Functional Capacity Evaluation (FCE) in Chronic Severe Disability

An FCE measures maximal voluntary performance of work-related tasks (lifting, carrying, posture tolerance, endurance).

In Long-Standing Severe Injury (22 years post-crush)

• Baseline function likely fixed – FCE may not change management.
• Safety risk – maximal testing could exacerbate pain, cause injury.
• Legal/insurance context – often requested for disability determination, not rehabilitation.

When FCE May Still Help

• Document current capacity for vocational planning.
• Identify specific deficits for targeted accommodations.
• Establish baseline for future comparison (e.g., after new intervention).

Decision

Should be clinician-directed. If rehabilitation potential exists, a modified/submaximal FCE with close monitoring may be appropriate. If purely for claims, ensure examiner understands chronic pain behaviors.