The components of the FCE will vary based on the purpose of the assessment. The FCE typically begins with a client interview, medical record review, and musculoskeletal screening. Functional testing may include graded materialhandling activities such as lifting, carrying, pushing, and pulling; and positional tolerance activities such as sitting, standing, walking, balancing, reaching, stooping, kneeling, crouching, crawling, object handling/manipulation, fingering, hand grasping, and hand manipulation. Pain monitoring is frequently performed during the FCE to document client-reported levels of pain during various activities as well as to manage pain. The FCE may also include evaluation of an individual’s hand dexterity, hand coordination, endurance, and other job-specific functions.
The FCE report includes an overall physical demand level (U.S. Department of Labor, n.d.), a summary of jobspecific physical abilities, a summary of performance consistency and overall voluntary effort, job match information, adaptations to enhance performance, and treatment recommendations, if requested. Some FCEs are designed to also report on the worker’s ability to meet the cognitive demands of the job in question. FCEs are done on a one-on-one basis and may range in length from 4 to 6 hours. The FCE may take place over 2 consecutive days.
Referral and Payment for FCEs
People are generally referred for an FCE by physicians, physician assistants, and nurse practitioners; insurance representatives; case managers; employers, human resources personnel, and risk managers; attorneys (for either the plaintiff or defense); other therapists; or chiropractors. Individuals can also self-refer in states that allow direct access to occupational therapy services, but a referral may be required for reimbursement. FCEs are paid for by workers’ compensation insurance plans; self-insured plans; individual insurance plans; federal, state, and/or local agencies; managed care plans; individuals themselves, employers, or legal firms. Email drkerry@omahaintegratedrehab.com or call 402-502-1819 to schedule or ask questions about Functional Capacity Evaluations.
