Learn about functional capacity evaluations (FCEs), including how to prepare for them and what they mean for your workers’ comp claim
What is a functional capacity evaluation?
A functional capacity evaluation (FCE), also sometimes referred to as a work capacity evaluation, is a series of tests designed to objectively assess an injured individual’s ability to perform in various situations, particularly in a work setting.
FCEs are typically used by authorized treating physicians in workers’ compensation cases. The FCE, while far from a perfect measuring tool, is one way for a doctor to confirm what their patient’s abilities or inabilities are at the end of the healing process.
Once the doctor has determined that their patient (injured worker) has reached maximum medical improvement (MMI), it then must be determined what return to work restrictions are to be considered.
After being ordered by the treating physician, an FCE is typically performed at a physical therapist’s office. This set of physical tests is conducted by a therapist, typically taking between 1 to 3 hours.
What does an FCE determine?
An FCE is used to evaluate an individual’s readiness to return to work after a prolonged medical absence. Should the employee be deemed unfit for work, the FCE offers insights into their prognosis and potential steps for occupational rehabilitation.
Additionally, the FCE aids in pinpointing adjustments to the employee’s work duties or environment, like ergonomic improvements, that could facilitate the accommodation of an employee with an ongoing disability or health issue.
Is a settlement in workers’ comp determined by FCE?
An FCE plays a crucial role in determining the value of a workers’ comp settlement, but it’s not the only factor.
FCEs provide critical information about an injured worker’s physical capabilities and limitations, helping to establish the extent of the injury and potential future work capacity. This evaluation can guide negotiations by offering a more objective assessment of the worker’s ability to perform job-related tasks.
However, settlement decisions in workers’ comp cases also consider other factors, such as the worker’s medical expenses, wage loss, and the potential need for ongoing treatment or vocational rehabilitation.
Therefore, while an FCE will definitely impact a workers’ comp settlement, it’s only part of a broader evaluation that includes various aspects of the worker’s claim.
What is an example of a functional capacity assessment?
The FCE is tailored to test the limitations of the specific injured body part(s) of the injured worker. For example, for a low back injury, the test would include evaluations of lifting, bending, stooping, crawling, walking, etc.
Walking up and down stairs is a measurable task that you could be asked to do as part of a functional capacity evaluation.
During most FCEs, the following measurements are also taken:
- Lifting power
- Push and pull power
- Standing or walking abilities
- Flexibility and reaching abilities
- Grasping and holding abilities
- Bending abilities
- Balance abilities
How should I prepare for a functional capacity evaluation?
The 2 most important pieces of advice we give our clients prior to an FCE are:
- Do your best.
- Be honest with the therapist.
When our clients attend an FCE, we typically advise them to wear comfortable clothes and exercise shoes, eat their normal diet and take their medications as scheduled. Do not try to be Superman, as it is impossible for someone to act the same way during a 1 to 3-hour test like they would over a 40-hour work week.
Our clients typically get amped up before the testing because they’re nervous and want to do well. However, it’s important to realize that you don’t want to set records or put yourself in a position to be further injured while testing.
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How are strength ratings determined in FCEs?
An FCE should provide something called a “Physical Demands Strength Rating,” which tells us how much strength a job requires. This rating uses letters to match the job with a strength level, showing what kind of physical effort is needed to do the job well. These levels range from sedentary (requiring the least effort) to very heavy (requiring the most effort).
S-Sedentary work
Sedentary work requires workers to exert up to 10 pounds of force occasionally (with “occasionally” meaning the activity or condition occurs up to one-third of the time) and/or a minimal amount of force frequently (with “frequently” meaning the activity or condition occurs from one-third to two-thirds of the time) to lift, carry, push, pull, or otherwise manipulate objects, including the human body.
Sedentary work primarily entails sitting, although it may also include brief periods of walking or standing. A job is considered sedentary if it requires walking and standing only on an occasional basis and meets other criteria for sedentary work.
M-Medium work
Medium work requires workers to exert 20 to 50 pounds of force on an occasional basis, and/or 10 to 25 pounds of force frequently, and/or more than a negligible amount but up to 10 pounds of force almost constantly to move objects.
H-Heavy work
Heavy work requires workers to exert 50 to 100 pounds of force occasionally, and/or 25 to 50 pounds of force frequently, and/or 10 to 20 pounds of force on a constant basis to move objects.
L-Light work
Light work requires workers to exert up to 20 pounds of force on an occasional basis, and/or up to 10 pounds of force frequently, and/or a minimal amount of force almost constantly (with “constantly” meaning the activity or condition occurs two-thirds of the time or more) to move objects.
A job is categorized as light work if it:
- Significantly involves walking or standing
- Requires sitting most of the time but includes pushing and/or pulling
- Involves maintaining a production rate pace that necessitates constant pushing and/or pulling of materials, even if those materials are lightweight
It’s important to note that the continuous effort to meet production targets, particularly in an industrial environment, can be physically taxing for a worker, even if the force applied is minimal.
V-Very heavy work
Very heavy work requires workers to exert more than 100 pounds of force occasionally, and/or more than 50 pounds of force frequently, and/or more than 20 pounds of force constantly to transport objects.
What happens after an FCE evaluation?
Once the FCE has concluded, the therapist administering the test will write up a report and submit it to the authorized treating physician for review and approval. Most treating doctors will generally agree with the findings. However, some of the more involved doctors will elaborate and issue a medical note specifically addressing the injuries at issue.
Often, in conjunction with the FCE, the physical therapist will also be asked to provide permanent physical impairment (PPI) ratings. These ratings are a percentage of permanent impairment loss due to the injuries.
The Directory of Occupational Impairment is the book issued by the American Medical Association that addresses PPI ratings. These ratings, in conjunction with the FCE findings, help the doctor form their professional opinions about the patient’s future situation.
These permanent evaluations assist the employer, the workers’ compensation insurance carrier, and the injured worker’s attorney in figuring out the last part of most claims. Those issues involve whether the worker can return to their former employment, whether the employer can accommodate any permanent restrictions, and whether the insurance carrier will make a settlement offer on the claim.
While there are many criticisms of FCEs, pursuant to Alabama law, it’s the most acceptable method to measure the injured workers’ permanent restrictions or limitations.
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What happens if you fail a functional capacity test?
If you fail a functional capacity evaluation (FCE) for workers’ comp, it means the assessment found you might not have the physical or sometimes cognitive ability to perform your job duties or return to your previous work due to the injuries or conditions assessed.
This outcome can have several implications:
- Adjustment of workers’ comp benefits. Your workers’ compensation benefits may be adjusted based on the FCE results. This could mean changes in the type or amount of benefits you receive, especially if the evaluation suggests you are capable of some form of work but perhaps not your previous job.
- Retraining. The results might indicate a need for vocational retraining if returning to your previous job is not feasible.
- Job modification or reassignment. Depending on the results of your evaluation, your employer may consider modifying your current job to accommodate your FCE permanent restrictions or possibly reassigning you to a different role that fits within your capabilities.
- Dispute or appeal. If you or your employer disagrees with the FCE results, there may be grounds for an appeal. This could involve a re-evaluation, seeking a second opinion, or legal action to contest the findings.
- Settlement discussions. The FCE outcome might prompt discussions for a settlement, especially if returning to work is unlikely.
It’s important to consult with a workers’ compensation attorney or a legal advisor to understand your rights and options following the results of an FCE. They can guide you through the process of appealing the decision, seeking further treatment, exploring alternative employment options and negotiating a settlement amount.
Get help from an experienced Alabama work injury attorney
If you have questions or concerns about an FCE or any other workers’ compensation issues in Alabama, contact the knowledgeable Birmingham work injury attorneys at Nomberg Law Firm. We specialize in navigating the complexities of workers’ compensation claims, ensuring your rights are protected throughout the process.
With extensive experience handling cases involving functional capacity evaluations (FCEs), we can provide the guidance and support you need to challenge any unfavorable outcomes and advocate for the benefits you deserve.