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VERTIGO/SEIZURES RESIDUAL FUNCTIONAL CAPACITY Name: Claim #: Date of Injury: Please Print Name of Medical Evaluator: Medical Specialty: What is the first date claimants impairment(s) became severe
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Functional limitations refer to any physical, mental, or emotional restrictions that may hinder a person's ability to perform daily activities or work tasks.
Individuals who have a disability or medical condition that affects their ability to work may be required to file functional limitations.
Functional limitations can typically be filled out by a healthcare provider or medical professional who is familiar with the individual's condition.
The purpose of functional limitations is to provide information about an individual's abilities and restrictions, which can help determine eligibility for disability benefits or accommodations in the workplace.
Information that must be reported on functional limitations may include specific limitations related to mobility, communication, cognitive function, and activities of daily living.
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