Discussion: View Thread

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

In VE forensics outside of SSVE it seems to me that there is a distinct growing trend to by some incompetent "experts" to merely accept an MD opinion that the individual is "unable to work". There is often zero attempt by the incompetent VE or unknowing or perhaps lazy attorney to obtain from the MD (or via FCE) specific, objective physical and/or mental work capacities. "Experts" who do that are failing to use a VR/VE 101 fundamental, any greenhorn knows, standard required method. There is no basis to support their favored "method" (of absence of method) that I can find, anywhere. It is a really quite excellent way for an expert to damage the attorney case. Sometimes of course once the work capacities are identified the VE may have basis to agree with the MD generic opinion. Sometimes injuries are so severe that you can be tempted not to seek to establish work capacities. But it is wise to do so.

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Unfortunately, I often come across VE's who defer to MD's on the suitability of occupations. Usually, those are defence reports. In doing so, those VE's abdicate their expertise to medical experts who are really not qualified to comment on employability. We are the experts who interpret medical impairments into vocational impairments. Medical experts should confine themselves to identifying physical impairments or psychological, in the case of psychologists or psychiatrists. This problem is compounded by the fact that insurers in Canada continue on asking MD's to opine on employability, something they should stop doing.

When I come across an MD who comment on employability, I focus instead on what physical impairments have been identified.

In VE forensics outside of SSVE it seems to me that there is a distinct growing trend to by some incompetent "experts" to merely accept an MD opinion that the individual is "unable to work". There is often zero attempt by the incompetent VE or unknowing or perhaps lazy attorney to obtain from the MD (or via FCE) specific, objective physical and/or mental work capacities. "Experts" who do that are failing to use a VR/VE 101 fundamental, any greenhorn knows, standard required method. There is no basis to support their favored "method" (of absence of method) that I can find, anywhere. It is a really quite excellent way for an expert to damage the attorney case. Sometimes of course once the work capacities are identified the VE may have basis to agree with the MD generic opinion. Sometimes injuries are so severe that you can be tempted not to seek to establish work capacities. But it is wise to do so.

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

It seems that forever, doctors were and are asked to write notes for getting out of school, or getting out of gym class.  And even returning to such.  A doctor's note is needed to clear a student athlete to compete in sports, claim insurance on an airfare ticket that was not used, due to sickness or impairment, or to use a sick day at work.   In workers' comp, we learned years ago to give a job description (most times only a job title!) to a doctor and ask about RTW.  

So, not that I intend to defend docs here, but the precedent for their opinion (outside of giving an impairment rating) is well set, and continues.  Regardless of if it may be outside of their scope of practice.   This notion or precedent does not go away lightly.

As VRC's however, this is one place where "any layperson's knowledge" and the use of standards for the general public just do not suit in our disability cases- placement or litigation.  I agree, otherwise it begs the question-- why do VRC's exist at all?

I often rely upon this is my cases, and in rebutting the opinion of others involved in a mutual case, the following fact:  

1. In 1991, The U.S. District Court [1] ruled that medical doctors are not experts in vocational matters.  Specifically, the Court said in this case that: "… The qualifications of Drs. xxxx and yyyy in the medical field in no way qualified either physician to speak as a vocational expert."<o:p></o:p>

Well, for example, at a Social Security hearing, an ALJ would not accept a "no work" opinion from a Medical Doctor as the doctor is not a vocational expert familiar with all occupations that exist in the labor market, hence the purpose of having vocational experts at disability hearings.  The Social Security Administration requires a residual functional capacity completed so a vocational expert may then evaluate one's vocational profile and determine employability issues (aka jobs that exist in the national economy),  a knowledge base not within the scope of Medical Doctor.  

This is true for all litigated and non litigated vocational rehab work. 

In my opinion, it is proper for a vocational rehabilitation consultant, outside of post acute injury, to pursue residual functional capacity opinions as opposed to blanket statement opinions from physicians regarding ability to work.  Otherwise, what is the point of vocational rehabilitation?

Ms. Pasikowski, please feel free to contact me directly if you would like to discuss further.  

Erin O'Callaghan, BS, MA, JD, LPC, CRC, NCC, CLCP

erinocallaghan@eorehab.com 

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Well - few months later and the opinion did not hold up - functioning outside of their lane

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Beth (if possible) please provide us all with a case name/reference. We could all then benefit by noting such when we encounter "experts" employing such strategies/error in failing to use standard method.

Well - few months later and the opinion did not hold up - functioning outside of their lane

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

I agree with many of the opinions expressed in this discussion.

Some thoughts:

1). Prior to MMI, most injured workers have some level of work capacity. When injured workers reach a point of medical stability (not MMI), a partial FCE could be helpful to objectively identify their residual functional abilities to safely perform work activities with "temporary" work restrictions. Partial FCEs can be done periodically as the injured recovers to objectively reevaluate their functional abilities and update their "temporary" work restrictions. Early return to work is therapeutic. Keeping injured workers off work is detrimental both physically and mentally often leading to needless disability. Unfortunately, partial FCEs for this purpose is rarely used. Why? Because most medical doctors aren't asked if the injured worker could participate in a partial FCE with certain restrictions (eg. non-weightbearing on right leg or right arm due to fracture healing). So, why not advocate for a partial FCE to be done much earlier in a WC claim?

2). In most cases that I see, when an injured worker has reached MMI their job of injury is no longer available. In these cases an FCE is certainly helpful. So, why not advocate for FCE examiners to review any proposed jobs in the future to assist in safe job placement? In my practice, many of the treating physicians defer review of future job descriptions/job analysis to me for that purpose.

As noted in the AMA Guides to the Evaluation of Permanent Impairment, 6th edition (2009): "Most physicians are not trained in assessing the full array of human functional activities and participations that are required for comprehensive disability determinations."

As noted in the AMA Guide to the Evaluation of Functional Ability (2009): "The physician or provider may determine diagnosis and medical prognosis, but functional testing is more objective than the current use of estimates, commonly called restrictions. In an evidence-based medical model, measurements are preferable to estimates. Thus the objective testing of a worker against work demands (in a reliable and valid manner) provides an evidence base to use in establishing the link between medical diagnosis and gainful employment. When ability to work is limited and disability is questioned, functional and vocational expertise is considered an important component in case determination."

One study concluded that informing physicians of FCE results prompted a change from physician-assigned restrictions to a higher level of work capacity in Veterans reporting chronic pain.(1)

Another study found that administering FCEs resulted in the tested individuals reporting perceived function that more closely matched their actual functional abilities.(2)

In another study, baseline functional data from FCEs were used to develop treatment programs that resulted in improved return to work outcomes.(3)

(1) Peppers D et al. Influence of functional capacity evaluation on physician's assessment of physical capacity of veterans with chronic pain: a retrospective analysis. PM&R. 2017.

(2) Schindl M et al. Impact of functional capacity evaluation on patient-reported functional ability: an exploratory diagnostic before-after study. J Occup Rehab. 2019.

(3) Chen JJ. Functional capacity evaluation and disability. Iowa Orthop J. 2007.

Beth (if possible) please provide us all with a case name/reference. We could all then benefit by noting such when we encounter "experts" employing such strategies/error in failing to use standard method.

Well - few months later and the opinion did not hold up - functioning outside of their lane

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

As I have mentioned before, I routinely see problems with FCE here. I wonder if most PT and OT even "get" the USDOL definitions since so often I see them conclude that someone can do Medium work, yet in the report limit bending to Occ or never, time on foot to a few minutes at a time/couple hours per day. Or they conclude Light whilst saying nearly no time on foot etc. Then I, the VE, say that is bunk, and why, quoting definitions. Then if I do not get the PT or OT to clarify their error (which is sometimes like pulling teeth) the attorney tries to make me out as "disagreeing with a medical opinion", if it is concurred upon by the MD (who doesn't understand the details of the definitions either.

MDs also often concur with FCE but hedge saying something like he may have been able to bend at X level but ought not to do such day in/out or asking for trouble.

I prefer the MD to simply complete a checklist of restrictions as is typical in WC, LTD, life in general, etc. 

I agree with many of the opinions expressed in this discussion.

Some thoughts:

1). Prior to MMI, most injured workers have some level of work capacity. When injured workers reach a point of medical stability (not MMI), a partial FCE could be helpful to objectively identify their residual functional abilities to safely perform work activities with "temporary" work restrictions. Partial FCEs can be done periodically as the injured recovers to objectively reevaluate their functional abilities and update their "temporary" work restrictions. Early return to work is therapeutic. Keeping injured workers off work is detrimental both physically and mentally often leading to needless disability. Unfortunately, partial FCEs for this purpose is rarely used. Why? Because most medical doctors aren't asked if the injured worker could participate in a partial FCE with certain restrictions (eg. non-weightbearing on right leg or right arm due to fracture healing). So, why not advocate for a partial FCE to be done much earlier in a WC claim?

2). In most cases that I see, when an injured worker has reached MMI their job of injury is no longer available. In these cases an FCE is certainly helpful. So, why not advocate for FCE examiners to review any proposed jobs in the future to assist in safe job placement? In my practice, many of the treating physicians defer review of future job descriptions/job analysis to me for that purpose.

As noted in the AMA Guides to the Evaluation of Permanent Impairment, 6th edition (2009): "Most physicians are not trained in assessing the full array of human functional activities and participations that are required for comprehensive disability determinations."

As noted in the AMA Guide to the Evaluation of Functional Ability (2009): "The physician or provider may determine diagnosis and medical prognosis, but functional testing is more objective than the current use of estimates, commonly called restrictions. In an evidence-based medical model, measurements are preferable to estimates. Thus the objective testing of a worker against work demands (in a reliable and valid manner) provides an evidence base to use in establishing the link between medical diagnosis and gainful employment. When ability to work is limited and disability is questioned, functional and vocational expertise is considered an important component in case determination."

One study concluded that informing physicians of FCE results prompted a change from physician-assigned restrictions to a higher level of work capacity in Veterans reporting chronic pain.(1)

Another study found that administering FCEs resulted in the tested individuals reporting perceived function that more closely matched their actual functional abilities.(2)

In another study, baseline functional data from FCEs were used to develop treatment programs that resulted in improved return to work outcomes.(3)

(1) Peppers D et al. Influence of functional capacity evaluation on physician's assessment of physical capacity of veterans with chronic pain: a retrospective analysis. PM&R. 2017.

(2) Schindl M et al. Impact of functional capacity evaluation on patient-reported functional ability: an exploratory diagnostic before-after study. J Occup Rehab. 2019.

(3) Chen JJ. Functional capacity evaluation and disability. Iowa Orthop J. 2007.

Beth (if possible) please provide us all with a case name/reference. We could all then benefit by noting such when we encounter "experts" employing such strategies/error in failing to use standard method.

Well - few months later and the opinion did not hold up - functioning outside of their lane

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

As I have mentioned before, I routinely see problems with FCE here. I wonder if most PT and OT even "get" the USDOL definitions since so often I see them conclude that someone can do Medium work, yet in the report limit bending to Occ or never, time on foot to a few minutes at a time/couple hours per day. Or they conclude Light whilst saying nearly no time on foot etc. Then I, the VE, say that is bunk, and why, quoting definitions. Then if I do not get the PT or OT to clarify their error (which is sometimes like pulling teeth) the attorney tries to make me out as "disagreeing with a medical opinion", if it is concurred upon by the MD (who doesn't understand the details of the definitions either. 

MDs also often concur with FCE but hedge saying something like he may have been able to bend at X level but ought not to do such day in/out or asking for trouble. 

I prefer the MD to simply complete a checklist of restrictions as is typical in WC, LTD, life in general, etc. 

I agree with many of the opinions expressed in this discussion.

Some thoughts:

1). Prior to MMI, most injured workers have some level of work capacity. When injured workers reach a point of medical stability (not MMI), a partial FCE could be helpful to objectively identify their residual functional abilities to safely perform work activities with "temporary" work restrictions. Partial FCEs can be done periodically as the injured recovers to objectively reevaluate their functional abilities and update their "temporary" work restrictions. Early return to work is therapeutic. Keeping injured workers off work is detrimental both physically and mentally often leading to needless disability. Unfortunately, partial FCEs for this purpose is rarely used. Why? Because most medical doctors aren't asked if the injured worker could participate in a partial FCE with certain restrictions (eg. non-weightbearing on right leg or right arm due to fracture healing). So, why not advocate for a partial FCE to be done much earlier in a WC claim?

2). In most cases that I see, when an injured worker has reached MMI their job of injury is no longer available. In these cases an FCE is certainly helpful. So, why not advocate for FCE examiners to review any proposed jobs in the future to assist in safe job placement? In my practice, many of the treating physicians defer review of future job descriptions/job analysis to me for that purpose.

As noted in the AMA Guides to the Evaluation of Permanent Impairment, 6th edition (2009): "Most physicians are not trained in assessing the full array of human functional activities and participations that are required for comprehensive disability determinations."

As noted in the AMA Guide to the Evaluation of Functional Ability (2009): "The physician or provider may determine diagnosis and medical prognosis, but functional testing is more objective than the current use of estimates, commonly called restrictions. In an evidence-based medical model, measurements are preferable to estimates. Thus the objective testing of a worker against work demands (in a reliable and valid manner) provides an evidence base to use in establishing the link between medical diagnosis and gainful employment. When ability to work is limited and disability is questioned, functional and vocational expertise is considered an important component in case determination."

One study concluded that informing physicians of FCE results prompted a change from physician-assigned restrictions to a higher level of work capacity in Veterans reporting chronic pain.(1)

Another study found that administering FCEs resulted in the tested individuals reporting perceived function that more closely matched their actual functional abilities.(2)

In another study, baseline functional data from FCEs were used to develop treatment programs that resulted in improved return to work outcomes.(3)

(1) Peppers D et al. Influence of functional capacity evaluation on physician's assessment of physical capacity of veterans with chronic pain: a retrospective analysis. PM&R. 2017.

(2) Schindl M et al. Impact of functional capacity evaluation on patient-reported functional ability: an exploratory diagnostic before-after study. J Occup Rehab. 2019.

(3) Chen JJ. Functional capacity evaluation and disability. Iowa Orthop J. 2007.

Beth (if possible) please provide us all with a case name/reference. We could all then benefit by noting such when we encounter "experts" employing such strategies/error in failing to use standard method.

Well - few months later and the opinion did not hold up - functioning outside of their lane

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)

Did you not notice that Pts and OTs are not vocational experts. They are medical. The part of the FCE report stipulating Medium or Light duty is not relevant. The objective physical assessment with validation of validity is. When I encounter an erroneous final paragraph discussion of residual work capacity, I point out that the physical report defines the work capacity for the VE to work with; not the work level that the medical person is unqualified to determine.

 

As a result, the determined residual functions stand. The report is not thrown out and, every time, the vocational testimony is accepted, at least on that score.

 

Best regards,

Jeff Barrett, M.Ed., CAP. CRC, CVE, CCM
Options Plus

optionsplusinc.com
954-929-9694


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As I have mentioned before, I routinely see problems with FCE here. I wonder if most PT and OT even "get" the USDOL definitions since so often I see them conclude that someone can do Medium work, yet in the report limit bending to Occ or never, time on foot to a few minutes at a time/couple hours per day. Or they conclude Light whilst saying nearly no time on foot etc. Then I, the VE, say that is bunk, and why, quoting definitions. Then if I do not get the PT or OT to clarify their error (which is sometimes like pulling teeth) the attorney tries to make me out as "disagreeing with a medical opinion", if it is concurred upon by the MD (who doesn't understand the details of the definitions either.

MDs also often concur with FCE but hedge saying something like he may have been able to bend at X level but ought not to do such day in/out or asking for trouble.

I prefer the MD to simply complete a checklist of restrictions as is typical in WC, LTD, life in general, etc. 

I agree with many of the opinions expressed in this discussion.

Some thoughts:

1). Prior to MMI, most injured workers have some level of work capacity. When injured workers reach a point of medical stability (not MMI), a partial FCE could be helpful to objectively identify their residual functional abilities to safely perform work activities with "temporary" work restrictions. Partial FCEs can be done periodically as the injured recovers to objectively reevaluate their functional abilities and update their "temporary" work restrictions. Early return to work is therapeutic. Keeping injured workers off work is detrimental both physically and mentally often leading to needless disability. Unfortunately, partial FCEs for this purpose is rarely used. Why? Because most medical doctors aren't asked if the injured worker could participate in a partial FCE with certain restrictions (eg. non-weightbearing on right leg or right arm due to fracture healing). So, why not advocate for a partial FCE to be done much earlier in a WC claim?

2). In most cases that I see, when an injured worker has reached MMI their job of injury is no longer available. In these cases an FCE is certainly helpful. So, why not advocate for FCE examiners to review any proposed jobs in the future to assist in safe job placement? In my practice, many of the treating physicians defer review of future job descriptions/job analysis to me for that purpose.

As noted in the AMA Guides to the Evaluation of Permanent Impairment, 6th edition (2009): "Most physicians are not trained in assessing the full array of human functional activities and participations that are required for comprehensive disability determinations."

As noted in the AMA Guide to the Evaluation of Functional Ability (2009): "The physician or provider may determine diagnosis and medical prognosis, but functional testing is more objective than the current use of estimates, commonly called restrictions. In an evidence-based medical model, measurements are preferable to estimates. Thus the objective testing of a worker against work demands (in a reliable and valid manner) provides an evidence base to use in establishing the link between medical diagnosis and gainful employment. When ability to work is limited and disability is questioned, functional and vocational expertise is considered an important component in case determination."

One study concluded that informing physicians of FCE results prompted a change from physician-assigned restrictions to a higher level of work capacity in Veterans reporting chronic pain.(1)

Another study found that administering FCEs resulted in the tested individuals reporting perceived function that more closely matched their actual functional abilities.(2)

In another study, baseline functional data from FCEs were used to develop treatment programs that resulted in improved return to work outcomes.(3)

(1) Peppers D et al. Influence of functional capacity evaluation on physician's assessment of physical capacity of veterans with chronic pain: a retrospective analysis. PM&R. 2017.

(2) Schindl M et al. Impact of functional capacity evaluation on patient-reported functional ability: an exploratory diagnostic before-after study. J Occup Rehab. 2019.

(3) Chen JJ. Functional capacity evaluation and disability. Iowa Orthop J. 2007.

Beth (if possible) please provide us all with a case name/reference. We could all then benefit by noting such when we encounter "experts" employing such strategies/error in failing to use standard method.

Well - few months later and the opinion did not hold up - functioning outside of their lane

Read this is in a report written by a "CRC" credentialed individual.

 Dr X has recommended that the "individual" is to remain off work and not perform any lifting activities.

The medical opinion that an individual is to remain off work or is unlikely to return to work does not provide any objective guideline for assessing vocational capacity. (agreed - no release, no work)

These are vocational opinions and not generally within the scope and practice of medical doctors. (WHAT?)

....

The most reasonable and objective method for assessing whether an individual can work and earn wages is to receive medical information that outlines what an individual is able to do safely without causing harm to himself or others... ( well of course)