What Is a Functional Capacity Evaluation?

When you are injured on the job, you will likely undergo medical treatment to help you recover. However, not everyone heals at the same pace, and you may not be able to perform your duties immediately after returning to work.

Your doctor is responsible for giving you a medical release after your treatment. Many employers require medical clearance to avoid liability if workers reinjure themselves or put others at risk.

If your injury was minor, it might be easy for your doctor to determine whether you can return to work. However, determining how much work an employee can do after suffering an injury is often challenging.

For more severe or complex injuries, doctors usually order a Functional Capacity Evaluation (FCE), also known as a functional capacity assessment or functional capacity examination. Although an FCE is not necessary or appropriate for all situations, it can be beneficial in many cases.

Keep on reading to learn more about FCE, its purpose and cost, and everything else you need to know before undergoing the test.

What is a Functional Capacity Evaluation?

A functional capacity evaluation (FCE) determines whether or not you can return to your regular job duties. The FCE involves a series of standardized physical tests, usually administered by a physical or occupational therapist. These tests are designed to objectively assess your physical abilities related to your work duties.

Functional capacity evaluations may be ordered by attorneys, employers, and insurance companies providing worker’s compensation benefits.

What is the Purpose of a Functional Capacity Evaluation?

The FCE is used to measure your physical ability after an injury. It can be beneficial for:

  • Developing rehabilitation and physical therapy plans
  • Increasing your ability to perform everyday activities
  • Filing a claim for workers’ compensation and Social Security benefits
  • Returning to work with a reduced risk of re-injury and causing harm to others

In workers’ compensation cases, a functional capacity evaluation will determine whether an employee can return to work at full capacity or must reduce their duties until they can safely perform their regular job.

What Happens During a Functional Capacity Evaluation?

A functional capacity evaluation is done by an evaluator certified to conduct the examinations involved, such as a physical therapist or a physical medicine specialist. It consists of a series of tests that will measure a worker’s abilities in the following areas:

  • Range of motion
  • Physical strength
  • Postural intolerances
  • Ability to carry objects
  • Stamina
  • Flexibility
  • Fine and gross motor skills
  • Other abilities required by the worker’s job

What Will The Occupational Therapist Ask You To Do?

The evaluator may ask you to perform the following challenges:

  • Lifting
  • Pushing and pulling
  • Reaching
  • Walking
  • Crawling
  • Stair climbing
  • Balancing
  • Bending
  • Sitting
  • Squatting
  • Kneeling
  • Standing

These tests will measure your exact physical capacity compared to the requirements of your job. Furthermore, you may be required to complete challenges multiple times on consecutive days to examine your abilities across a more extended period.

You can expect these standardized tests to last for several hours, depending on the physical demands of your job.

The focus of the functional capacity evaluation may also differ depending on the nature of the job. For instance, if your job requires you to lift heavy objects multiple times a day, heavy lifting will be the focus area for your evaluation.

When is a Functional Capacity Evaluation Contraindicated?

Physical and occupational therapists recommend against undergoing a functional capacity evaluation for specific medical conditions, such as cardiac, pulmonary, or mental health illnesses. The test may also be contraindicated for people with difficulty communicating or understanding instructions.

Furthermore, you should not undergo a functional capacity evaluation if you are still recovering from surgery or undergoing rehabilitative therapy. Tell your evaluator about these circumstances before scheduling your appointment.

How Do You Prepare For a Functional Capacity Evaluation?

Functional capacity evaluations are usually performed in medical facilities, typically physical therapy centers. The evaluator will ask you to demonstrate multiple tasks, which may be overwhelming.

The following tips can help make your functional capacity evaluation go smoother:

  • Dress comfortably; your clothes should allow a full range of motion
  • Get plenty of sleep the night before
  • Bring any medications you’re taking and assistive devices
  • Bring a list of your job’s physical requirements
  • Expect to perform each test at maximum capacity
  • Consider asking another person to give you a ride to the testing center

The evaluator will likely ask you about your injury or disability to better grasp your diagnosis and symptoms. They may also ask you about other medical conditions and drugs you’re taking. Try to provide as much information as necessary to allow your evaluator to create a more comprehensive functional capacity evaluation.

How to Avoid Excessive Fatigue, Pain, and Re-injury While Measuring Your Physical Ability

An FCE will require you to perform a battery of tests at maximum capacity, meaning you must give your full effort for every physical challenge. Unfortunately, this expectation puts you at risk of re-injuring yourself.

Notify the evaluator if you experience significant pain during the test or are too tired to continue. They will give you a chance to rest or stop if necessary. You can also take breaks between tests to eat or go to the bathroom.

Tell your evaluator immediately if you experience extreme fatigue or pain after the first day. Try your best, but do not overexert yourself to the point of risking another injury.

What Not to Do Before and During an FCE

Don’t take excessive pain medications before an FCE. It can hinder your ability to measure how much your symptoms affect you while engaging in physical activity.

Furthermore, never exaggerate your injuries or lie to your evaluator. FCE specialists are trained to spot signs of faking.

How Much Does a Functional Capacity Evaluation Cost?

The cost of functional capacity evaluations varies based on several factors. If your physician referred you for an FCE, your insurance company might cover the costs. You could pay out-of-pocket for the evaluation if you do not have insurance coverage.

In that case, the costs of functional capacity evaluations vary based on the following:

  • The facility’s rates
  • The complexity of your injury or disability
  • The length of the evaluation

FCE prices range from $500 to $2,000. According to MD Save, the national average cost for functional capacity evaluations is $880. Your employer might help you cover the costs.

Why is a Functional Capacity Evaluation Important For Claiming Workers’ Compensation Benefits?

Workers’ compensation is a no-fault system, meaning injured workers can file for income and disability benefits regardless of who caused the underlying accident. However, some employers or insurance companies may dispute claims, barring workers from receiving medical treatment, income replacement, and other benefits they need.

An injured worker can undergo a functional capacity evaluation to show how their disability or injury affects their ability to work. The FCE can help determine whether you can return to the same duties or have to work at a reduced capacity. It can also help identify the need for specific accommodations at work.

Furthermore, a functional capacity evaluation can help determine a worker’s qualification for workers’ compensation and Social Security benefits. Usually, an FCE report comes with recommendations for treatment that will help a worker receive appropriate benefits based on their disability status.

Additionally, a functional capacity evaluation can objectively resolve disputes from an employer or workers’ compensation insurance provider. Sometimes, employers or insurers dispute workers’ level of injury in an attempt to hinder claims.

If you face contention on your claim, an FCE can help you recover the benefits you deserve. Alternatively, an FCE can help prevent insurance fraud. The test evaluates a worker’s medical condition and determines if and when they can return to work.

Is a Doctor’s Diagnosis Not Enough?

Sometimes, a doctor’s diagnosis is conclusive of a person’s ability to return to work. For instance, a person with chronic pain due to a patellar fracture needs accommodations to work safely. However, not all cases are straightforward.

Moreover, doctors don’t perform comprehensive tests to evaluate a patient’s physical abilities relative to their job description.

What is a Failed Functional Capacity Evaluation?

A “failed” FCE occurs when the evaluator decides you can no longer meet the basic requirements of your job. Failing the FCE can be bad news if you want to return to your previous position.

Alternatively, it can help you get the support you need from the government.

Can Functional Capacity Evaluations Be Used Against Workers?

An insurance company may order you to undergo an FCE to try and demonstrate that you can return to work, even if you are not ready. It may try to use the FCE as a weapon by:

  • Convincing a doctor that the client is exaggerating or faking their medical condition
  • Ordering someone to return to their job even when they are physically unable to perform the same job duties
  • Prematurely releasing a patient from therapy

Moreover, an FCE provider can manipulate a client’s results to help an insurance company deny the workers’ compensation case.

If you feel that your FCE results have been manipulated or are inaccurate, consider getting a second opinion.

Is a Functional Capacity Evaluation Enough to Claim Disability Benefits?

An FCE may be enough for some patients to receive benefits, but not always. People’s bodies can feel and respond differently to physical challenges on different days; the FCE is not a perfect assessment of someone’s physical capability.

Injured employees may also be required to undergo impairment ratings, return to work (RTW) evaluations, and other tests.

Conclusion

A functional capacity evaluation is helpful for many applications, including devising a treatment plan for maximum medical improvement. Additionally, an FCE can help employees recover medical costs, disability benefits, and other support they need.

If you suffer a work-related injury or medical condition, your employer may ask you to undergo an FCE. Now that you know what to expect, you should be able to breeze through the process.

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