A 2018 systematic review published in the Journal of Occupational Rehabilitation sheds important light on the reliability and validity of various Functional Capacity Evaluation (FCE) methods commonly used in return-to-work decisions and disability determinations. The study analyzed 20 eligible studies evaluating nine different FCE tools, providing much-needed clarity on how well these tools actually perform.
Key Findings
The study revealed mixed results across different FCE methods:
- Baltimore Therapeutic Equipment (BTE) Work Simulator: Showed moderate predictive validity, suggesting a fair ability to anticipate future work capacity.
- Ergo-Kit (EK): Demonstrated high inter- and intra-rater reliability and moderate variability, indicating consistent results across different evaluators and time points. However, its discriminative validity was low, raising questions about its ability to distinguish between varying levels of function.
- ERGOS Work Simulator: Similar to EK, showed low to moderate concurrent validity, which limits confidence in its real-time accuracy compared to other benchmarks.
- Isernhagen Work Systems (IWS): Offered moderate to high reliability in repeated testing and among different raters, but its predictive validity was low, which is a concern when projecting future work capability.
- Physical Work Performance Evaluation (PWPE): Scored moderate reliability, with high inter-rater agreement, yet demonstrated low responsiveness—meaning it may not detect changes in patient status over time.
- Short-Form FCE: Reported high predictive validity, but the authors caution that more data are needed to assess its full range of psychometric properties.
- Work Disability Functional Assessment Battery: Found to have low discriminative and convergent validity, calling into question its overall utility.
- WorkHab: Showed moderate to high reliability, making it one of the more consistent tools evaluated.
Why This Matters
Functional Capacity Evaluations are often used in workers’ compensation and disability cases to assess whether a worker can safely return to work or perform specific job-related tasks. This new analysis confirms that while many FCE tools demonstrate good reliability (consistency of results), several fall short on validity (whether they measure what they claim to measure).
These findings have real-world implications for attorneys, physicians, claims professionals, and vocational experts who rely on FCEs when making critical decisions about work ability, accommodations, or benefits.
What’s Next?
The authors urge future research to focus on improving the weaker aspects of current FCE methods, especially their predictive and discriminative validity. Until then, practitioners should remain cautious and consider the limitations of each tool when interpreting FCE results.
Prime FCEs
Florida and Georgia Large Markets
813-679-1961