In order to resolve your long term disability insurance claim, you are almost certainly going to need to go through a functional capacity exam to help determine your ability to perform specific physical and mental tasks. You might think that these tests will be straightforward and simple to “pass” – after all, you’ve got a real condition and it’s making your ability to live normally difficult – but unfortunately that isn’t always the case.
Throughout the examination, you’ll be asked how bad your pain is and how often you feel it, as well is how much physical labor is required by your job and how frequently. If you don’t know the specific definitions they’re using for words like “occasionally” or “moderate,” it’s entirely possible to self-diagnose yourself incorrectly and have that used against you.
FCE Terms You Need to Know
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Frequency
This one applies to both work tasks and pain related to your condition. How often something occurs is broken down into Occasional, Frequent, and Constant. Occasional pain or tasks are said to take up a third or less of your day, happen 12 or fewer times per hour, or go on for less than two and a half hours a day. Something that is frequent takes up one- to two-thirds of your day, occurs 13-60 times an hour, or continues for two and a half to five and a half hours a day. Constant pain or work makes up at least 67% of your day or more than five and a half hours.
Reported Pain Levels
Is your pain Low, Moderate, High, or Severe? The scales here are not quite as clear, because everyone perceives pain differently, but it’s still useful to know them. Low pain is defined as non-disabling or functionally disabling (an important distinction) and would be something that an average person would rate as 3 or lower on a scale of 10, with 10 being the worst pain imaginable. Moderate pain is very disabling and should be rated between 4 and 6. High pain is severely disabling and ranks as a 7, 8, or 9. Severe pain is the worst of the worst being a 10 out of 10 where you can’t even imagine anything worse.
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Physical Demand Level
You’ll be asked whether the work you do is Sedentary, Light, Medium, Heavy, or Very Heavy. How do you know which one describes your job? Sedentary workers do next-to-no physical labor and only occasionally exert up to 10 pounds of force. Light workers regularly exert up to 10 pounds of force and occasionally exert up to 20 pounds. Medium workers are constantly exerting around 10 pounds of force, regularly exerting 10-25 pounds of force, and occasionally exerting 20-50 pounds of force. For Heavy and Very Heavy, the frequency is the same, but the numbers go up:
- Constant – 10-20 pounds and over 20 pounds, respectively.
- Regularly – 25-50 pounds and over 50 pounds, respectively.
- Occasionally – 50-100 pounds and over 100 pounds, respectively.
Tests are supposed to provide this information, but it’s not always easy to absorb in the heat of the moment, and may not be explained so clearly. If you want to give yourself the best chance at winning your long term disability insurance claim, knowing the process beforehand is vital.
Find out more about disability insurance policies from our free eBook, and then give one of our experienced long term disability lawyers a call to discuss your specific situation.
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