Typically, a medical diagnosis will determine the nature or cause of a disease or impairment.
Diagnosis may be clinical in origin based on signs, symptoms, imaging, or laboratory findings. These findings can also be found by physical examination, patient interview, medical history; etc. It is so important to remember that a medical diagnosis is only as good as the functional assessment that backs it up!
While the informational pieces listed above can certainly help an insurance adjuster or jury member understand what pathological condition the patient is suffering from, it by no means helps them understand the INTENSITY or MAGNITUDE of their suffering. A medical diagnosis alone does not clearly depict how a patient’s facet sprain, partial rotator cuff tear, or bulging lumbar disc impedes upon their ability to perform work related tasks, activities of daily living, or leisure activities.
Here is where solely relying on a medical diagnosis alone provides insufficient information towards the true injuries your client is experiencing. Over the course of 20 years as a treating doctor, I have received numerous physician referrals with the diagnosis “lumbago” or “cervicalgia” written at the top. These diagnoses are also known as “low back pain” and “neck pain”, respectively. While the patient may indeed be suffering from such pain and there may be a real and underlying pathological condition as to why they are suffering from them, a medical diagnosis alone does not provide enough impact to alarm the reader of the true functional effect the diagnosis has on the person.
Millions of people are walking around today with neck and lower back pain that have never been in a car accident, work-related incident, sports trauma incident; etc.
Insurance adjusters are aware that while a diagnosis helps to decipher what is wrong with the patient medically, it doesn’t give any information from a functional standpoint as to how that diagnosis affects their ability to carry on a normal life. In terms of functional loss, I am referring to disability.
In fact, according to the Guidelines to the Evaluation of Permanent Impairment 5th edition, the American Medical Association defines, “ability and disability can and should involve non-medical practitioners in such determinations.” It was also stated that, “it is not possible for a physician, using medical information alone, to make reliable predictions about the ability of an individual to perform tasks or to meet functional demands…when functional ability is assessed by a standardized non-medical procedure in a vocational rehabilitation setting, the physician may have confidence in the determination.”
According to the Orthopedic Section of the American Physical Therapy Association, a Functional Capacity Evaluation (FCE) is noted as a comprehensive battery of performance-based tests that are used commonly to determine one’s ability for work related tasks, activities of daily living, and leisure activities.
As you can see, while it is important to have a medical diagnosis, the diagnosis itself is only as powerful and objectively reliable as the functional assessment that backs it up. In personal injury, the hardest aspect to prove to an insurance adjuster or jury member is how the person’s accident and subsequent diagnosis affect their daily life.
This is why it is imperative to obtain a Functional Capacity Evaluation in concert with a medical diagnosis in order to not only confirm the medical diagnosis but to quantify its severity as well. A Functional Capacity Evaluation allows the insurance adjuster to understand why the patient is hurt and what they are or are not able to do because of their injuries and thus a viable pathway for settlement is created.
If you have a case that you feel as though you may need more objective data in order to properly educate an insurance adjuster or potential jury, please reach out to discuss your clients’ needs.
Dr. Poppie has served the legal industry as a treating clinician, damages expert, and educator for over 20 years. He specializes in the evaluation and treatment of multi-trauma injuries related to motor vehicle collisions, standard of care and malpractice claims, and as a damages expert to help educate insurance companies and both plaintiff and defense counsel to provide a viable pathway for obtaining a fair settlement based on ethics, research, and evidence-based standards of care.
As a certified Functional Capacity Evaluator, Dr. Poppie helps to guide attorneys through all phases of their case and documents functional objective data that is reliable in educating opposing sides as to the true extent of injury. Evidence-based practice guidelines are utilized in all reports in order to ensure the needed criteria is met to withstand scrutiny within all legal jurisdictions.
Dr. Poppie founded Injury Reporting Consultants to help attorneys and insurance companies resolve personal injury cases through medical analysis and reporting. Injury Reporting Consultants is a collaborative team of dedicated medical professionals using their knowledge to ensure fair outcomes for all parties in personal injury cases.
Recognized specialties include Motor Vehicle Collision, Life Care Planning, Medical Cost Projection, Functional Capacity Evaluation, Onsite Job Analysis, Functional Impairment and Disability, Workplace Injuries, Orthopedic Physical Therapy, Standards of Care, Current Best Practices, Physical Therapy Malpractice, Negligence, File and Medical Record Review, Improper Documentation, Expert Rebuttal Reports, and Expert Testimony.
If you have a client that you would like to discuss their need for an expert report, please contact me directly at 720-982-2000 or email me at: brad@
Dr. Brad Poppie, DPT, CLCP, CFCE, CSCS
Doctor of Physical Therapy | Certified Life Care Planner | Medical Cost Projection Specialist | Certified Functional Capacity Evaluator | Certified Strength and Conditioning Specialist.