A Functional Capacity Evaluation (FCE) is a comprehensive assessment designed to objectively measure an individual’s current physical abilities and limitations affecting work performance. This process uses a standardized series of tests to quantify what a person can safely do, moving beyond a clinical diagnosis to define functional ability. The primary purpose of an FCE is to determine a person’s maximum safe functional ability for work-related tasks. Conducted by trained physical or occupational therapists, the evaluation often plays a role in workers’ compensation, disability claims, or return-to-work planning.
The Role of Validity and Effort Scores
The FCE report begins with a section dedicated to assessing the consistency of effort and the overall reliability of the performance demonstrated during testing. This component addresses the evaluator’s confidence that the physical measurements recorded represent the individual’s true, safe maximum capacity, rather than a submaximal performance. The assessment of effort is important because the physical capacity findings are considered accurate only if the effort is determined to be consistent and maximal.
Evaluators use various methods to check for consistency of effort, often comparing results from different types of tests that should produce similar outcomes. A common technique involves comparing the maximum grip strength recorded during a single effort with the strength demonstrated during a rapid exchange grip test. If the results from these different testing methods are markedly inconsistent, the evaluation may be deemed unreliable or invalid, suggesting a submaximal effort was given.
Reports also include detailed behavioral observations of the individual, noting pain behaviors, willingness to participate, and any sudden, unexplained changes in performance. The evaluator records whether the person’s physical output and pain complaints align with objective measures and known medical conditions. A finding of “submaximal effort” or “inconsistent performance” means the therapist believes the person could have performed at higher levels than demonstrated.
When the effort is determined to be submaximal, the reported physical tolerances are not considered a true measure of the person’s capacity but rather a description of what they were willing to do on that day. This finding is typically presented early in the report because it frames the interpretation of all subsequent physical measurement data. A lack of consistent effort can significantly affect how the FCE results are used by referring parties in making return-to-work or disability determinations.
Decoding Physical Capacity Measurements
The core of the FCE report details the actual physical tolerances, quantifying what the person can safely perform across various work-related activities. These measurements are presented as maximum safe capacities demonstrated during the evaluation. The findings are often broken down into specific categories of frequency, based on the US Department of Labor’s guidelines, which define activity duration over an eight-hour workday.
These time designations include “occasional,” meaning the activity exists up to one-third of the workday (approximately 2.5 hours). “Frequent” describes an activity performed from one-third up to two-thirds of the workday (between 2.5 and 5.5 hours). “Constant” applies to activities performed for two-thirds or more of the day, typically exceeding 5.5 hours. The report applies these frequency modifiers to material handling and postural tolerances.
Lifting and carrying tolerances are measured for various heights, such as floor-to-waist, waist-to-shoulder, and overhead. The maximum safe weight is recorded for occasional, frequent, and sometimes constant exertion. For example, the report might state the person can “occasionally lift 50 pounds” and ” frequentemente lift 25 pounds,” with the frequent capacity often estimated as 50% to 60% of the occasional capacity.
Postural tolerances detail the maximum safe duration for positions like sitting, standing, and walking, as well as the frequency of movements like bending, squatting, kneeling, and reaching. Fine motor skills are also assessed, providing measurements for handling (gross manipulation), fingering (fine manipulation), and feeling (tactile discrimination). These measurements provide a profile of the person’s functional abilities, which is essential for determining their match to specific job requirements.
Applying FCE Results to Functional Job Descriptions
The final section of the FCE report synthesizes the raw physical measurements into a practical conclusion by matching the individual’s capacity to standardized work categories. This uses the US Department of Labor’s standardized work classification system, defined by the maximum weight required to be lifted or carried and the frequency of that exertion. The system includes:
- Sedentary
- Light
- Medium
- Heavy
- Very Heavy
The therapist compares the individual’s demonstrated maximum safe capacities to these established standards to determine the highest overall work level they can safely sustain. This determined work level provides a concise summary of the person’s general physical capacity.
For instance, Light work requires occasionally lifting up to 20 pounds and frequently lifting up to 10 pounds. Medium work involves occasionally lifting up to 50 pounds and frequently lifting up to 25 pounds.
If the FCE was ordered with a specific job description, the report includes a job demands match analysis. This is a direct comparison of the person’s functional capacity against the requirements of their previous job. This analysis highlights discrepancies between the job’s essential functions and the person’s current physical limitations, noting tasks that would require modification or accommodation.
The report concludes with specific return-to-work recommendations, such as whether the individual can return to full duty, modified duty, or is currently unable to perform the job’s essential functions. This information guides the treating physician, employer, and insurance company in making decisions about return-to-work status and any necessary accommodations.