The open and active phase of an L&I claim or self-insured employer workers’ compensation claim is the phase where the claim is open and the injured worker is actively receiving necessary and proper treatment for claim related conditions. The open and active phase of a claim begins to wind down as the injured worker reaches Maximum Medical Improvement or Medical Fixity (MMI). MMI does not mean that the injured worker returned to the same level of physical health prior to the injury or disease. MMI means that the medical providers have given the injured worker all available diagnostic, curative or rehabilitative treatment available and that any further treatment will be palliative only.
What is Physical or Functional Capacity Evaluation (PCE/PFE)?
Once injured workers reaches MMI, it is important to assess their overall level of functioning to determine their permanent post injury or disease abilities. In some cases, the attending provider can provide a reasonably accurate assessment of the injured workers permanent abilities. However, sometimes a provider would like additional data to assess an injured worker’s abilities. As part of this step, and a Physical Capacity Evaluation (PCE) or Functional Capacity Evaluation (FCE) can be a tremendously helpful. This tool can help better understand an injured worker’s ability to return to work. It can also help guide recommendations regarding the type or length of treatment that may still be needed.
A qualified and licenses physical or occupational therapist will perform the evaluation. The Department of Labor and Industries (L&I) requires the findings of the evaluation to be put into a report containing six elements that include:
(1) Worker information;
(2) A musculoskeletal screening;
(3) Positional, material handling and non-material handling capacity testing;
(4) Cardiorespiratory endurance testing;
(5) Consistency and level of effort testing; and
(6) Musculoskeletal and psychosocial questionnaires.
Additionally, effective July 1, 2016, L&I started requiring PCE or FCE providers to complete a FCE Summary Form.
Best practices and recommendations
L&I has several resources on their website regarding PCE and FCE for evaluators and vocational counselors. However, these resources can be equally informative for injured workers. For example, L&I has a list of FCE Definitions that can help injured workers understand the activities to perform during an evaluation. L&I also has an informational sheet regarding FCE Evaluator Standards. The sheet also provides useful information that can help injured workers know what to expect from their evaluation. Finally, once a PCE/FCE report has been completed it must be sent to the attending physician. In turn, the attending physician will provide feedback concerning the accuracy of the findings. For this reason, I think it is usually a good idea for the injured worker to meet with their attending provider to review the PCE/FCE report and recommendations.
Additional resources: The Physical Capacities Evaluation form on the L&I website