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What is a Functional Capacity Exam (FCE) and should I go to a FCE?


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What is a Functional Capacity Exam (FCE) and Should I Go to an FCE?

Disability attorney Stephen Jessup discusses what a functional capacity exam is and if a disability claimant should attend a FCE.

A Functional Capacity Evaluation or Exam or an FCE is a test that’s a battery of tests that you will be put through to see what your physical capabilities are with regard to work. Usually, it’s going to be weighed against the typical Department of Labor and Dictionary of Occupational title standards of sedentary, light, medium, heavy. Going to one; FCEs can be a double-edge sword. It could come up that there’s nothing wrong with you or, on the flipside, you may have something where it says, “Listen, this person can’t even work at a sedentary level.” And there’s many ways of having them performed; there’s different types.

Insurance companies are always very quick to try to point out that the one you had wasn’t sufficient, it’s unreliable, that theirs is better. So there’s a lot that goes into giving an FCE. FCEs can be wonderful, wonderful evidence of disability, but at the same time can also hurt you. And like statistics, it can be used any which way you want to do it, so it’s very important to know what all your options are before going to have an FCE. If you have any questions, if the insurance company wants to send you to one, or you have a question about your own claim and possibly your doctor’s even referring you to one, or if your doctor is suggesting you undergo have an FCE, give us a call and we can discuss what your options are, what your possibilities are, and what you might be able to expect.

There are 6 opinions so far. Add your comment now.

Doug Miller:

Can a contract physical therapist who get pain by my company legally do my FCE or dose it have to be an outside the company contractor? I fill it, is a conflict of intrust if I have to use the one the company already pays to work for them. All she is going to tell them is what they want to hear.

Attorney Stephen Jessup:

Doug,

Unfortunately, it is legal for the insurance company to send you for an examination performed by a medical professional of their choosing. You could consider having an FCE performed by your doctor, or someone recommended by your doctor, as a way to protect yourself from the insurance company’s examiner writing a report to their liking.

Grace:

I have been totally disabled for over twelve years. The new physician I have is now wanting me to take a FCE test which I have had several times and was not sufficient enough. The test is not being required by my employer or by SSI, so I don’t want to open up a can of worms. I feel this doctor wants to hurt me because my employer long term disability wants a form filled out maybe once a year. Is she still disabled if yes please indicate that on this form. That’s what a doctor is supposed to do if he is my pain management physician. I feel he is now trying to throw me under under a bus. What can I do the test will cost me $540.00 and I’m on a fixed income. My employer nor SSI will pay for it. What can I do?

Attorney Stephen Jessup:

Grace,

When it comes to filling out forms detailing a patient’s physical functional abilities, it is not uncommon that a doctor will want an FCE to document the level of restrictions and limitations so they can then in turn complete the form. If you are not satisfied with the level of care you receive from your doctor then you have the right to seek new treatment.

Lola:

Will the test be performed based on the job I was doing? I am being investigated by my Dr. for a serious nerve condition, and the wait list for the specialist is 8+ months. I worked as a custodian and was wondering if they base their testing on previous work performed.

Attorney Stephen Jessup:

Lola,

The testing is generalized in nature and does not typically replicate any one occupation. Is your insurance carrier requiring the testing as part of its review?

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