According to the International Labour Organisation (ILO), approximately US 2.8 trillion dollars are lost annually as a result of the direct and indirect costs associated with workplace injuries and illnesses such as workers' compensation, medical expenses, and loss of productivity. The Occupational Health and Safety Act mandates that every employer must, as far as reasonable practicable, provide and maintain a healthy and safe working environment. This includes planning, developing and implementing medical surveillance programs that include functional capacity evaluations. Preventing injury, as well as ensuring the efficiency of the workplace, is vital to the successful operations of an organization. Functional capacity evaluations therefore, provide employers with a tool for measuring an injured worker's ability to return to the workplace.
What is a Functional Capacity Evaluation?
A Functional Capacity Evaluation (FCE) is used to measure an individual’s capacity to carry out tasks associated with his or her job role. Traditionally, functional capacity evaluations measured an individual’s ability to perform the physical demands of a specific job. However, within recent years they have evolved to include the cognitive and psychological demands of a job as well. Therefore, in an occupational setting, functional capacity evaluations are conducted to provide a comparison of a worker’s health status, as well as body functions and structure, relative to the demands of their job and work environment.
Types of Functional Capacity Evaluations
There are two types of functional capacity evaluations that are commonly utilized. These are: Job Specific Functional Capacity Evaluations and General Purpose Functional Capacity Evaluations.
- Job Specific FCEs measures a worker's ability to perform the physical demands of the job. This type of FCE can either be performed in a clinical setting or at the job site. The results of job specific FCEs will determine whether or not the worker can do the assigned job duties safely, or if modifications to the job tasks are required.
- General Purpose FCEs are conducted when there is no longer a specific job for a worker, for example, returning to work after an illness or injury. Standardized tests are conducted to evaluate the individual's overall physical capabilities, the results of which will help to determine if the employee's ability to perform specific jobs that may be come available to the employee in the future.
The Benefits of Conducting Functional Capacity Evaluations in an Occupational Setting
The benefits of conducting functional capacity evaluations are not only limited to matching the capacity of workers with their job role. Functional capacity evaluations can also:
- Reduce the rate of workplace injuries
- Reduce worker compensation claims and insurance costs
- Create a safer work environment
- Assist with the planning and structuring of effective return-to-work programs and guidelines
- Minimise downtime
The Components of a Functional Capacity Evaluation
The components of a functional capacity evaluation will vary based on the purpose for which it is being conducted. FCEs are conducted on a one-on-one basis and may range in lengths from 4 hours up to two consecutive days. In an occupational setting, the worker will first be interviewed by either a physiotherapist, occupational therapist, or exercise physiologist. That interview is then followed by a review of the worker's medical records. Next, a series of assessment activities are carried out, including:
- Material-handling activities (lifting, carrying, pushing, and pulling)
- Positional/postural tolerance activities (sitting, standing, walking, balancing, squatting, etc.)
- Pain monitoring
- Cardiovascular fitness test (step test)
- Endurance lift evaluations
- Job specific tasks as required
- Hand dexterity and coordination
- Safe maximum lifting capacity
- Safe maximum carrying capacity evaluation
- Cognitive evaluations
Following the evaluation the worker, as well as the employer, will be provided with a comprehensive report produced by the physiotherapists, and occupational therapists or exercise physiologists detailing the following:
- The worker's ability to return safely to work
- The need for any workplace modifications or adjustments, if any
- The need for additional rehabilitation
Practical Applications of Functional Capacity Evaluations in the Workplace
Functional capacity evaluations are useful in the following occupational settings:
- To determine a worker's physical capabilities and limitations after an illness or injury
- For pre-employment screenings to ensure that the potential worker is able cope with the physical and cognitive demands of the job position
- To settle workers' compensation and disability cases
- To determine whether a worker is able to safely return to his/her full job duties
- To provide an objective analysis of a worker's functional performance so that the psychosocial factors that influence return-to-work outcomes can be identified
- To identify additional rehabilitation needs of workers, if any
- To obtain baseline measurements
Advantages of Conducting Functional Capacity Evaluations
Although the validity of functional capacity evaluations have received much criticism with regards to the extent it measures an individual's ability or inability to work, FCEs are still widely viewed as one of the most reliable and objective ways to measure a person's physical and cognitive capabilities. For employees, it ensures that there is a safe transition from injury to return-to-work. For employers, there is a greater chance of increased productivity and profitability, as well as the creation of a safer work environment for their workers. The latter makes employers less vulnerable to workers’ compensation claims and lawsuits over alleged safety breaches. Thus, FCEs are essential in ensuring the safety and well-being of both employers and their workers.