Your Workers’ Compensation claim can require you to see a lot of different doctors and other care providers, and it can be difficult to keep all of the exams and reviews straight. On top of that, it can be difficult to know what you have to do and what your rights are during those exams.
A Functional Capacity Evaluation (FCE) is usually performed toward the end of your case when you are at or approaching maximum medical improvement (MMI). The goal is to determine what limitations and restrictions you need for your return to work. You typically have the right to speak with your attorney before the exam, but you cannot have them present. You do not choose the provider, and you cannot refuse the evaluation without jeopardizing your benefits. You do not have to pay for the FCE.
For a free case review, call the Pennsylvania Certified Workers’ Compensation Lawyers at Cardamone Law by dialing (267) 651-7945.
What Is a Functional Capacity Evaluation?
A Functional Capacity Evaluation (FCE) is used to evaluate what abilities and skills you have now that your disability has stabilized. At this stage of maximal medical improvement (MMI), your doctors will have found that your disability is as much improved as it will be, and it is time to start thinking about a return to work.
In the FCE, the evaluator will determine what abilities you have, what you still cannot do, and what restrictions you need on your work going forward. It often involves simulated work tasks, like walking, lifting, carrying, etc., to test your abilities.
FCEs vs. Other Exams
There are a bunch of abbreviations for different exams, and keeping all of the exams you need straight can be difficult:
- FCE – Functional Capacity Evaluation – determines what skills and abilities a disabled worker has so decisions can be made about return to work, what restrictions are needed, etc.
- IME – Independent Medical Exam – a medical exam from a doctor the Work Comp carrier selects to evaluate your condition, disability, and need for care.
- IRE – Impairment Rating Evaluation – a medical exam to determine full-body impairment rating, used to select whether you remain on total disability status or switch to 500 weeks max of partial disability status (if your rating is under 35%).
- Labor Market Survey – determines what work meeting your restrictions is available in your area.
- Vocational Evaluation – determines, at the beginning of your case, what skills you have with your disability and what your effect on earning capacity is.
Why Do I Need an FCE?
FCEs are used to determine when you can return to work and what tasks you can perform. They are there primarily to define your limits so your employer doesn’t push you beyond your restrictions.
When Does it Take Place?
FCEs usually take place toward the end of your case, after you have reached maximum medical improvement (MMI).
Who Performs the Evaluation
The FCE is usually performed by a physical therapist, occupational therapist, or other trained professional. They are not usually performed by doctors, but the person performing it does need to be licensed.
Who Pays for an FCE?
Your employer or their insurance carrier pays for the FCE. You should not have to spend money on this.
Can I Refuse a Functional Capacity Evaluation in a Workers’ Comp Case?
You can technically say no to an FCE, an IME, an IRE, or any other evaluation. In fact, you can refuse to use Workers’ Compensation entirely. However, refusing any of these required exams means you will lose your benefits.
The employer/insurance carrier has a right to demand certain exams as part of your case, and refusal to cooperate with the required exams means pausing your benefits until you do. If you are hesitant to go to one of these exams, our Pennsylvania Workers’ Comp lawyers can explain what the purpose of the exam is, what happens during it, and why you need to attend.
Attending all scheduled exams is an important part of keeping your benefits.
Can I Choose My FCE Doctor?
The Workers’ Comp insurance carrier or your employer usually selects who will perform the FCE. If there is a problem with their selection – such as a conflict of interest – we can see if they are willing to compromise and select a different provider or take it up with the WCJ.
Do I Have to Pay for Transportation to an FCE?
Generally, any required appointments should be in a location you can access. However, if they cause you to miss work or you need transportation to the exam, the Workers’ Comp insurance carrier should be required to pay for that or provide transportation.
Can I Meet with My Lawyer Before an FCE?
You can – and should – meet with your lawyers before attending an FCE. We can explain to you what you should expect, how you should act, and what you should avoid.
For example, you should know going into the exam that there are no “right” or “wrong” answers, and that you should just do your best to answer any questions truthfully and to perform the tasks to the best of your ability. You should also know that it is typically bad to hold back, “fake” your condition, or exaggerate your injuries.
Can I Have My Lawyer Present During My FCE?
Generally speaking, workers do not bring their lawyers to their FCEs. These exams can take quite some time and, on top of the fact that you do not want to have to pay a lawyer for those hours, you usually don’t need a lawyer.
You can meet with us before your FCE, and we can talk to you about any concerns or questions you might have.
Can I Get a Second Opinion?
In many of the required exams, like IMEs and IREs, the insurance carrier tells you what provider to go to for the exam. However, we can hire our own outside doctors to perform exams, too. If the insurance carrier’s doctor gives you a bad result and tries to convince the WCJ to stop your benefits, having that second opinion from our own doctor can provide counter evidence.
With an FCE, your benefits aren’t on the line. The findings only determine what you can do at work going forward, and there is usually no need to combat these findings. We can potentially seek out an alternative FCE to rebut their findings, but it is often in your best interests to get back to work, even if it seems difficult.
This is always analyzed on a case-by-case basis, so let us know if you think the FCE findings are wrong.
Call Our Workers’ Compensation Specialists in Pennsylvania Today
For help with your case, call Cardamone Law’s Philadelphia, PA Workers’ Compensation attorneys at (267) 651-7945.
