Functional Abilities Evaluation - FAE

Functional Abilities Evaluations in Disability Management

A Functional Abilities Evaluation (FAE) or Functional Capacity Evaluation (FCE) is a comprehensive analysis of an individual’s physical and functional abilities using objective and measurable tests.

The terms are frequently used interchangeably.

What’s in this Article

  1. What Does the FAE Measure?
  2. How is the FAE Utilized?
  3. What Does the FAE Protocol Examine?
  4. FAE Purpose for Insurers and Benefits Administrators
  5. What is Cognitive Functional Abilities Evaluation?
  6. What is a Job Demands Analysis (JDA)?
  7. Using FAEs as a Return to Function/Work Tool
  8. Benefits of Early and Safe Return to Work and Function

What Does the FAE Measure?

A Functional Abilities Evaluation provides a clear picture of an individual’s physical and functional ability, measures their ability to do tasks safely, and can assist in determining disability and/or impairment levels.

The FAE allows for the objective collection of information on an individual’s demonstrated abilities and limitations and provides interpreted data for use in compensation matters, as well as workplace reintegration.

The FAE also assists in objectively clarifying any immediate or long-term risks that may arise from resuming regular work duties.

The purpose of the FAE is to objectively identify impairments or disabilities and how they may affect a person’s ability to return to their typical work duties.  It can also determine which job modifications or restrictions are required to protect a person’s current abilities as well as to prevent future injury.

An FAE also gauges the validity of an individual’s functional abilities by testing for things such as effort, strength, muscular endurance, overall conditioning, and sustained activity tolerances. FAE’s may be used to determine whether work restrictions, job modifications, or reasonable accommodations are necessary to prevent further injury.

They are used to determine an individual’s ability to safely return to full or modified work duties following injury or illness, predict the potential to perform work following acute rehabilitation or a work-hardening/work-conditioning program, and can help to determine whether further treatment is warranted.

While treatment is not part of the FAE, the evaluation process can be used to predict potential improvements to an individual’s abilities once a rehabilitation program is implemented.

How is the FAE Utilized?

Employers utilize FAE’s to examine unsafe functional work conditions by identifying any discrepancies between an employee’s abilities and their job task requirements, in order to allow for injured or absent employees to return to work and provides suggested activity modifications where necessary to help the employee return to work safely.

From the pre-hire phase to the return-to-work process, an FAE can assist employers in objectively determining safe work parameters by comparing worker abilities with the physical demands of the specific job.

As indicated, evaluators also test for consistency of effort and barriers throughout the process, making for much more informed decisions. Disability insurers also utilize FAE’s to assist in their claims decisions with regard to entitlements such as income replacement benefits, as well as in assisting individuals back to work, be it in their own occupation or to another.

FAE evaluators may also recommend specific work conditioning or work hardening programs where requested; however, an FAE cannot determine a diagnosis.

What Does the FAE Protocol Examine?

Specifically, the FAE protocol examines an individual’s physical abilities, which encompasses a review of medical documentation, an interview, along with objective computer-assisted physical testing of functional tasks such as:

  • walking
  • stair climbing
  • grip strength
  • lifting
  • pushing and pulling

As well as repetitive activities and those requiring fine motor skills.

By simulating everyday life skills and job-specific skills, the FAE can evaluate abilities, determine risks and define impairments for a variety of stakeholders in the disability management process, such as insurers, employers, the individual, as well as their treatment team.

Functional abilities evaluations are typically performed by registered physiotherapists, chiropractors, occupational therapists or kinesiologists who have the requisite knowledge, skills and experience needed to assess physical and biomechanical function.

FAE Purpose for Insurers and Benefits Administrators

As indicated, insurers and benefit administrators often utilize FAE’s to gage an individual’s ability to engage in self-care, activities of daily living, and to establish a baseline for safe return to work functioning.

For purposes of return to work, the functional abilities evaluation evaluates the individual’s current abilities and identifies any barriers to return to work. It also highlights any immediate or long-term risks that may occur if regular work was to resume.

It uses measurable tests that can also be interpreted and compared to specific job demands, often through job-site analyses that are conducted separately.

A Job Demands Analysis (JDA) may include both a physical demands description as well as a cognitive (mental) demands analysis of the occupation. They can also contain one or the other depending on the needs of stakeholder.

A job demands analysis aims to systematically quantify and evaluate the physical, cognitive (mental), and environmental demands of a task or job.

What is Cognitive Functional Abilities Evaluation?

Cognitive Functional Abilities Evaluations follow the same lines as a physical FAE, but they also evaluate an individual’s cognitive abilities, such as memory, attention, concentration, and executive functioning.

These types of assessments can assist stakeholders in determining an individual’s cognitive ability to perform their pre-injury job and outline their general work abilities as they relate to the demands of that job.

They can also assist in measuring an individual’s progress during or following a rehabilitation program.

As noted, FAE’s can be used to assess both physical and cognitive abilities. Although the concept is the same, they are separate protocols and separate evaluations, although they can be combined where warranted.

Using FAEs as a Return to Function/Work Tool

Functional abilities evaluations (physical and/or cognitive) are often used as a return to function/work tool in order to determine whether activity modifications are required to maintain an individual’s current abilities and to prevent re-injury.

They can also help to avoid unsafe conditions by identifying the gap between abilities and task requirements.

Ostensibly, FAE’s provide stakeholders with information about what the ill or injured individual can do and cannot do and provide invaluable information when implementing return-to-work programs that include prevention, accommodation, and support for recovery.

Through collaboration, the goal of the return to work process is to have the worker return to their pre-injury or pre-illness job, where appropriate, and in a timely manner.

Benefits of Early and Safe Return to Work and Function

A carefully managed, early and safe return to work and other functional life tasks is beneficial to all parties and the FAE is an essential tool for garnering information to be used in effective return-to-work planning and/or achieving optimal functioning.

Generally speaking, the longer an individual is away from work and their normal activities of daily living, the less likely they are to return to their pre-injury job and pre-injury functional tasks.

Therefore, it is important to support people in their return to work and optimal functioning and to work with all those involved in the disability management process to bring people back to work and their expected daily tasks as soon as it is safe to do so.

While an early and safe return to function and return to work is the goal, we must also be aware of situations where returning prematurely may increase the risk of re-injury.

Summary

  • A Functional Abilities Evaluation (FAE) is a comprehensive analysis of an individual’s physical and functional abilities using objective and measurable tests.
  • FAE’s provide employers with information about what the ill or injured individual can do and cannot do, and can be used to determine whether activity modifications are required to maintain an individual’s current abilities and to prevent re-injury.
  • FAE’s can also be used to objectively identify impairments or disabilities, assist in determining disability and/or impairment levels, and predict potential improvements to an individual’s abilities once a rehabilitation program is implemented.
  • They are beneficial in examining unsafe functional work conditions by identifying any discrepancies between an employee’s abilities and their job task requirements, to allow for injured or absent employees to return to work safely.
  • FAE’s provide invaluable information when implementing return-to-work programs that include prevention, accommodation, and support for recovery, allowing for an early and safe return to function and return to work.

Determining the right time for workers to return to work and for people to resume their normal activities of daily living is important and the Functional Abilities Evaluation is a sound strategy to employ in making a safe and fair return to work and return to function determinations.