Traumatic Brain Injury (TBI) or Post-Concussive Syndrome is unfortunately a very underdiagnosed cognitive pathological condition in personal injury. Oftentimes diagnostic imaging, neuropsychological testing, and/or cognitive therapy are relied upon heavily for diagnostic and treatment purposes. While these studies and experts can certainly help diagnose the injured persons’ condition, there is typically one very important clinical presentation that is not discovered with all of this testing. That is, how the brain injured individual is functioning in real environments, promoting the ecological validity of an evaluation.

The ecological validity differentiates how generalized experimental findings are relatable to the real world such as situations or settings that are typical of everyday life. Think of ecological validity as a subtype of external validity. This is where the Cognitive Functional Capacity Evaluation (CogFCE) comes into play.

The CogFCE evaluates an individual’s functional and cognitive capacity in relation to their ability to perform essential critical job demands with a focus on the intersection of physical, psychological, cognitive, and behavioral implications of an injury or medical condition.

The CogFCE includes the formal / standard functional testing such as range of motion, strength, mobility, limb coordination, postural tolerances; etc in addition to a standardized assessment of cognitive function. These assessments are both component and performance based tests, non-standardized assessment, with structured observations of physical, cognitive, behavioral, and psychosocial functioning.

The evaluator has the unique opportunity to evaluate executive functioning skills both practically and formally by using the clinical environment and environmental demands as an additional tool to measure the evaluee’s performance.

This form of environmental evaluation is a very useful and relevant quantifiable assessment for determining one’s functional capacity for employment and/or how the evaluee’s cognitive deficits affect their ability to perform activities of daily living or leisure activities. This approach highlights ecologically valid measures of work-specific tolerance, particularly in the areas of attention, activity tolerance / mental stamina, and executive functioning.

Make sure your cognitively injured client’s impairments are properly documented to effectively show how the injury affects their livelihood.

Dr. Brad Poppie has over 20 years of personal injury experience providing care as a treating doctor, coordinating rehabilitative case management, and expert trial testimony services. 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: