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We firmly believe in the medical necessity of an IME coupled with an FCE. This test is performed at the time of an Independent Medical Evaluation. The combination of these procedures provides the most realistic insight as to impairment/disability, causation, apportionment, and retained safe work capabilities.  

A Functional Capacity Evaluation (FCE) is a systematic process of measuring an individual’s ability to perform meaningful tasks safely and dependably. It is based on objective performance measurements that are analyzed and recorded by state-of-the-art computer technology. An FCE is not an observation or subjective determination of an individual’s self report of abilities.  

A Functional Capacity Evaluation should be used in the determination of the safe return to work of an injured employee; matching job demands to retained capabilities. A Functional Capacity Evaluation can identify functional weakness and strength deficits, allowing for proper treatment and rehabilitation. An FCE also aids in establishing an impartial and objective measurement of the worker’s capabilities; necessary for a bureaucratic or judicial resolution and/or disability determination. Leonard Matheson, Ph.D., indicated: 

“An FCE is used as a model of service to improve the health and function of our citizens so that they can return to work, resume full-fledged participation in the economy, restore dignity to themselves and to their families, and improve the overall financial and emotional health of the nation.” 

The relevance of a Functional Capacity Evaluation in the State of Kentucky as objective measurement of strength capabilities bears a direct relationship in the calculation of extent of injury and impairment. Kentucky Statute defines “injury” occurring on or after December 12, 1996, as: 

“Injury means any work-related traumatic event or series of traumatic events, including cumulative trauma, arising out of and in the course of employment which is the proximate cause producing harmful change in the human organism, evidenced by objective medical findings.” Injury does not include the affects of the natural aging process and does not include any communicable disease unless the risk of contracting the disease is increased by the nature of the employment. “Injury”, when used generally, unless the context indicates otherwise, shall include an occupational disease and damage to a prosthetic appliance, but shall not include a psychological, psychiatric, or stress‑related change in the human organism unless it is the direct result of a physical injury.” 

Therefore, in Kentucky law, impairment and disability are directly related to the “harmful change in the human organism.” An objective measurement of strength and work capabilities is substantial proof of “injury” and may directly reflect the long-term effects of “injury.”  

Also in Kentucky, an “Impairment Grid” was established for the calculation of benefits.  Under KRS 342-730 (1)(b) the Impairment Grid takes into consideration the impairment rating by the AMA Guides and is multiplied by a “factor” relative to the impairment percentage.  

Then, KRS 342-730 (1)(c)(1) provides: 

“If an injured worker does not retain the physical capacity to return to the type of work that the employee performed at the time of the injury, the benefit rate is multiplied by three (3) times the amount otherwise determined.”  

Therefore, the Functional Capacity Evaluation becomes an integral part in claims resolution. Measurements of the physical requirements of a job activity may be measured by conventional means. The Functional Capacity Evaluation then measures the retained strength capabilities of the individual. This means of objective comparison determines whether the individual possesses the strength capabilities of safely returning to that job. The FCE, therefore, takes out of play the subjective impressions of the evaluator. Therefore, should the patient possess the strength capabilities required for the previous job, the permanent partial disability benefits would not be tripled.

Statistical analysis of the direct and indirect costs of restricted-duty workdays and absence are typically $500 to $700 per day and may affect 12% to 15% of a company’s average payroll. Directly, the cost of medical care, rehabilitation, TTD, and claims processing is significant. However, even when the injured worker is on restricted duty, the indirect costs of hiring temporary help, overtime hours, additional training and supervision, as well as reduced output result in increased cost to the employers. The Functional Capacity Evaluation is an objective measurement that more scientifically determines maximum medical improvement and, therefore, cessation of TTD and return to work. Furthermore, it is a tool by which measurements can be formed to place the patient in meaningful work activities and, therefore, decreasing direct and indirect costs.

In summary, the FCE increases the credibility of the Impairment Analysis System. It provides objective measurements of function relevant not only to the safe return to work of the injured employee, but also directly reflecting maximum medical improvement and compensation awards. It is a means to better help prevent reinjury.



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Lexington, KY 40513