had written down all my symptoms so I wouldn't forget anything and he folded the paper up and tossed it back in my lap without even reading it. When I mentioned that my right hand was colder than my left he attributed it to the room being cold. The phsyiatrist I had seen before says that TOS is a "notion" and this neurosurgeon said that since the physiatrist had ruled that out he wasn't even considering that as a possibility. I feel like I'm going in circles here and that nobody is interested in finding out what the problem is let alone treating it.

I think also that there is also a testing procedure for FCEs?
usually done at a PT place??
while I was having PT yrs ago -another therapist was doing one on a client.
involved various activities similar to what a person would do on the job.
I think the guy was an electrician- so he used screwdrivers in various positions and odd angles and also did other hand wrist, arm twisting and tool uses.
they timed how long he could do those jobs and discomfort rating

there are a few threads here and on the workers comp forum here that mention FCE.

Good to see you!
What were you primary complaints when you went to the neuro, or other W/C doc's. They are the codes they use. Also, they may just be treating symnptoms, as myofascial as opposed to calling it a brachial plexus injury. Myofacial is the trigger points, making spasms and pain where the nerve inserts to the muscle to make it move...

We had a diagx two or more years before the actually spoken words from W/C doctor. HE KNEW but did not share as he knew it was something that has a poor recuperation from due to repetative jobs, workplaces induced, long term truma. Unless it is an accident that an injury happens; then you still do not get a good diagx but they send you to rehab before all the hoops.

This doctor feels likely that you may not improve to return to the job, and wants the functual capacity to say that you can do another type of job. Of which they are not required to find for you....
You need an aggressive attorney, and a doctor extremly knowledgabe in TOS to take on the W/C company and dispute and treat your symptoms for optimal recovery and remission of symptoms.

In any w/c injury if you are not back after 14 months they assume that you are at optimum recovery and see what you can do.

Unfortunatly you can like a small box, or squeeze a grip once, but the day of working you could not do those task.

You are your own best advocate. but on good days or days I have to escape the problems of the heart, I come to our home on the forums and hammer out to keep my mind busy.
I hope you find help, very few doctors ever see TOS, and I am not even sure a neuro is the best treating for you.

di

Hiya
I wrote a detailed blog about my FCE and posted it somewhere on this forum but also here:
http://rsi-wc-california.blogspot.co...03/my-fce.html.

on the off chance that it is myofascial in origin, is there a therapist close enough to you, and you could afford to see? i speak from recent experience...