A functional capacity evaluation (FCE) test is a broad assessment of an individual’s ability to perform work-related movements and/or tasks. It measures both capability and tolerance, including:

• Strength
• Endurance
• Speed
• Flexibility
• Physical effort

The American Occupational Therapy Association (AOTA) says a well-designed functional capacity evaluation includes a series of standardized assessments. Each assessment uses performance-based metrics to predict a person’s ability to perform specific demands. The exact components vary according to the nature of the person’s work. In recent years, some types of FCE tests have been expanded to measure cognitive ability.

There is no standard FCE test that is always used. That’s because each injured worker and their diagnosis are different. Dr. Joseph P. Chen studied FCE testing in chronic pain patients. It would be ideal, he says, if all tests could be measured against an established “gold standard.” But he admits much of medicine cannot be measured as such. The function of an individual is definitely not something that has a universal ‘gold standard.’”

The Five Pillars

For an FCE test, the evaluator chooses which testing methods to use. Nonetheless, to have value every test must meet five standards, or “pillars:”

1. Safety – you must conduct the test in a manner that will not harm the person.
2. Reliability – whatever methods you use, you must administer the test consistently. This ensures resultsare objective, fair, accurate and trustworthy
3. Validity – the test itself must be plausible and pertinent. It must reflectactual job-related tasks and movements.
4. Practicality–testing must be worth the investment of time and effort, for the worker and for your company.Overall, an FCE test typically takes 4 to 6 hours. Sometimes individual components are administered over two days rather than all in one day.
5. Utility – there must be a valid reason to gather the data.In workers’ comp cases, this means the test must be legally defensible.

How is it used?

Dr. Chen cites Matheson as a pioneer in functional capacity evaluation. Since Matheson’s original work in 1984, as many as 10 variations of FCE tests have been introduced. They all rely on scientifically-accepted evaluation methods and tools. Matheson’s FCE test uses the five pillars to answer three referral questions. The goal is to determine the individual’s ability to return to work safely.

Matheson’sthree questions are:

• What can the injured worker physically do right now? Do they have the physical tolerance to return to former job? Are they able to meet job-specific physical demands?
• What is the person’s potential for work?
• Did he/she “try their” best during the test? Workers may suffer from lingering pain or lack of confidencein their own recovery. They may exert less-than-full effort to avoid real or imagined physical consequences.

Test results will show if any gaps exist between job requirements and the person’s capabilities. If so, the individual:

• May need further rehab.
• Can return with restrictions or accommodations.
• Will not be able to return to their former job. Then the FCE test results are used to determine if the person is able to return to any job.

Physical therapists who specialize in treating injured workers are often called upon to conduct functional capability evaluations. They understand the correlation between physical demands testing and actual on-the-job performance. And they use a holistic approach that includes the worker, the job requirements and the actual working environment.

In our next blog article, we’ll examine why your company might want to conduct FCE tests.