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How to fill out the Functional Abilities Form online
Filling out the Functional Abilities Form online can help streamline the documentation of an individual's physical capabilities and needs. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and effectively.
Follow the steps to successfully complete the Functional Abilities Form.
- Click ‘Get Form’ button to access the form and open it in your preferred digital format.
- Begin by entering the claimant's name, date of injury, social security number, and claim number at the top of the form. This information is essential for identifying the individual and their claim.
- In Section 1, indicate the individual's capacity for sitting, standing, and walking during an 8-hour workday by circling a number from 0 to 8 for each activity.
- Proceed to Section 2 and check the appropriate columns that describe the individual’s lifting and carrying capabilities, as well as bending, squatting, crawling, climbing, and reaching. Be mindful to assess these activities based on the prescribed frequency during an 8-hour day.
- In Section 3, identify whether the patient can perform repetitive actions using their hands, such as simple grasping and fine manipulation. Indicate the capability for the right and left hand by selecting ‘Yes’ or ‘No’ for each action.
- Review Section 4 where you must assess the individual’s ability to operate a motor vehicle and use foot controls. Mark ‘Yes’ or ‘No’ for each statement regarding walking around machinery and tolerance to various environmental conditions.
- In Section 5, determine if the individual has reached maximum medical improvement (MMI) and if not, provide an anticipated date of MMI. Also indicate whether they can return to work within the specified physical capacities.
- Lastly, add any additional comments in the designated space. Ensure both the physician’s and claimant’s signatures and dates are recorded at the bottom of the form.
- After filling out the form, save your changes, and choose to download, print, or share the completed Functional Abilities Form as needed.
Complete your Functional Abilities Form online today to ensure accurate processing of your claim.
A FAF form, or Functional Abilities Form, is a document used to assess and record an individual’s physical abilities and limitations. This form is crucial for healthcare providers to create effective rehabilitation strategies and workplace accommodations. Utilizing a FAF ensures that all parties involved have access to a standardized assessment, promoting clear communication and effective care.
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