Industrial rehabilitation is rehabilitation aimed at helping an injured workers return to work safely and effectively and to help with prevention and reduction of work-related injuries. A functional capacity evaluation (FCE) is a major tool in industrial rehabilitation. A FCE is an objective, functional evaluation of a series of tests administered to help determine current functional and physical status of an employee. We must remember that industrial does not automatically mean that it is labor intensive; it includes jobs that are repetitive or that may involve awkward positions or motions.
And not all worker compensation cases need a FCE. Some injuries don’t limit work duties and many times physical and/or occupational therapy provides the healing and assistance to return a patient to work safely. But there are many benefits of a FCE:
- Determine if a client has the physical abilities to meet job demands to return to their original work
- Determine if work restrictions/limitations are needed
- Determine if Work Conditioning (an intensive, work-related, goal oriented conditioning program designed to specifically restore neuromuscular and musculoskeletal function including strength, power, endurance, joint mobility, ROM (range of motion), motor control, cardiovascular endurance and functional abilities) is appropriate
- Determine if there are reasonable accommodations needed
- Determine if a client has the physical abilities to return to any type of work
- Assist in determination of a level of disability
The components involved in a FCE are an intake interview (vitals, subjective information regarding the injury, and subjective current functional abilities), a musculoskeletal screen (pre and post), an aerobic capacity test (assist in determining work endurance over an eight-hour day), material handling tests (lifting/carrying), and functional positional tests (stoop, squat, bend, sit, stand, walk, grasp, perform fine motor tasks, and reach at various heights and positions). With work/job tasks, the terms occasional, frequent, and constant are used to describe frequencies of an activity (ex. occasionally lifting 25 pounds or reaching floor level frequently). See the definitions (based on the U.S. Department of Labor Standards) below:
- Occasional:
- Time based: less than 20 minutes/hour; less than 2.5 hours/day; less than 1/3 of the day.
- Repetition based: 1-4 times/hour; 1-32 repetitions/8 hours.
- Frequent:
- Time based: less than 20-45 minutes/hour; 2.5 to 5.5 hours/day; 1/3 to 2/3 of the day.
- Repetition based: 5-24 times/hour; 32-192 repetitions/8 hours.
- Constant:
- Time based: greater than 45 minutes/hour; greater than 5.5 hours/day; greater than 2/3 of the day.
- Repetition based: greater than 25 times/hour or defined to a whole day; greater than 192 repetitions/8 hours.
A FCE should also provide a physical demand/work level (sedentary, light, medium, heavy, and very heavy), and these help describe the physical demands of a job that an employee can safely perform. If the test is for returning to a specific job or type of work, then there will be specific job tasks that may be tested. The complete evaluation takes approximately 4 hours.
With all the information gathered during a FCE, it can assist a person’s knowledge of safe activity levels and decrease their return to work anxiety, determine if an employee has the physical abilities to return to their original job or to return to any type of work, determine if they need any work restrictions/limitations (if they can return to work), determine if Work Conditioning may benefit them (if they can’t return to full duty work at this time), and/or even assist a physician in determining a level of disability. A FCE can truly help return an employee safely back to work.