A Functional Independent Medical Examination (FIME) is a powerful assessment tool that combines the information found in a Functional Capacity Evaluation with that of an Independent Medical Examination. Results from both assessments are used to link specific injuries to a client’s disability status.
The First Step of a Functional Independent Medical Examination (FIME)
The first step of an FIME is the Functional Capacity Evaluation. A functional capacity evaluation (FCE) is an evaluation with the purpose of deciding if an individual is physically able to perform the specified duties of a job. This assessment is usually performed by a team of physicians and Occupational Therapists. The elements of the FCE measure the following:
- Ability to repetitively lift various amounts of weight to various heights
- Capacities to repetitively push, pull, or carry various weights
- Strength of grip
- Tolerance of elevated levels of work
- Repetitive squats
- Tolerance to sit or stand for long periods of time
- Capacity for walking stairs or climbing a step ladder
- Hand-Eye Coordination
The FCE is usually performed in a series of tests over a period of two days. The client’s performance from this assessment will be combined with the results of the second step of the process.
The Second Step of the Functional Independent Medical Examination
Step two of the FIME consists of an Independent Medical Evaluation. An IME is an examination conducted by a third party physician and is usually sought for legal reasons. Elements of an IME include:
- Causality of injury or illness
- Maximum Medical Improvement
- Identification of Work Restrictions or Limitations
- Need for Alternative Treatment or Diagnostic Workup
- Medical Necessity of Care and Reasonableness of Current Treatment
- Fitness for Duty or Return to Work Status
- Relevant Preexisting Injuries
- Disability Status Determination
The results from the preceding FCE provide the physicians performing the IME with function based statistics. This information will directly affect the physicians’ decisions regarding maximum medical improvement, identifying work restrictions, fitness for duty, and disability status. This two-step process is vital to fully assess a client’s physical condition by using an FIME. The FIME may be used to determine the cause of impairment whether it be an on the job accident or preexisting condition. Another important determination is disability status. This determines the probability of a client returning to work. If the client’s return is unlikely, the physician may decide to refer the client for disability compensation.
An FIME provides a full and powerful assessment of the physical condition of a client as it pertains to the client’s fitness for duty. This may be performed after an on the job injury or illness that limited the client’s ability to perform essential duties. This service provides employers with the necessary information to accurately and fairly reassign employees to work. The FIME may also be used by a client who feels that the treatment received from an employer is inadequate.