A Functional Capacity Evaluation (FCE) is a detailed forensic process which is a series of evaluative tests that will measure ability to work. The physician orders this test as one of many tools to accurately determine a safe and acceptable physical demand level for the IW as it relates to the job they were performing at the time of their injury. A thorough review and the history of the injury are discussed prior to the start of an FCE. So when should an FCE be ordered?
  • When treatment is completed but a full duty release has not been provided
  • For any IW that you feel is capable of working but has not been released
  • General sprain or strain injury is not back to work at least to a modified duty job
  • If abnormal pain behavior or work-related concerns are present
  • If an employee is medically stable but remains on disability
  • If an employee is medically stable but there is evidence of symptom magnification
  • The employee has reached MMI but has not been released
  • The employee has reached a plateau with general rehab efforts
  • To objectively document a functional, behavioral, or physical impairment
  • Objectively determine whether the employee can return to their previous occupation
Results can vary depending on who is performing the test. Example: A nurse once watched an FCE and the technician had the shoe off the injured foot but on the well foot. As expected, the results reflected that the injured foot was significantly weaker than the well foot. Clinics use poorly trained techs to do the core testing and this is not the best policy. Make sure a licensed practitioner is performing the testing and use an independent clinic to assure unbiased results.
Validity and effort are tested. If there is malingering detected or submaximal effort you will see comments such as not acceptable effort, over guarding (fearful), may not represent true work capacity. These are red flags, as is a refusal to complete testing. A true FCE is one that is properly performed by professionals that provide reliable and accurate data. Make sure you use a respected provider. Your case manager can help you find a tried and true provider.