Physician’s Guide

Physician’s Guide to Functional Capacity Evaluationsbook

The goal of this instructional text is to introduce the evaluator to an objective Functional Capacity Evaluation (FCE) system. After mastering the FCE and incorporating these principles into your practice, you will be able to objectively answer the following questions:

  • When is a worker ready to return to work safely?

  • Are work restrictions or modified duty required?

  • How do we achieve a fair balance between returning a patient back to work and determining long-term disability?

  • How can we differentiate actual physical limitations from psychosocial factors?

  • Is there a valid impairment or is the patient malingering?

When we restrict someone’s job duties based on impairment, this also limits their potential earning capacity and is usually compensated by the responsible party. The need to distinguish actual from perceived impairment has a tremendous impact on our economy. Studies indicate that Functional Capacity Evaluations (FCEs) are currently the most effective tool available to identify a person’s task abilities for disability rating.

The purpose of the Functional Capacity Evaluation (FCE) is to identify the worker’s physical capabilities and the expected critical demands of the job. Once this is completed objectively, the necessity for further intervention can be addressed. For example, after a baseline FCE, the effectiveness of future medical care or physical therapy can be objectively rated. Conversely, if no gains are evident with additional care, the patient has reached a maximal medical improvement or permanent and stationary status.

The Functional Capacity Evaluation (FCE) can also be used to determine any impairment the patient may present with. This information can then be used to determine if any disability persists. It is important to recognize the subtle difference between impairment and disability. The two terms are closely related and commonly used interchangeably within the medical community, but a distinct difference does exist. This textbook covers medical and legal definitions and applications of the Functional Capacity Evaluation (FCE).