When Functional Capacity Evaluations (FCE) Should be Used over Independent Medical Examinations

A Functional Capacity Evaluation (FCE) measures the actual physical capabilities of a patient after an illness or injury. This differs from Independent Medical Evaluations which are a series of tests that estimate a patient’s capabilities. In certain cases directly measuring a patient’s capabilities is of utmost importance. These instances call for the focus of an FCE.

The Process of a Functional Capacity Evaluation

A Physician completing an FCE or IME                An FCE is usually performed by a physician or team of physicians over a two day period in which a series of functional tests takes place. These tests may measure any or all of the following capabilities:

  • Ability to repetitively lift various amounts of weight to various heights
  • Capacities to repetitively push, pull, or carry various weights
  • Strength of grip
  • Tolerance of elevated levels of work
  • Repetitive squats
  • Tolerance to sit or stand for long periods of time
  • Capacity for walking stairs or climbing a step ladder
  • Hand-Eye Coordination
  • Balance

A patient’s performance of these capabilities strongly affects the physician’s determination of whether the patient is able to perform the necessary duties of a job. The results of an FCE may also be used to determine a patient’s work status. This is usually split into three conditions: fully functional, impaired, or disabled. With serious implications for an impaired or disabled determination, it is important to have the most accurate information to make the correct decision.

Benefits of Functional Capacity Evaluations

Because the physician performing an FCE measures the physical capabilities of a patient, the test measures actual physical functions or limitations rather than estimations produced by other examinations including Independent Medical Examinations. Physicians have a wide range of uses for the information collected from an FCE:

  • Develop a treatment plan
  • Measure a patient’s functional capacity preceding and following a rehabilitation program
  • Determine a patient’s Maximum Medical Improvement
  • Justify making modifications to a treatment plan
  • Decide if a patient is able to work
  • Decide when a patient is able to return to work

All of these depend heavily on the information gathered from an FCE. Once a physician directly measures the capabilities of a patient he or she may accurately decide on the next step of the treatment process.

How a Functional Capacity Evaluation Betters an Independent Medical Examination

Just about every aspect of an IME depends on a Functional Capacity Evaluation. Six out of the eight elements of an IME depend on the results of an FCE. These include:

  • Maximum Medical Improvement
  • Identification of Work Restrictions or Limitations
  • Need for Alternate Treatment
  • Medical Necessity of Care and Reasonableness of Current Treatment
  • Fitness for Duty or Return to Work Status
  • Disability Status

All of these elements depend fully on the physical capabilities of the patient. Although inferences can be made by a physician conducting an IME, it is important for the safety of the patient and the accuracy of the examination for the physician to have the most accurate information possible to make the correct decision regarding a patient’s health.

                There are many benefits to performing an FCE. Most importantly, the FCE provides actual concrete information to physicians pertaining to the patient’s working capacities. This provides the best chance for a physician to make the correct determination in regards to physical impairments. By providing this information, the FCE is a great support tool for physicians performing an IME. This will provide the whole picture for physicians and ultimately improve the medical care that they can provide.

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Gilbert is an accomplished academic who has a deep desire to learn and a passion for sharing his knowledge with others. He loves to spend his evenings curled up with a good book and a glazed cherry doughnut.

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