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Fce Functional Capactiy tests?

#1 User is offline   Kiwee 

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Posted 13 April 2004 - 08:24 PM

Are the FCE tests still applicable (ie if a medical examiner uses them as proof that I dont try hard enough, due to an fce rating of 4 for performance). I was starting to get sore after the first 3 hours and yet they kept going, i was probably not performing fully due to increased pain. However... can they still refer to fce reports or have they been found to be faulty evidence?
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kiwee
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#2 User is offline   Kiwee 

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Posted 13 April 2004 - 08:34 PM

from the Herald:
http://www.nzherald.co.nz/storydisplay.cfm...789&reportID=16



Assessor works to find the truth behind ACC claims

20.12.2000
GEOFF CUMMING, following up his ACC series, meets a man paid by the corporation to put long-term injury claimants to the test.

Bob Sellars reckons he can tell people with genuine injuries from those he calls the Hollywood actors.

His company, FCE Systems, does "functional capacity evaluations," which compare an injured person's physical efforts against "normal" function.

ACC sends him claimants with short and long-term complaints for evaluation. They hobble into his gym to be put through their paces. Squats, lifts, presses, flexes - the range of exercises is designed to show just how much the injury is affecting the victim physically.

The American-developed FCE programme also tries to pinpoint psychological and social factors that may be affecting recovery.

The corporation bought into the FCE programme as part of its clampdown on long-term claimants - those whose pain persists long after the accepted recovery time.

Since securing a nationwide contract in 1998, Mr Sellars' company has tested about 2500 ACC claimants. He says most exaggerate their symptoms - consciously or unconsciously.

"From a physical point of view, the vast majority are capable of working. Just because you've got a sprained ankle doesn't mean you can't sit in front of a word processor."

But sections of the medical profession are highly sceptical about FCE. Pain specialist Dr John Hancock says the tests are a "grossly ridiculous money-making venture" without proper scientific grounding.

He is not alone. When it comes to the causes and effects of chronic pain, particularly lower back pain and occupational overuse syndrome (OOS), medical knowledge is lacking and the profession is split.

"It's helpful for insurers so they use these people," says Dr Hancock. "[The FCE system] has an air of respectability. They have all this paraphernalia but it's absolute pseudo-science."

He says the corporation has latched on to a group of health professionals who believe that chronic pain is more psychological than physical. The corporation will pay out only on injuries that stem from a specific cause - so assessments that find a complaint is not, or no longer, related to an "event" injury can save it money.

Thousands of long-term claimants cut off by ACC, particularly OOS sufferers, maintain that they remain unfit for work because of their original injury.

Scores have complained to the Herald about being cut off on the basis of ACC medical and physical assessments - even though they have specialist opinions supporting their claim.

Mr Sellars, a physiotherapist, concedes that chronic pain and the workings of the nervous system remain mysteries for modern science. But he has faith in his evaluation programme.

The effects of an injury on physical function can be measured, he says. FCE, one of several similar programmes, measures performance against "normal" function and allows cross-test comparisons.

The evaluation takes three to four hours and includes questionnaires to gauge claimants' physical and psychological perceptions of their injuries.

"If it all correlates we start to believe the patient. If it doesn't, we start to believe that psychological or social factors may play a part."

Mr Sellars says most people whose injuries linger well beyond the "normal" recovery period have developed some form of chronic pain syndrome.

"They believe they are severely disabled but there is little or no medical or physical explanation of why this should be so," he says.

The brain may become conditioned to associating movement or action with pain, or wider psycho-social beliefs come into play.

"With the vast majority we find it's not so much a physical disability they've got but the threat of going off ACC."

He says that most of the long-term claimants he sees lack "transferable skills" and live in areas where there are no jobs to go back to.

"The chances of them getting a job are pretty well zero. The vast majority fear they are going to end up on a [Work and Income NZ] benefit."

Several claimants responding to the Herald's series on ACC have complained that, far from helping their rehabilitation, physical FCE tests aggravated their condition and delayed recovery.

Claimants also say such medical assessments often contradict diagnoses by their own specialist or GP.

Mr Sellars says patients can be selective in their recall. "A lot go through a process of what we call catastrophisation. They believe only the worst of what they hear from the surgeon. It becomes a self-fulfilling prophecy."

But specialists in the opposing camp, including Dr Hancock, say the psycho-social theory is far too simplistic.

ACC says few long-term claimants have legitimate grievances when their compensation ceases. Most injured people simply get better.

The story so far

* Thousands of accident victims with long-term injuries have lost their compensation in a three-year clampdown by ACC.

* Many maintain they are unfit for work but that opinions of their surgeons and GPs are overruled by ACC assessors.

* The trend to rediagnose chronic injuries as degenerative or generalised pain, not covered by ACC, has been criticised by judges and lawyers.

* Workers fear being cut off on the basis of notional jobs that bear no comparison with their pre-injury skills and earnings.

* More than 150 claimants have contacted the Herald alleging harassment and mismanagement by ACC.

* ACC says some long-term claimants develop a victim mentality.

Herald Online Health



Bob Sellars has seen thousands of claimants. Herald Picture / David White

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#3 User is offline   Gary Webster 

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Posted 07 January 2005 - 06:59 AM

Hi just visiting from canada todayand thought I would mention something about FCE's, and that is the lack of evidence supporting their use. If one of you was interested in going to a medical library at one of your universities you might find it usefull to make photocopies of these articles.

Functional Restoration; Spine 1996 vol 21 pgs 844-847

Estimates of weight that subjects can lift frequently in functional capacity evaluations Physical Therapy; 1997 vol 77 pgs 1717-1728

Trust me you will find these articles both interesting and usefull. Gary
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#4 User is offline   greg 

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Posted 08 January 2005 - 06:55 AM

Please correct me if I am wrong, your Dr. has to tick a box stating that
the IP. has some reason not to do a FCE.

This is on the forms the Dr. fills out on your ongoing injury state.
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#5 User is offline   fairgo 

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Posted 08 January 2005 - 03:30 PM

It was in a letter from the ombudsman re FCE's. ACC was told that they could not force people to do FCE if the person believed it could worsen their condition. I am sure it is already up on the forum or on the alternative site.
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#6 User is offline   Gary Webster 

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Posted 09 January 2005 - 08:09 PM

Hi just visiting again browsing through I noticed some discussion about sincerity of effort, so here is another reference to check out.

The sensitivity and specifity of functional capacity evaluations in determining maximal effort Spine 2004 April 23 vol 29 (9) pgs 953-959


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#7 User is offline   Gary Webster 

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Posted 20 February 2005 - 09:25 AM

Hi we have some interesting medical documents posted at our site now, check it out.
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#8 User is offline   doppelganger 

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Posted 20 February 2005 - 10:31 AM

yes here are and are at http://wcbcanada.com...l/resources.htm
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#9 User is offline   jocko 

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Posted 20 February 2005 - 10:35 AM

Thanks for the info Gary. The international watchdog for insurers is is the IAIS (google search) and for Canada it is OSFI. They are the insurance regulators, who are obviously doing what the insurers want them too. NZ is listed with the IAIS, ISU but when you click on it, it comes up page can not be displayed.
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#10 User is offline   Kiwee 

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Posted 21 November 2005 - 12:31 AM

The Sensitivity and Specificity of Functional Capacity Evaluations in Determining

Maximal Effort: A Randomized Trial.
Spine. 29(9):953-959, May 1, 2004.
Lemstra, Mark MSc *; Olszynski, W. P. MD, PhD, FRCP© +; Enright, Wayne BScOT

Abstract:
Study Design. Randomized trial.

Objectives. To determine the sensitivity and specificity of maximal effort testing in
functional capacity evaluations.

Summary of Background Data. Functional capacity evaluations are widely used to
determine when an injured worker is able to return to work. The accurate assessment
of function is dependent on a patient's willingness to exert maximal effort during
evaluation. Although many tests are used to suggest the presence of maximal or
submaximal effort, it is unclear whether these tests can actually do what they are
hoped to do.

Methods. Ninety study participants with low back pain were randomized into either a
100% effort group or a 60% effort group. After a thorough evaluation, the blinded
tester was asked to give an overall opinion as to whether or not the participant was
giving 100% effort or 60% effort.

Results. The tester's opinion on maximal effort tests within the functional capacity
evaluation had an overall specificity of 84.1% and a sensitivity of 65.2%. Only 5 of 17
commonly used maximal effort tests were able to individually differentiate between
maximal and submaximal effort. The final logistic regression model was able to find
three covariates with reasonable explanation of the proportion of variance in the
outcome variable of effort (R2 3 0.444) with goodness of fit.

Conclusions. The determination of maximal effort in a functional capacity evaluation is
complex. Because of the wide-ranging medicolegal and ethical considerations, caution
is recommended in the labeling of patients as exerting either maximal or submaximal
effort.
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#11 User is offline   doppelganger 

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Posted 21 November 2005 - 09:28 PM

there are several document on the canadian site (under documents) that show that the FEC test and not all that they seam to be. the fact is that the test may not and very unlikely be true and acurate determination of injury.

in above post
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#12 User is offline   Easyrider 

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Posted 22 November 2005 - 09:04 AM

I have a full copy of the FCE tests here, most of them are not proven, and says so on the bottom of the sheet. Anybody that has been disentitled from doing one of these tests will have a good cause for reenststment. Will not stsnd up in court.
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#13 User is offline   hukildaspida 

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Posted 15 February 2011 - 09:06 PM

View Postdoppelganger, on 20 February 2005 - 10:31 AM, said:



Dopple this website link doesn't work, do you recall what it is?

Herald article re Robert (Bob) Sellars.FCE Systems

http://www.nzherald....objectid=165789
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#14 User is offline   hukildaspida 

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Posted 15 September 2013 - 03:19 PM

Is Bob, also known as Robert, Sellars heading for retirement or other?

It's understood this building is where he & his "wife" Maureen O'Neil operated from, does anyone know if they are still there?


Khyber Pass site on market
By Colin Taylor Email Colin 2:08 PM Saturday Sep 14, 2013

http://www.nzherald....jectid=11124803

Five-level, fully tenanted building just five minutes from Auckland CBD is sure to attract plenty of investor interest


Expand 210 Khyber Pass Rd is well placed to take advantage of the university development on the old Lion site. A five-level, high-profile and fully leased Khyber Pass office building that has been upgraded and is seismically strong, is being marketed for sale by Jonathan Ogg and Warren Hutt of CBRE.

"This building will attract prudent investors seeking a strong passive holding property," Ogg says. "It is a well-presented building with a full complement of quality tenants with a good weighted average lease term."

The building at 210 Khyber Pass Rd is being offered on behalf of the owner, 210 KPR, and will be sold by deadline private treaty closing at 4pm on September 25 unless sold beforehand.

"This property is very well positioned for future growth and development," Ogg says. "It is anchored by international heavy hitter Zimmer and has a strong cash flow profile. It also presents alternative future use options as the area continues to go through considerable evolution and growth with the redevelopment of the nearby Lion site and a number of office buildings being converted into residential apartments."

Ogg says attraction of the neighbourhood is rising exponentially with the University of Auckland's redevelopment of the former Lion Breweries site in Newmarket now actively underway and "the prospect of thousands of people flocking to the area upon completion".

"As a potential sweet spot for private investors and family trusts seeking an attractive yield with the potential for future development, it's already attracting interest from a wide range of investors from across New Zealand and overseas."

The 1980s building occupies a 1555sq m strategic freehold site with three street frontages to Khyber Pass Rd, Parkfield Terrace and Claremont St. Divided into several tenancies around a common, central access core, the building offers a total of 3043sq m of lettable space, with parking provided across two basement levels which accommodate 52 cars.

Hutt says that over the past two years the owners have undertaken an upgrade of the building including all common areas, bathrooms, lift, lobbies and all tenancy areas.

"Recent renovation and refurbishment to the tenancies included new carpets, new suspended ceilings together with upgraded air conditioning and fire protection services. Common area bathrooms, corridors and stairwells have been recently refurbished to a modern standard.

"A recently completed engineering report highlights the building at 100 per cent of the New Building Standard [NBS], which is highly beneficial in the current market for mortgage lending purposes and insurance cover and also as a prime consideration for occupiers."

Five tenants generate a net annual rental of $720,267, plus GST, with a weighted average lease term to expiry (WALT) of five years based on net operating income. Medical supplier company Zimmer New Zealand occupies 1391.21sq m of the rentable space equating to 46 per cent of the total property.

A tenant in the building since 2004, Zimmer is the New Zealand subsidiary of New York Stock Exchange-listed Zimmer (NYSE: ZMH). With a market capitalisation of US$13.4 billion, Zimmer provides high-quality orthopaedic products and has in recent times more than doubled its sales and customer service teams to manage demand.

Taxicharge, New Zealand's only specialist nationwide taxi billing solution, has been a tenant in the building since 2004. Occupying 441.91sq m, it committed to a new six-year lease beginning 2010 for majority of Unit E of Level 4 along with 10 car parks.

The Knowledge Warehouse Unit Trust, occupying 469.36sq m on Level 5, is part of an associated group of companies, headquartered in Melbourne Australia, which offers an extensive range of data collection solutions.

Country Wide Monitoring Services occupies 260.54sq m, also on Level 4 and has been a tenant in the building since 2008. It provides security monitoring services to small to medium-sized enterprises throughout the greater Auckland region.

Occupying 349.04sq m on Level 3 is Auckland primary health organisation PHO Limited. It is government funded and is one of the five PHOs that form part of the Auckland District Health Board

Murchison Group Property Management, a successful boutique commercial property management and consultancy company, occupies 130.74sq m, also on Level 4.

"As the property managers of 210 Khyber Pass Road, Murchison Group has played a major part in the transformation of this property and would welcome the opportunity to continue in this role," Ogg says.

"With over 40 per cent of the annual income stream being generated by Zimmer, the reduced risk offered by multiple tenants and built in annual Consumer Price Index rental growth within the lease terms, this is property provides a strong and stable cash flow for investors."

Under the operative District Plan, the property is zoned Mixed-Use, which has an emphasis towards retail, residential and commercial activity to provide for a diverse mixed use environment.

"This property will benefit significantly from the redevelopment of the 5.2ha former Lion Brewery site," Ogg says. "The University of Auckland completed its purchase of the site in May this year and is actively progressing the development of the site to create a mixed use campus, with purpose-built teaching and research facilities, student accommodation, business development and other facilities."

By Colin Taylor Email Colin


Robert Sellars

Owner, FCE Systems

Location
New Zealand
Industry
Hospital & Health Care


http://nz.linkedin.c...llars/6/19a/3b0

Robert Sellars's Overview

Current

* Owner at FCE Systems

Education

* University of Otago

Connections

36 connections
Websites

* Company Website

Robert Sellars' Experience
Owner
FCE Systems

Currently holds this position
Robert Sellars' Education
University of Otago

1969 – 1971

Robert Sellars' Additional Information

Websites:

* Company Website

Interests:

Physical Rehabilitation, Functional Capacity Evaluation, Tramping

Workplace Assessments / FCE Systems / Occupational Rehabilitation 2008.
http://www.fcesystems.co.nz/

View PostKiwee, on 13 April 2004 - 08:34 PM, said:

from the Herald:
http://www.nzherald.co.nz/storydisplay.cfm...789&reportID=16



Assessor works to find the truth behind ACC claims

20.12.2000
GEOFF CUMMING, following up his ACC series, meets a man paid by the corporation to put long-term injury claimants to the test.

Bob Sellars reckons he can tell people with genuine injuries from those he calls the Hollywood actors.

His company, FCE Systems, does "functional capacity evaluations," which compare an injured person's physical efforts against "normal" function.

ACC sends him claimants with short and long-term complaints for evaluation. They hobble into his gym to be put through their paces. Squats, lifts, presses, flexes - the range of exercises is designed to show just how much the injury is affecting the victim physically.

The American-developed FCE programme also tries to pinpoint psychological and social factors that may be affecting recovery.

The corporation bought into the FCE programme as part of its clampdown on long-term claimants - those whose pain persists long after the accepted recovery time.

Since securing a nationwide contract in 1998, Mr Sellars' company has tested about 2500 ACC claimants. He says most exaggerate their symptoms - consciously or unconsciously.

"From a physical point of view, the vast majority are capable of working. Just because you've got a sprained ankle doesn't mean you can't sit in front of a word processor."

But sections of the medical profession are highly sceptical about FCE. Pain specialist Dr John Hancock says the tests are a "grossly ridiculous money-making venture" without proper scientific grounding.

He is not alone. When it comes to the causes and effects of chronic pain, particularly lower back pain and occupational overuse syndrome (OOS), medical knowledge is lacking and the profession is split.

"It's helpful for insurers so they use these people," says Dr Hancock. "[The FCE system] has an air of respectability. They have all this paraphernalia but it's absolute pseudo-science."

He says the corporation has latched on to a group of health professionals who believe that chronic pain is more psychological than physical. The corporation will pay out only on injuries that stem from a specific cause - so assessments that find a complaint is not, or no longer, related to an "event" injury can save it money.

Thousands of long-term claimants cut off by ACC, particularly OOS sufferers, maintain that they remain unfit for work because of their original injury.

Scores have complained to the Herald about being cut off on the basis of ACC medical and physical assessments - even though they have specialist opinions supporting their claim.

Mr Sellars, a physiotherapist, concedes that chronic pain and the workings of the nervous system remain mysteries for modern science. But he has faith in his evaluation programme.

The effects of an injury on physical function can be measured, he says. FCE, one of several similar programmes, measures performance against "normal" function and allows cross-test comparisons.

The evaluation takes three to four hours and includes questionnaires to gauge claimants' physical and psychological perceptions of their injuries.

"If it all correlates we start to believe the patient. If it doesn't, we start to believe that psychological or social factors may play a part."

Mr Sellars says most people whose injuries linger well beyond the "normal" recovery period have developed some form of chronic pain syndrome.

"They believe they are severely disabled but there is little or no medical or physical explanation of why this should be so," he says.

The brain may become conditioned to associating movement or action with pain, or wider psycho-social beliefs come into play.

"With the vast majority we find it's not so much a physical disability they've got but the threat of going off ACC."

He says that most of the long-term claimants he sees lack "transferable skills" and live in areas where there are no jobs to go back to.

"The chances of them getting a job are pretty well zero. The vast majority fear they are going to end up on a [Work and Income NZ] benefit."

Several claimants responding to the Herald's series on ACC have complained that, far from helping their rehabilitation, physical FCE tests aggravated their condition and delayed recovery.

Claimants also say such medical assessments often contradict diagnoses by their own specialist or GP.

Mr Sellars says patients can be selective in their recall. "A lot go through a process of what we call catastrophisation. They believe only the worst of what they hear from the surgeon. It becomes a self-fulfilling prophecy."

But specialists in the opposing camp, including Dr Hancock, say the psycho-social theory is far too simplistic.

ACC says few long-term claimants have legitimate grievances when their compensation ceases. Most injured people simply get better.

The story so far

* Thousands of accident victims with long-term injuries have lost their compensation in a three-year clampdown by ACC.

* Many maintain they are unfit for work but that opinions of their surgeons and GPs are overruled by ACC assessors.

* The trend to rediagnose chronic injuries as degenerative or generalised pain, not covered by ACC, has been criticised by judges and lawyers.

* Workers fear being cut off on the basis of notional jobs that bear no comparison with their pre-injury skills and earnings.

* More than 150 claimants have contacted the Herald alleging harassment and mismanagement by ACC.

* ACC says some long-term claimants develop a victim mentality.

Herald Online Health



Bob Sellars has seen thousands of claimants. Herald Picture / David White

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