Insight

Functional Capacity Evaluations: Issues and Concerns

The shorter actual testing time may make the FCE less reliable and allow for challenging its validity.

Functional Capacity Evaluations
Glen D. Wieland

Glen D. Wieland

December 13, 2017 11:27 AM

Functional capacity evaluations (also known as FCEs) are being used more and more in an attempt to better define work restrictions and limitations for injured workers. When I first started practicing law in 1982, many functional capacity evaluations were done over three days where the injured worker spent eight hours per day performing a variety of tasks. After three days of performing a variety of typical day to day work tasks, the evaluator was able to document how the person was likely to perform in an actual work setting. Today, the evaluations are done in about four hours with at least one hour of interview between the patient and the physical therapist.

The shorter actual testing time may make the FCE less reliable and allow for challenging its validity.[1]

Some doctors are hesitant to state what restrictions and limitations should be assigned and want to simply follow the recommendations of a “therapist” who has performed some type of series of timed tasks performed by the injured worker. Most doctors do not participate in the evaluation, and rarely do they ever see the patient going through the FCE or know the specific tasks or time spent on each task. They rarely understand how much time is spent on the individual tasks and the formula utilized to extrapolate that into a 40-hour five-day workweek.

The American Physical Therapy Association has created standards for measurement and documentation. Not all rehabilitation facilities that perform functional capacity evaluations use the same measurements and criteria. Many are not CARF (Commission on Accreditation of Rehabilitation Facilities) certified.

An FCE administered over a two- or even three-day period will provide much better indicators as to what a person can do in a true work environment. Some evaluations have been done in one to two hours, with some of that time being an interview with the injured worker. Simply having someone perform a function for 20 minutes and then saying that the person can do that for eight hours per day, five days per week is a stretch and a guess. The attempt to extrapolate data from a one to two hour assessment to an eight-hour workday creates major errors in the design of the FCE.[2]

The reliability and validity of the test that is administered over a two-day period provides the most reliable format. It allows for retesting for accuracy and for assessing the person’s abilities on day two after they worked their body on day one, and allows the examiner to determine the effect of the day one testing on the body.[3]

The National Institute for Occupational Safety and Health determined that continuous eight hour expenditures should not exceed 33 percent of a worker’s aerobic capacity.[4]

Neither employers nor injured workers should simply accept the FCE at its face value. Question it and its validity and reliability. If someone returns to work too soon and the FCE was wrong, there could be a re-injury and a worsening of the condition. There are risks for the employers and the workers, and a thorough FCE can be helpful, but it must be done properly.

----------------------

[1] Lechner DE, Roth D, Straaton K. Functional capacity evaluation in work disability. Work. 1991;1:37–47; Isernhagen SJ, Advancements in functional capacity evaluation. In D’Orazio BP, ed Back Pain Rehabilitation. Boston Mass: Butterworth: 1993: 180–204.

[2] Abdel-Moty E, Fishbain D, Khali T, et al. Functional Capacity and residual functional capacity and their utility in measuring work capacity. Clin J Pain 1993;9:168–173

[3] Isernhagen SJ, Work Injury Management and Prevention. Gaithersberg, Md: Aspen Publishers Inc. 1988; Advancements in functional capacity evaluation. In D’Orazio BP, ed Back Pain Rehabilitation. Boston Mass: Butterworth: 1993: 180–204.

[4] Work Practices Guide for Manual Lifting. Washington, D.C.: National Institute for Occupational Safety and Health, Astrand I, Rohahl, K. Textbook of Work Physiology. New York, NY: McGraw-Hill; 1970.

----------------------

Glen Wieland is a partner in Wieland, Hilado & DeLattre, P.A. He is past-president of Florida Workers’ Advocates, past-chair of Workers’ Compensation Section of the AFTL, executive council of Workers’ Compensation Section of the Florida Bar, statewide Workers’ Compensation Fraud Task Force, and past-chair of O.A.T.H.

Related Articles

Announcing the 2022 Best Lawyers: The Employment Law Issue


by Best Lawyers

Featuring the top legal talent from The Best Lawyers in America, Best Lawyers: Ones to Watch in America and “Lawyer of the Year” recipients for Labor and Employment Law, Workers’ Compensation Law, ERISA Law and Ethics and Professional Responsibility Law.

Best Lawyers Employment Law Publication

One Reason Why Uber Is Fighting to Classify Drivers as Contractors


by Stephen Hasner

How Workers' Compensation Is Setting Up a Legal Battle

 Why Uber Wants Drivers as Contractors

Teamwork and Strategy


by Justin Smulison

In 2018, Block O'Toole & Murphy continued to secure multimillion-dollar results for injured victims and workers.

Block O'Toole & Murphy Gets Results

Pennsylvania Supreme Court Issues Landmark Workers’ Compensation Decision


by Dave Brown

The claimants’ workers’ compensation bar in Pennsylvania scored a significant victory when the state’s high court issued its decision in Protz v. WCAB.

Pennsylvania Workers' Comp

The Workers’ Compensation System as a Prescription for Addiction


by Karen Gail Treece

While estimates vary, it is believed that the top 5 percent of opioid users likely account for more than half of total opioid use.

Prescription for Addiction

Colorado Broadens Scope of Workers’ Comp, but There’s More to Be Done


by Nick Fogel

When the law goes into effect in July, Colorado will join 32 other states in allowing PTSD claims for first responders without a physical component to the claim.

Colorado Workers' Compensation

Key Minnesota Workers’ Compensation Cases of 2017


by Thomas P. Kieselbach

A rundown of important workers' compensation cases in Minnesota over the past year.

Minnesota Workers' Compensation

Trending Articles

How Palworld Is Testing the Limits of Nintendo’s Legal Power


by Gregory Sirico

Many are calling the new game Palworld “Pokémon GO with guns,” noting the games striking similarities. Experts speculate how Nintendo could take legal action.

Animated figures with guns stand on top of creatures

Announcing the 2023 The Best Lawyers in America Honorees


by Best Lawyers

Only the top 5.3% of all practicing lawyers in the U.S. were selected by their peers for inclusion in the 29th edition of The Best Lawyers in America®.

Gold strings and dots connecting to form US map

The U.S. Best Lawyers Voting Season Is Open


by Best Lawyers

The voting season for the 31st edition of The Best Lawyers in America® and the 5th edition of Best Lawyers: Ones to Watch® in America is officially underway, and we are offering some helpful advice to this year’s voters.

Golden figures of people standing on blue surface connected by white lines

Announcing the 2022 Best Lawyers® in the United States


by Best Lawyers

The results include an elite field of top lawyers listed in the 28th Edition of The Best Lawyers in America® and in the 2nd Edition of Best Lawyers: Ones to Watch in America for 2022.

2022 Best Lawyers Listings for United States

How To Find A Pro Bono Lawyer


by Best Lawyers

Best Lawyers dives into the vital role pro bono lawyers play in ensuring access to justice for all and the transformative impact they have on communities.

Hands joined around a table with phone, paper, pen and glasses

What the Courts Say About Recording in the Classroom


by Christina Henagen Peer and Peter Zawadski

Students and parents are increasingly asking to use audio devices to record what's being said in the classroom. But is it legal? A recent ruling offer gives the answer to a question confusing parents and administrators alike.

Is It Legal for Students to Record Teachers?

2021 Best Lawyers: The Global Issue


by Best Lawyers

The 2021 Global Issue features top legal talent from the most recent editions of Best Lawyers and Best Lawyers: Ones to Watch worldwide.

2021 Best Lawyers: The Global Issue

Best Lawyers: Ones to Watch in America for 2023


by Best Lawyers

The third edition of Best Lawyers: Ones to Watch in America™ highlights the legal talent of lawyers who have been in practice less than 10 years.

Three arrows made of lines and dots on blue background

The Upcycle Conundrum


by Karen Kreider Gaunt

Laudable or litigious? What you need to know about potential copyright and trademark infringement when repurposing products.

Repurposed Products and Copyright Infringemen

The Best Lawyers in Australia™ 2024 Launch


by Best Lawyers

Best Lawyers is excited to announce The Best Lawyers in Australia™ for 2023, including the top lawyers and law firms from Australia.

Australian Parliament beside water at sunset

Best Lawyers Voting Is Now Open


by Best Lawyers

Voting has begun in several countries across the globe, including the United States, the United Kingdom and Europe. Below we offer dates, details and answers to voting-related questions to assist with the voting process.

Hands holding smartphone with five stars above phone

Inflation Escalation


by Ashley S. Wagner

Inflation and rising costs are at the forefront of everyone’s mind as we enter 2023. The current volatile market makes it more important than ever to understand the rent escalation clauses in current and future commercial lease agreements.

Suited figure in front of rising market and inflated balloon

Wage and Overtime Laws for Truck Drivers


by Greg Mansell

For truck drivers nationwide, underpayment and overtime violations are just the beginning of a long list of problems. Below we explore the wages you are entitled to but may not be receiving.

Truck Driver Wage and Overtime Laws in the US

A Celebration of Excellence: The Best Lawyers in Canada 2024 Awards


by Best Lawyers

As we embark on the 18th edition of The Best Lawyers in Canada™, we are excited to highlight excellence and top legal talent across the country.

Abstract image of red and white Canada flag in triangles

Presenting the 2024 Best Lawyers Family Law Legal Guide


by Best Lawyers

The 2024 Best Lawyers Family Law Legal Guide is now live and includes recognitions for all Best Lawyers family law awards. Read below and explore the legal guide.

Man entering home and hugging two children in doorway

Announcing the 2023 The Best Lawyers in Canada Honorees


by Best Lawyers

The Best Lawyers in Canada™ is entering its 17th edition for 2023. We highlight the elite lawyers awarded this year.

Red map of Canada with white lines and dots