Range of Motion tests instead of Functional Capacity Exams

[Rivet62]

Has anyone had difficulty in just obtaining simple range of motion (ROM) tests using a goniometer? Practically every physical therapist I have contacted, in my city and neighboring cities, insists on doing a Functional Capacity Exam and Impairment Rating in addition to ROM tests. I already have SSDI and an 80% combined service connect. What's lacking in the evidence VA has considered is measured range of motion tests (with a goniometer), instead of the eye-balling produced by C&P exams, prior physical therapists, neurology and spine specialists. The spine specialist I had seen (in 2018) states measured tests, when in fact he did not ask me to move anything at all.

Has anyone encountered difficulties in getting just the range of motion tests? It's like they want to sell me a Cadillac when all I need is scooter.

I'm going to pay for this out of pocket, which is another reason I don't want a Functional Capacity Exam and Impairment Rating.

Can anyone recommend who or what else does measured ROM tests? I thought physical therapy would be the easiest way to obtain measured ROM tests, short of orthopedics, or spine specialists. I was wrong.

[broncovet]

Yes, its difficult to order a medical report, "at the color, time, size, and with the optional equipment you want, but not the optional equipment they have".  

    I see it you have 2 choices:

1.  Keep looking for what you want..the medical exam with the stuff you want but not the stuff you dont want.  OR

2.  Settle for what you can get.  

     I see this with cars:  I want a hybrid, great gas mileage, dont want a sun roof, DO want heated seats and heated steering wheel as well as blind spot monitor.  

     Of course, I want them to pay KBB for my old car, and give me a deal on the new car.  Usually what really happens is some type of compromise.  You get some of the stuff you want, when you want it, but you have to settle for a color you dont like, or a price you dont approve of.  

    Most stuff winds up being a negotiation, and you have to decide "what is more important"...getting the exam, or getting a low price.  You really need a competent doc, with experience with VA med exams, and, sometimes you wind up paying more than you would like.  

[Rivet62]

1 hour ago, broncovet said:

Yes, its difficult to order a medical report, "at the color, time, size, and with the optional equipment you want, but not the optional equipment they have".  

LMAO! Oh dear. It looks like I was looking for the Drive-Thru, but no this is fine dining with separate courses served.  I'm learning...

1 hour ago, broncovet said:

sometimes you wind up paying more than you would like.  

Yeah so...lol...yeah. I'm going to do the functional exam because that's the one-trick pony everyone seems to understand. And maybe I can get some other outcomes I hadn't anticipated. I'll pony up the $700 for the functional exam. I do wish I could find a doc that specializes in VA exams, but after reading what you paid in another thread I might have to stick with the functional exam.

[Rivet62]

18 hours ago, broncovet said:

Yes, its difficult to order a medical report, "at the color, time, size, and with the optional equipment you want, but not the optional equipment they have".  

Rant:

The difficulty is made more apparent when a Functional Capacity Exam requires a physician referral for specific diagnoses, complete with ICD-10 codes, even if I pay out of pocket. So, I have to seek conclusive diagnoses first on several areas of the body, which takes time to arrive at. This is not like a general physical exam that would include range of motion tests.

I'm just letting everybody know that it can be quite difficult to get those measured range of motion tests to counter the eye-balled C&P exams for range of motion.

Post rant:

Eureka! I have discovered the purpose of a physiatrist. They do measured range of motion. My own primary care doctor is scheduled for the referral to see one. This way I can get VA to pay for it. She recommended it, and one of my neurosurgeons recommended it too. I AM ON MY WAY 

Edited January 12, 2022 by Rivet62
Added Physiatrist, as a means to have measured tests

[Rivet62]

19 hours ago, Rivet62 said:

Can anyone recommend who or what else does measured ROM tests? I thought physical therapy would be the easiest way to obtain measured ROM tests, short of orthopedics, or spine specialists. I was wrong.

I think I may have found the answer.  A physiatrist. In fact, one of my neurosurgeons recommended follow-ups with a physiatrist. My own primary care doctor has suggested seeing one (I have an appointment with her specifically for the referral to a physiatrist.

In a nutshell, this is what a physiatrist does, including measured range of motion:

"Physiatrists are Physicians who specialize in treating musculoskeletal conditions, such as issues that affect the bones, joints, nerves, spinal cord, muscles, ligaments, and brain.

The work of a Physiatrist is often confused with Physical Therapy or Orthopedic Medicine, as they help patients deal with pain and mobility problems.

Unlike Physical Therapists, Physiatrists need to complete medical school and residency training. As with Orthopedists, Physiatrists often treat back pain, neck pain, and conditions related to physical injuries. However, they do not perform surgery."  Source:  https://www.owlguru.com/career/physiatrists/#:~:text=Physiatrists perform physical exams of patients to test,or disease on their mobility. Develop Rehabilitation Plans