Nearly $50 million in workers’ compensation claims get paid every year, so you might think obtaining workers’ comp benefits is easy. Unfortunately, that’s not so.
Injured workers often have a rude awakening when they learn about the gauntlet they need to run simply to obtain the benefits they deserve.
One of the many hurdles workers may need to clear before they receive benefits is called a Functional Capacity Evaluation (FCE).
Here’s a brief overview of what an FCE is and the role it plays for injured workers seeking workers’ compensation benefits.
An FCE is a series of physical tests that measure an injured person’s ability to complete certain physical tasks. Workers’ compensation insurance companies frequently require injured workers to undergo FCEs to receive disability benefits.
When requested in connection with a workers’ comp claim, the FCE measures an injured worker’s ability to perform the physical tasks required to do that worker’s job, so that the workers’ comp insurance company can assess whether the worker can return to work. The tests are tailored to, and performed in light of, the physical challenges of the occupation in question.
For example, for a worker who performs manual labor in a fulfillment center, an FCE may examine arm strength and overhead range of motion, leg strength and ability to squat and lift, the ability to bend over, how long the worker can stand or sit at a stretch, and so on.
Certified physicians, physical therapists, or other medical practitioners typically perform FCEs. An FCE happens in a setting appropriate for the measurement of the physical activities involved in the test.
The primary purpose of an FCE is to determine whether the injured worker can perform job functions. A secondary purpose of an FCE is to smooth a worker’s transition back to work. An employer may rely on the findings of an FCE, for example, as a means of identifying ways to modify an employee’s job requirements to permit the employee to return to work without pain or physical limitation.
For example, if the FCE shows the employee does not yet have full use of his left hand, an employer may modify his job responsibilities to eliminate tasks requiring the use of the left hand, or may purchase assistive equipment to help support the employee in left-handed tasks.
An FCE can also measure mental fitness. A so-called mental functional capacity evaluation (MFCE) typically measures the memory, problem-solving, and social skills required of the employee’s job, to determine if the employee has the cognitive and emotional capacity to return to work.
Problems That Can Arise in FCE Tests
In theory, an FCE is an objective test of specific physical (or, when appropriate, mental) capabilities. It is different from an independent medical exam (IME), in which a doctor gives an opinion about an injured worker’s medical condition.
Those distinctions, however, can get blurred. An accurate FCE test requires the full, good faith participation of the FCE evaluator.
Problems can arise in FCE tests when:
- Evaluators claim injured workers have not made a full, good-faith effort to perform each of the types of physical activities involved in the exam;
- Evaluators administer tests in an unfair, improper, or unrealistic way that gives inaccurate results or causes harm to the injured worker;
- Evaluators misreport test findings.
Injured workers subjected to unfair, improper, or skewed FCE tests should seek the help of an experienced workers’ compensation lawyer right away to ensure that they receive the benefits they need and deserve.
If You Receive a Request for an FCE Test
Workers’ compensation insurance companies often request FCEs as the injured worker’s treatment is coming to a close, to determine if and when the worker can return to work, and if so, in what capacity. They can also request an FCE in connection with their initial evaluation of an injured worker’s disability claim.
Though FCEs are commonplace, that does not mean an injured worker should take a request for one lightly. As a practical matter, a request for an injured worker to undergo an FCE signals that a workers’ compensation insurance company wants to deny or end certain workers’ compensation benefits.
If you receive a written request from your employer’s workers’ compensation insurance company that you undergo an FCE, then seek the advice of an experienced workers’ compensation attorney immediately.
An attorney can:
- Find out why the workers’ comp carrier has asked for the FCE, and potentially find an alternative way to address the insurance company’s concerns that saves you from undergoing the FCE at this time;
- Negotiate the time, place, and scope of an FCE, including the specific job capacities or physical activities it may measure;
- Push back against the request for an FCE in the event your medical team recommends against you undergoing that testing; and/or
- Appeal or challenge the findings of an FCE if it is flawed, such as if the evaluator fails to administer an FCE fairly or appropriately.
If an experienced attorney advises you to undergo an FCE, then follow the attorney’s advice about how to participate in the test.
Common advice many skilled lawyers give their clients about participating in an FCE test includes:
- Never skip or be late to an FCE appointment;
- Wear comfortable clothes that give you a full range of motion;
- Do your best to participate fully in every activity the evaluator requests;
- Speak up immediately (but do not exaggerate) if any activity the evaluator requests causes you pain or goes against medical advice you have received;
- If an evaluator persists in putting you through painful or medically contraindicated activities, ask for a break and call your lawyer immediately.
For more information about your rights when seeking workers’ compensation benefits, especially if you have received notice from a workers’ comp carrier requesting that you submit to an FCE, contact an experienced workers’ compensation lawyer today.