Services / WCB Claims and Disability Management

Functional Capacity Evaluation

Using a Physical Demands Analysis (PDA), the FCE process compares the health status, body functions and structures of the individual to the demands of the job and the work environment. Information and interpretation gained through the functional test should take into account the historical, medical, and physical examination findings, and the psychological and motivational status of the individual.

What are the benefits of booking a Functional Capacity Evaluation through SureHire?

  • Centralized booking department which will provide confirmation of appointment within 24 hours.
  • National Network – SureHire is able to provision Functional Capacity Evaluations across Canada.
  • Standardized reporting template – all clinicians who complete Functional Capacity Evaluations through SureHire submit their finalized report on a standardized Functional Capacity Evaluation report template.
  • Standardized review of reports – all Functional Capacity Evaluation reports are reviewed by an evaluator at SureHire who has extensive knowledge and experience in Functional Capacity Testing prior to submitting final report to the referral source.

Functional Capacity Evaluations will typically involve the following components:
  • Review of the client’s medical file by the attending clinician, prior to scheduled testing

  • Review of the Physical Demands Analysis report, if provided, by the attending clinician prior to scheduled testing

  • Client interview

  • Completion of psychometric measures relevant to injury, medical condition, or reason for disability

  • Musculoskeletal and neurological screenin

  • Graded material handling activities

  • Positional tolerance activities

  • Hand dexterity activities

  • Sincerity of effort testing

The Dictionary of Occupational Titles (US. Department of Labor) gives 20 separate functions on which work capabilities are based and an FCE should evaluate these functions, although the functions evaluated will often depend on the specific job functions required of the patient:

  • Lifting
  • Climbing
  • Balancing
  • Stooping
  • Kneeling
  • Crouching
  • Crawling
  • Reaching
  • Pushing/pulling
  • Standing
  • Carrying
  • Talking
  • Hearing
  • Tasting/smelling
  • Near/far acuity
  • Sitting
  • Walking
  • Handling
  • Fingering
  • Feeling

Once all information is gathered, a final report will be provided to the referral source. This report includes all of the following:
  • Summary of injury details, current complaints, current and past medical history and treatment provided

  • Vocational status summary

  • Summary of psychometric questionnaires

  • Summary of performance consistency and overall voluntary effort

  • Answers to specific referral source questions

  • Summation of overall functional capabilities

  • Job match information

  • Treatment recommendations (if requested)

If applicable, some FCEs will report on the worker’s ability to meet cognitive demands of the job in question.


What does a Cognitive Functional Capacity Evaluation Involve?

A Cognitive Functional Capacity Evaluation (CFCE) is similar to an ordinary FCE. However, it also considers certain cognitive, behavioural, and psychosocial factors that are not usually considered during an FCE. A CFCE may be required after an acquired brain injury or the onset of a neurological event or other condition that can affect normal brain functioning (depression, for example).

Is a physical demands analysis (PDA) required?

A physical demands analysis (PDA) quantifies and evaluates all physical and environmental demands of the job, helping establish precisely what a job involvesIt’s the cornerstone of the analytical process used to determine compatibility between a worker and a specific job.

It is generally preferable for the FCE to be job-specific and tailored to the position that the candidate would be returning to. Therefore, it is ideal that the evaluator be provided with a PDA for the job position in question prior to completing the Functional Capacity Evaluation. 

What will an FCE tell the employer?

The Functional Capacity Evaluation report will

  • Describe the claimant’s appearance, height and weight, attitude and general demeanor during the assessment.
  • Advise if the ability demonstrated during testing is consistent with the reported complaints and/or symptomology (reliability of self-reports) through various psychometric questionnaires.
  • Identify what the candidate’s functional capabilities are.
  • Advise if the observed interview findings and testing process are consistent with each other, the diagnosis, and the medical review.
The Cognitive Functional Capacity Evaluation report will evaluate the overall functional capacity (more specifically, abilities and limitations as well as the integration of the physical, cognitive, behavioral, and psychosocial factors) and make observations on a range of critical factors (pain, fatigue, task persistence, etc.) that influence functioning over time.

Using these tests, the evaluator may formally and practically assess executive functioning – an area that can be challenging to evaluate – using the environment and environmental demands as additional tools to measure performance.

How do you know if the candidate is making a genuine effort?

Physical effort testing is an integral portion of a Functional Capacity Evaluation, as physical effort during an evaluation affects both the reliability and the validity of the test result. Effort testing gives the reader of the functional evaluation report confidence that the results represent a true picture of the worker’s ability. Reports compromised by less than full effort are read as representing the worker’s minimum ability.

There are several metrics of functional capacity that evaluators take into account during an FCE, many of which are beyond the candidate's direct control. One metric evaluators use is self-reports of pain and disability through the use of psychometric questionnaires (for example: the PACT Spinal Function sort, the Neck Disability Index, pain questionnaires, etc.). However, measures of heart rate, muscle recruiting, stance, speed, pace, and end-range of motion are also taken into account and compared with observation and self-reports. These metrics are considered together to determine the level of effort demonstrated in each test and arrive at an accurate picture of functional capacity.

What are the credentials of the evaluator?

Many of our evaluators have completed university-level coursework with a major in anatomy, physiology, or vocational assessment. At a minimum, all SureHire evaluators have participated in comprehensive Functional Capacity Evaluation training through certified educators such as Matheson Group or Metriks. This training includes data interpretation and case resolution as well as the FCE thought process. 

How should the candidate prepare for an FCE appointment?

As is the case with all SureHire testing procedures, the candidate will be required to present government-issued photo identification prior to participating in Functional Capacity Evaluation testing. It is also recommended that the candidate bring a list of all current medications if applicable. As testing lengths may vary, it is strongly recommended that the candidate bring light snacks and beverages to the testing facility. In addition, the candidate should come prepared with running shoes and a comfortable shirt and pair of pants.

The duration of the testing is dependent on the referral source, varying from one to two days. Testing may take anywhere from four to eight hours on each testing day. The evaluator is free to shorten or lengthen the evaluation in response to the referral source’s questions and to maximize the predictive validity of the result. Test length will also depend on the referral questions asked, the type of evaluation, and the physical demands level of the target job (heavy or highly repetitive work, etc.). However, it is important to note that the candidate is in control of the test and has the option to stop testing at any time. 

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