Workers’ comp provides no-fault coverage of most employees’ work-related accidental injuries and occupational illnesses. If you’re hurt or become sick in the course of performing your job duties, you generally may file a claim for workers’ comp benefits. If your claim is successful, your benefits will cover all your medical expenses and two-thirds of your lost wages.
Impairment Rating and Job Restrictions
In most cases, your weekly wage benefits will continue until your doctor determines that you’ve reached maximum medical improvement (MMI) and releases you to return to your job. Some work-related injuries, however, are so serious that you might be left disabled after you’ve completed your treatment. In such a case, your doctor will give you an impairment rating in numerical form. If, for example, you’ve injured your arm and have only 90% of the strength and range of motion you had before your accident, you’ll receive a 10% impairment rating.
Your resulting job restrictions will be determined by this rating and the nature of your job. If you normally use your arms to lift and carry heavy objects, your restrictions could affect your ability to work. If, however, you sit at a desk and use a computer, the strength and range of motion in your arm might not restrict you at all from doing your job. The functional capacity evaluation (FCE) helps your doctor assign an accurate impairment rating and appropriate job restrictions for you.
What a Functional Capacity Evaluation Tests
A functional capacity evaluation (FCE) is a battery of physical tests usually administered by a physical therapist who is given a copy of your job description. The therapist will measure the strength and range of motion you’ve lost due to your injury and use U.S. Department of Labor guidelines to determine the level of work that you can do. Ratings include the following:
- Very heavy
Your FCE is likely to include the following tests:
Test of Endurance
You might have to walk or run on a treadmill while the therapist checks your posture and gait, recording your heart rate and noting how long you’re able to continue without stopping.
Test of Physical Ability
After performing baseline physical tests, the therapist will rate your ability to:
- Grasp and handle an object with either hand
- Reach overhead
- Push and pull an object
- Stand, sit, and walk
- Crouch, stoop, kneel, and crawl
- Climb stairs or ladders
- Lift an object from the floor to your waist, from your waist to your shoulder, and from the floor to your shoulder
The musculoskeletal test determines your ability to stand up straight and walk without a limp. It also measures your muscle tone, flexibility, reflexes, and range of motion.
The therapist will ask you about how you were injured, the treatment you’ve received, physical therapy in which you’ve participated, and medications you have taken or are taking. You should answer all questions honestly and in detail.
You Should Try Your Best on These Tests
It’s very important that you perform to the best of your ability on all the tasks you’re given.
The therapist will be able to spot any intentional underachieving which will damage your claim for future benefits. Your doctor will use the results of your FCE to give you an impairment rating, decide whether you can return to your previous job or a light-duty job, and set your work restrictions.
FCE Results Can Impact Your Life
If your impairment makes it impossible for you to resume your previous duties, your employer might be able to offer you a light-duty job that accommodates your restrictions. If that job pays less than your previous job did, you could receive further workers’ comp benefits to cover a portion of the salary you lose. If you cannot perform even a light-duty job, or no such job is available to you, you could receive long-term disability benefits. With certain catastrophic injuries like brain damage or paralysis, you could even receive benefits for life.
In any of these scenarios, your claim is a potentially expensive one for your employer’s insurance company, which is in business to make a profit, not to pay expensive workers’ comp claims. If your FCE shows that you are seriously impaired or completely unable to work, the insurer stands to lose a lot of money on your claim. It might try to ignore or discredit the FCE results in order to avoid paying long-term benefits. It might even encourage your doctor, who must be approved by the insurer, to downplay your poor performance on a FCE and give you a low impairment rating or minimal restrictions so that you can resume work.
FCE Testing Is Subjective
Neither FCEs nor the methods for interpreting their results are completely standardized. There are many versions of the FCE that vary from one another in different ways, and the interpretation of FCE results can be somewhat subjective. There are cases in which the doctor interpreting the results is not especially experienced with or knowledgeable about the validity of FCE procedures. In workers’ comp claim cases challenging the admissibility of FCE results at the appellate level, decisions have been varied. FCE evidence has sometimes been admitted and sometimes thrown out. The insurer’s attorneys will cite the subjectivity surrounding FCEs to argue against a high impairment rating and extreme job restrictions based on your test results.
When this happens, we recommend having an experienced workers’ comp attorney to be sure your FCE results are accurate and properly interpreted by your doctor. If you feel your doctor has not given you a fair impairment rating or reasonable restrictions, your lawyer can:
- Call in expert witnesses
- Enlist the help of a vocational specialist
- Help you request an independent medical exam
- Request a hearing before the South Carolina Workers’ Compensation Commission (SCWCC)
- Appeal your case to the South Carolina Court of Appeals if necessary
Due to the complexity and non-standardization of FCE testing, as well as the inconsistent precedents in FCE court cases, you don’t want to face the insurer’s attorneys without an experienced workers’ comp lawyer in your corner.
Have You Been Injured on the Job in Conway, South Carolina?
If you've been hurt at your job, you can speak with a workers' compensation lawyer. Please contact us online or call our Conway office directly at 843.248.7486 to schedule your consultation. We are also able to meet clients at our Charleston, Myrtle Beach, Murrells Inlet, Mt. Pleasant, North Myrtle Beach, Florence or North Charleston office locations.