Estimating Functional Capacity vs. Testing Functional Capacity
Posted by Sandy Goldstein on Thu, May 12, 2011 @ 07:46 AM
I will never forget the time I was taking a history from an evaluee during a Functional Capacity Evaluation. This 50-something-year-old male had suffered a compression fracture of his thoracic spine eight years prior. After surgery and extensive physical rehabilitation, he was declared maximum medically improved with permanent restrictions.
He was not tested; rather his physician gave him a note stating he should not lift more than 20 lbs. The note had no timeline associated with it, and no follow up was scheduled. My evaluee literally folded up the note, placed it in his wallet, and ceased working as a plumber.
He left his career of nearly 25 years. For the subsequent eight years he was “unable to perform his past work as a plumber,” he had been on Social Security Disability and was seeking vocational assistance.
Functional testing I performed revealed he could safely lift 50 lbs. Based on a reasonable degree of medical and ergonomic certainty, I concluded that he could have likely worked as a plumber all along.
A lesson to all medical, vocational, and human resources professionals: The advantages of going the extra step and using objective functional testing to assess function and fitness-for-duty cannot be overstated.
Research supports that job-specific testing is superior to functional estimates by a physician outside of the workplace.
The well-known research study Comparing self-report, clinical examination and functional testing in the assessment of work-related limitations in patients with chronic low back pain, 2005, (Disab and Rehabilitation, 2005 Sep 2;27 (17): 999-1005) showed the importance of actually testing subjects.
The researchers, Brouwer et al, concluded that that limitations derived from the clinical examination were higher than those derived from Functional Capacity Evaluation.
With our clients’ lives and livelihoods at risk, I strongly advocate objective functional and fitness-for-duty testing. Not because it is my line of work; it‘s simply the right thing to do.
Ethically and legally, we medical, vocational and human resources professionals owe it to our clients to not cut corners when assessing function and fitness-for-duty.
When objective testing is performed, the results provide evidence-based information on which stakeholders can rely to place a worker into a specific job, or at least, to specific job tasks.