Functional Capacity Evaluation

The Functional Capacity Evaluation (FCE)

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 physician referral 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 the job classification that the client is able to perform). Recommendations may also be given to help guide the direction of the management of the case if requested.

Material handling consists of lifting capabilities from floor to overhead, carrying, pushing and pulling. Job specific testing can also occur to get a better idea of a client’s capabilities.

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.

Behavioral testing occurs with Ransford Pain Drawing, Visual Analog, Borg Pain Scales, Inappropriate Illness Questionnaire and the Oswestry test results Questionnaire, 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 the 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.

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 GROUP, Greensburg at (724) 838-7111.