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Workers Comp Claims and Functional Capacity Evaluations

Posted by David Ross on Sat, Oct 08, 2016

Tips for when to use functional capacity evaluations (FCE's) in a workers compensation insurance claim. We serve Philadelpnhia, Reading, Lancaster, Allentown, Lehigh Valley, Harrisburg, York, Camp Hill, Pittsburgh, Erie, PA and beyond with high quality, afforcable workers comp insurance.Employers and insurance companies have been using functional capacity evaluations (FCE) for over thirty years. In workers compensation insurance cases, the FCE is used to evaluate an employee's ability to perform activities related to his or her employment.

The FCE process compares the individual's health status, body functions, and structures to the demands of the job and the work environment.

 

What is the purpose of an FCE in workers’ comp?

An FCE's primary objective in workers’ comp insurance cases is to evaluate objectively an injured employee’s ability to return to work. By identifying functional restrictions and determining the degree of disability, the test is designed to increase the likelihood that an injured worker can safely return to work. The test can also uncover “symptom magnifications,” which, in layman terms, are exaggerated claims of incapacity and pain.

How does the FCE test work?

Experts with a background in industrial rehabilitation and social work administer the physical and cognitive tests. The tests measure the worker’s resilience and endurance. If the employee is unable to perform his pre-injury job, the testers attempt to determine if there are skills that are transferable to another line of work. The results of the testing, used in combination with opinions and other findings, are used to decide if the employee can return to work.

The FCE provides objective information in the following areas:

  • When to allow the employee to return to work
  • If the employee can return to the same job
  • The employee’s functional abilities on the job
  • The employee’s functional abilities away from work
  • A disability evaluation
  • A rehabilitation plan
  • The need for other medical treatments

There are two types of FCE

The Job Specific FCE evaluates an injured worker’s ability to work in a particular job. The test can be performed at a clinic or on the actual job site. The therapist will determine if the worker can safely perform the tasks of the job he held before the injury or if modifications of the required work will be needed.

The General Purpose FCE is used if the employee no longer has a job to which he can return or if the job functions have not been determined. The results of this test will be used to find out the worker’s ability to work at specific jobs that may become available in the future.

When should you use an FCE?

It probably goes without saying that you won’t need to use a functional capacity evaluation in every one of your workers’ comp cases. But the tests should be utilized in any case in which the injured worker’s functional ability is at issue. You would certainly consider using the evaluations when the employee claims not to be able to return to work because of restrictions, education, or non-transferable skills. If the worker is requesting retraining benefits or looking for permanent total disability, an FCE would be warranted.

Choose the right time to seek an FCE

If your employee is currently at a point in the healing process where additional medical care will be needed, the FCE will not help the defense of the workers comp insurance claim. But if you suspect that your employee is malingering, the tests may help to detect the symptom magnification mentioned above. The report from the tests could lead to a quick settlement or bring about an advantageous result in litigation.

Finding the right evaluator

Choosing an expert comes down to looking at a few vital factors:

  • Professional reputation
  • Education and background
  • Ability to write a plausible FCE report
  • Capability to provide trustworthy testimony
Don't Overpay for Workers Comp Insurance - Contact us Today!

Contact us for help in acquiring the right workers comp insurance, and to learn more about FCE claims.To learn more about workers compensation insurance, contact American Insuring Group online, or call us at (800) 947-1270 or (610) 775-3848. We're independent agents who with access to many competing providers.

We'll match up your needs with the companies who can provide reliable workers compensation insurance at a competitive price. Call or click today to get started!

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