A functional capacity evaluation (FCE) is a medical test that is designed to help an injured worker determine what level of work that they can handle. It’s typically done at the end of your medical care when a doctor thinks you are as good as you are going to get. It doesn’t happen for workers who make a full recovery. It happens to workers that are in continued pain and will likely have permanent physical restrictions.

The FCE is usually performed by a physical therapist who has special training in those exams, but also could be performed by a doctor or even an athletic trainer. The exam itself usually lasts 4-6 hours and will involve pushing, lifting, squatting, range of motion tests and even things like crawling or balance tests.

It’s designed to be an objective test and it will often be done in a way to see if you are exaggerating your symptoms. For example you might be asked to lift something weighing 25 pounds early in the exam and then asked later to lift something that either looks much heavier or you are told is much heavier but actually is the same weight or lighter.

At the end of the exam a report will be issued that will list what restrictions you need such as no lifting over a certain amount. They will also discuss what tasks you can and can not safely do.

It’s not uncommon for people to tell us that after the FCE they are in a lot of pain. That makes sense as it’s a long exam and often happens when you aren’t conditioned for a long day like that. In fact, it’s not uncommon for one of the recommendations to be to send you to work hardening which is a way to build up strength before going back to work.

So what happens when you don’t agree with the FCE recommendations? I had this same scenario recently with an injured worker who was given 20 pound lifting restrictions, but no limit on standing. They strongly felt that they couldn’t do that and wanted to know their options.

The issue is that the FCE is objective so usually a doctor will go along with those findings. If they do, your best option is to try your best and see what happens. If you go back to work and after 2-3 days you are in so much pain that you feel you can’t work, you can go back to your doctor and report that you tried. They may or may not agree to limit your activities more at that point.

What you can’t do is say that you disagree, refuse to work and expect to get benefits. I get why you’d want to do that if you don’t feel safe or comfortable, but under the Illinois Workers’ Compensation Act, you almost always need a medical opinion that supports you missing work if you want to get compensated.

My strongest advice is don’t try to trick the FCE examiner. Again the test is looking to see if you are faking or exaggerating your symptoms. Just do your best, see where you land and go from there. And if you strongly disagree with the findings, talk to your doctor and see what they have to say.