Here’s What You Can Expect From Your Functional Capacity Evaluation
Registered nurses, truck drivers, retail workers, and general laborers are amongst the top ten most likely to be hurt on the job and require workman’s comp to heal from their injuries.
But workplace injuries are common no matter the profession. So anyone can find themselves dealing with a workers’ compensation claim sometimes in their life due to back injuries, slip-and-fall accidents, or other incidents that cause injuries on the job.
In 2020, there were 1.2 million nonfatal workplace injuries and illnesses in the United States. If you were injured in the workplace, you must know that you have the right to adequate compensation.
Your insurance company may not cover all of your injury costs. To make up for the difference, you can file a claim to receive wage loss benefits and medical care cost benefits to supplement.
But what if your injury impacts your functional abilities and prohibits you from meeting the physical demands of your specific job? What if these impairments carry over into your day-to-day life?
If you require long-term disability benefits, you may be required by your insurance company to take a functional capacity evaluation or FCE test.
An FCE test is critical to the workers’ compensation claims process. So what does it involve, and what do you need to know before you complete one? Let’s find out.
What Is an FCE Test?
An FCE test is a functional capacity evaluation taken by the injured employee in a workers’ compensation case. This evaluation is typically ordered by the physician who is seeing the patient.
An FCE could also be ordered by an insurance adjuster, lawyer, or employer. Here are a few things you should know before completing an FCE test, as well as what happens if you have failed an FCE test.
Who Needs A Functional Capacity Evaluation?
Anyone who has filed a workers’ compensation claim can be subject to an FCE test. A physician usually orders the test, but it can be requested by your insurance company, lawyer, or employers.
It’s used as a baseline to gauge the worker’s ability to meet the demands of the job. You can choose to refuse a CFE exam, but there are consequences. Refusing to take a functional capacity evaluation will be noted by your case manager, and the test administrator will record the exact words you used when refusing.
If you have a high possibility of re-injury, your healthcare provider may recommend an FCE before you return to your job duties.
Why Do I Need to Do an FCE Test?
If you have been injured on the job and must undergo physical therapy or require the services of an occupational therapist to heal, you may need to complete an FCE test.
An FCE test evaluates your physical abilities to see if there might be any limitations to you being able to perform the job you had before your injury.
From the test results, your physician, or the healthcare professional evaluating you, can determine whether you can end physical therapy completely and go back to work. They will submit an FCE report to the party that requested the test and your case manager.
Depending on how you do on your FCE test, you might have permanent restrictions on work performance or be deemed unable to return to your previous position.
An FCE test is typically completed at the end of the physical therapy or occupational therapy process. However, you could also complete it any time you are ordered to be released from care.
An injured worker could also take an FCE test if they have not completed physical therapy.
What Happens During an FCE Test?
An FCE test happens at a medical facility, such as a physical therapy center, and will be completed by the certified healthcare provider who received the referral.
This could be a physical therapist, physician, or athletic trainer. The test takes about two to three hours. Always wear comfortable clothes that do not restrict movement. You’ll also need your medications and mobility devices, such as a brace.
When you arrive, the clinician will know your job, required duties, and injury diagnosis. They will also know about any physical therapy you received.
During the test, the physician will test several elements of your physical strength necessary to perform your job, including the following:
- Functional Testing: You will undergo physical tests that involve pulling, pushing, lifting, and carrying materials.
- Dexterity: The healthcare professional will test your physical capacity for actions such as squatting, walking, kneeling, reaching, standing, balancing, crawling, bending, sitting
- Injury Testing: The doctor will measure your muscle strength and range of motion in the areas affected by your injuries compared to your previous physical condition reported in your medical records.
If you feel fatigued or cannot complete the required test, simply communicate that to the clinicians at any time. The testing physician will note this in the final FCE report and any observations of pain, discomfort, or struggle during the test.
Your case manager will add all information to your workman’s comp case file. This includes anything you say during the appointment and any observations the testing physician makes.
What To Know Before Taking Your FCE Test
Whether you are taking the FCE to obtain disability benefits or looking to return to your duties, you must be prepared for the exam. You’ll want to be sure to answer every question asked of you and provide the most accurate information possible.
Here are some ways you can prepare for your FCE test.
Learn What Information The Employer’s Insurance Company Provided
The insurance company representing your employer will have a claims adjuster write a letter to the FCE physician.
This letter may describe your injuries or details of the treatments you have received or are currently receiving.
Before going through the exam, you must know exactly what this letter contains. Ask to review the letter and address any discrepancies during your exam.
Request a hard copy of the letter and send a copy to your workman’s comp case manager.
Review Your Medical Records
The doctor administering your FCE test will be familiar with your medical records related to your claim. This may include information about any previous injuries you sustained in the same area.
Be prepared to answer questions about any other injuries you’ve experienced. Always be honest, and never try to hide or downplay them.
Highlight any differences between your previous injuries and your current condition.
Find Out What Questions You Can Expect From The Examiner
Your employer’s insurance company will have requested specific information. You must learn the questions they’d like answered so you can be prepared.
This information will be in the letter you requested from the insurance company. Be fully prepared to answer each question.
Make A List Of Current Symptoms
During your CFE exam, you must be clear about your current pain levels and symptoms. It may help to make a list of the main areas affected by your injury, additional symptoms, and any limitations you’re experiencing.
These limitations could include the inability to do simple daily tasks like grooming, walking, or preparing meals.
If you’re experiencing referred pain or pain in other areas due to your injury, you must also mention that. Add it to your list even if it seems like a minor symptom.
Review The Accident To Ensure Your Account Is Consistent With Records
You’ll have to recount specific details about your injury and the accident itself. It’s essential to be clear that the accident was related to your job.
The doctor may be looking for discrepancies or inconsistencies in your story to include in the report. Be sure all of your answers are consistent and concise.
Don’t overelaborate or talk for long periods. This can affect the outcome of your claim.
Once you feel prepared and have reviewed all
What To Do During Your FCE Exam
On the day of your exam, you must conduct yourself appropriately. Don’t be nervous and consider the tone of your voice when speaking to the doctor.
Plan to arrive at least 10 minutes early for your appointment. You could miss the appointment and delay your overall claim if you’re late. It will also reflect poorly on you.
Here’s what you can do to ensure the appointment goes smoothly.
- Always act as though you are being observed. Your doctor is evaluating you to ensure your workers’ compensation claims are accurate, so you should always honestly display your symptoms. If you claim that you cannot walk without limping but take painkillers that allow you to walk briskly into the doctor’s office, your claim might be in trouble.
- Be honest during the examination. Part of the results of your FCE test have to do with whether the examiner believes you were making a genuine effort during your test. They look for specific signs that you are exaggerating your pain levels.
- Avoid taking pain medication before the exam. Pain medication helps you function even when you’re dealing with debilitating injuries. However, even over-the-counter pain medication, like acetaminophen and ibuprofen, could minimize the effects of your injury. This will cause the examiner to think you feel better than you actually do.
- Wear loose, comfortable clothing. The examination requires that you perform physical tasks for at least a couple of hours, so make sure you wear clothes that won’t prevent you from moving freely.
If you follow these tips during your appointment, the clinicians can accurately assess your physical activity. This will give you a better chance of securing social security disability or a favorable workmen’s compensation claim.
What If I Failed My FCE Test?
Once the test is over, your results will be compiled by the examination team and sent to your doctor. They then can approve the results and the recommendations for working restrictions.
Be sure to review these restrictions thoroughly to understand exactly what is expected of you when you return to work. If there’s anything you’re unsure about, don’t be afraid to ask your doctor.
You might think you’ve “failed” your FCE test if the examiner determines that you cannot perform tasks essential to the work you did before your injury.
The examination report might have such stringent restrictions that you won’t be able to go back to work at all and will have to file for total disability.
But your case isn’t over even if you’ve received results like this. You still have the option to appeal the examination results. This might mean that you must take the examination all over again or consult a workers’ compensation attorney for help.
How to Fight FCE Test Results
If you’re unhappy with the results of your FCE test, there is no need to feel at a loss for what to do next.
The work comp lawyers at Shook & Stone will work with you to ensure you completely understand the options available after receiving your FCE results.
Each situation is unique, and our team can help worker’s compensation claimants to challenge a failed FCE test, fight for ongoing wage loss benefits, and find an employment situation that works best for your post-injury lifestyle.
Contact the attorneys at Shook & Stone to better understand the results of your FCE test. Call us at (702) 570-0000 or contact us online for a free case review.
Bureau Of Labor Statistics . (2021, November 3). Employer-Reported Workplace Injuries And Illnesses-2020 . In BLS.gov. Retrieved from https://www.bls.gov/news.release/pdf/osh.pdf
Facts+Statistics: Workplace Safety/Worker’s Comp. (2022). In Insurance Information Institute . Retrieved from https://www.iii.org/fact-statistic/facts-statistics-workplace-safety-workers-comp
An FCE test can cost between $500 and $2000, depending on the test type and testing institution.
While there are many different FCE tests, the two main ones are mental functional capacity evaluation (MFCE) and physical functional capacity evaluation (PFCE).
A functional capacity test can last between 2-6 hours. The doctor may break it up over two consecutive days.