FCE is also often referred to as a Work Capacity Evaluation and the terms can be used interchangeably. 

 

There is no consensus amongst clinicians and evaluators as to what is the best definition of a FCE. But generally it will be an assessment of your capacity to perform critical physical aspects of your work or of the primary role you had prior to your injury or illness. 

 

The FCE can also involve as assessment of your cognitive (or mental) capacity to perform the demands of your work. 

There is no one specific clinician that will be designated to conduct the FCE and the expertise of the clinician will be dependent of university training, post graduate training, and experience.

 

Most commonly an Occupational Therapist will conduct the functional capacity evaluation and are often times best trained to take a broader perspective of one’s capacity to function in a work environment. That is, the OT is trained to assess the individual’s capacity from a broader holistic perspective involving the bio/psycho/social approach to working rather than simply from a physical perspective.

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Simply designating oneself as a certified work capacity evaluator does not make one sufficiently trained to conduct a work capacity evaluator and there is nothing wrong with you exploring the qualifications of the individual assessing you.

There is no consensus and no peer review evidence that indicates a FCE should be any specific length, should involve any specific tests, or should be organized in any particular order. 

 

Commonly the assessment will be at least 4 to 6 hours. There are evaluators that will take 8 hours. However, there is no evidence available that shows a longer assessment is any more effective in determining capacity to return to work than a shorter assessment.

 

The history of the FCE and work capacity evaluating is an interesting one and goes back as far as the late 1800’s with the introduction of Occupational Therapy and sheltered work shops in the USA.  HYPERLINK "https://en.wikipedia.org/wiki/Functional_capacity_evaluation" https://en.wikipedia.org/wiki/Functional_capacity_evaluation 

The assessment is typically broken into sections similar to a typical work day and depends on the type of work you are expected to go back to.

 

Typically during the assessment there will be a clinical interview where the evaluator will gather a history of injury, how you are managing, and how it affects other aspects of your life, along with what treatment has been conducted.

 

The evaluator will take you through various tests that will involve your tolerance to perform activity such as standing, reaching, and bending. Your capacity for lifting, carrying, and/or pushing pulling may be tested. You may be asked to work in crouching and/or kneeling.

 

Various standardized tests such as the Minnesota Rate of Manipulation or non-standardized tests may be used. Standardized means that there is a specific testing procedure and this allows for the results to be compared to healthy populations or populations of the same age and gender. 

 

The end result is to gather a picture of your tolerance to perform the critical or important aspects of your work.

The assessment procedure should be structured such that the difficulty or physical demands of the testing are increased in a graduated (step wise) manner in order to keep you safe. Evaluators will not place you in a situation of being at risk for further injury. However, the point of the testing is to determine what you can do despite your pain. Therefore, even with increased pain you should be persisting with the tests to completion. This does not mean that you can complete the test the way you have been asked and you may need to alter how you complete the test.

 

Do not be afraid to ask questions if you have concerns. Your evaluator is there to ensure you are safety and to ensure that you understand the testing procedures. 

You should discuss your concerns about returning to work with the therapist. You should also discuss the return to work recommendation with your family physician or specialist. 

 

Prior to returning to work you should request a Functional/Work Capacity Evaluation in order to determine your capacity to perform the work but also to assist in setting any accommodations that you may need to return to work.

 

You can then discuss accommodations with your employer or human resource department.  Accommodations could include a graduated return to work (gradual increase in work hours) or light duties if available. 

 

Accommodations could also include possible ergonomic or assistive devices that may assist you in returning to work.

Often times the FCE and return to work planning will include the Occupational Therapist coming to your job site to assess the physical demands of the work and to explore with your employer/ supervisor / human resource department if accommodations to return to work are available.

 

Depending on the complexity of the work the the JSA will also assist in the FCE as the evaluator will have a better understanding of the demands of your work and how to bets assess your capacity to perform the work. 

 

Alternately the JSA can also be used as part of the FCE as you may already be back to work but struggling and experiencing increased pain. The Occupational Therapist can come to work and observe you performing your job in order to assessment the difficulties you are having in a real world situation.