Tara Marchand is the national director of functional capacity evaluation (FCE) services with One Call Care Management. Possessing years of experience in public entity healthcare, she has devoted much of her career to the field of industrial rehabilitation, along with conducting FCE and impairment rating analysis. She explains the role FCE plays in cases of public entity workers' symptom exaggeration.
For public entities, symptom exaggeration (SE) is often an avoidable problem. About 10% of injury cases include some sort of SE, be it a minor strength loss or a claim of total disability. Symptom exaggeration can have a significant effect on public entity indemnity costs and can contribute to higher payouts for injured workers based on inaccurate impairment ratings.
Functional Capacity Evaluation - A tool for identifying cases of symptom exaggeration
Wielded by a skilled therapist, FCE is capable of documenting the inconsistencies in a patients' claims and then measuring the influence these inconsistencies have on impairment ratings.
But, as with many health-related situations, prevention is the key. Research and practice have shown that the majority of SE cases stem from the workers' injury claims being neglected by their employers. Overlooking these claims may plant seeds for future symptom exaggeration. Employers, however busy they may be, should respond to the employee injury the moment it occurs. In these instances, workers need to feel that they will be taken care of.
Symptom Exaggeration Factors
Some of the factors that play a role in increasing SE rates include:
- Occupation: People with low-paying, repetitive jobs may feel the need to capitalize on an opportunity to get back at the "system" that they feel is suppressing them.
- Education and/or Skill Level: The lower the education or skill level, the greater the chance of symptom exaggeration. At times, these workers come to the therapist well prepared, even googling the symptoms they need to exhibit.
- Employment duration: Short-term workers tend to exaggerate symptoms more often, however, long-term workers may also exaggerate symptoms if they feel they are owed something after dedicating years to their entity.