Specialty Solutions Spotlight: When to Use Functional Capacity Evaluations (FCE) in Workers’ Compensation Claims

What is an FCE and why does it matter in workers’ compensation?

Complex claims often come with uncertainty. A well-timed Functional Capacity Evaluation (FCE) can bring clarity, but only if used with purpose. Done right, an FCE helps move claims forward. Used too early or without clear direction, it can stall progress or increase costs.

Understanding the Role of an FCE

An FCE is a standardized, objective evaluation of an injured employee’s physical capabilities in relation to specific job demands. It’s typically conducted by a trained health care professional, such as a physical therapist or occupational therapist. It measures:

• Strength and endurance
• Range of motion
• Postural tolerances (sitting, standing, bending, etc.)
• Functional limitations and tolerances

The goal? To clarify work readiness, identify permanent restrictions, or guide next steps.

The Right Time to Schedule an FCE

FCEs are most valuable when:

• The injured employee has reached maximum medical improvement (MMI)
• Conflicting medical opinions need clarification
• You need objective data to support return-to-work decisions or settlements

Avoid premature referrals. Scheduling an FCE during active treatment can result in unreliable findings that complicate rather than clarify claim direction.

Common Pitfalls to Avoid

FCEs are only as effective as the clinical reasoning and context behind them. Common missteps include:

• Unclear purpose—Is it for RTW, disability rating, or litigation?
• Poor timing—Ordered during treatment or before MMI
• Unvetted providers—Lack of specialty experience or standardized reporting

Without proper coordination, adjusters risk investing in evaluations that fail to advance the claim or worse, contradict other medical opinions. 

How Apricus Adds Value

Apricus helps you get the most from FCEs. Not just by scheduling them, but by timing them right and ensuring clinical soundness. Our coordinated approach delivers:

• Clinically vetted referrals aligned to the appropriate phase of care
• Access to credentialed providers with workers’ compensation expertise
• Clear guidance on referral intent, documentation, and use
• Seamless coordination with case managers and treating providers

When well-timed, FCEs confirm readiness for return-to-work, support restrictions, and speed claim resolution.

FCEs can be a powerful tool, but only when used intentionally. With Apricus as your specialty solutions partner, you gain more than access to evaluations; you gain the clinical insight and coordination needed to make smarter, faster decisions. 

Apricus delivers a full suite of integrated specialty services, including a robust physical medicine program, a nationwide network of quality providers, and in-house licensed physical therapists for clinical oversight. Whether it’s an FCE, home health, diagnostics, durable medical equipment, or another service, Apricus simplifies the process, reduces delays, and helps injured employees get what they need, when they need it.

This information is meant to serve as a general overview, and any specific questions should be fully reviewed with a health care professional or specialty service provider.

To make a referral for physical medicine, diagnostics and other services, call us today at 877.203.9899 or send an email to apricus.referrals@enlyte.com.