Employers are required to manage injured or ill workers in accordance with workplace health and safety legislation along with organisational policies and procedures. Obtaining independent opinion is common as sometimes this is their only method of gaining clarity and direction for decision making.

A Functional Capacity Evaluation (FCE) evaluates an individual’s capacity to perform work activities related to his or her participation in employment. 

Sometimes also called a Functional Capacity Assessment, this blog discusses how they work and why they are essential for successful return-to-work planning. 

Evaluating Physical and Cognitive Abilities

Functional Capacity Evaluations (FCEs) are vital for return-to-work planning after an injury or illness. They are generally carried out by one of the following allied health professionals: Occupational Therapist, Exercise Physiologist, Physiotherapist or Clinical Psychologist. The focus of the evaluation is to assess a person’s physical and psychological (inc cognitive) capacity with reference to the inherent requirements of their job duties.  The FCE process compares the individual’s health status, and body functions and structures to the demands of the job and the work environment.

In essence, an FCE’s primary purpose is to evaluate a person’s ability to participate in work, although other instrumental activities of daily living that support work performance may also be evaluated.

The Role of the Allied Health Practitioner

The ability to analyse an activity in detail to determine the necessary components to perform the task competently is a core skill of many allied health practitioners, based on their education and training.

This is contrary to what many referring customers believe, and it is common for a medical specialist such as an orthopaedic surgeon or occupational and environmental physician to provide opinion on a worker’s fitness for work through an independent medical examination.

The Evaluation:

During a Functional Capacity Assessment the practitioner observes physical and behavioural responses to determine an individual’s safe capacity to perform the inherent role requirements. 

For FCEs relating to physical injuries or conditions, physical testing is performed which mimics the job demands (i.e. manual handling – overhead reach, lifting, pushing etc) to assess the functional ability of the individual.

For FCEs relating to psychological conditions, psychological testing is undertaken to evaluate an individual’s cognitive capacity to perform their tasks at work. The specific testing used will evaluate the individual’s ability to manage the cognitive tasks and psychosocial demands of their role.

A Functional Capacity Assessment commonly includes: 

• Strength testing through weightlifting, pushing/pulling objects, or carrying items.
• Endurance/sustained physical activity like walking or climbing stairs for a set time.
• Flexibility to determine the range of motion in different joints through reaching, bending, or twisting exercises.
• Maintaining balance tasks, such as walking on a balance beam or catching objects.
• Fine motor skills such as writing or manipulating small objects.
• Cardiovascular fitness through the measuring of blood pressure at rest and after activity.
• Manual handling technique through demonstrated lifting and task completion.

The practitioner considers the position description, job demands and clinical findings to help determine an individual’s:

• Fitness for duty / work capacity
• Ability to safely return to work including hours per day / week
• Suitability for alternative roles
• Suitable duties and graduated return to work plans
• Alternative duties or role modifications
• Ergonomic and equipment needs
• Ability to meet job demands as part of a recruitment process (pre-employment) or following injury or illness (work related or non-work related)
• Rehabilitation and treatment needs.

Matching Abilities with Job Demands

It is standard practice for the assessor to consider the inherent requirements of the worker’s role when evaluating their work capacity. 

The assessor will use the position description and job task analysis as provided by the employer along with any other documentation when evaluating the worker. This information is vital for the assessor as it helps them identify the required testing and helps them to understand the inherent requirements of the role. Once the assessor has completed the testing component of the FCE they will use the results of the physical and/or cognitive testing to determine whether the employee’s current abilities match the role requirements.

If there are any incongruencies, the assessor will provide a report which documents the functional restrictions and limitations along with any recommendations they have associated with the employees fitness for duty and return to work. They can also provide recommendations on suitable duties and or environment adjustments, which the employer can utilise when determining next steps. This might involve changes in equipment, work schedules, or practices.

Additional resources or support, such as ergonomic assessments, assistive devices, or training on modified work tasks, may be needed to help the employee perform their job effectively and safely.

Promoting a Human-Centred Approach

It can be a challenging time for both an employee and employer when navigating illness and injury whether it be work-related or not. Both are often faced with a scenario that is unfamiliar to them which creates a level of concern, worry and frustration.

The employee’s understanding of an employer’s WHS obligations can be limited and often they may be unsure of why medical input is required beyond that provided by their treating practitioner/s. Speaking about their medical condition and how it impacts them may be embarrassing and upsetting, especially where they are being asked to share with their manager or someone who they aren’t familiar with from the workplace.  

An employer is commonly restricted by the access of information which makes decision making challenging and difficult, particularly when they must adhere to legislative or policy requirements.

They often feel in the dark and this is especially the case if an employee is uncomfortable about sharing details of their medical condition. Human Resource, and People and Culture Managers can feel out of their depth when dealing with matters relating to injury or illness as they are concerned, they will worsen the situation by saying or doing something that upsets the worker.

Open and transparent communication between parties with a splash of compassion is the most effective approach when dealing with illness or injury within the workplace. Employers should attempt to involve the employee from the early stages right through to the return-to-work planning process. Keeping them informed about the steps being taken and why they are required helps to reduce worry and can make them feel heard.

Ensuring Long-Term Success for RTW

A sudden return to full duties can be overwhelming, so a gradual return-to-work plan helps the employee safely and confidently ease into their role and work hours. This graduated method is commonly recommended as it is effective. It also gives the employee the opportunity to condition themselves to their role which reduces the risk of further injury or exacerbation of their symptoms. 

After the initial return to work, regular monitoring is crucial and can be done through follow-up reviews with treating practitioners, check-ins with supervisors and adjustments to the plan as needed. Emotional support and mental health resources may also be beneficial for a smooth transition. This may be reminders to utilise services such as well-being or EAP services.

We recommend that an employer:

• Maintains open communication  
• Promotes a culture of safety
• Focuses on overall well-being
• Gives positive reinforcement and recognition

Effective Outcomes with a Functional Capacity Assessment

A Functional Capacity Assessment is an effective and reliable tool that provides employers with an accurate and affordable opinion on an employee’s ability to safely perform the inherent requirements of their role.

It offers the employee the opportunity to understand how their medical condition may impact them at work and why their employer needs to implement strategies to support them at work. Through the use of allied health practitioners, employers are able to access practical tools that help navigate the management people.

Where medical input may be necessary, Red Health has additional services which may be suited to your situation. These include our Red Assess Plus Service which involves the use of a medical specialist in conjunction with a Functional Capacity Assessment. Learn more here.

The post The Role of Functional Capacity Assessment in Return-to-Work Planning appeared first on Red Health.

A study published in the Pain Medicine journal found virtual examinations could actually be as accurate as in-person assessments when it comes to cases of chronic pain. Another in the Journal of the American Medical Association determined that virtual IMEs were as reliable for assessing functional capacity with work-related injuries.

So, let’s look into the typical issues and concerns of virtual Independent Medical Assessments and best practice tips and advice for maximising a virtual independent medical exam for a medico-legal report.

The Reliability and Accuracy of Virtual IMEs

Medical Experts, especially those in the Red Health referral network, are highly qualified and experienced medical professionals trained to conduct thorough and objective assessments, regardless of whether it is in person or virtually.

Before the IME appointment, the individual’s identity will be verified. The environment is controlled meaning that the appointment will take place in a medical consulting suite and where a physical assessment is required, a surrogate practitioner will be in attendance with the examinee. The surrogate will perform any clinical testing required by the medical expert and will be under their direct supervision. During the appointment, the medical expert and surrogate monitor the examinee’s presentation and record any observations that may help determine the independent medical opinion.

Maintaining Objectivity and Impartiality

Using a secure video conferencing platform helps protect the examinee’s privacy and confidentiality, along with explaining that the IME should be held in a controlled setting to ensure the examinee is comfortable and minimises distractions.

The virtual setting can sometimes make it more difficult for the medical expert to interpret the examinee’s mood and emotions, which may be important to the unique case in question, so they are trained to be additionally cognisant of body language, voice tone, and general observations of the examinee.

As always, IME medical experts will tailor their interview with the examinee to the claim type and to ensure they can answer any specific questions with confidence and reasoning.

Overcoming Technological Challenges

Weak and unstable internet connection is the most common problem that disrupts a virtual IME, as does poor video and audio quality. The medical expert and the examinee must both ensure that they have access to reliable technology in order for the virtual assessment to be a success.

Prepare for your IME by

• Ensuring your software is the latest version
• Testing your equipment before the appointment 
• Attending the appointment in a controlled and private space
• Being mindful of your positioning on camera
• Closing any unnecessary programs to free up internet bandwidth

To ensure everything goes smoothly with our virtual IMEs, Red Health have an in-house IT team that uses encrypted software to safeguard your client’s data at all times and testing prior to each assessment is undertaken!

Addressing Privacy and Confidentiality Concerns

Concerns about data security, examinee privacy, and the transmission of sensitive information are common with virtual IMEs. However, we live in a digital world and being aware of privacy and confidentiality obligations and preventing breaches is becoming second nature for individuals and organisations alike.

Another concern is that others might overhear the content of an assessment, which is why a quiet and controlled location is essential for the examination.

Red Health provides a secure system for storing and transmitting assessment data which has password protection, two-factor authentication and encryption measures built in.

IME experts should have a policy for virtual assessments that outlines the measures they take to protect customer data and privacy, which includes auditing to ensure policies are followed.

The Virtual Era of Medico-Legal Assessment

Virtual Independent Medical Examinations are a fantastic way to ensure everyone can access a medico-legal report performed by a medical specialist to evaluate and provide an opinion about their injury or illness. 

With some planning and measures in place, we can make virtual IMEs a safe and effective way to assess the impact of illness and injury in medico-legal cases.

Not sure whether a virtual assessment is suitable for your needs? Let our friendly client experience team guide the way. Simply click here to learn more!

The post Virtual IMEs – Addressing Industry Concerns appeared first on Red Health.