How to Evaluate a Functional Capacity Exam

The functional capacity exam (FCE) is a comprehensive evaluation performed by a qualified health care professional to determine a person's physical abilities as they relate to work. The FCE is sometimes administered pre-employment to assess an applicant's ability to perform required physical demands. It is also commonly used to test an injured worker's functional capabilities after medical treatment is completed. There are several components that should be included in an FCE and the quality of the FCE is judged in these areas.

Instructions

• 1

  Assess the objectivity of the FCE. Personal opinions about the patient should not be included, however specific patient behaviors should be described in the document. For example: "Mr. Jones did not try his hardest during this evaluation" should be replaced with "Mr. Jones demonstrated inconsistent performance during the evaluation. Grip strength measurement of 5 lbs. does not correlate with his observed ability to lift his jacket with his left hand." Statements about the patient's performance need to be accompanied by objective measurements, particularly if the document is used in court.

• 2

  Review the tests used to measure the patient's abilities during the FCE. Standardized testing should be used whenever possible to demonstrate how the patient performs compared to his peers, using the normative data that accompanies the test. Standardized tests scores are then used to determine the patient's "real-world" functional abilities. For example, the standardized Jamar dynamometer grip test results should correlate with the patient's ability to grip before, after and during other aspects of the FCE.

• 3

  Review the tasks that were assessed during the FCE to the patient's job requirements. Box lift-testing should be performed for any patient whose job includes lifting, regardless of the part of the body that was injured. On the other hand, a patient with a knee injury who has a sedentary desk job does not need to complete fine motor speed testing as part of his FCE.

• 4

  Look for consistency of effort testing, which assesses whether the patient is putting forth full effort during the FCE. A coefficient of variance (COV) is calculated based on the patient's scores in each test. In general, a COV of 15 percent or less is considered good effort. If a patient's functional abilities are significantly limited by an injury but they are putting forth full effort, they will still demonstrate good consistency despite low test scores.