A functional capacity evaluation lands on the desk with numbers attached. Lift tolerances in lbs. Sitting and standing durations in minutes. A grip-strength reading, a validity profile, a summary that says the examinee can manage light, sedentary or medium work. It looks decisive - and that is exactly where files go wrong. The numbers are not the answer. They are evidence, and evidence has to be read.
Open a difficult catastrophic file and you’ll often find no shortage of expertise. A physiatrist’s report. A neuropsychological assessment. An occupational therapist’s attendant care evaluation. A functional capacity evaluation. A future cost of care assessment. Each one competent. Each one answering its own question. And somehow the file still doesn’t add up - because the assessments were commissioned in isolation, months apart, by people who never compared notes.
November is Indigenous Disability Awareness Month - a prompt to look at something that sits quietly underneath every medical-legal assessment, regardless of who is being assessed: the assumptions the assessor brings into the room. They rarely announce themselves. But they shape what gets noticed, what gets recorded, and ultimately what the report concludes.
Two documents describe the same person. The treating psychiatrist’s letter says the individual remains significantly impaired and unable to work. The independent psychiatric assessment concludes that the impairment is milder than reported, and that a graded work return is reasonable. Same examinee, same diagnosis on paper, two different conclusions. The instinct is to decide which one is right. That instinct is the mistake.
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Every 21 September, the world marks World Alzheimer’s Day - a date Alzheimer’s Disease International established in 1994 to confront one stubborn, expensive problem: cognitive impairment that hides in plain sight.
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A single assessment captures how someone presents at one point in time. For a stable condition, that’s usually fine - the snapshot is representative, and the picture holds. For a fluctuating condition, it’s a coin toss.
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The claims that escalate almost never look like they’re going to. On day ten, an escalating file is indistinguishable from a merely slow one. That’s precisely what makes it worth talking about - and worth catching.
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When you’re choosing an IME provider, the conversation usually centres on clinical quality - assessor credentials, specialty coverage, turnaround times. Those things matter. But there’s a layer underneath the clinical work that most case managers and adjusters never ask about.
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Every year on July 22nd, the World Federation of Neurology marks World Brain Day - a global platform to raise awareness about neurological health.
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Not every claim that looks like depression is depression. For case managers and adjusters working STD and LTD files, this distinction matters - and missing it can mean a claim stays open far longer than it should, or closes prematurely without the right support in place.
