The term, “Functional Capacity Evaluation” if often abbreviated as “FCE” by many human resource managers, disability management specialists or industry personnel. Functional Capacity Evaluation is defined as “an intensive, short-term (usually one day) evaluation that focuses on major physical tolerance abilities related to musculoskeletal strength, endurance, speed and flexibility.” Understanding and properly utilizing functional capacity evaluations is integral to empowering injured workers and patients to returning to gainful employment while assisting personnel within the disability management spectrum of professional with timely, goal-oriented functional data with respect to matching workers and job descriptions.
We are trained and using the Roy Matheson Method for FCE
What type of information will I receive if I refer my patient for an FCE?
FCE recommendations are valuable to assist the physician or referral source in a more objective determination of:
- the individual’s ability to perform the essential physical tasks of their job or alternative job options
- return-to-work feasibility
- appropriate job modifications or job placement
- disability considerations
- rehabilitation potential
- appropriate ergonomic intervention
- case management and case closure
The FCE evaluator is also able to use the information from the FCE to assist the physician in completing insurance paperwork requesting documentation of physical capabilities. Communication is the key to a successful FCE. Appropriate referrals should have a specific purpose and this purpose should be indicated to the FCE evaluator at the time of referral. Please include what information you expect the FCE to provide and what questions need to be answered to progress an individual through an efficient continuum of care. Our FCE evaluators will be happy to discuss any patient’s case prior to referral if you are unsure whether an FCE is appropriate or will provide you with the information you are seeking.
What type of patient or case would benefit from an FCE?
The following suggestions may help determine if an FCE would be beneficial for your patient. Consider referral if the individual:
- has achieved maximum medical/functional benefit from medical or rehabilitation intervention
- has not resumed work or functional responsibilities in regular job or modified capacity
- is ready to return to work but limitations need to be delineated
- is working but exhibits difficulty performing essential job tasks or functional activities
- exhibits a discrepancy between subjective complaints and objective physical findings
- requires objective or predictive information for vocational planning, alternate job placement or future rehabilitation decisions
- requires objective or predictive information for disability determination, litigation, case management or case resolution
- is requested to demonstrate safe ability to perform essential job tasks prior to return to work by employer
- requires determination of function in a non-occupational situation
Are there any contraindications to performing an FCE?
When considering whether your patient is appropriate for an FCE remember, the individual must be medically stable and agree to participate in the evaluation through an informed consent. A functional capacity evaluation should not be ordered, and will not be performed, if the individual’s safety or medical condition could be compromised. The following contraindications should be observed: surgery without adequate healing time or unhealed fractures, blood pressure above 150/100, recent abdominal or inguinal hernia, specific cardio respiratory concerns or pregnancy. Pregnancy referrals should be postponed until at least 3 months post partum.
In our physical therapy practice, a musculoskeletal screening including vital signs is performed at the beginning of the FCE. Although it is not necessary to include the musculoskeletal examination in a FCE, it assists us to determine precautions that should be followed during the evaluation. On occasion, we may also identify ‘red flags’ which increase the potential of compromising an individual’s medical condition or safety.
Are all FCEs the same?
Confusion may arise when providers use different Functional Capacity Evaluation protocols (e.g. Matheson, Blankenship, Key), but the information they provide is actually very similar. The majority of FCEs are based on the 20 Physical activities, physical demand levels and frequency of Work as identified by the US Department of Labor in the Dictionary of Occupational Titles (D.O.T.).
For additional information please contact Prime Health Physical Therapy at (908) 925-9700