Home Assessment Visits on Long Term Care Insurance Claims Can Be Improper “Functional Capacity Examinations”

Long term care insurance  companies will often request a field visit: an in-home assessment by a nurse to evaluate what types of assistance is needed by the long term care patient.  These visits are typically not required under the terms of a long term care insurance policy, but claimants often agree to have these visits take place.  The claimants and their families should be aware, however, that testing or rehearsal of various Activities of Daily Living are actually improper Functional Capacity Evlauations.

Functional Capacity Evaluations are improper for a variety of reasons.  First, the ability to perform a function on one occasion, for a few seconds, does not mean that a person can repeatedly perform that function on an hourly or daily basis.  There are published journal articles — internationally — that have commented upon the limited or poor level of usefulness of such tests.  Second, the particular test or command requested usually seeks a person to use an infirm or compromised body part or mechanism and the claimant may be hesitant or fearful of injury or pain and then can be easily accused of  what the insurance companies call “sub-maximal effort”.  And finally, there is a possibility of injury during these exercises and the long term care insurance company is unlikely to take financial responsibility for any injuries.

Claimants with long term care insurance claims should be armed with legal knowledge as their rights and as to what is proper or improper in the handling of their long term care claims.  You can contact us with any questions at http://www.quadrinoschwartz.com/contact/.

5 Responses to “Home Assessment Visits on Long Term Care Insurance Claims Can Be Improper “Functional Capacity Examinations””

  1. Julie Lowell Says:

    Most people overestimate the cost of a good long-term care policy. A healthy, married couple in their mid/late fifties, can share a policy that starts off with over a half million in benefits for about $100 per month per spouse.
    There’s a new type of government-approved long-term care policy that can protect your assets from Medicaid even after the policy runs out of benefits. Here’s an explanation of how these policies work:

    -Julie

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