In this video, Bernard is joined by Dave Bledsoe, Jr. of Bledsoe Occupational Therapy (fcealabama.com). Bernard and Dave discuss what a functional capacity evaluation (FCE) is, why they are performed and the impact they have on Alabama workers’ compensation claims.
We have previously written about FCEs: nomberglaw.com/blog/workers-compensation/functional-capacity-evaluations-prepare/
Functional capacity evaluations (FCE) 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 his patient’s abilities or inabilities are at the end of the healing process. Once the doctor has determined that his 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 are conducted by a therapist, typically taking between 1 to 3 hours. Depending on what injuries were to the injured worker, the FCE will be tailored to test the limitations of the injured body parts. For example, for a low back injury, the test will include evaluations of lifting, bending, stooping, crawling, walking, etc.
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 which addresses PPI ratings. These ratings, in conjunction with the FCE findings, help the doctor form his professional opinions about his patient’s future situation.
These permanent evaluations assist the employer, the workers’ compensation insurance carrier, and the injured worker’s attorney to figure out the last part of most claims. Those issues involve whether the worker can return back to his former employment, whether the employer can accommodate any permanent restrictions, and for the insurance carrier to hopefully make a settlement offer on the claim.
While there are many criticisms of FCEs that I will not go into at this time, pursuant to Alabama law it is the most acceptable method to measure the injured workers’ permanent restrictions or limitations.
The most important advice we give our clients prior to an FCE is 1. do your best and 2. be honest with the therapist. We typically advise our clients that when they attend an FCE, that they 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 40 hour work week. Our clients typically get amped up before the testing because they are nervous and want to do well. However, it is important that they realize that it is not their day to set records or to put themselves in a position to be further injured while testing.