How A Functional Capacity Exam (FCE) Could Help Or Hurt Your Long-Term Disability Claim

If an illness or injury prevents you from working, long-term disability (LTD) insurance coverage provided through your employer can help in offsetting your lost income. However, when filing a claim, be aware that you will likely face heavy scrutiny from the insurance company. As for-profit businesses, it is in their best interests to reduce the amount paid out in claims. One of the factors that could either work for or against you is a Functional Capacity Exam (FCE).

What Is A Functional Capacity Exam and How Does It Impact My Rights To LTD Benefits? 

A Functional Capacity Exam (FCE) comprises a series of tests designed to determine whether you are physically capable of performing different tasks that may or may not be associated with your job. The American Occupational Therapy Association advises that they are useful and often ordered prior to starting physical therapy or to monitor your recovery in the aftermath of an injury or illness. They are also commonly used by insurance companies in determining whether to deny or approve a long-term disability claim.

Undergoing an FCE can take hours or days, depending on the extent of your injuries and the type of work you previously performed. Common tasks an examiner will likely ask you to perform include:

• Walking on a treadmill;
• Lifting, carrying, and pushing objects;
• Bending, crouching, kneeling, and crawling;
• Reaching for overhead items;
• Standing or sitting for periods of time;
• Grasping, scooping, pressing, or otherwise manipulating objects with your hands;
• Overall manual dexterity and endurance in performing requested tasks.

In general, a low overall score in regards to your ability to perform the above tasks (regardless of whether they are required on the job), makes you more likely to be approved for long-term disability benefits while a high score could result in denial of your claim.

How Our Florida Long-Term Disability Attorney Can Help

Under the Employment Retirement Income Security Act (ERISA), which governs employer-provided long-term disability benefits, you are required to undergo an FCE at the insurance company’s request. It is important to be aware of the factors that work against you in this situation:

• Examiners are often hired by the insurance company, which influences how they administer the exam and assess results.
• As insurers look at your overall score, tasks relevant to your job that you are unable to perform adequately can easily get overlooked.

To protect yourself in this situation, you need an experienced Florida long-term disability attorney on your side. We can make sure the exam is done fairly, with an independent third party acting as examiner and areas tested relevant to your job.

Contact Our Florida Long-Term Disability Attorney Today

Do not take chances when it comes to your long-term disability benefits. To protect your rights, reach out to Farrell Disability Law. Whether an FCE is requested or you are dealing with a previously denied claim, our Jacksonville long-term disability attorney can help. Call or contact us online today to request a consultation in our office.

Source:

aota.org/-/media/corporate/files/aboutot/professionals/whatisot/wi/facts/functional-capacity.pdf

dol.gov/general/topic/retirement/erisa