Medical Legal

Medical legal functional capacity evaluations are comprehensive whole person assessments providing a 360 degree perspective of how a trauma impacted an individual's life and function. Assessments usually comprise the following: 

• 1-2 day evaluations focused on assessing physical, cognitive and mental health function comparing pre-injury/incident status with post-injury/ incident status. Standard for concussion/brain injury is 1.5 days. 
• Physical testing is inclusive of musculoskeletal strength, endurance, speed, and flexibility. Functional testing can include lifting, pushing/pulling, repetitive tasks using the upper extremities, ability to work at high and low levels, hand and finger manipulation tasks, tasks assessing postural tolerances, etc. 
• Visual, perceptual and cognitive testing is inclusive of oculomotor function, visual tracking and processing, visual attention, vestibular, spatial, memory, attention, executive functioning, etc. 
• Psychosocial testing is inclusive of anxiety, depression, mood, emotional dysregulation and gauging mental health adjustment. 
• Body sensory and perceptual changes stemming from neurological conditions and injuries

A future cost of care evaluation is a needs based assessment for individuals who have been diagnosed with chronic health issues that are expected to be lifelong. A future cost of care evaluation is usually completed in conjunction with a medical legal functional capacity evaluation. Minor to catastrophic injuries stem from motor vehicle accidents (MVA), slips and falls, dog bites, disability claims, medical malpractice, birth trauma, etc. The functional status of the individual varies across a broad spectrum and extent of assessment is based on residual functional capacity. Assessed needs generally cover categories like equipment, adaptive aids, housekeeping services, healthcare services, medication, etc., and/or in cases of catastrophic injury such as a brain injury, amputation, or spinal cord injury, cost of care plans are much more extensive including items like home accessibility and architectural renovations, home personal care support services, etc.

Formulating a Life Care Plan involves objective examination of medical documentation to identify diagnosis and prognosis, interview with the client (and in some cases significant others/family members), functional capacity testing, activities of daily living assessment, in-home functional assessment, and then researching of costs associated. The OT then provides an expert opinion regarding a persons’ residual functional capacities relating to daily living, residual employability, and loss of work/earning capacity, and housekeeping capacity. 

Determining loss of housekeeping as a result of an injury or incident. Functional capacity is assessed with the focus of providing an opinion on a person's capacity for housekeeping. Level of assessment will vary depending on the residual functional status of the individual involved. 

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Case management involves evaluating, planning, implementing, coordinating, monitoring and evaluating services to meet an individual’s needs through resources that are cost-effective and give positive outcomes. Case management services will vary depending on point of involvement:

• If obtained prior to the future cost of care assessment, the OT will support an injured person in accessing needed medical care, healthcare professionals, providing needed OT intervention, and involving other community services to help the patient recover to the best of their ability and move a case forward.
• If obtained after the future cost of care assessment, the OT involved is responsible for carrying out the care plan outlined by the OT. 

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