A Physical Capacity Evaluation “PCE” (also known as a Functional Capacity Evaluation “FCE”, a Functional Capacity Assessment “FCA” or Work Capacity Evaluation “WCE”) consists of a battery of tests designed to determine ability to perform physical work. These tests measure range of motion, strength, stamina, and ability to lift/carry.

The tests are administered by a trained evaluator whose goal is to determine objectively as possible, functional ability / impairment against what should be measurable standard. While the tests aim is objectivity, test results can be colored by the evaluator’s methods, focus and bias. Like magic, evaluators hired by long term disability insurers rarely support a finding of disability.

In the context of long term disability appeals, insurers such as The Standard, Aetna, Mutual of Omaha, Met Life, Cigna, The Hartford and others pay for any request such tests in hopes of generating evidence to quash an appeal of a long term disability denial or termination of benefits. On the other hand, these batteries of tests sometimes provide good evidence to support functional incapacity. Check your policy to determine what functional capacity test applies.

A unbiased PCE may be useful to substantiate conditions such as fibromyalgia which are often difficult to objectively verify with an MRI, CT scan or X-ray. The two most common long term disability compensability tests are:

  1. Inability to perform one’s own occupation or;
  2. Inability to perform any occupation.

If you long term disability carrier has requested that you attend a PCE, know that it is attempting to generate evidence to support a disability declination or termination.

Author: Rizk Law

Were you injured in an accident that was not your fault? Are your bills piling up while your pain and suffering seem to never end? Is an insurance carrier standing in your way of the money you need to get your life back on track? Then you need a lawyer who knows how insurance carriers think — and can fight them for the maximum compensation you deserve. You need Rizk Law.