A Functional Capacity Evaluation (FCE) determines an individual’s ability to return to work and perform the tasks related to their occupation. The FCE process compares the individual's health status, and body functions and structures to the demands of the job and the work environment. FCEs are done on a one-on-one basis and take 4 to 6 hours to complete.
Who Can Benefit From an FCE?
- Someone who has been injured on the job to determine his or her ability to return to the job or alternate work
- Someone applying for Social Security Disability benefits
- Someone seeking to return to work or volunteer activities after an injury or illness
- Someone injured in a catastrophic accident (i.e., automobile accident) for whom an FCE can determine performance skills and abilities related to resuming former employment or a new job
- Someone seeking vocational rehabilitation services
- Students receiving transitional services from school to the work setting to determine their skills and the extent of support required to perform in a job
What is Determined by an FCE?
- Goals for rehabilitation or readiness for discharge planning
- Ability to safely return to work status (including full duty, modified duty, or transitional duty)
- Work ability status for vocational rehabilitation
- Workers' compensation case settlement
- Disability status
- Ability to meet job demands as part of a hiring process (pre-work/post-offer employment testing)
- Ability to meet the demands of other activities (i.e., being a student, volunteering)
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.
Rates can and do change based on geography and overall evaluation time. Precertification of the service and verification of the state fee schedule or reimbursement policy is advised.
“Functional Capacity Evaluation.” Aota.org, American Occupational Therapy Association , www.aota.org/about-occupational-therapy/professionals/wi/capacity-eval.aspx. Sept. 26, 2018.