The term “Functional IME” was coined by D+WC’s founder, David W. Clifton when he authored (2005) an article entitled; “The Functional IME: A linkage of expertise across the disability continuum.” This article appeared in 2006 in WORK Journal (see abstract link below).
Mr. Clifton was well positioned to recognize the value and limitations of both the independent medical examination or IMEs and functional capacity evaluations or FCEs. These silo-based assessment tools were rarely considered in tandem despite the fact that each provided unique data that span the disability continuum as described by the World Health Organization, Nagi, Guccione, Clifton, Delitto and others.
Generally speaking, physicians assess pathology and impairment via IMEs while, physical and occupational therapists assess disability through batteries of functionally-based tests that comprise FCEs.
A “Functional IME” is a term used to describe a situation when both an IME and FCE are performed in order to more fully assess physical functioning/ability or disability. It is preferable that the FCE occur first so that the IME physician has access to objective function-based data before making determinations concerning disability status, work restrictions or job accommodations, functional limitations and return-to-work or RTW judgements. Medicare, Social Security and Workers’ Compensation systems have all finally embraced a function-based perspective of determining disability status of claimants, applicants and beneficiaries. The prevalence of Functional IMES should logically grow with the graying of America.