What is a functional capacity evaluation (FCE), and why is it important in your Georgia workers’ compensation case?
We have many clients who ask us the following questions:
What is an FCE, why do I have to undergo one, and what is the purpose?
Not everyone who has been injured on the job has to undergo a functional capacity evaluation, but many do. In this article we will explain what role they play in a workers’ compensation case and how to achieve the best results from them.
But first, it’s necessary to understand Georgia’s permanent disability rating system.
What are PPD benefits?
One of the benefits provided to an injured worker in a compensable workers’ compensation case is a permanent partial disability rating. This rating is defined and described in Georgia law (O.C.G.A. 34-9-263) as a disability that is, “partial in character but permanent in quality resulting from loss or loss of use of body members of from the partial loss of use of the employee’s body.” This means that when an individual suffers a permanent injury as a result of their on-the-job injury, they can be compensated for it.
The state legislature in Georgia has set the value of each body part, determining how many weeks of benefits an individual would be eligible for if they were to lose that body part in a work-related tragedy. These rates are as follows:
|Georgia permanent partial disability (PPD) chart
|Maximum weeks of compensation
|Any other toe
|Loss of hearing to one ear
|Loss of hearing to both ears
|Loss of vision of one eye
|Disability to the body as a whole
If the individual who is injured did not lose the body part, but sustained an injury to that body part resulting in a permanent disability, the authorized treating physician assigns a permanent disability rating. This disability is based upon the guidelines set up in the 5th edition of the Guides to the Evaluation of Permanent Impairment by the American Medical Association.
How long until PPD benefits are awarded?
Board Rule 263 lays out the procedure for obtaining and paying a permanent partial disability rating. When an injured worker is no longer receiving temporary total disability (TTD) or temporary partial disability (TPD) benefits, and a rating has not already been issued, the insurance carrier has 30 days to request a rating from the authorized treating physician. The insurance carrier then has 21 days to make payment of that rating.
How are PPD benefits calculated?
The calculation on how to determine the amount of payment is determined as follows:
The body part is multiplied by the rating given by the authorized treating physician, which is then multiplied by the workers’ compensation rate.
(Body part injured x Impairment rating) x Workers’ compensation rate = Payment amount
How is a workers’ compensation rate determined?
A workers’ compensation rate is determined by taking the average gross pay of the 13 weeks the injured worker earned before their injury. If the individual didn’t work for the employer for 13 weeks prior to the injury (perhaps because they were recently hired), or didn’t work substantially the whole of the 13 weeks for another reason, there are other ways to calculate what the average weekly wage should be.
So, for example, let’s say you were hurt on the job in June 2019 and lost an eye. Is it possible that my your eye is only worth $7,500. Unfortunately, the answer may be yes. That is considering the lowest workers’ compensation rate at the time, along with the total benefits allowed under Georgia law (O.C.G.A. 34-9-263).
Not every instance is this tragic though. This leads us directly into the discussion of functional capacity evaluations.
What is an FCE?
A functional capacity evaluation (FCE) is a tool used by authorized treating physicians to assist them in determining what the permanent impartial impairment rating should be in a workers’ compensation case. FCE’s are typically performed by an injured worker at a facility separate from the authorized treating physician’s office. They are executed by an individual who has training and certifications in performing FCE’s.
A typical FCE will run the injured worker through a battery of tests. These tests may include walking on a treadmill, lifting certain amounts of weight from ground to table height or from ground to overhead, walking stairs, bending over, repetitive lifting, etc. The injured worker is judged not only on their ability to perform these activities, but also on their perceived effort. This is obviously a very subjective area and can lead to litigation.
Why is an FCE necessary?
After the FCE, the test provider may make a recommendation to the authorized treating physician regarding what the individual’s permanent partial disability rating should be, and to what body part. Many times, the authorized treating physician just adopts the rating and that becomes official pursuant to Board Rule 263.
The problem with FCE testing
Injured workers’ who are attending functional capacity evaluations are just that, injured. Evaluating effort while they are in pain is a very difficult thing to determine.
Furthermore, sometimes injured workers’ try so hard during their FCE that they are left in more pain after the test than they were before it. The test provider may not be privy to this information because the injured worker may have already left their facility.
Finally, there is no universal uniformity among FCE’s. By nature, they are subjective. It is a determination of how much an injured worker can do and if they are attempting to perform it with maximum effort. It’s very important for an injured worker to perform to the best of their abilities during the FCE and to report what occurred during the FCE to their authorized treating physician and their attorney. Remembering what happened and how they feel afterwards, can be of great benefit if the need to contest a rating occurs.
Don’t hesitate to contact the experienced Atlanta workers’ compensation attorneys at Gerber & Holder Attorney At Law if you have any questions about functional capacity evaluations.