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What is a Functional Capacity Exam (FCE) and should I go to a 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 30 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?

Lisa:

I have Cauda Equina Syndrome as a result of a work related injury. I have bowel and bladder regimes like a paraplegic and weakness in my lower legs with numbness. Also sitting causes numbness to exacerbate and I get numb from the waist down on the backside. I am suffering depression from this. Will this test include those types of injury?

Attorney Stephen Jessup:

Lisa,

A functional capacity evaluation tests your overall physical functional ability for work, which would take into account lower extremity weakness.

Kat:

I have been having chronic back pain for over 10 yrs. Now it seems to be getting worst. My Doctor put me on restrictions from my job. Now my job needs them to fill out some fmla paper work. But I requested that she allows me to get off restrictions and allow me to return to work. Since I am on leave with out pay. My job said the restrictions that my doctor put me on is basically my whole job. So now my doctor wants me to go do a fce test before she will sign the papers. It is about a month or two wait before I can get in to do the fce test. What should I do? I need to continue to work to take care of home. I have been dealing with the pain for years and I will continue if she allows me to. I don’t want a test that can cause more problems. I had a M.I.r. done and a xray on my back and it came back negative. Help me please.

Stephen Jessup:

Kat,

If your employer provides Short Term Disability insurance you may be able to make a claim for benefits until you are cleared for work.

di:

The insurance company want me to do a functional capacity assessment as I have had a shoulder injury which was done moving heavy item at work. It has gone into a secondary condition frozen shoulder which I have now had for nearly two years. I was doing restricted duties but I could not keep it up and have now been off work for 3 months in which time they have had me job searching and stopping and starting my physio. The job search person who works for interact injury management has now asked for this assessment I could not attend job trials that where over an hours driving and it set off the pain in shoulder blade, top of arm and up neck giving me headaches I get excused very quickly. I am taking Ritalin for add, valium for anxiety and panic and also taking endep everyday. I am wondering if these will affect my tests they give me.

Attorney Stephen Jessup:

di,

Unfortunately, we would not be able to know if the medication would affect the test results. When is the FCE scheduled for and who is your disability insurance carrier?

Edward:

Hello, so I’ve been dealing with chronic back pain for years now, as of recently I’ve had 3 separate procedures ranging over a 5 month span and have seen zero relief of pain. In fact my pain has worsened over the course of my pain management treatment. I’m on restricted duty and the doc had ordered an FCE to determine my permanent restrictions. If the results (if showing a percentage loss use of my lower back) come back with a permanent loss use, will that be the start to being on some type of disability for an undetermined amount of time? Is that thru my jobs insurance or SSI? I’ve had MRI and xray showing damage in my L3 L4 and L5 S-1 vertebrae. As well as moderate herniated lower dics and sciatic nerve damage along with arthritis. Mind you I am only 27 going on 28 years old at time of this post.. Will being on permanent restrictions not allow me to make a certain amount of money a year? Or how is that determined? I have a family and a mortgage to support and pay.. I don’t know what to expect. I am clearly damaged and in constant pain but I need to work to live. Will I be able to work with restrictions and be partial disability payments? Thank you so much.

Allison:

I have been recently diagnosed with Ehlers Danlos Syndrome and Complex Regional Pain Syndrome. My primary is sending me for an FCE on April 4th. I am currently still working full time, my employer has me on FMLA and ADA. My biggest concerns are what they will be testing for as I have trouble walking up/down stairs without severe pain. Walking long distances I have to stop and rest. I cannot lift my right arm above my head without severe pain and my joint sublaxing. My hips/right thumb are sublaxing often as well. I am going through a battery of tests including genetic testing and with a heart specialist. Originally I asked if my primary would sign a form for me to obtain a handicap hand tag, this is when he scheduled me with the FCE. What if they determine I am more than temporarily disabled, would this help with applying for long term disability through my employer or SSI?

Attorney Stephen Jessup:

Edward, do you have a disability insurance policy through an employer? If so you will need to see if it provides partial disability benefits. If you do not have an employer provided or private disability coverage your only option may be for Social Security Disability if you are eligible for same. You would need to contact a SSDI attorney though to determine work /income rights under the SSA guidelines.

Attorney Stephen Jessup:

Allison, if the FCE indicates restrictions and limitations that would prevent you from performing the duties of your occupation, then it would be strong evidence in supporting a claim for disability under your employer policy or the SSA.

Jane Doe:

Diagnosed with critical stenosis and told I would become paralyzed from waist down without multiple fusion. New doctor at work says need FCE. Is there risk of damage from doing theirtest with broken vertebrae & what the surgeon called “critical “critical stenosis.”

Attorney Stephen Jessup:

Jane, this is certainly something you need to discuss with your doctor as the FCE is physical and could result in injury.

Neicey:

I injured my knee at work back in October of last year. I received physical therapy for 3 months before being sent for a MRI …results stated I had a torn meniscus. I received a cortisone injection to determine if surgery could be prevented. The injection didn’t help and I had the surgery a month later. After another 6 months of physical therapy and 2 more cortisone injections. I was told that nothing else could be done for me. My doctor listed activities that I am unable to perform after trying to contact him by phone I wrote him to tell him I wasn’t able to perform some of the duties he stated I could. After speaking with my liaison for my job’s insurance company, it has been determined that they would send me for a Functional Capacity Eval. I can no longer fully squat, kneel, pivot, climb stairs or ladder, lift anything over 15 lbs without causing pain or swelling. Is this something I can trust to be accurate.

Attorney Stephen Jessup:

Neicey, FCE’s are typically reliable in determining one’s physical capacity. That being said, it is by no means foolproof. As we only handle claims for short and long term disability benefits under disability insurance policies, I would recommend you contact a worker’s compensation attorney to discuss your situation/case further.

Susan P.:

I am scheduled for an FCE. I have a degenerative shoulder and had surgery 6years ago. My dr and my surgeon have put me inya 5lb permanent restriction. Can they push me past the 5lb restrictions?

Attorney Stephen Jessup:

Susan, the examiner will likely have you attempt a wide range of tests that may go beyond 5lbs. Who is sending you to the FCE? A disability insurance carrier? Your doctor?

Ron:

I am a police officer and was in an accident while on duty. I fractured my right wrist and had a screw put in..this was back in March 2016, and ever since the surgery my hand Hurst worse than before. I explained this to my doctor and he stated that it was portion of my bone is rubbing together and gave me two steroid shots…that worked for about a week and I went back and explained to him that my hand doesn’t feel right and i dont want to put myself,fellow officers or community in danger if something should arise. He now is sending me to an FCE……should I go….

Susan P.:

Workmans comp and Dept of labor are making me have it. I just got done with the 2nd day. He determined that I have a 10lb limit with both arms and 5lb limit individually. I also can’t work above my shoulder with my left arm. This has been a complete fight since the beginning because I work for the Post Office. There isn’t a single lawyer in Illinois that will help me so I go thru everything. Had an arthrogram MRI a couple months ago that determined I have a degenerative shoulder but I still have been made to do test after test.

Attorney Stephen Jessup:

Ron, your doctor is sending you for the FCE? Is this a worker’s compensation doctor? If your treatment is under a worker’s compensation claim you would need to consult with an attorney that handles same to better understand your obligations. If you are unable to perform the duties of your occupation you could also explore the possibility of filing a claim for disability benefits under your department’s disability insurance policy (if applicable)

Attorney Stephen Jessup:

Susan, unfortunately, we do not handle Worker’s Compensation cases so we would not be able to offer any assistance.

JohnM:

I led a very clean life full of exercise but still got GIST Stage 3A Cancer and related partial gastric resection surgery and cytotoxic Chemotherapy poisons destroyed my health. The Chemo poisons and B12 mal-absorbtion caused by Gastric stomach resection caused me 47 known side effects plus at least 52 known ailments, including chronic pain and spreading Neurological damage plus Cognitive impairment but tests to confirm that damage are not precise and neurology is not an exact science (saw 26 doctors and 4 neurologists since 4Q2012). MRI of spine shows cervical stenosis and spines pressing on root nerves but LTD insurance provider is pushing for FCE and stopped my LIWOP. I don’t think FCE will verify my nerve damage and not encouraged by what I’ve read, so what is your thought? My pain overwhelms me most days and is worse at night as chronic Intractable Skeletal Muscular Spasticity destroys my sleep as it crushes my spine and ribs into lungs every night but I don’t have types of physical damage those in accidents would have so not sure FCE would help me. My nerve damage causes me to lose muscle control and immune system damage causes me to get things like flu, chronic Bronchitis and Walking Pneumonia 3-5 weeks straight every year since cytoxic Chemo but I still look OK as i wait for Cancer with 90% recurrence and 80% 5 yr death rate to take me out. I want to prevent insurance from stopping my LTD and be able to sue if they do so as my health issues make just getting out of bed, sitting or walking difficult and no way I can ever work again especially since I need weekly Methyl-B12 injections to fight Dementia plus weekly DT massage and Chiropractic Heat Electrostim CT treatments to function at all.

Attorney Stephen Jessup:

JohnM, FCEs can be valuable in assessing physical ability, but it would not by its nature verify nerve pain- merely how the symptoms of your condition would impact your physical ability for work. If you would like to discuss representation as it relates to your LTD claim please feel free to contact out our office.

Tracey:

I’m scheduled for a FCE in January. I’m in the phase of my disability appeal waiting for a hearing date. My PCP has known me for 20 years. She knows that I have good and bad days. I would probably be able to do whatever they want me to during the test but then won’t be able to function or get out of bed the next day. This is how I lost my job. One step forward, two steps back. I’ve been dealing with major depression, anxiety and PTSD for years. Then this physical stuff started which has caused severe fatigue, pain after any physical exertion, brain fog, and more. I’m worried that this test will not show this. I’d hope that my record of work my whole life would be considered too. Thanks

Attorney Stephen Jessup:

Tracey, it sounds like yours is a claim for SSDI benefits, as such I would advise you to speak to your SSDI attorney as we do not handle SSDI claims and would not be in the position to best advise you.

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