The Functional Capacity Evaluation (FCE) is an examination that documents the client’s current ability to perform work from a physical, medical and behavioral perspective. It is most commonly performed on individuals who have been off work to determine their ability to return to employment. This service is offered at most centers. Functional Capacity Evaluations do not need a prescription under PA physical therapy regulations.
The components of the FCE consist of Materials Handling, Lifting, Non-Materials Handling (sitting, standing, reaching etc.), Behavioral Testing, Validity Profile (whether the test is an accurate representation of the individual’s current capabilities) and a Physical Capabilities Sheet (listing job classification the client is able to perform). Recommendations may also be given to help guide the direction of the management of the case, if requested.
Materials handling consists of lifting capabilities for the above from floor to overhead, carrying, pushing and pulling. Job specific testing can also occur to get a better idea of a client’s capabilities. Material handling is classified into three categories: 1) occasional lifting or 1-33 percent of the day; 2) frequent lifting or 33-66 percent of the day; 3) constant lifting (over 66 percent of the day).
Non-material handling consists of testing hand function, sitting, standing, bending, reaching, climbing, squatting, kneeling, walking, crawling, balancing, arm and leg movement, but is not limited to these activities. THE pt GROUP Greensburg has a truck simulator to test truck drivers’ endurance to driving as well as other specialty equipment to test non-material function of works in many different industries
Behavioral testing occurs with Ransford Pain Drawing, Visual Analog, Borg Pain Scales, Inappropriate Illness Questionnaire and the Oswestry test resultsQuestionnaire, Pre & Post Examination. The Somatic Amplification Rating Scale (SARS) and Waddell’s Testing also occur during the physical examination. These help us determine if there is a non-organic or behavioral component during testing that will need to be identified.
Validity Profiling is done to determine the client’s effort during examination to ensure they have tested to their maximal effort. This is also combined with the behavioral aspect of the test to get validity score which indicates a valid, equivocal or invalid test. A valid test gives a good idea of the person’s capabilities for return to work. If tests are equivocal or invalid, this does to mean that the person is being tested is a bad person. It usually means that there is a behavioral component to their injury that needs to be addressed.
These behavioral issues are addressed throughout THE pt GROUP. Often these clients return to work when these problems have been addressed. This is what separates this program from others. We treat with a return-to-work success rate of between 80 and 90 percent because we are able to address the behavioral component.
A physical capabilities sheet is always provided with every FCE. This sheet lists the weights the client performed, as well as the non-materials handling capabilities and a Physical Demand Level. A Physical Demand Level is a government rating on job classifications based on the weight needed to perform the job. This is the gold standard for employers, physicians, insurance carriers and therapists. It gives a snap shot of the client’s physical capabilities on one sheet of paper.
Recommendations may also be given if requested. This allows us to use our experience to help manage the flow of the client throughout the medical model of care and helps ensure the client gets the best outcome. Recommendations may be to return-to-work, begin a work hardening program, lifestyle health counseling (to address the behavioral aspect identified during the examination) or many others depending on the results of the examination.
If you would like more information regarding FCE’s, please free to contact THE pt GROUPSM, Greensburg at (724) 838-7111.
Clients who are beyond the initial acute stage of modalities and strengthening may be candidates for Work Conditioning. Typical clients are deconditioned post injury and their work requires heavy job demands. This is an intensive 2-4 hour program, 3-5 days a week, which is both work and goal-oriented. This service is offered at most of The pt Group centers.
This program helps restore physical capabilities that are required for work. Programs typically are 2-4 weeks depending on the functional levels needed before full return–to–work.
Occupational Solutions (SM)
As a natural extension of THE pt GROUP’s commitment to cost-effective quality care, an industrial consulting service has been developed that emphasizes proper management and prevention of work-related injuries. The educational and training services include Healthy Back Care Seminars, Healthy Neck Care and Supervisor’s Seminars. The customized services include the Workers’ Compensation Health Care Provider Panel and many other helpful services.
As a natural extension of THE pt GROUP’s commitment to cost-effective quality care, an industrial consulting service has been developed that emphasizes proper management and prevention of work-related injuries. These services include:
Education and Training
Healthy Back Care Seminars
Presentations addressing the causes, management, and prevention of low back problems in the workplace. Emphasis is on addressing risk factors for back problems, body mechanics principles, common sense ergonomics and exercise/fitness issues.
Healthy Neck Care and Cumulative Trauma Disease (CTD) Prevention Seminars
Presentations identifying the causes, management, and prevention of neck and upper extremity problems in the workplace, with emphasis on common sense ergonomics, risk factors, exercise principles and fatigue-control techniques.
Training sessions for supervisors to aid them in understanding the issues surrounding back/neck/CTD problem prevention and management.
Workers’ Compensation Health Care Provider Panel
• Assist identifying and developing a panel of health care providers interested in cost-effective, quality care emphasizing a safe and timely return to work.
Functional Job Description
• Detailed documentation of essential job functions derived from on-site job analysis, compliant with the Americans with Disabilities Act (ADA).
Pre-Placement/Post Offer Job Screening
• A “mini-FCE,” linked to essential job functions, to ensure new hires meet critical job demands. Education/training can be added.
Design and Implementation
• A transitional duty and on-the-job exercise program.
• On–site general walk-through for common sense ergonomic assessment and recommendations and/or specific work station assessment.
Individual Lifestyle Health Counseling
• Counseling programs for clients whose motivation and/or attitude may be interfering with their return to work.
• Consultation on complex, challenging or long-standing workers’ compensation cases and mediation of these cases to develop a “win” for the employer and the employee.