What happens when your FCE is invalid?

By Jason Weinstock on February 10, 2016


An FCE is a Functional Capacity Evaluation that takes about 2-3 hours at a physical therapist’s office selected by the adjuster to help the treating doctor determine whether the injured worker should have permanent work restrictions.  More and more treating physicians are requesting that they be done before the doctor gives permanent work restrictions.   Unfortunately, some doctors don’t understand (or don’t want to understand) that they have the final authority as treating doctor to agree or disagree with the FCE findings.

If the FCE comes back invalid, most doctors feel compelled to return the injured worker to full duty work even though it is obvious that the injured worker is incapable of doing full duty work.  I’ve been told by one facility that does many FCE’s that almost a third of its evaluations are invalid, because the injured worker did not pass 70% of the validity criteria necessary to make the test valid.   The validity criteria are supposedly a measure of whether a person is giving a legitimate effort to do the tasks asked by the FCE examiner.  For example, if the injured worker does not show an increase in blood pressure but reports that it is too difficult to  lift a certain weight, the test may be regarded as invalid.  While these FCE examiners swear by their validity criteria, there are legitimate reasons why a person may have invalid results.

Claimants’ attorneys compare what facilities routinely showed invalid FCE evaluations.  Repeat FCE’s done at other reputable facilities often show valid efforts.  Of course, it takes time and money to schedule a repeat FCE that should then be sent to the treating physician for realistic permanent work restrictions.  Meanwhile, the adjuster has stopped compensation checks based on the prior full duty work release, and an appeal must be filed.

If you have an invalid FCE, the sooner you have your attorney file an appeal and schedule a repeat FCE at a different facility, the faster you compensation checks can be restored.

Tags: , ,