What is a Functional Capacity Evaluation (FCE)?

By: Roxanne Williams, PT

A Functional Capacity Evaluation (FCE) is an assessment comprised of several tests designed to measure a worker’s safe and dependable physical abilities and limitations in regard to a variety of real and/or simulated work activities. The evaluation focuses on musculoskeletal strength, endurance, speed and flexibility. An injured worker is typically referred for a FCE once he or she has reached maximum medical improvement and the worker’s ability to return to gainful employment is in question.

FCE performance and results can be compared to an individual’s pre-injury job demands. The results of a FCE are provided in neutral and standardized terminology. When results suggest a worker is not safe to return to his or her pre-injury position, the information can facilitate case resolution by suggesting a return-to-work plan.

This plan may include alternative employment options or a transition into a work hardening/conditioning program. FCE results may be combined with a rating of permanent impairment to provide insight on how an individual’s residual impairment could contribute to a workplace disability.

The duration of an FCE may range from two to eight hours, with a typical length of four to five hours for evaluations performed in Virginia. A

 trained evaluator familiar with the individual’s medical history and pre-injury job demands will be present throughout the FCE process. This evaluator is typically a physical or occupational therapist who has completed additional training to administer and interpret FCEs, evaluate workplace demands, understand worker’s compensation laws and regulations and structure assessments to capture a worker’s physical abilities. The evaluator will also assess and consider the worker’s effort and reliability. 

What Should a Worker Expect When Arriving for an FCE?

Upon arrival at the clinic, the worker will be guided through an extensive interview to help the evaluator understand the worker’s course of care since the injury, determine the worker’s perceptions of their injury and construct a plan for the physical abilities assessments the worker will perform based on pre-injury job demands.

Following the interview, the worker will complete subjective pain and disability questionnaires. Strength, flexibility and sensation are then measured and a test to screen for any conditions that may pose a safety risk during the physical abilities test of the FCE is completed.

Work-related physical abilities testing then begins in a gym-like setting with specialized equipment. Physical testing based on the worker’s pre-injury job demands may include tasks such as walking, bending, squatting, reaching, handling, balancing, lifting, carrying, pushing and pulling.

After the evaluation is complete, the collected data is analyzed and compiled into a concise report summarizing the worker’s physical abilities and limitations, guiding return-to-work recommendations.

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