Your inability to work is the key issue in a long-term disability claim. If you have physical limitations, a functional capacity evaluation (FCE) may help the insurance company gauge your ability to do your job or any type of employment. While these tests are not necessary in every disability claim, they can be a powerful, fact-based tool.
However, functional capacity evaluations are not as ironclad as some would like you to believe, and a negative report can seriously harm your disability insurance claim. Before you attend an exam, you should know what to expect. Below, we’ll explain the realities of an FCE.
What Is the Purpose of a Functional Capacity Evaluation?
An FCE assesses your physical abilities through a series of standardized tests. While there are different FCE models, they all try to objectively evaluate your abilities instead of relying on the doctor’s judgment. For this reason, both disability lawyers and disability insurance companies typically give FCE results significant weight.
While the tests gauge a wide variety of physical activities, most functional capacity evaluations do not assess your readiness to work from a mental or emotional standpoint.
An FCE is also different than a physical or mental residual functional capacity form, sometimes called an RFC. These forms are completed by a physician and do not involve physical or psychological testing. RFCs are most frequently used in Social Security claims.
How Long Does an FCE Take to Complete?
Different facilities take different approaches to functional capacity evaluations. However, most FCEs take one to two days. If you have a two-day FCE, the therapist should evaluate whether your abilities and tolerances change between the first and second days.
How Should I Prepare for My Functional Capacity Evaluation?
There’s not much you need to do before an FCE. We recommend that you get a good night’s sleep beforehand and take your medications as you would on a normal day. You should also pack a bag that includes a water bottle, your necessary medications, and any assistive devices that are prescribed by your doctor, like braces, a cane, or eyeglasses.
You may also want to consider arranging a ride to and from the evaluation. Some people end up exhausted after a day or two of testing and don’t feel safe behind the wheel.
You typically will not need to bring your medical records to the FCE. Instead, your lawyer or the insurance company will provide the therapist with the necessary information.
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What Happens During an FCE?
Functional capacity evaluations are usually run by occupational therapists. During the FCE, the therapist will:
- Interview you about your medical conditions, limitations, and vocational background
- Review your medical records
- Test your ability to perform activities like lifting, carrying, pushing, pulling, walking, standing, sitting, balancing, kneeling, crouching, crawling, and manipulating objects
- Track your pain levels
The therapist will also evaluate your level of effort, so you should try your best throughout the testing.
After the testing is complete, the therapist will create a detailed report that summarizes your test results as well as your level of effort. The report will also render a general opinion about your ability to work. The therapist will send the FCE report to the party that requested the examination.
Sometimes, the results of an FCE will focus on your ability to do a specific job; in other cases, the FCE will consider your ability to perform any type of work. The final report may also indicate whether you can do sedentary, light, medium, or heavy work. Your long-term disability lawyer can help you get a copy of the report and interpret its results.
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Functional Capacity FAQs
If you’re preparing for an FCE, you probably have some questions and concerns. While nothing compares to personalized advice from an experienced disability lawyer, we’ve provided the answers to some frequently asked questions about FCEs.
What Should I Wear to an FCE?
You should wear comfortable clothing and athletic shoes to your exam. You may want to dress in layers, especially if you tend to get warm when you’re active. If you have a prescribed brace, cane, or other medical device, bring it with you.
Can I Take Breaks During an FCE?
Typically, you’ll get scheduled time for bathroom and lunch breaks. However, if you need to rest because of pain, fatigue, or other issues, talk to the therapist.
What if I Can’t Complete a Test?
You should always give your best effort during an FCE. However, if you cannot safely perform a task, voice your concerns to the therapist. They may be willing to adjust the test or skip it entirely.
Should I Tell the Therapist About My Pain Levels?
Yes. You should never suffer silently during a functional capacity evaluation. However, you also should never exaggerate your symptoms. It’s always best to be open and honest about your pain and other symptoms.
I Just Had Surgery. Should I Participate in an FCE?
If you just had major surgery, you may be unable to complete an FCE safely. You should discuss the exam with your doctor and notify the occupational therapist about your recent medical procedure.
The Insurance Company Scheduled an FCE. Do I Have to Attend?
As long as the FCE request is a reasonable one, you typically must participate in an FCE that’s ordered by the insurance company. However, if the exam is hours away from your home, you just had surgery, or there is another extenuating circumstance, contact your disability lawyer and tell them about your concerns.
If FCEs Are Objective, Why Did I Get Different Results During Different Tests?
Even though insurance companies and some attorneys tout FCEs as objective, fact-based assessments, there are some subjective elements to these exams. For example, the therapist must assess whether you gave your full effort and whether your pain levels truly prevented you from completing a task. While most therapists will give you the benefit of the doubt, some examiners are more cynical. It’s also not uncommon for insurance companies to argue that their FCE methods are more accurate than another provider’s approach.
In these cases, it’s in your best interest to consult with an experienced disability lawyer. At Bryant Law Group, our team can fully analyze competing FCE reports, determine their accuracy, and respond to the insurance company’s objections.
Bryant Legal Group: Determined and Knowledgeable Chicago Disability Lawyers
Bryant Legal Group is one of Chicago’s most respected disability insurance law firms. We assist disabled individuals with their complex insurance claims and educate them about their rights and responsibilities. If you have questions about an FCE or any other aspect of your disability claim, contact us today by calling 312-561-3010 or filling out our online contact form.