How Are Functional Limitations Assessed for My Disability Claim?

What are Functional Limitations?

Having a functional limitation in Ontario means having a considerable impairment in the person’s ability to function in the condition, manner, or duration of life and work. To succeed in claiming disability you must establish that an injury or illness prevents you from performing essential duties of your pre-disability job in the first 24 months (“own occupation stage”) and any suitable job after that (“any occupation stage”). Ascertaining what your injury or illness is, or, put differently, a proper diagnosis is only part of the process. You must also prove that your injury or illness causes specific functional limitations that affect your ability to work.

Your functional limitations arising out of an injury or illness will be assessed right at the outset of your disability claim. It is usually done by your family doctor or a specialist completing an Attending Physician Statement in support of your application for disability benefits. In-person assessment and testing will be performed. In addition to explaining your diagnosis, prognosis, and treatments, your doctor will write about your restrictions and limitations (physical, psychiatric, cognitive, visual, cardiac, etc.) that affect your ability to perform activities of daily living, including managing essential work duties.

Functional Limitations and Disability

Disability insurer might ask your treating doctor for updated assessments of your functional limitations while you are in receipt of disability benefits already. A list of questions will be provided to your doctor. While your doctor might be inclined to limit his response to a very short letter repeating the diagnoses and that his/her opinion remains the same, it is very important that functional abilities evaluation be performed and results are delivered to your disability insurer in a timely fashion. The unsatisfactory reply might result in your disability claim being denied on the basis of “lack of sufficient medical information to support your continuing disability”.

Disability insurer might periodically ask you to complete a Disability Questionnaire in order to assess the extent of functional limitations that you continue to claim.

Disability insurers might ask you to attend an in-person medical assessment with their doctor(s) in order to measure your functional restrictions. Such assessment is usually done via standardized testing of physical, psychological, cognitive, or other abilities.
Your functional limitations might be assessed via an independent paper review commissioned by your disability insurer. Your medical records will be usually reviewed by a GP, who will then answer a series of questions about what functional limitations a person with your diagnosis is expected to have and for how long.

Evaluating Your Functional Abilities

Functional Abilities Evaluation is another way of evaluating your functional limitations. Normally requisitioned by your disability insurer, it involves comprehensive testing of your physical tolerance abilities with respect to musculoskeletal strength, endurance, speed, and flexibility. Such testing might be done in conjunction with Transferrable Skill Analysis in order to determine a pool of jobs that you might still be able to effectively perform based on your test results.

Assessment of functional limitations in disability context is needed in order to gauge the ways in which your disability affects your capacity to handle the essential duties of your employment. If your tolerance for standing and walking is seriously restricted, for example, due to some injury or illness, you might still be determined physically able to perform some sedentary job. It would be prudent to contact an experienced disability lawyer for advice if your disability insurer claims that your claim has been denied because there are plenty of alternate jobs that you should still be able to manage while being disabled.