When you file a long-term disability claim for an injury or illness, your insurance company could require that you complete a Functional Capacity Evaluation (FCE).
Insurance companies routinely require claimants to jump through a series of hoops when filing disability claims. These will ultimately determine whether their claims will be approved or denied. An FCE is just another one of these “hoops” that could have a life-changing impact, for better or worse.
If your insurance company asks you to participate in an FCE, you should contact a disability lawyer right away. The stakes are much too high to take chances, and an experienced legal team can help you to know what to expect and how to prepare.
We’ve outlined some important information about the FCE for you here, but we encourage you to contact us for a free consultation before you agree to participate in the test.
What is a Functional Capacity Evaluation?
An FCE is a performance-based series of tests to assess your ability to perform your job duties.
During an FCE, a physical therapist will assess the following:
- Your physical movement capacity
- Muscle ability and weakness
- Balance and dexterity issues
- Levels of pain or fatigue with various physical activities
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 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 of your test, your physical therapist might ask you 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 knows all too well the tactics some insurers use 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
- Recommend additional testing if needed to support your claim
Our goal is to help you get through the process, obtain your disability benefits, and hang onto them as seamlessly as possible. It might seem daunting, but a Functional Capacity Evaluation is not always bad. In many cases, it can strengthen 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.