Functional Capacity Evaluations (FCE) in Virginia Workers’ Comp Claims

Virginia FCE Workers’ Comp Claims

If an employee is injured at work and files a workers’ compensation claim, they may be asked to participate in a functional capacity evaluation (“FCE”) at various times throughout the recovery process. While insurance companies often claim that these evaluations are a valuable tool to determine return-to-work ability, the results of FCEs are routinely weaponized against injured workers during the workers’ compensation claims process and litigation. Further, many injured workers and their attorneys believe that FCE results are of little real value in determining what job activities an individual can complete forty hours per week, week after week.

As such, if an injured worker is ordered to undergo an FCE, it is advisable to consult with an experienced attorney beforehand to understand what to expect and how to avoid common pitfalls that can compromise a claim.

If you or a loved one suffered a work-related injury or illness, we invite you to call The Law Offices of Mark T. Hurt today to schedule a free consultation. As a Virginia workers’ compensation attorney with over two decades of practicing law, firm-founding attorney Mark Hurt can listen to the facts of your injury, explain your legal options, and help navigate through each step of the workers’ compensation process, including FCEs. Further, Mark and our firm represent injured employees on a contingency-fee-basis, meaning you will never owe a fee unless we are successful in obtaining compensation on your behalf.

We invite you to call our firm today to schedule your free consultation.

What is an FCE?

A functional capacity evaluation is a series of tests conducted on an injured employee in a workers’ compensation claim to assess disabilities and limitations. The test is typically ordered by a treating physician; however, insurance adjusters, lawyers, employers, or even an injured claimant can request an evaluation.

When and Why Do You Need an FCE?

Virginia law does not explicitly require individuals to undergo functional capacity evaluations, but any individual who files a Virginia workers’ compensation claim can be subject to an FCE. Further, if an FCE is ordered by a treating physician, a workers’ compensation claimant must undergo the examination or risk losing valuable wage loss compensation.

Insurers often request physicians to prescribe an FCE at one of the following times:

• At the outset of a work injury (subsequent FCE results may be compared to these tests to measure the extent of recovery);
• When an individual reaches Maximum Medical Improvement (“MMI”);
• When an injured worker is having difficulty performing light-duty tasks;
• When objective findings on diagnostic tests do not reflect a patient’s subjective pain complaints;
• When an individual is healing slower than anticipated; or
• When surveillance shows an individual engaged in daily living activities outside of work restrictions.

How to Prepare for an FCE

Before an FCE, the examiner will typically provide an injured worker with paperwork that must be completed one week before testing. It is critical to note, in many cases, the questions posed on the paperwork will be of little relevance to an injury. Thus, it is advisable to consult with an experienced Virginia FCE attorney to determine if the information must be completed.

The FCE will take place at a medical facility near the injured worker and will involve three to eight hours of testing over one to two days (some FCEs can take longer to complete). Because of the grueling nature of FCEs, the following are a few actions that can be taken to prepare:

• Arrange transportation to and from the appointment;
• Dress comfortably and wear athletic shoes;
• Bring water;
• Avoid taking pain medication, as this can skew performance and pain levels;
• Try but do not overdo it; and
• Always act as if the FCE examiner is watching you, even in the waiting room and parking lot.

What Types of Tests Are Administered During a Virginia FCE?

During an FCE, various tests may be administered to evaluate a wide range of factors, such as:

• Psychosocial issues
• Blood pressure
• Heart Rate
• Pain Assessment
• Aerobic Abilities
• Material Handling
• Postural Abilities
• Flexibility
• Coordination
• Raping Exchange Grip
• Visual
• Work Simulation
• Spinal Function
• Whole Body Range of Motion
• Mobility
• Strength
• Repetitive Motions

The FCE examiner will then prepare a written report detailing the results and his or her conclusions within a few days.

Can I Challenge Unfavorable FCE Results?

Based on an FCE, a physician will review the examination results and then determine a worker’s physical ability to rejoin the workforce. A significant percentage of FCE results are unfavorable, often calling into question an injured employee’s efforts, suggesting they may be lying for monetary gain, or concluding an individual can do more than they (or their treating physician) believe is possible.

If you were ordered to undergo an FCE and disagree with the results, it is critical to challenge such findings, as they can significantly impact your ongoing workers’ compensation claim and benefits.

As an experienced Virginia workers’ compensation law firm, we routinely use examiner’s FCE depositions and discovery tools to develop evidence to refute unfavorable FCEs. We regularly take action to subpoena physical therapists’ files and request:

• Handwritten notes from the FCE,
• The FCE software manual,
• Any correspondence between the FCE examiner and insurers,
• Billing statements related to the FCE
• Diagnostic testing results,
• Raw FCE data, and
• Copies of written job descriptions to review to determine accuracy and completeness.

Can An Injured Employee Request an FCE in Virginia?

Injured employees and their attorneys may request an FCE; however, if an FCE is independently arranged, the examination costs may not be covered by workers’ compensation. Conversely, if the FCE is requested by a treating physician or insurance company, the expense associated with the evaluation will be fully covered.

If you would like to arrange an independent evaluation, the following are several Virginia providers offering functional capacity evaluations:

• Alliance Physical Therapy
• Amelia Physical Therapy
• Bon Secours in Motion
• Centra Industrial Rehabilitation
• CORA Physical Therapy
• Dynamic Rehab Therapy
• Industrial Health
• Ivy Rehab Network

Call Today to Schedule a Free Consultation with An Experienced Virginia FCE Workers’ Comp Attorney.

One unfavorable FCE can place an entire workers’ compensation claim in jeopardy. As such, it is vital to understand how FCEs work and to consult with an experienced Virginia workers’ compensation attorney who can provide strategic guidance throughout the entire process, helping to increase the chances of securing full and fair benefits and compensation.

If you or a loved one was injured at work and ordered to undergo an FCE, we invite you to call The Law Offices of Mark T. Hurt today to schedule a free, no-obligation consultation to learn how we can help protect your rights and workers’ compensation benefits.