The Functional Capacity Evaluation
In the last issue of the newsletter, Employment Testing was introduced by Vic Zuccarello, OTR/L as a way to help select the best candidate for a physically demanding job opening. However, even with the best screening tools and ergonomic and safety measures on the job, injuries still occur. The ergonomist should have a working knowledge of what a worker can expect when they are going through testing processes that will clear or prevent a worker from returning to work. One of the testing methods is the Functional Capacity Evaluation (F.C.E.).
In a news release from the Bureau of Labor Statistic back in 2004, it was presented that: “A total of 1.4 million injuries and illnesses in private industry required recuperation away from work beyond the day of the incident.
Sprains and strains, most often involving the back, accounted for 43 percent of injuries and illnesses resulting in days away from work in 2002. Among major disabling injuries and illnesses, median days away from work were highest for carpal tunnel syndrome (30 days), fractures (29 days), and amputations (26 days).
Among the most frequent events or exposures, repetitive motion, such as grasping tools, scanning groceries and typing, resulted in the longest absences from work — a median of 23 days. Falls to lower level resulted in the next longest absences from work with a median of 14 days.”
In many industries the worker cannot return to work until they are cleared by their physician and/or had a F.C.E. to help determine either their level of fitness for work or to determine performance deficits against their job descriptions.
Reference: BLS 4-2-04 news release.
Institutions such as the University of Vermont have a Return To Work-Transitional Duty Program that covers all compensable disabling conditions insured under Workers Compensation and is limited to employees with temporary impairments. These periods may last up to 12 weeks.
For an employer as well as the worker themselves, a method to help determine the abilities of the worker to return to work after time away due to injury is needed to make meaningful decisions regarding either the return to gainful employment or to determine a level of disability needed for compensation ratings. Therefore the F.C.E. is a tool that measures a worker’s ability to safely perform related tasks. The goals being to: 1) Determine safe levels of function for specific jobs or for general function 2) Determine the degree of impairment 3) Case settlement 4) Determine the level of willful participation by the worker 5) Return to work status.
F.C.E. Referrals may come from:
* Case managers
* Other therapists
* Insurance carriers
* Employers/human resource personnel/risk managers
F.C.E.’s have been used for over 30 years to find these values. Dr. Marcos Streibelt who has done research on the value of using F.C.E.’s to determine the predictability for a worker to return to work. He found that the information from this study did help the researchers identify and then test a Clinical Prediction Rule (CPR). The CPR was used to identify people who were likely to be returners and those who would be non-returners.
The CPR was defined as follows: returnees would be workers who had low rates of sick leave before entering rehab. They also had a positive expectation that they could handle the job if they returned. And they failed five or fewer parts of the F.C.E.
Applying this CPR to his research group of 145 workers, the authors reported it was possible to accurately predict returners from non-returners for three out of four workers when the potential status of workers was unclear. Combining the already used and accurate self-report model with the F.C.E can help improve the success of the clinical prediction rule.
Marco Streibelt, PhD, et al. Value of Functional Capacity Evaluation Information in a Clinical Setting for Predicting Return to Work. In Archives of Physical Medicine and Rehabilitation. March 2009. Vol. 90. No. 3. Pp. 429-434.
Topics from the Journals and Websites
The American Physical Therapy Association as well as the American Occupational Therapy Association generally agree that the guidelines for effective F.C.E.’s must provide objective measurements of safe, functional ability relative to the demands of the work. In other words, an office worker’s F.C.E. will not be given the same goals for passing an evaluation as would a truck driver.
Components of a F.C.E. include: Intake Interview; Musculoskeletal Screening; Medical History including recent and current complaints of pain and/or limitation; Work History; Cardiovascular and Neurological status; specific functional testing (static, material or non-material handling); consistency of the level of effort of the tested worker. The F.C.E report includes an overall level of work, a summary of physical abilities that is usually couched in the language used by the Dictionary Of Titles (DOT), information about consistency of effort, job match information, and recommendations, if requested.
Testing can cover a period of 4-8 hours over 1-2 days in some cases and produce a report of approximately 34 pages.
For an ergonomist whose client has had a F.C.E., they should utilize the valuable information that is gathered and analyzed in the report in order to help return the worker to their job and livelihood. The ergonomist should also work with with the case manager and/or H.R. department of the company to employ the results of the F.C.E. to help set-up the work station to promote the rehabilitation progress on the job. For those who would like to learn more about F.C.E.’s or to become certified as provider of this service, contact: www.backschoolofatlanta.com for more details.
F.C.E.'s on www.apta.org
F.C.E.'s on www.aota.org
Back School of Atlanta News
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Back School of Atlanta is now looking for co-sponsors for live courses in 2009 and 2010. The courses are targeted to groups including Occupational and Physical Therapists, Safety Professionals, Risk & Claims Managers, Human Resources Professionals, Occupational Medicine Professionals and Nurse Practitioners. For information on co-sponsorship of a course, please contact Back School of Atlanta for details. Otherwise, watch the website for courses scheduled.
The Government Corner
The National Safety Council is valuable resource that is available to the public regarding all aspects of health and safety. Their resource library includes over 162,000 documents that cover a wide range of safety issues and topics, such as: Safety management programs, Compliance and regulations, Safety systems, Ergonomics, Training, Statistics, Occupational safety, Traffic safety, Agricultural safety, Community safety, and Home safety.
They have information from reliable sources from all media. They reference documents dating back to the early 1900's, helping you put safety into context.
Find them at:
Did you know…?
By walking an extra 20 minutes every day, an average person will burn off seven pounds of body fat in an year. So wean your clients off their desks and getting them doing regular ergo breaks and walking.
Boost Your Ergonomics Consulting Business
The Back School of Atlanta is pleased to announce the launch of a new service - the Certified Professionals listing on our website, for all of our past graduates aimed at helping grow your ergonomics consulting business.
We will list your name and the city and state of your practice/business for one year. We will also include a link which will allow potential clients the ability to email you without seeing your actual email address and, if you choose, your contact phone number. You can also apply to become a Premium listing so that your expanded listing will always appear at the top.
After the first year, there is a quick recertification process to continue your listing on our site as a Certified Ergonomics Professional.
For more information, please click here.
Let us help support you and your business.
Director Back School of Atlanta
Ergo Websites, Ergo Products, gadgets and doodads
The Roller Mouse
The RollerMouse is a unique ergonomic pointing device that helps prevent strain and tension of upper extremity muscles including shoulders and elbows. It is a remarkable way to control the cursor without the need to grip or reach for a mouse, and requires minimal space. A rubber covered tube, much like a straw runs the width of the tray and allows the worker to scroll or laterally move the cursor with their fingers or thumb. The cost is around $200.00
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In this issue:
• Topics from the Journals and Websites
• Back School of Atlanta News
• The Government Corner
• Did you know...
• Boost Your Ergonomics Consulting Business
• Ergo Websites, Ergo Products, gadgets and doodads
Upcoming Back School of Atlanta Workshops: LEVEL I: Musculoskeletal Disorders and Ergonomics Certification
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Springfield, MA - July 25 & 26, 2009
St. Petersburg, FL - August 6 & 7, 2009 LEVEL I: Functional Capacity Evaluation Certification
Greenville, SC - August 14 & 15, 2009
Robert Niklewicz, PT, DHSc, CIE, CEAS
Ronald W. Porter, PT, CEAS
Director, Back School of Atlanta