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  1. #1
    Join Date
    Apr 2008

    Default Confused About FCE And Doctor's Restrictions

    Hello to all. I have a question regarding my FCE and what Dr changed from the results of FCE. First off I have had for the better part of 3yrs low back pain w/ radiating pain down the back of my left leg. I gone through all conservative treatments shots predisone and PT, also have had a PDD on L4-5 L5-S1 to no avail. I sought from PM dr surgical options, 1st was bi-level fusion what I won't do because no better odds then 50/50 it will decrease pain and then 2nd was from neuro how said in the begging I had a healthy spine just mild bulges and no sciatic nerve compression. So off to FCE and I was able to do what they asked was in pain but sucked it up and did it. According to the FCE my Dr said that the test said I could lift up to 50lbs but never picked up n e thing but a empty milk crate, but the Dr disagreed w/ FCE and put a restriction of no more then 20lbs no ladder climbing above 3 steps(part of job) and gave me a RTW notice even though I cant return because of a)been out past company policy of 180days and 2)restrictions put on me. So what is my MMI based on Dr or FCE? ho has the final say? Ever since FCE been in alot of pain and I think I have reherniated 1 of my discs but have been denied any visits to PM DR because he agrees w/ FCE and deems me MMI. Any thoughts or advice from n e 1 would be greatly appreciated? I do have an attorney but I dunno. Thanks and sorry for the rambling.

  2. #2
    Join Date
    Jan 2007
    PA, but worked in NJ

    Default Re: Confused About FCE And DR Restrictions?

    Hi I believe I am able to help explain the answers to your questions regarding your work injury and how your FCE will relate. I am not familiar with one of your abbreviations, which was the "PDD" can you tell me what this stands for?

    The purpose of the FCE is to help the Dr determine if you are able to return to your regular line of work, if you must seek a new line of work, or if in fact this injury has left you totally disabled. The FCE is based on years of medical research in the area of how pain effects our abilities, which includes employment. It also looks for what research indicates as inappropriate illness behaviors. It truly is a very complex exam, however it can only be as effective as the physical therapist who performs it, therefore it is not a medical conclusion but only a tool for the Dr.

    Its been my experience that surgery only helps those with some kind of nerve compression, by relieving this compression. So unless this was the case with your studies surgery was best avoided, as it could make things worst. Your condition is basically DDD and the outcomes of this condition are as individual as people are themselves.

    You are mentioning two separate issues 1) your return to work status. 2) Your employers requirement to maintain your position. Its unfair but in a work injury case the NJ employer is under no obligation to keep you as an employee if you are unable to perform the job tasks assigned, nor are they responsible to find you sedentary work.

    Stress will make your symptoms exasperate, and I think this could be what you are feeling not another herniated disc?? That is correct once the treating Dr rates you MMI the employer is no longer required to provide corrective medical care, any palliative care must be solely on you. There are VERY few circumstances where palliative care is covered under wc and usually requires some kind of work agreement (contract) between the parties that state palliative care is to be covered. You are able to seek medical care on your own as after MMI this can be considered a pre existing condition.

    So to answer you directly the Drs opinion is given the medical weight over the therapist findings in the FCE.

    If you feel that you are totally disabled from this work injury you are best advised to seek an expert in WC/SS law. You will need to file and win total disability benefits from the SSA and present these findings to WC court as there may be additional benefits due you through the state, which an expert is WC/SS law will be capable of getting for you.

    If you should have any other questions or want to discuss in greater detail what I have posted feel free to post again, or you can leave me a private message, or write me direct, my address is found by clicking bugmann on any of my posts.

    Good luck


  3. #3
    Join Date
    Apr 2008

    Default Re: Confused About FCE And DR Restrictions?

    Thanks for the reply BUG. PDD=percantaneous disc decompression(sp?). I know that my job isnt there for me , I was just curious because of what I had read that a DR would go against an FCE because he lowered the amount of weight stairs laddering climbing that I could do. He also asked for 3rd opinon because his (he is the neuro)findings are at one end of the spectrum and spine specialists says fusion bi level which is at the other end of spectrum. My PM DR(who when I last saw him feels muscle spasms are related to disc problems and some surgical intervention is needed)seems to be persauded by WC(what a surprise) to side w/ neuro who says that no nerve compression the discs are just resting on the nerve and since he has done that TTD has stopped. So hopefully my attny can fight enough to get 3rd eval and continue TTD so that we have 2 dr's that can agree on something, I know that stress adds to pain but trust me the FCE started this new flair up and having hernaited these discs before it feels the same. Its just very frustrating !

  4. #4
    Join Date
    Mar 2008

    Default Re: Confused About FCE And DR Restrictions?

    I think the FCE's are a crock anyway. When I did my FCE it hurt when I picked up the crate with 20 lbs in it so I set it down and said I can't do it it hurts too much. I did that on just a few things and he put in his report that there was alot of symptom magnification meaning it was all in my head. Sorry but if I am not suppose to do it at work I shouldn't have to do it there either if it hurts stop but no he said I was not willing to try. I did try when it hurt I put it down. I feel I should not injure myself more to have him put I was able to do all when it hurt like he&%. My doctor agreed with me that I should not push myself on it or it would make matters worse. But believe me the nurse kept pushing the issue saying well the FCE says this and my doctors like well I know her better then the pt and I feel this is what she can do. So they(IC)shopped around until they got a doctor to agree with my nurse so now I am stuck with no job and waiting to see one of their doctors at the end of the month. Just beware.

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