Functional Capacity Evaluation (FCE)

Functional capacity evaluation is defined as “a systematic method of measuring an individual’s ability to perform meaningful tasks on a safe and dependable basis.”

FCE includes all impairments, not just those that result in physical functional limitations.

In general, the purpose of FCE is to collect information about the functional limitations of a person with medical impairment. Beyond this general purpose, FCE has three specific purposes:

  1. Improve the likelihood that the patient will be safe in subsequent job task performance. A comparison of a patient’s abilities to a job’s demands is made in an attempt to diminish the risk of re-injury associated with a mismatch. Shortfalls between the patient’s resources and the environment’s demands result in stress or increased risk for injury.
  2. Assist the patient to improve role performance through identification of functional decrements so that they may be resolved or worked around. Health care professionals use this information to triage patients into proper treatment programs and to measure progress.
  3. Determine the presence (and, if present, the degree) of disability so that a bureaucratic or juridical entity can assign, apportion, or deny financial and medical disability benefits.

The term functional connotes performance of a purposeful, meaningful, or useful task that has a beginning and an end with a result that can be measured. Functional limitations are the effect of the patient’s impairment on his or her ability to perform meaningful tasks. Function is the focus of this type of evaluation process because functional limitations translate the effect of impairment on disability. Functional limitations are the proximal cause of disability.

In recent years, there has been an increased emphasis on development of the scientific basis of FCE. This has been stimulated by a growing awareness of its utility, and supported by major investments in research by large insurance providers and by state, provincial, and federal governmental agencies such as the United States Social Security Administration. The most important development has been the application of a taxonomic approach to FCE to organize and focus this research. The reference below employs this taxonomic approach, using it to organize both conceptual and applied information.

Matheson, L. (2003). The functional capacity evaluation. In G. Andersson & S. Demeter & G. Smith (Eds.), Disability Evaluation. 2nd Edition. Chicago, IL: Mosby Yearbook.

Leonard N. Matheson, PhD
Washington University School of Medicine, St. Louis