A Functional Capacity Evaluation (FCE) is an all-encompassing term to describe the physical assessment of an individual's ability to perform work- related activity. It can also be known as a Functional Capacity Assessment (FCA), Physical Capacity Assessment or Evaluation (PCA or PCE), or Work Capacity Assessment or Evaluation (WCA or WCE). A well-designed FCE should be comprehensive in terms of encompassing the physical demands of work as defined by the U.S. Department of Labor in the Dictionary of Occupational Titles (DOT.)1, have standardized instructions and operational definitions, be practical regarding space and length of time for administration, be objective in minimizing examiner bias, and, most importantly, be reliable and valid.2 An FCE must also be administered with care for the patient's safety and well-being, with due diligence to minimize the chance for injury during the course of the evaluation.
An FCE usually consists of a medical record review, a musculoskeletal screening, and physical ability testing. Physical testing may include graded strength activities such as lifting, carrying, pushing and pulling; position tolerance activities such as standing, sitting, and stooping; and mobility activities such as walking, crawling, and climbing. An FCE may also include information about an individual's dexterity, coordination, balance, endurance, and other job specific testing. The FCE report includes an overall level of work, a summary of physical abilities that is usually couched in the language used by the DOT1, information about consistency of effort, job match information, and recommendations, if requested.
FCEs are done on a one-to-one basis and may range in length from 4 to 6 hours. An FCE may take place over two consecutive days.
The occupational therapy practitioner has the unique combination of skills and abilities necessary to assess the physiological, psychophysical, and biomechanical function of the individual engaged in occupation. Occupational therapy practitioners also have the observational skills, training, and experience to perform complex task analysis and assessment of environmental factors affecting work performance. Physical therapists, exercise physiologists, athletic trainers, and those in other disciplines may also perform FCEs. Advanced certification in FCE is available from many vendors.
