Our functional capacity evaluations are 2-day, 5-hour tests which can be modified for spine, upper extremity, lower extremity, or neck/upper quadrant injuries. Our evaluations feature standardized procedures and methods of performance as well as definitions and extrapolation formulas which enhance reproducibility and reliability.

Our approach is kinesio-psychophysical which means that the trained rehabilitation professional (we use only physical or occupational therapists for our tests) is in control of the tests and the results at all times. Safe and proper body mechanics are utilized at all times.

A kinesio-psychophysical approach integrates the history and diagnosis with a complete musculoskeletal exam. It then uses trained and skilled observation to determine the endpoints. Subjective reports are used to inform and support the observations when there is correlation with objective findings. Subjective reports that are not associated with objective findings and observations are of less value in determining endpoints.

Our FCE therapists are CEU-trained and meet the Maryland WCC requirements for vocational service providers. Reports are reviewed for quality assurance by the Program Manager. In order to improve predictive validity, we also recommend that a comprehensive job task analysis be performed prior to the FCE.

There are some FCE tools that claim to have research for interrater reliability and predictive validity. (Note: These studies were not performed on a workers' compensation population.) Any tool that has standardized procedures and definitional operations has a high likelihood of interrater reliability. However, there are many variables which affect RTW, and in turn, the predictive value of any FCE.

There are no existing tools that can measure sincerity of effort or detect intentional or conscious motivation to deceive. The purpose of all functional testing is to objectively outline for the reader the physical capabilities and limitations of an injured worker based on either maximal or sub-maximal effort. If the worker's performance is so self-limited or sub-maximal that a level of work is lower than expected, we can conclude that there is no objective evidence to support this result.

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MedStar Union Memorial Hospital

201 E. University Pkwy.
Baltimore, MD 21218