What is a Functional Capacity Evaluation?

A functional capacity evaluation, or "FCE" is an assessment tool utilized for those who have suffered an injury that may affect employment. It is a standardized way to collect information regarding physical abilities to determine whether or not you can return to your previous job duties.

FCE's are commonly used with Job Demands Analysis (JDA). JDA's determine the physical demands of a specific occupation. Used together, FCE's and JDA's can determine your strengths, abilities, weaknesses and needs. It can establish the level of physical performance within your tolerance.

FCE's are normally conducted by physical therapists with special training and certification. They are typically used after a workman's compensation claim to determine if the injury sustained will inhibit your abilities to return to work.

Components of FCE's
Questionnaire. An in-depth questionnaire is used to determine other conditions and specific limitations you may have, whether directly or indirectly related to your job duties. It gives baseline pain values and a general idea of what types of activities exacerbate your pain.

Real and Simulated Work. FCE's utilize real and simulated workstations to evaluate your abilities. These stations are used to mimic the types of physical activities you may perform on-the-job. They also typically include other activities of daily living.

Workstations include anything from lifting, pushing/pulling, squatting with and without weights, overhead activities and endurance activities, such as maintaining a position for a specified length of time or walking for a specified distance, plus any other work-specific activities you may perform when at work.

Through these standardized tests, consistency effort measurements are taken to establish the level of work that can be performed. It can identify whether there is a need for special accommodations in order for you to return to work.

A typical FCE lasts several hours to a couple of days, depending on the scope of testing. It can measure strength, flexibility, balance, coordination, cardiovascular condition and body mechanics. Pain is documented through the use of a "0-10"pain scale, "0" being no pain, "10" being excruciating pain.

FCE Limitations
Typically, FCE's are performed one activity after another with only occasional, brief rest periods. It is a comprehensive, often exhausting expenditure of physical abilities. And, even though you may not have to climb under a car to change the oil or climb a ladder to install a light fixture overhead or pull a sled with gradually increasing weight, things such as these are also tested!

FCE's provide a standardized way of determining your abilities and your weaknesses. However, even though a pain scale is utilized, pain is highly subjective in nature. It is impossible to determine the amount of pain you may be experiencing. Take for example, a herniated or slipped disc. Two people experience the same injury, yet client "A" only experiences mild pain with certain activities, whereas client "B" experiences constant moderate pain with excruciating pain with activities. How can you tell which one is realistic? You can't!

Pain is a perceived sensation, and is different for everyone! You can't see pain - you can't feel someone else's pain, so you have to take their word for it. And, there's not much room for subjective complaints like pain in a standardized FCE! Only the sufferer knows how much pain they are in. Only the sufferer knows all of their limitations.

Yes, FCE's have their usefulness - the only way to really tell if you are ready to return to work is to try. FCE's provide a safe, supervised environment to test your abilities. Plus, you can gain invaluable information from the therapist regarding things like improper body mechanics that may increase the likelihood of future injuries. It also provides you with motivation to do your best.

But pain has very little to do with the test. And there is no documentation of the pain you may experience a few hours after such an intensive workout! Pain is not a sign of weakness - it's a sign that something is wrong. It is a very real condition, whether physical or psychological in nature. To be productive and safe in a work environment, you must be able to get a gripe on your pain, regardless of the outcome of the functional capacity evaluation.