Functional Capacity Evaluation (FCE)
The Worker Assessment and Rehabilitation Center (WARC) of Community Memorial Hospital uses the WorkWell Systems Functional Capacity Evaluation (FCE), an objective musculoskeletal-oriented assessment. It is based on internationally accepted principles used by physical and occupational therapists for identification of abilities and limitations of an injured worker. Features of this particular FCE include:
- Measures the maximum objective strength of an individual
- Determines a worker’s tolerance levels to specific activities
- Offers safety procedures that prevent injuries during the testing situation
- Includes 29 critical job tasks from worker’s compensation and the Department of Labor’s Dictionary of Occupational Titles
- Describes those tasks that a worker could perform in an eight-hour day
- Links functional deficiencies with physical causes
- Identifies the difference between sub-maximum and maximum efforts to rate cooperation and consistency
- Provides a very specific and objective report that includes observations, conclusions and recommendations
- Emphasis on return to work physical abilities explained in clear, objective language
About the Evaluation
The FCE is performed by a physical or occupational therapist, and begins with a full body musculoskeletal assessment to determine gross muscle strength and flexibility. FCEs involve the worker in various activities that simulate physical demands at work. Through the evaluation, the therapists will define the worker’s ability to perform activities such as lifting, carrying, pushing, pulling, bending, squatting, standing, sitting, reaching, grasping, etc. Whenever a job target is identified, the therapist can match the worker’s abilities to specific job tasks, if information detailing the job’s physical demands is provided.
The WorkWell Systems FCE is conducted over one to two half-days. The length of the evaluation is determined based on the situation, how the results will be used, and the diagnosis. A two-day FCE provides an opportunity to see how the individual responded to the first day of testing and to follow-up with some consistency measures on day two. To maximize the FCE for job-matching purposes, it is often combined with a job analysis or ergonomics consultation by the evaluating therapist. Not only does this enhance the therapist’s ability to match functional tolerances with job demands, but also allows for input on job modifications. Most workstation modifications are minor and can improve the job for the non-injured population as well as for the injured worker.
How it is Done
A physician order is required. A referral screening is conducted to identify possible contraindications or restrictions for the evaluation. If identified, these would be clarified prior to the evaluation. Workers are carefully monitored throughout testing. Therapists monitor posture, observable signs of muscular effort and heart rate.
The following is used to conduct the assessment: hand coordination set; adjustable shelving unit; weight carry equipment (tool boxes, crates), weight sled, heart rate monitor, hand-grasp dynamometer, push-pull force dynamometer, weights, ladder, boards, blood pressure cuff and stethoscope and job simulation materials and equipment.
In order to perform the assessment, a referral should be forwarded to the center from an employer or physician with the following information: pertinent medical information, job demands information, specific referral questions or stated reason for referral and physician’s order. Orders should include: diagnosis, contraindications or restrictions for testing, or approval to test to maximum tolerances.
WorkWell Systems conducts outcomes studies from information submitted nationally by certified providers, such as the WARC. The FCE studies have demonstrated the following benefits:
- High return to work rate, even in chronic cases
- Worker agreement with the results
- A differentiation between pain and function
- Strong medical evidence to give physicians clear information
- Empowerment of the worker to return to work
- Significant cost savings in medical costs and indemnity