Our eclectic background in job site analyses, pre-placement, post-offer employment testing, home health services and treatment in both in-patient and out-patient rehabilitation settings will allow us to understand complex medical conditions.
At Starting Point Rehabilitation, we specialize in Functional Capacity Evaluations, and providing expert testimony. We use various types of evaluation formats ranging in time from several hours to several days to assess all aspects of human function. Our FCE’s are tailored to provide information needed in each case, but generally includes assessment of one’s ability to engage in self-care, community activities, social outings, leisure pursuits, and work tasks. We use widely accepted methods in the field of FCE’s which provide very specific information about physical and cognitive abilities and limitations.
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Colorado Occupational Therapy
The practice of occupational therapy includes: A. Evaluation of factors affecting activities of daily living (ADL), instrumental activities of daily living (IADL), rest and sleep, education, work, play, leisure, and social participation, including:
1. Client factors, including body functions (such as neuro-musculoskeletal, sensory-perceptual, visual, mental, cognitive, and pain factors) and body structures (such as cardiovascular, digestive, nervous, integumentary, genitourinary systems, and structures related to movement), values, beliefs, and spirituality.
2. Habits, routines, roles, rituals, and behavior patterns.
3. Physical and social environments, cultural, personal, temporal, and virtual contexts and activity demands that affect performance.
4. Performance skills, including motor and praxis, sensory-perceptual, emotional regulation, cognitive, communication and social skills.
Sherry Young, Principal
Sherry has been an occupational therapist for 30 years. She has extensive experience in occupational rehabilitation and treatment of chronic pain and post-concussive syndrome. She began performing functional capacity evaluations in 1997 and has been extensively trained by Roy Matheson and Associates, the largest organization of its kind that certifies therapists in the administration of FCE’s. She has served on the Workman’s Compensation Treatment Guidelines Task Forces for chronic pain and lower extremity and has worked as an expert witness in the areas of occupation therapy and functional capacity evaluations since 2004.
Starting Point begins with the “Matheson” approach to testing where protocols are chosen and implemented in a specific way in order to get the most useful, reliable, and valid information possible. It does not promote using the same sub-tests in the same order on each and every client as some other, more rigid systems promote. Rather, they should be chosen and strategically administered in the appropriate order to get the most useful and accurate information. For instance, when evaluating someone with back pain, it would be important to avoid too much lifting in the beginning of the testing order which could exacerbate symptoms, affecting the client’s ability to perform subsequent sedentary types of activities.
The definition of a Functional Capacity Evaluation (FCE) assigned by Leonard Matheson back in 1986 is as follows: “A systematic process of measuring and developing an individual’s capacity to dependably sustain performance in response to broadly defined work demands.” The key words in this definition are “dependably sustain” as any employer expects dependability, reliability, and consistency in a worker’s performance.
1 Day Functional Capacity Evaluation
A 1-day FCE involves 3-6 hours in the clinic setting. Typically, a one-day evaluation is best suited for someone with no limitations in positional tolerances like sitting or standing. Injuries to extremities, for example, typically don’t take too long to evaluate.
3 Day Functional Capacity Evaluation
The 3-day format involves 3 hours of testing on the first day, 7 hours on the second day, and 3 hours on the third day. Having a client come to the clinic on 3 consecutive days simulates the same type of schedule any worker would have. It requires them to get up early, go through a morning routine, drive, and arrive to the job on time (often after disrupted sleep). It allows the evaluator to observe how the effects of pain or other symptoms affect someone’s ability to show up every day on time and to see what impact, if any, driving has on the person. A one day FCE could not possibly take these factors into account. Almost all clients with cognitive deficits benefit more from the 3-day FCE due to the number of tests that need to be administered.
Rationale for 1 vs 3 day FCE
If the person is overtly and obviously impaired and declines quickly; especially positional tolerances (they have to lie down often, etc.)
These people can only maintain sitting or standing for 5-10 minutes before they need to change positions and typically have to lie down every couple of hours.
Severe conditions that cause a lot of pain and they are clearly disabled (uncontrolled pain from CRPS, TOS, head pain, etc.)
If it’s a single joint injury: wrist/knee/thumb, etc. with no spinal problems or pain and the focus is on dexterity, strength, range of motion, or ability to perform repetitive movements.
Appropriate for those who take longer to show functional decline. Those who say they can’t work at all or work full-time but look fairly normal at first glance; walk normally, talk normally, etc.
Chronic fatigue/FM/auto-immune diseases/spinal pain.
These people need longer periods of time to show decline in positional tolerances, especially for sedentary jobs.
Post-concussive syndromes usually require time to show functional decline cognitively
Those diagnoses that have a lot of fatigue that accompany them.
3-day evaluations are very good for those who have cognitive problems due to fatigue or distraction from chronic pain versus true organic brain injury
There are very strange conditions that are very uncommon and make the person look like they are malingerers.
A full narrative report is provided with understandable terminology on the basis of the functional capacity test that gives you a perfect snapshot of the client’s performance. It provides details of how your client’s injury has impacted all aspects of function, including quality of life.
Main assessment areas:
Manual Speed and Dexterity
Level of Effort
Cognitive/Emotional Status Abilities
“It is with great pleasure that I write this recommendation for Sherry Young, OTR. We required a more detailed, objective, and comprehensive evaluation of the Residual Functional Capacity for several complex medical issues. It was necessary to perform the evaluation over multiple days for assessment of both physical and cognitive abilities. The Starting Point staff did an excellent job in testing, with consideration of balancing the need to assess maximal effort with continuous monitoring of the discomfort. They were caring and compassionate throughout the testing procedures. Ms. Young demonstrated extensive experience, training, and talent putting it all together with a highly detailed and comprehensive analysis and report. The report was thorough, specific, and supported by available medical science. Thank you very much. - Anonymous Client
After being totally ignored by the first judge in my case, I went through federal court, my case was kicked back to a different judge (the first one retired) and I was found disabled from May 2016 onward (a fully favorable decision). "The functional capacity evaluator found the claimant could only lift 15 pounds from floor to waist, from waist to shoulder and 5 pounds overhead... She found the claimant would need frequent breaks even if only functioning more than a couple of hours as noted by her need for breaks 36% of the evaluation time over two days...She found the claimant's current work capacity at 3.5 hours per day is her absolute limit. She noted the claimant's cognitive abilities declined over the course of the day due to fatigue and pain. This opinion is well supported by reference to test results and observations over a two-day period of testing... The undersigned gives this opinion significant weight." I am very grateful to you for providing such a thorough evaluation of my abilities. My attorney also remarked that your evaluation was one of the most thorough and comprehensive examinations she had ever read (actually, so did my primary physician) and stated that it is exceedingly rare for a disability judge to give significant weight to the opinion other than a Medical Doctor. I hope this email finds you well and I hope you are still doing such good work on behalf of those who must labor under the weight of a system that does not understand their disability. Your work does not go unnoticed or unappreciated and can make a world of difference for some of us. With a debt of gratitude and a thankful heart, - Shannon D., Client
I have worked with Sherry for almost a decade on a variety of personal injury matters and every time she delivers an honest, powerful, and helpful analysis. She is detail oriented, kind, intelligent, and very easy to work with. I learn new things every time we collaborate and I very much value her expertise and professionalism. She cares about each client she meets and her passion for what she does shines through. - Kurt Zaner, Zaner Harden Law
Sherry Young, OTR did an excellent job for our client on a functional capacity evaluation for a long term disability case. Her evaluation and report were detailed, clear and very helpful in allowing others to understand how our client’s medical issues impacted her ability to work. I highly recommend Sherry and Starting Point Rehabilitation. - H. Loeffel
Dear Sherry, I want to say thank you for your help. It was about a year ago that I came to your office for an evaluation – and what a difference a year has made. Last May, I was able to return to work in a graduated hours program that you’d recommended for me and my recovery. My company agreed to have me back starting with just a few hours a day. In September I had worked my way back up to full time work. I found a tai chi class for better balance and have been attending for almost a year now. The tai chi work continues to help me. I still experience some symptoms, but only occasionally. I’m not sure how many success stories you hear about – but wanted to let you know I feel I am one! I feel that it was because of your recommended treatment plan and assessment, I was able to improve. Thank you so much Sherry for your help in getting my life back together! - D.M.
Sherry is very professional and thorough in her testing and reporting for the FCE. The report is very clear about the testing and how the testing is validated as an accurate representation. She is very helpful through the process and also makes sure you understand the report. The test being over a three day period was what I needed for the issues I have. She is reasonable in price and meets her timeline commitments. - Richard H
Thank you Sherry and team for your expertise in functional capacity testing. I submitted your report in my appeal. Unum reversed their denial of my claim for disability. Your report was instrumental in being awarded disability. I also appreciate your compassion for your clients and knowing when we need a gentle push to see what we are really capable of. - Debbie A.
I was injured at work about a year and a half ago. Dealing with some of the people through workman’s comp has been a nightmare. Little did I know how much a person truly stands to lose if they are permanently injured at work. I was diagnosed with Chronic Regional Pain Syndrome. However, as time went on and cost went up, work comp has attempted to change my diagnosis and lessen my restrictions. With that being said, I chose to go to Starting Point to get a FCE to see where I truly am in terms of restrictions. Sherry is incredibly knowledgeable! I was nervous about how much pain I would be enduring throughout the FCE and worried that it would just be one more person who would sweep my CRPS under the rug. Wow was I wrong! Sherry educated me more about nerve damage and how the body is all interconnected and how each thing can affect the next. She was patient, compassionate, encouraging, and supportive. More importantly, she expected me to do exactly what I can, without slacking and without trying to push beyond my limitations. She was very adept at knowing when I was attempting to do more than I can. She set up realistic scenario’s so that she could get a true picture of what my job entails. Furthermore, Sherry validated my condition and my frustration. She gave me encouragement and hope when I needed it most. The bottom line is, if you need an FCE, Starting Point is where you need to go. Sherry is the best, most professional and most knowledgeable person to get this evaluation done through. - Katherine Hudson
The Functional Capacity Evaluation from Starting Point was the basis and foundation for my successful disability appeal with Cigna for Parkinson’s. Sherry Young was professional and thorough, while maintaining a comfortable, caring and respectful atmosphere through the entire process. The overall work product exceeded the work scope and my expectations. I received advice and recommendations on many topics that have resulted in significant improvements to my overall quality of life. This includes physical exercise, diet, cognitive exercises, stretching and organization, as well as generally understanding and dealing with my disease. It was an amazing learning experience. My time at Starting Point was more than productive. It was financially and personally rewarding. I heartily recommend Sherry Young to anyone or any organization in need of Functional Capacity Evaluations or Occupational Therapy. - Paul "Mike" Satterlee
It is with pleasure that I write this referral for Sherry Young. She was very thorough with my functional capacity evaluation. She was also very thorough with the report she wrote and it made all the difference in navigating the paperwork and criteria to continue insurance benefits and Social Security. She was very compassionate and understanding with my limitations and she made me feel comfortable. I would recommend her services to anyone that needs a functional capacity evaluation or physical therapy. - Anonymous
I highly recommend Sherry Young for an FCE if you are going through a difficult time with an injury. I personally have a difficult time meeting new people due to severe anxiety, and she made me feel very comfortable and provided a safe space for my evaluation. She was amazing at taking the time to properly evaluate what is going on physically, mentally and emotionally with me due to my complex injuries. Sherry took the time over a 3 day period to evaluate my ability to perform everyday tasks in a work environment, and an in home setting. Sherry was very observant overall at everything I did so she could provide accurate information in my FCE report. She also took the time to offer suggestions for future care I may be able to utilize, and will personally speak with my specialists about her findings and recommendations. She is most definitely one of a kind and very empathetic, understanding, and caring! It is very obvious she loves what she does and cares about people genuinely and helping them find a road to living a better quality of life! Thank you so much for everything Sherry! - Rachel