Call Now:

Se Habla Español

Functional Capacity Evaluations in Workers’ Compensation Cases

  • Dave Brown, Esquire
  • 02/16/2021

If you have injured yourself at work, it is possible that at some point one of your treating doctors will recommend that you undergo a Functional Capacity Evaluation – also known as an FCE. If that happens, you will probably wonder – what is an FCE? And how could it affect my workers’ compensation case? They are very good questions, and we are here you to provide you with the answers.

Let’s go through a hypothetical to help you understand FCEs. You were completely healthy until you injured your back and knee when you slipped on grease and fell at the factory where you work. You go to your employer’s occupational doctor who restricts you to no lifting of more than 20 pounds, occasional walking, and occasional bending. Because your job requires you to be on your feet almost the entire day and regularly lift items which weigh in excess of 50 pounds, you are unable to perform your job. The workers’ compensation insurance company for your employer starts to pay you weekly benefits.

For the first 90 days following your injury, you treat with the occupational doctor, participate in physical therapy, and undergo MRIs to your low back and knee. After the 90 days, when Pennsylvania workers’ compensation law provides that you can treat with the doctors of your choice, you begin treatment with a chiropractor and pain management/physical medicine physician. You attempt chiropractic treatment for a few months, and it helps alleviate your back and knee pain temporarily but nothing more. You take medication daily and it makes your pain more tolerable but does not come close to eliminating it. Your physician suggests that you undergo an injection to your back, which you agree to because you are determined to do everything you can to get better and return to work. The injection affords you 50% pain relief, but then your pain comes back full throttle.

Your pain management physician refers you to an orthopedic surgeon for an evaluation. The surgeon confirms that you have back and knee injuries but does not think you are a surgical candidate, as surgery will not improve your condition. You become increasingly frustrated with your situation.

A year after your injury, the insurance company sends you to an evaluation with one of its doctors The insurance company is entitled to have you evaluated twice a year for “independent” medical evaluations. They are hardly independent evaluations because the doctor is hired by the insurance company and usually renders opinions about the injured worker which are favorable to the insurance company. You attend the evaluation, and the doctor completes a physical capacities report, estimating your ability to stand, sit, walk, lift, bend, squat, and participate in other activities. Most notably, the insurance company doctor states that you are now able to lift 30 pounds frequently, bend frequently, and stand/walk up to six hours a day. When a doctor completes a physical capacities report, it is not based on any formal testing. The doctor considers your complaints, his examination findings, and the results of the MRIs and other diagnostic tests (maybe a nerve study called an EMG) and estimates how long you can engage in various activities.

The workers’ comp. insurance company very well may rely on the doctor’s physical capacities report in an attempt to reduce your benefits. Suppose that your employer is able to offer you a modified-duty position which will require you to lift up to 30 pounds, bend throughout the day, and be on your feet up to six hours in an eight-hour day. Much as you are eager to return to work because not working has caused you to become depressed, you know that your back and knee injuries will prevent you from handling the requirements of this job. You decline the job offer, and the insurance company files a petition to suspend your benefits, which goes before a Workers’ Compensation Judge.

Fearful that your benefits are going to be cut off based on a job that you are sure you cannot handle, you discuss the situation with your pain management doctor who writes you a ‘script for an FCE. Your doctor explains that the results of this test could provide objective data that you are not able to perform the duties of the modified-duty job. He suggests that you undergo the FCE at a nearby physical therapy facility under the direction of a licensed physical therapist.

You participate in the FCE, which takes six hours – it really is a very comprehensive test. Your ability to lift, bend, walk, stand, balance, and grip, among other activities, are tested. The results of the test are detailed in a lengthy report, as long as 20 pages, which are provided to your doctor. The therapist has concluded in the FCE that the maximum weight you can lift is 13 pounds, and you can only do this on an occasional basis. You are only able to tolerate standing for 15 minutes at a time and 35 minutes in an hour. The therapist is also able to determine whether the results of the test are valid. Unfortunately, some people do not put forth their best effort when they participate in an FCE, and the therapist will conclude that the results are invalid. On the other hand, if you put forth your best effort, and we are sure you will – you lift as much as you can, walk for as long as you can – the therapist will determine the results of the test are valid, which will further bolster the conclusion that you can only lift 13 pounds and stand for up to 35 minutes in an hour. When your doctor does a deposition in your case, he can rely on the results of the FCE, which will improve the chances that the Judge will find that the modified-duty position offered by your employer is beyond your physical capabilities, and therefore your benefits should not be suspended.

Whether or not your doctor recommends that you undergo an FCE, workers’ compensation cases are complicated and contentious. It is important that you are represented by a competent, experienced workers’ comp. lawyer. At Pearson Koutcher Law, workers’ comp. is all we do. Every one of our lawyers has at least 20 years of experience representing injured workers and will make sure that your rights are fully protected so your benefits are not cut off when they should not be. Please call us for a free, comprehensive evaluation.