By Marcello Cherchi, MD PhD
When a patient suffers from a medical condition that may interfere his or her ability to carry out work responsibilities, the patient often wants to know (from a safety perspective) whether it is feasible to continue (or return to) work, and their employer often wants to know (from a safety and liability perspective) whether they should permit the employee to continue (or resume) work. Currently the most objective (though imperfect) way of answering this question is through a functional capacity evaluation (“FCE”).
A functional capacity evaluation is a process undertaken by a specialized physical therapist whose goal is to provide a quantitative assessment of a patient’s ability (“fitness”) to meet the physical requirements to fulfill the responsibilities of a specific job for a specific employer in a safe manner.
Many investigators conclude that an FCE provides a good objective assessment of a patient’s abilities (Soo Hoo 2019). Others conclude that the overall FCE process is good but requires refinement (Allen, Rainwater et al. 2004). There is some disagreement about whether an FCE has predictive value for a patient’s “occupational outcome” (Pransky and Dempsey 2004).
Reports by expert committees reveal that there is room for debate about how an FCE should be conducted and what conclusions can be drawn from it (Soer, van der Schans et al. 2008). Points of debate include whether a patient’s particular characteristics and life circumstances merit customization of the FCE process (Buhne, Alles et al. 2022).
There is some disagreement in the literature regarding the optimal FCE procedure to evaluate vestibular disorders (Cohen 2011) in particular. However, there is not yet an evaluative process proven superior to an FCE, so when questions arise of whether a patient can physically fulfill job duties safely, we strongly encourage the employer to refer the patient for an FCE.
Many physical therapy facilities provide FCE services. Some hospitals and medical centers also offer FCE services under the umbrella of “occupational medicine.”
As of the date of this web page, our patients in the Chicagoland area have had evaluations at the following locations (listed alphabetically); note that we are not endorsing any of these facilities.
- Associated Medical Centers of Illinois
- Athletico
- Banner Health
- Chicago Rehabilitation Services
- Epic Rehab
- Illinois Bone and Joint Institute
- Maximum Rehabilitation Services
- Premier Health Network Occupational Medicine
- PT Solutions
- Team Rehabilitation Physical Therapy
References
Allen, S., A. Rainwater, A. Newbold, N. Deacon and K. Slatter (2004). “Functional capacity evaluation reports for clients with personal injury claims: A content analysis.” Occup Ther Int 11(2): 82-95.
Buhne, D., T. Alles, C. Hetzel, M. Streibelt and I. Frobose (2022). “Do patient characteristics affect the predictive validity of Functional Capacity Evaluations?” Int Arch Occup Environ Health 95(4): 877-885.
Cohen, H. S. (2011). “Assessment of functional outcomes in patients with vestibular disorders after rehabilitation.” NeuroRehabilitation 29(2): 173-178.
Pransky, G. S. and P. G. Dempsey (2004). “Practical aspects of functional capacity evaluations.” J Occup Rehabil 14(3): 217-229.
Soer, R., C. P. van der Schans, J. W. Groothoff, J. H. Geertzen and M. F. Reneman (2008). “Towards consensus in operational definitions in functional capacity evaluation: a Delphi Survey.” J Occup Rehabil 18(4): 389-400.
Soo Hoo, E. R. (2019). “Evaluating Return-to-work Ability Using Functional Capacity Evaluation.” Phys Med Rehabil Clin N Am 30(3): 541-559.
