Insurance companies routinely require claimants to jump through a series of hoops when filing disability claims, which ultimately determine whether your claim will be approved or denied. The stakes could not be higher at an already stressful time.
One of those required “hoops” in the claims process is the Functional Capacity Evaluation (or FCE).
A Functional Capacity Evaluation is a series of physical tests performed by a physical therapist to assess your ability to perform your job duties. During these tests, a physical therapist will determine your physical movement capacity, muscle ability and weakness, identify balance and dexterity issues, as well as your levels of pain or fatigue with various physical activities.
These tests are all designed to determine your functional ability and identify any work restrictions and limitations that might exist at the time of taking your exam.
The therapist will also often run through a validity testing protocol to determine if the test results are reliable. These tests are all designed to determine your functional ability and identify any work restrictions and limitations that might exist at the time of taking your exam.
- A work restriction refers to an activity that your doctor has advised you against performing because of the risk of it aggravating your symptoms/risk of harm.
- A work limitation refers to an activity that you cannot perform due to a lack of physical or psychological capacity.
A work restriction or limitation can be temporary or permanent.
What to expect at a Functional Capacity Evaluation
It could take up to two days to complete
A Functional Capacity Evaluation usually takes, at minimum, several hours to perform. Some evaluations stretch out over two days depending on how how difficult it is to determine your functional ability. Often when fatigue is the main disabling symptom, a two-day FCE is needed to measure the impact the first day of testing has on the second.
It’s designed to push your abilities
The tests are sometimes tailored to simulate your specific job duties so the physical therapist can observe your tolerances and levels of effort.
- Range of motion
- Physical strength
- Lifting ability
- Stamina and ability to carry objects
- Other functional testing as appropriate
The testing is designed to push you to your maximum abilities, so be prepared to feel fatigued. All of this will be recorded during your evaluation. It is very important to alert your evaluating therapist if your symptoms worsen during the testing. They should note which activities are causing your symptoms to worsen and stop that activity for safety.
Depending on the purpose for your test, you may be asked to perform any of the following tasks:
- Get on a treadmill
- Move your hands or other parts of the body
- Handle or manipulate objects
- Undergo hand-eye coordination tests
- Push or pull
- Undergo cognitive tests
- Lift weights
- Test your grip
- Stack boxes
- Undergo dexterity tests
- Take step exercises
The results are not the end
Our team at Roy Law Group know all too well the tactics some insurers use in order to deny claims. One of those tactics is misstating or misinterpreting a therapist’s medical opinion in an FCE. This can have a devastating impact on your claim.
Read about Roy Law Group’s fight against Mutual of Omaha after an incorrectly stated outcome of an FCE: Noone v Mutual of Omaha.
If you fail your FCE, don’t think of it as the end of the fight. You may still have options, and you are not alone.
How Roy Law Group can help
With Roy Law Group by your side, we will review and assess your FCE report as your advocate, refute inaccurate results, and recommend additional testing if needed to support your claim.
Our goal is to help you through the process, obtain your disability benefits, and hang onto them as seamlessly as possible, without the financial worry of not having your disability benefits accessible once your claim is approved. Although it might seem daunting, a Functional Capacity Evaluation is not always bad, and in many cases it can flesh out your claim and support your entitlement to benefits.
Our disability insurance experts have reviewed hundreds of FCEs, and our experience can be invaluable when your insurance company sends you for FCE testing. As in all cases, we always work tirelessly to help you secure your benefits and stand up for your rights.
Contact Roy Law Group today for help with your disability claim or appeal.