Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).

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Old 03-19-2013, 02:59 PM #1
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Default Functional Assessment Evaluation

Functional Assessment Evaluation or FAE, ordered by WCB.

Has anyone had one of these done?

Mine is a week away. It is a whole day in an office situated in a city thats 2.5 hours away. I will be seen by a chiropractor, a physical therapist, and occupational therapist and a general practioner (GP) or what many call a PCP.

The outcome of their individual assessments will determine my return to work and any therapies needed to get me there. None of these medical professionals will ever see me again. They will have no actual involvement in anything they recommend. (Just like the neuro psych back in Feb)

Even if after I say that, it STILL sounds like this FAE is perhaps in my best interests, please remember it's ordered through workers comp, so they get the result they ask for. It is highly unlikely to result in actual therapies and more likely to result (AT BEST) in recommendations to WCB about workplace accommodations.

Wondering if anyone has gone through one with Workers Comp. (I know it's different in the U.S.) What to expect and will it be useful? Should I expect to be drained like I was from the NP testing?

My symptoms coming up on month 5 of PCS are the same. Head and neck pain, fullness in the head, tightness in head and deep within ears, ears ringing, vision problems, speech problems, cognitive problems.

Thanks for any info out there.
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About it: October 26, 2012 I fell backward on an icy parking lot at work. I was on Workers Comp for 9 months. My PCS : everyday headaches became once in a while headaches, and neck pain became manageable. Still have occasional mild dizziness, sometimes fullness in the ears, convergence insufficiency, sequencing struggles, short term memory struggles, verbal processing delays. CT neg, MRI neg. Therapies: prism glasses, acupuncture, icing neck, resting, supplementing, Elavil 20mg at bedtime.

NEW: Completed 12 weeks of physical therapy and returned to work full time.

About me: I'm a marketing manager, a mom with a blended family and wife to a heart attack survivor. I believe my brain injury taught me more than it cost me. I'm grateful to still be me!
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Old 03-19-2013, 08:04 PM #2
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Sounds like you will be poked and prodded and asked to do range of motion and lift and grasp and other physical tasks. I hope they are thorough enough to see your physical limitations.

If they ask you to try something, don't say, I can't do that. Say something like "When I try to do that, I get a pain ..... or I feel dizzy when I bend over like that. " You don't want to be labeled as uncooperative. Take it slow and let them know what is happening as you do the task. You'll be fine.

My best to you.
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Old 03-19-2013, 09:55 PM #3
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Mark I posted about the NP report, I finally got my copy after leaving him the terse voicemail. It is an atrocious report. I wish you could see it.
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About it: October 26, 2012 I fell backward on an icy parking lot at work. I was on Workers Comp for 9 months. My PCS : everyday headaches became once in a while headaches, and neck pain became manageable. Still have occasional mild dizziness, sometimes fullness in the ears, convergence insufficiency, sequencing struggles, short term memory struggles, verbal processing delays. CT neg, MRI neg. Therapies: prism glasses, acupuncture, icing neck, resting, supplementing, Elavil 20mg at bedtime.

NEW: Completed 12 weeks of physical therapy and returned to work full time.

About me: I'm a marketing manager, a mom with a blended family and wife to a heart attack survivor. I believe my brain injury taught me more than it cost me. I'm grateful to still be me!
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Old 03-20-2013, 09:24 AM #4
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Just wanted to wish you luck and tell you my thoughts are with you. I am pulling for you. These reports are going to work in the favor of the insurance company as much as possible. If your speech is bad enough, would they really want you back at work? Hope this is not too bad for you.
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Had MVA in 2006 resulting in post concussive syndrome manifested by cognitive impairment, chronic pain/ fatigue. Chronic pain of head, neck, back, left leg.
Other problems include REM sleep behavior disorder, nocturnal frontal lobe epilepsy, chronic migraines associated with nausea/vertigo, episodes of passing out, hypoglycemia, liver dysfunction (had accidental overdose of acetaminophen in 2009) had liver and kidney failure, hernia, degenerative disc disease with compression of nerve root, PTSD, and other problems associated with functioning problems from traumatic brain injury (light, sound sensitive, easily overloaded, easily distracted, cannot focus, anxiety problems etc.)
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Old 03-20-2013, 09:42 AM #5
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I want to wish you luck , also.

I would ask first about your report from that NPA - did he include a complete rundown of all the testing and the scoring? - if so, pay for someone else to review it and give you another opinion, base on that, or have one done by them to compare......you obviously disagree and need to find answers.

I know you are very disappointed in your treatment by the WCB, and how everything has been handled, and how you have been treated, you have to take the bull by the horns and do something about this yourself - get a lawyer, deal with them.

Now, onto your upcoming Functional Assessment Evaluation:

- do not go alone;
- have an advocate with you at all times - even if they are upset by their presence, have one at your side;
- it is your right to have an advocate present to observe and hear what is said - face it, you are anxious, you are befuddled, you are upset; someone not troubled should be of a better state of mind to advocate for you during these tests ;
- if you are tired, take a break; ask for them and take them.

I haven't seen a Chiropractor doing FAE's ; a Physiatrist, a Physical Therapist, an Occupational Therapist, a Physical Medicine /Rehab.Medicine Specialist, a Certified I.M.E. would be choices, but I guess in Canada the WCB allows for Chiropractors to do FAE's, I just haven't seen that in my area.

As I have shown in my previous links, I just offer best hopes for your evaluations.........but wish you could get other supports as soon as possible and get more fight on against those people. You can do it.

Best wishes.
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Current: Changes of more insomnia, new reviews with findings of more Depression, tremors, vertigo, tinnitus, loss of focus, fatigue; SSDI - accepted on Depression, Cognitive Deficits; Seizures ruled out, mTBI changes including cognitive slowing/lapses.
Medication update: Topamax 200mg twice daily it seems to minimize daily headaches to a 1-2/10 quality(I still know they are there); and acute headaches erupt without warnings.
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Old 03-20-2013, 10:30 AM #6
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Hi MsRRio,

I have not had one of these but have had a few assessments by doctors ordered by my long term insurance company in the past. Now that I think about it, I'm not sure what they were called so maybe it was the same thing. This was when I was off with Fibromyalgia about 15 years ago, not PCS, but it is very similar in that you look normal with it, there are no tests for it and doctors don't believe in it. I went to the appointment thinking, this is it I'm going to be cut off and I won't have any way to support myself. I was then a single mother. The anxiety and worry was terrible.

I had to get a ride to the appointment, about an hour away, and I was there the whole day. They did treadmill stuff, physical tests (squats,etc.) and asked a LOT of questions. The questions were probably similar to the ones you answered at your neuropsych testing... are you on drugs, are you lazy and looking for money, are you doing other work while on disability, etc. They don't come right out and ask you, they're trick questions!

They wanted to know what I did all day, what I did for a living, etc. It was a VERY long day and totally exhausting but they treated me well and I didn't feel put down or judged. I did the best I could with everything and answered all the questions. I agree that you have to try your absolute hardest because they are looking for people that aren't trying to get better or are faking it.

Make sure you mention that the testing is going to make you worse for days afterwards. I was given a phone number to call if I had any increase in symptoms afterwards and I made sure I called and told them.

I did not have anyone with me. I also agree with what Concussion (I think) said, you need to get your own doctors notes also. You can't just go on their doctors reports. Find a neuropsycologist with concussion experience and get their help. On top of getting help with your WC case you can also get help to get better.

Oh, I almost forgot the most important part of my writing,.... I was NOT cut off my long term disability. It was approved and I continued to try to get my life back. I eventually succeeded and got back to work. All you can do is be honest, show them how sick you are and hope they're humans and not just WCB slaves. You thought you were going to be denied before and you weren't so maybe the same thing will happen here.

Make sure you have plans in place (food prepared or frozen stuff) so that you can rest for a couple days afterwards. You'll need it.

Good luck to you! Let us know how it goes.

CC
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I'm a 39 year old, female, accountant. On July 2, 2012 I crashed my bike at the end of a 65KM road ride. I was fine that day but woke up the next morning to my current world.

Ongoing symptoms include: dizziness, blurred vision, light and noise sensitivities, cognitive problems, uncontrollable emotions/depression/anxiety, headaches (but they're getting better), mental and physical fatigue, difficulty communicating and sleep disturbances.

Currently seeing a fabulous Neuro Psychologist and vestibular physiotherapist and hoping to soon see a neuro ophthalmologist. I am currently doing 20 minute stationary bike rides daily, 20 minutes of meditating, 15 minutes of Lumosity and lots of resting. I have not been able to work or drive since the accident.

The things that have helped me the most since the accident are vestibular therapy, gel eye drops (for blurred vision, sensitivity and dryness), amitriptyline (10mg), and meditating. I am finally starting to see some slight improvements and am hopeful!

My brain WANTS to heal itself... I just have to let it and stop trying to get better!
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