A Functional Capacity Evaluation (FCE) is a series of tests conducted using appropriate medical standards by licensed FCE evaluators to determine an injured worker’s or accident victim’s capacity to return to work and outlines what job duties the person can and cannot do. They are also used to assist in injury management and for validity testing, which determines if the person is putting forth 100% effort in performing the tasks or if he or she is exaggerating symptoms. Additionally, they are being used in increasing frequency to determine if a job applicant is able to safely perform the duties of the job for which he or she is applying. FCEs are usually conducted at a medical facility, such as the one at Burk Physical Therapy & Rehabilitation, but may also be conducted at the job site.
A Functional Capacity Evaluation can:
- Resolve disputes about the level of injury
- Provide more information about a worker's injury or illness
- Determining a job candidate's ability to perform the job for which he/she is applying
- Help to determine a claimant's qualifications for workers' compensation, Social Security, State disability and other benefits
FCEs are the most accurate way to:
- Determine a worker's ability to return to work
- Determine if a job candidate can safely perform the necessary functions of the job for which he or she is applying and
- Determine what form of support a worker or accident victim needs (e.g., occupational therapy, physical therapy, dry needling, etc.) to aid in his or her recovery and return to work.
What happens during an FCE?
An FCE evaluator performs FCE evaluations based on information in the job description for which a job applicant is applying or the job to which an injured worker or accident victim is returning. If a job description is not available, the FCE evaluator will ask the person about his/her occupation and the physical requirements of the job. During the FCE, the injured person is asked to perform a series of tasks which simulate his or her customary job duties including:
- Material handling, which may include fingering, reaching overhead, lifting, pushing, pulling and carrying.
- Positional tolerance, including squatting, kneeling, stooping, walking, bending, sitting, standing and other positions the person must assume to do his/her job.
During the FCE, the evaluator will also assess the injured body part(s), including range of motion, muscle strength, circumferential measurements to determine swelling or atrophy to help determine level of injury and if the person is well enough to return to work to perform all job duties or modified duties until he or she is fully recovered.
How is someone referred for an FCE?
Workers are typically referred for FCEs by healthcare providers, workers’ compensation claims managers, their employer, lawyers (both plaintiff and defense) or vocational consultants. Accident victims may be referred by healthcare providers, insurance companies or lawyers (both plaintiff and defense). For job candidates, the FCE is generally part of the employment application process and may be performed at a medical facility or at the job site.
FCEs take anywhere from a few hours to several days to perform, depending on the complexity of the exam. The exam results are typically sent to insurance companies, healthcare providers, employers, plaintiff/defense lawyers, workers’ comp case managers or vocational consultants. Exam results provide information for adjudication of short-term and long-term disability cases and return-to-work capabilities, as well as determining ability levels for liability cases. They also provide validity information, which lets the recipient know if the person being assessed put forth the required effort to perform the tasks or if he or she exaggerated injury/illness symptoms.
For injury management in workers’ comp, accident and disability cases, the injured person will undergo more than one FCE. The first is done to determine the legitimacy and severity of the injury. Another is then done during rehabilitation to determine the injured person’s recovery progress and another is done post-rehab to determine the person’s ability to return to work to perform all his/her duties or modified duties until he/she fully recovers. More FCEs may be needed, depending on the case. Sometimes, it is determined that the person is too sick or injured to return to work and must be put on permanent disability.
Under the Pennsylvania Workers’ Compensation Act, employers have the right to establish a panel of healthcare providers from which an injured worker must choose for work-related injuries and illnesses. The employee must see a provider from that list for at least the first 90 days after an injury. After the 90 days has elapsed, the employee can choose his/her own healthcare provider. But the employee must provide notice to the workers’ compensation insurer within 5 days of changing providers. However, if the employee requires emergency treatment, he or she is not required to seek treatment from the designated list of providers until the emergency condition no longer exists, then the employee must choose a provider from the list.