Know Two Types of Functional Capacity Evaluations (FCE) January 26,2011 by Rebecca Shafer, 0. |=] 9 Comments When a physician is treating an employee fora back injury or other job related injury, tne decision on when to ‘Tetum the injured employee to work is often a subjective decision, The physician whois unsure of the employees physical capability wl often tum to the physical therapist for an objective opinion ofthe ‘employees abilty for work. The physical therapist will provide a Functional Capacity Evaluation (FCE) by ‘aoministering various tets to determine the employee's functional capacities and limtations The FCE isa comprehensive examination and evaluation by the physical therapist that objectively measures the employees level o functioning, The testing will document the employees ably or the lack of ability, to perform the essential ob related task over a spectfic time frame. The FCE will provide objective information to the physician in several areas: (WCxt) 4. theemeloyee's functonalaities and joo demands the asabity evauaton when to etum the employee to work ‘whether ornate employee can return to tre ob held prior to the injury the employee's tunctonalacitiesanay tom te job {oinformaton to design a renabittaton pla, i needed ‘he need for other medical intervention andlor treetment While most workers compensation adjusters and employers wil look at a FCE 2s a way of proving the employee is able to retum to work it serves @ much greater function. The resuts ofthe FCE wil often lit the disability rating of the employee, preventing the physician from assigning a higher dsabilty rating than is {ustfied. Furermore, the FC wil determine physical imitations the employer wil need to know to modity the employee's job, preventing a needless re-njury of the same body part. ‘There are two types of FCE, the Job Speci FCE and the General Purpose FCE. The Job Specific FCE. measures the employees abilty to perform the task and physical demands of a specif job. Itcan be performed atthe physical therapists clinic, but the physical therapists can go withthe employee to the actual {ob ste and evaluate the employee's abily to Co the essential task ofthe employees job. The job spectic FCE will cetermine i tie employee can safely do his prt job or modifications ofthe required work are needed,‘The Gonoral Purpose FCE ic normaly used ven thero ie no longar aj forthe empleyee to retum to or \Wnen the Joo unctions nave not ogen determines. The General Puppose FCE conssts ofa group of slancardzed test and measurements that can be used to estabish the employees overall physical capabilias. The results of the General Pursose FCE can be used to evaluate the employees aoity to jerorm specife jobs that may come avalaal te the emeloyee. Prior to starting the FCE, the physica therapist will review the medica records ofthe employee to termine the medical status othe employee. The physical terapist wil estabish 2 baseline for he ‘employee based cn the known job denancs. The job cemands ofthe employee wil be characterized per the US Department of Lators “Selected Cnaractaristies of Ozcupations as Defined in the Revised Dictionary of (Cccupationa Tees” as: 41. sedentary exerting up to 10 pounds of force occasionally, 2. light exerting uo to 20 pounds of force occasionally cr un to 10 rounds of force frequently 2. medium — exerting 20 to £0 pounds of force occasionally or 10 to 25 pound of force frequently 4. heavy exerting £0 to 100 pounds of force ovcasionally of 25 to £0 pounds of force frequently very heavy ~ exerting in excess of 100 pounds of force oscasionaly oF in excess of 80 pounds cf free ‘requenily orn excess of 20 pounds of force constantly ‘Both te Jcb Spesifis FCE arc the General Pursose FCE measure the employee's ably to perform varus ‘motions, movements and sls The abilty to co the accomplish the physical ¢emands ofthe job will be measured in these areas: 1. Balancing Carying cimang Crawing 2 Crouching Farvision Feeling Finger dexterity 2. Fingering Handing Hearing Knecing 4 ting Manual dextenty Motor coordination Near vision 5. Puling Pushing Reaching sting & Standing ——_Stooping Taking waking ‘Again, using the US Department of Labor guicelines, the emoloyee's tolerance level during an eight hour Work cay for the anove actvtias is categories as:{Not Present (Never) - The activity does not exist in the job (examole: Crawling cauld be classified as Not Present inte job) 2 Oscasionaly- The activity exists less than 1/3 of the time (example: Climbing - occasionally) 3. Frequerty ~The acy exists rom ‘13 to 2/3 of te time (example: Caring ~ frequently) 4, Constant - The actvty exists 25 or more ofthe time (example: Walking - constantly) When performing the FCE, the physical therapists responsible for ensuring the test are appropriate forthe employee and the test can be done safely. The physical therapist wil reve the musculoskelota condtion of the employee as reporied by the beating physician. The physical therapist will screen the employee for any ‘underying mecical pathology that would mit or prohibit tne employee from participating in the FCE. (WexKitz) Upon completion of the FCE, the physical trerapist will document tne evaluation resuts. The FCE report wil confrm the employee can return to work wehout joo modificatons, or will conf te empoyee can return work with spec fic job mocifications. orthe need to delay the employge's retum to work The FCE may also address the need for work hardening or other interventions that would imgrove the employee's physical ables. Properly utized, a FCE can provide te treatng physician the necessary information fo retum the employee batk to work.