What to Expect in a Functional Capacity Evaluation

What to Expect in a Functional Capacity Evaluation

Functional Capacity Evaluations (FCEs), otherwise known as Functional Abilities Evaluations (FAEs), are conducted by various healthcare providers. They provide objective information about an individual’s ability to perform work tasks and activities of daily living.

Insurance companies frequently use FCEs in the evaluation of long-term disability claims.

An FCE may include a wide range of activities to test the limits of the claimant’s physical abilities in relation to their occupation. Activities such as lifting, pushing and pulling, repetitive tasks for the upper extremities, precision tasks such as finger dexterity; and postural tolerances such as sitting, standing and walking are just some of the functions that a claimant may be expected to perform.

The duration of an FCE can range from two hours to two days. Once completed, a comprehensive report is produced outlining the claimant’s ability to perform the essential duties of their occupation in a safe way on a regular basis and may include a recommendation of temporary or permanent leave from work, further rehabilitation or a graduated return to work to their current occupation or another more suitable occupation. The report will also include ergonomic equipment requirements and work modifications that may facilitate a return to work.

Are FCEs a reliable way to measure a claimant’s ability to work? When you consider that there are numerous factors in play that could skew the results of evaluation, such as the Occupational Therapist’s experience, the severity of the claimant’s symptoms on that particular day, and most importantly, who is paying the bill for the evaluation (i.e. the insurance company), it might be argued that FCEs may not be the most objective way to measure a claimant’s ability to perform the essential duties of their occupation on a regular basis.

Nevertheless, insurance companies rely upon FCEs when evaluating claims for long-term disability benefits, as do the lawyers who represent the claimants when they have been denied their benefits. In many cases, lawyers will send their clients to FCEs to get a second opinion in response to the insurance company’s FCE report.

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