A Functional Capacity Evaluation (FCE) is a comprehensive assessment of an individual’s work-related abilities. An occupational therapist or physical therapist usually performs the main portion of the FCE. FCEs are crucial for disability or worker’s compensation claims. The components of an FCE are often specific to the current job placement of the individual being assessed.
Doctors, insurance companies, departments of labor, and other entities utilize FCEs for a number of reasons, including job placements, analyzing an individual’s ability to return to work, evaluating the presence of a disability and treatment planning.
FCE Components - Interview and Clinical Evaluation
The FCE is comprised of four phases: the interview, clinical evaluation, functional evaluation and analysis and recommendations. During the interview phase, a nurse will meet with the individual to determine if any conditions or limitations exist that would prohibit the individual’s participation in the FCE, such as extreme high blood pressure or breathing limitations. Body systems evaluated during the clinical evaluation include: integumentary, cardiovascular, pulmonary, neuromuscular, and musculoskeletal. The therapist will also interview the client to assess the client’s perception of his own condition. In the clinical evaluation phase, the therapist will examine the client’s grip strength, coordination, balance, range of motion and sensation. Any physical limitations would be apparent at this point in the assessment.
FCE Components - Functional Examination and Analysis
During the functional examination sequence, the therapist asks the client to complete physical tasks, such as walking, lifting, and carrying items. These tasks are often specific to the individual’s current job placement. In the final phase of the evaluation, the therapist analyzes the individual’s performance, discusses her findings with the client, and makes recommendations related to the stated purpose of the examination.
Physical Demand Characteristic Levels
As part of the FCE, the therapist determines the level of physical job expectations the individual could reasonably meet. The physical demand levels are as follows: very heavy, heavy, medium, light and sedentary. Very heavy means the individual must exert over 20 pounds of force (in pushing, lifting, pulling, or carrying) constantly, over 50 pounds of force frequently, or over 100 pounds of force occasionally. Heavy demands include: exerting between 10 and 20 pounds of force constantly, 25 to 50 pounds often, or 50 to 100 pounds on occasion. Medium means using up to 10 pounds of force constantly, 10 to 25 pounds of force often, or 20 to 50 pounds on occasion. Light work requires using a negligible amount of force to move objects regularly, up to 10 pounds frequently, or up to 20 pounds on occasion. Sedentary jobs may require exerting up to 10 pounds of force to manipulate objects on occasion. These jobs involve sitting most of the time, but may require some walking or standing.
Once the FCE is completed, the examiner must list her findings, including the individual’s aerobic level, his physical demands characteristics strength level, how closely the individual’s abilities match or do not match the target occupation and his functional progress. Functional progress may include how well the client appears to be responding to treatment.
- Rhode Island Department of Labor: Functional Capacity Evaluations
- Disabled World: Functional Capacity Evaluation
- American Physical Therapy Association: GUIDELINES: Occupational Health Physical Therapy: Evaluating Functional Capacity
- Iowa Orthopaedic Journal: Functional Capacity Evaluation & Disability
- Matheson: What is a Functional Capacity Evaluation (FCE)?
- Photo Credit Massage therapist carrying out a Thai body massage. image by Deborah Benbrook from Fotolia.com