CVE Functional Capacity Evaluation 5 — Questions and Answers
Question 1: In vocational evaluation, the PRIMARY difference between an FCE and a Physical Capacities Evaluation (PCE) is that an FCE:
- Focuses exclusively on upper extremity function
- Includes comprehensive work simulation and occupational task performance (Correct answer)
- Is conducted only by licensed physical therapists
- Uses only self-report measures validated against normative databases
Correct answer: Includes comprehensive work simulation and occupational task performance
An FCE incorporates work simulation and broad functional assessment across multiple domains, whereas a PCE typically addresses specific physical parameters like range of motion and strength.
Question 2: A referring physician requests an FCE to determine 'maximum medical improvement' (MMI). The evaluator should clarify that FCEs:
- Are the standard method for determining MMI in workers' compensation
- Measure functional capacity at the time of testing, not medical stability (Correct answer)
- Can only be performed after MMI has been established by a physician
- Provide the legal basis for MMI determinations in all states
Correct answer: Measure functional capacity at the time of testing, not medical stability
FCEs measure current functional capacity as a snapshot in time; MMI is a medical determination made by a physician, not an FCE finding.
Question 3: When conducting an FCE on a client with a below-elbow amputation who uses a prosthesis, the evaluator MUST:
- Test with and without the prosthesis and document both sets of results (Correct answer)
- Exclude the client from material handling testing due to liability concerns
- Apply standard norms without modification since prostheses restore full function
- Refer immediately to occupational therapy before proceeding with any FCE testing
Correct answer: Test with and without the prosthesis and document both sets of results
Testing with and without the prosthesis provides complete functional data; prosthetic function varies significantly by task and work conditions may not always permit prosthesis use.
Question 4: The Americans with Disabilities Act requires that job demands analyses used in conjunction with FCEs must identify:
- Every marginal function performed in the position
- Essential job functions that define the core purpose of the position (Correct answer)
- Salary range and promotion criteria for the position
- Number of current employees performing the same duties
Correct answer: Essential job functions that define the core purpose of the position
ADA compliance requires that FCE comparisons focus on essential job functions, as employers cannot exclude qualified individuals with disabilities from positions they can perform with reasonable accommodation.
Question 5: Which finding during an FCE would MOST suggest a fear-avoidance model of disability rather than structural physical limitation?
- Consistent performance below predicted capacity on all tested tasks
- Marked performance improvement with verbal encouragement and reassurance (Correct answer)
- Waddell signs present on clinical examination prior to testing
- Asymmetric grip strength with the dominant hand stronger than non-dominant
Correct answer: Marked performance improvement with verbal encouragement and reassurance
Performance that significantly improves with reassurance and encouragement is consistent with fear-avoidance, where psychological factors rather than structural damage limit participation.
Question 6: Under the ICF (International Classification of Functioning, Disability and Health) framework, FCE results PRIMARILY address which domain?
- Health conditions and pathophysiology
- Activity limitations and participation restrictions (Correct answer)
- Environmental contextual factors
- Personal factors including personality traits
Correct answer: Activity limitations and participation restrictions
FCEs measure what individuals can do (activity) and the extent to which impairments affect work participation, which falls within the Activity and Participation domain of the ICF.
Question 7: When an FCE evaluator is asked to provide transferable skills analysis alongside FCE results, the combination is used PRIMARILY to:
- Determine the client's eligibility for Social Security benefits
- Identify occupational alternatives that match demonstrated functional capacity (Correct answer)
- Assess the client's academic potential for retraining programs
- Calculate wage loss for litigation purposes only
Correct answer: Identify occupational alternatives that match demonstrated functional capacity
Combining FCE capacity data with transferable skills analysis allows the vocational evaluator to identify feasible alternative occupations the client can perform given their functional limitations.
CVE Functional Capacity Evaluation 5
In vocational evaluation, the PRIMARY difference between an FCE and a Physical Capacities Evaluation (PCE) is that an FCE: