Kootenay Health Services - Snowflake


Since 1996

What is a Functional Capacity Evaluation

T“It is a systematic process of measuring and developing an individual’s capacity to dependably sustain performance in response to broadly defined work demands” (A Systematic Approach to Industrial Rehabilitation, Dr. Leonard Matheson, 1986).

At Kootenay Health Services, FCEs are completed by therapists who have attended a post graduate residency program to become a certified work capacity evaluator (Roy Matheson and Associates).

Functional Capacity Evaluations

Benefits & Process

The benefit of an FCE over a brief functional review is the increased validity of the assessment. The assessor uses objective tests and skilled clinical observation over one-two days to determine the level of effort the worker is providing, as well as the worker’s demonstrated consistency of function and consistency of presentation of symptoms.

Functional information is gathered by assessment with a variety of tests, which are objective and standardized, and most of the tests have normative data for comparison. The therapist develops the flow and the content of the assessment based on the purpose of the assessment (i.e. referral question (s)). Specific functional information obtained in an FCE includes:

  • Strength rating per the NOC/DOT (lifting, carrying, pushing and pulling)
  • Postural tolerances for work (sitting, standing, stooping)
  • Body dexterity (kneel, crouch, crawl, low level work, overhead reaching etc,)
  • Reaching, handling and dexterity tolerances
  • Simulated work situations to mimic the worker’s job demands (i.e. driving, shoveling, clerical tasks)
  • Cardiovascular fitness and endurance for full time work tasks

The worker’s functional profile is then compared to the demands of the specific job. If requested, information to increase function for work tasks is provided such as equipment supports, gradual return to work programs etc.

Specific questions from the fee payer are helpful prior to the FCE.

Cognitive Functional Capacity Evaluation

A Cognitive Functional Capacity Evaluation is a comprehensive and evidence-based assessment that assists to determine a client’s cognitive abilities and limitations. Cognitive issues can arise from brain injury, concussion, mental illness, cancer, and other neurological illnesses.

The Cognitive FCE will assess a client’s attention, memory, problem solving, behavioural changes, emotional tolerance, fatigue and executive functioning. The Cognitive FCE can be completed in conjunction with a regular FCE or as a stand-alone assessment.

The Cognitive FCE can assist with determining a client’s ability to perform their occupation, provide recommendations for return to function/return to work and work place accommodations.

Medical-Legal Services

Occupational Therapists at Kootenay Health Services can assist with managing complex medical-legal files and work to facilitate a client’s recovery from their injuries using evidence based assessments and interventions.

Cost of Future Care (CFC) Assessment is often completed in conjunction with a Functional Capacity Evaluation (but can be a stand alone service). The CFC is often conducted within a client’s home to assess their limitations with respect to their capacity to complete activities of daily living. The CFC may also be completed in other environments where the client is experiencing limitations. The CFC provides a thorough list of services/equipment required for the client by working closely with medical professionals/experts and other healthcare professionals to provide a defensible, justifiable and reasonable (with respect to cost) report.

Functional Capacity Evaluations

Robyn Clark

Emma Haley