What Does a Functional Capacity or Functional Ability Evaluation Cover?
A functional capacity evaluation (FCE) or functional ability evaluation (FAE) evaluates an examinee’s capacity to perform physical functions and/or cognitive functions, and work simulation activities related to employment. The FCE or FAE then compares the individual’s physical musculoskeletal and/or cognitive functions to the demands of a specific job, group of jobs, or generally to a work and/or non-work environment. In essence, the primary purpose of an FCE or FAE is to evaluate an individual’s functional ability to participate in work activities, although other instrumental activities of daily living that support work performance may also be evaluated.
The FCE or FAE will examine an individual’s physical or cognitive abilities using a review of the existing medical documentation, a thorough interview processes and objective physical and/or cognitive testing, as well as work or non-work simulated activities.
When is a Functional Capacity or Functional Ability Evaluation Needed?
There are a number of scenarios where a FCE or FAE would be needed, such as:
- Someone who has been injured on the job to determine their ability to return to the pre-injury job or to an alternate work situation, such as an accommodated position
- Someone applying for short-term or long-term disability benefits
- Someone seeking to return to work or activities of daily living after an injury or illness
- Someone injured in an accident (i.e., automobile collision or slip and fall event) for whom an FCE/FAE can determine residual abilities related to resuming a former job, new employment or activities of daily living
- Someone seeking vocational rehabilitation services
How does a Physical Functional Capacity or Functional Ability Evaluation Work?
The components of the FCE or FAE will vary based on the purpose of the assessment. The FCE or FAE typically begins with a client interview of 15-60 minutes, and musculoskeletal screening (a check of bone, muscle, ligament and nervous system health). A healthcare professional will lead you through functional tasks such as sitting, standing, walking, and climbing stairs, as well as gripping, lifting, pushing and pulling objects. Repetitive activities and those requiring fine motor skills are often both a part of the tests. By simulating everyday life skills and job-specific skills, the FCE or FAE will evaluate overall functional abilities, determine physical functional limitations and outlined any impediments to return to function.
Specific functional testing may include
- Material-handling activities such as lifting, carrying, pushing, and pulling
- Positional tolerance activities such as sitting, standing, walking, balancing, reaching, stooping, kneeling, crouching, crawling,
- Object handling/manipulation, fingering, handling, and fine motor manipulation
Pain and fatigue monitoring are performed during the FCE or FAE to document the examinee’s reported levels of pain and fatigue during various activities as well as to manage symptom response. The FCE or FAE report includes an overall physical demand level, a summary of job-specific physical abilities, a summary of performance, consistency and overall effort, job match information, adaptations and accommodations to enhance overall performance, and may include treatment recommendations, if requested. An FCE or FAE is done on a one-on-one basis and may range in length from 4 to 8 hours and may also take place over two consecutive days.
How does a Cognitive Functional Capacity or Functional Ability Evaluation Work?
Following an interview, a healthcare professional will lead the interviewee through a series of cognitive functional tasks that may look a lot like work activities. Repetitive activities and those requiring fine motor skills are often a part of both the physical and cognitive tests. By simulating everyday life skills and job-specific skills, the FCE or FAE will evaluate overall functional abilities, determine cognitive functional limitations and outline any impediments to return to function.
The components of the FCE or FAE will vary based on the purpose of the assessment. The FCE typically begins with a client interview, and brief cognitive screening.
Specific cognitive functional testing will include:
- a step wise approach assessing work related cognitive abilities
- executive functioning
- psycho-emotional function
- may include cognitive work simulation activities