A Functional Capacity Evaluation Can Bolster Your Long Term Disability Claim
- Matthew Maddox
- a few seconds ago
- 10 min read
When your disability claim depends on proving how your symptoms limit your ability to work, a functional capacity evaluation (“FCE”) can be one of the most effective tools available. Insurance companies often require objective proof of your physical restrictions, and traditional medical records may not show how your condition impacts real-world tasks like lifting, sitting, standing, or sustaining activity throughout the day.
In this article, we’ll answer common questions about how FCEs work, when they are most helpful, what you can expect during the evaluation, and how the results can strengthen your short term disability or long term disability claim.
What Is a Functional Capacity Evaluation?
A functional capacity evaluation (“FCE”) is a type of assessment used to evaluate your physical restrictions and limitations in relation to your ability to perform specific job tasks. It is performed by a trained clinician, often a physical therapist or occupational therapist, who measures your physical functioning while performing specific tasks. The goal is to determine whether you can safely perform work activities on a consistent, full-time basis.
Common components of a functional capacity evaluation may include:
Strength Testing: Evaluating how much you can lift, carry, push, or pull without triggering pain or risking injury.
Range of Motion Measurements: Assessing how far you can bend, twist, or reach in different directions.
Postural Tolerance: Measuring how long you can sit, stand, walk, or stay in one position before symptoms worsen.
Fine Motor and Grip Tasks: Testing hand strength, dexterity, and your ability to manipulate objects.
Endurance Assessments: Determining how fatigue or pain develops over the course of physical tasks.
Functional Simulations: Recreating typical workplace activities to see whether you can complete them safely and consistently.
By offering objective measurements, an FCE helps clarify how your medical condition affects your ability to work and can provide substantive evidence of your limitations and restrictions. The information gathered during the evaluation is typically documented in a detailed report, which can then be submitted to your insurance company as evidence in support of your disability claim.
What Kinds of Disability Claims Can a Functional Capacity Evaluation Support?
A functional capacity evaluation is especially valuable when your disability claim is based on a condition that affects your physical functioning. Because an FCE measures how your body performs under controlled conditions, it provides detailed, objective data about your strength, mobility, endurance, and ability to tolerate common workplace activities. This information helps the insurance company understand the real-world impact of your condition, especially when your symptoms fluctuate or are not fully captured in your medical records. An FCE can be used in both short term disability and long term disability claims to prove why you cannot safely or reliably meet the physical demands of your job.
Common physical conditions an FCE can support include:
Spine Disorders: Documenting how lower back or neck problems restrict lifting, bending, twisting, or maintaining postures like sitting or standing for extended periods.
Joint and Orthopedic Injuries: Measuring limitations caused by knee, hip, shoulder, or ankle injuries that affect your ability to walk, climb stairs, reach overhead, or carry objects.
Neurological Conditions: Demonstrating impairments in balance, coordination, reflexes, or motor control that make tasks such as standing, gripping, or operating equipment unsafe.
Chronic Pain Syndromes: If you carry diagnoses of ME/CFS, fibromyalgia, complex regional pain syndrome, or similar conditions, or if you just suffer from chronic pain, an FCE can help by showing how pain intensifies with repeated movements, sustained activity, or even routine tasks, making it difficult to maintain productivity over a full workday.
Arthritis and Degenerative Conditions: Identifying reduced joint mobility, swelling, stiffness, and decreased grip or pinch strength that interfere with both fine and gross motor tasks.
Post-Surgical Recovery: Providing objective proof that, even after initial healing, you still have limited stamina, weakness, or restricted range of motion that prevents you from returning to full duty.
Injury-Related Weakness or Instability: Demonstrating how lingering weakness, instability, or gait abnormalities affect your ability to perform repetitive or weight-bearing activities safely.
By offering a detailed picture of your physical capabilities and limitations, an FCE helps establish that your condition prevents you from performing the essential duties of your occupation on a consistent, full-time basis.
How Does a Functional Capacity Evaluation Support My Disability Claim?
A functional capacity evaluation supports your disability claim by offering your insurance company a clearer, more detailed picture of how your condition affects your ability to work. While medical records, imaging, and office visit notes describe your diagnosis and symptoms, they do not always show how those symptoms translate into your day-to-day functioning. An FCE bridges that gap by documenting your physical abilities, your limitations, and how your body responds to tasks that resemble the demands of your job. This kind of evidence is especially important in both short term disability and long term disability claims, where your ability to perform your occupational duties consistently and safely is the central question.
Some of the ways an FCE can help support your disability claim include:
Objective Evidence: An FCE provides quantifiable measurements of your strength, mobility, endurance, and postural tolerance. This objective data helps confirm that your symptoms genuinely limit your ability to perform work-related activities.
Assessment of Specific Job Demands: An FCE evaluates your ability to carry out tasks similar to those required in your job, such as lifting, carrying, reaching, typing, standing, or sitting for extended periods. This helps show why you cannot meet the essential duties of your occupation or sustain them throughout a full workday.
Credibility and Consistency: An FCE includes built-in validity checks that demonstrate whether your performance is consistent with your diagnosis and reported symptoms. These validity measures help counter any insurance company argument that you are exaggerating or overstating your limitations.
Documentation of Symptom Progression: An FCE records when pain, fatigue, numbness, or other symptoms begin during activity and how they worsen over time. This is critical when your condition limits your ability to sustain work-related tasks rather than perform them briefly.
Evidence of Safety Concerns: The evaluation may show that certain movements or tasks put you at risk of worsening your condition, losing balance, or injuring yourself, which helps demonstrate why returning to work is not safe.
This type of assessment can be especially important when your job is sedentary, because insurers often assume desk work is physically easy. For example, you may have neck pain that prevents you from keeping your head in a fixed position, back pain that makes prolonged sitting unbearable, or nerve symptoms that limit your ability to type or use a computer for long periods. An FCE can objectively measure how long you can sit, how frequently you need breaks, and whether static postures cause significant pain or functional decline.
By translating your symptoms into concrete functional limitations, an FCE provides the kind of detailed, objective evidence the insurance company relies on when deciding whether your condition prevents you from working.
What Should I Expect From a Functional Capacity Evaluation?
A functional capacity evaluation is a structured, hands-on assessment, so you should expect the evaluator to guide you through a series of tasks designed to measure your physical abilities and limitations. The clinician (often a physical therapist or occupational therapist) will observe how your body responds to activity, how quickly your symptoms develop, and whether you can safely and consistently perform tasks that resemble work-related activities. The goal is not to see how much you can push through, but to understand your real-world functional limits.
Common elements you may encounter during an FCE include:
Detailed Interview and Medical Record Review: Prior to the testing, the evaluator will discuss with you your medical history, current symptoms, medications, and how your condition affects your daily function. It is always recommended to send your medical records from your treating doctors to the evaluator beforehand so that they have time to review and gain familiarity with your condition and symptoms.
Strength and Mobility Testing: The testing will evaluate your ability to lift, carry, push, pull, bend, twist, kneel, reach overhead, and move through different ranges of motion.
Postural Tolerance Assessments: The FCE will measure how long you can sit, stand, walk, climb stairs, or maintain one position before pain or fatigue sets in.
Grip and Fine Motor Tasks: The FCE will include testing your hand strength, dexterity, and ability to manipulate small objects or tools.
Endurance and Stamina Evaluation: Your evaluator will observe how symptoms change over time as you repeat tasks or sustain activity throughout the session.
Functional Simulations: The FCE will have you perform tasks that resemble workplace activities—such as lifting boxes, sorting items, or reaching at different heights—to assess your ability to complete them safely.
Pain and Symptom Monitoring: Your evaluator will record when pain, weakness, dizziness, or fatigue appear and how those symptoms affect your performance.
Consistency and Effort Checks: Using standardized methods, your evaluator will confirm that your performance is consistent with your reported symptoms and medical condition.
Throughout the evaluation, you should expect the clinician to give clear instructions, monitor your safety, and stop a task if it becomes too painful or unsafe. The results help show whether you can sustain physical work activities over a full day, which is often a key issue in short term disability and long term disability claims.
Should I Undergo A One-Day or Two-Day FCE?
Choosing between a one-day or two-day functional capacity evaluation depends on how your symptoms behave over time, but many claimants benefit from the additional insight a two-day FCE provides. A one-day FCE focuses on your abilities in a single session, which may be appropriate if your symptoms remain fairly steady and do not significantly worsen as the day goes on. A two-day FCE, however, is often more effective for showing how your condition impacts your ability to sustain activity over multiple days—something your insurance company evaluates closely when determining whether you can maintain full-time work.
You may benefit from a two-day FCE for several reasons:
Captures Delayed Symptom Flares: Many conditions do not show their full impact until the next day. A two-day FCE can highlight post-exertional pain, stiffness, fatigue, or neurological symptoms that appear after physical activity.
Shows Reduced Recovery Capacity: If you cannot bounce back after exertion, the second day often reveals a meaningful drop in your performance, supporting the argument that you cannot sustain full-time work.
Demonstrates Real-World Limitations: Work requires you to show up day after day. A two-day FCE mirrors this demand more realistically and may document how quickly your functioning declines under repeated activity.
Strengthens Claims Involving Fatigue or Endurance Issues: Conditions like fibromyalgia, chronic pain syndromes, neurological disorders, or autoimmune diseases often worsen after activity. A two-day test provides clearer data on how your endurance deteriorates.
Reduces the Risk of Overestimating Your Abilities: A one-day FCE may capture your “best day,” especially if adrenaline or determination helps you push through. The second day shows what happens after your body has already been stressed.
Provides Stronger Objective Evidence: When the second day reflects poorer performance, the results offer compelling, measurable proof that your limitations are genuine and consistent with your reported symptoms.
Overall, if your condition worsens with exertion, varies day-to-day, or causes significant fatigue or flare-ups after activity, a two-day FCE is often the more accurate and more persuasive choice for your short term disability or long term disability claim.
How Should I Present My FCE Results to My Insurance Company?
You should present your functional capacity evaluation results in a way that clearly explains how your physical limitations prevent you from performing your job on a consistent, full-time basis. Insurance companies often look for reasons to discount or minimize FCE results, so the way the information is framed can make a significant difference in how the report is interpreted. Rather than simply submitting the FCE report on its own, you want to present it as part of a coordinated, well-supported explanation of your functional limitations.
Before sharing your FCE with the insurance company, consider the following approach:
Work With an Attorney to Frame the Findings: An experienced disability insurance attorney can review the FCE report, highlight the conclusions that directly relate to your occupational duties, and explain the results in a way that makes it harder for the insurance company to overlook your limitations. Your attorney can also address any ambiguous findings and make sure the strongest points of the report are emphasized.
Have Your Doctor Comment on the Results: Your treating physician’s endorsement can carry considerable weight. Asking your doctor to review the FCE and provide a written statement connecting its findings to your symptoms, treatment history, and work capacity can help reinforce that the results are medically appropriate and consistent with your ongoing condition.
Tie the Results to Your Specific Job Demands: Your insurance company needs to understand how the limitations documented in the FCE translate into problems performing the essential duties of your occupation. You or your attorney can highlight where the FCE shows difficulty with prolonged sitting, lifting requirements, static postures, repetitive movements, or any other tasks central to your occupation, and connect this to vocational documentation outlining your job duties.
Address Any Validity or Consistency Measures: FCEs include embedded validity checks to confirm that your performance was consistent and reliable. Highlighting these measures can help demonstrate that the report accurately reflects your physical capabilities.
By presenting your FCE results strategically, with support from your treating physician and guidance from your disability insurance attorney, you can make it easier for your insurance company to understand why the findings show that you cannot perform your job safely or consistently. This coordinated approach strengthens your overall claim and reduces the risk that the insurer will misinterpret or undervalue your FCE.
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How Can The Maddox Firm Prove My Short Term or Long Term Disability Claim?
The Maddox Firm can help prove your short term disability or long term disability claim by guiding you through every stage of the process and ensuring your insurance company receives clear, compelling evidence of why you cannot perform your job. If your case involves an FCE, our experienced team can also help you prepare for the testing, interpret the results, and present them to the insurer in the strongest possible way.
Here are a few ways The Maddox Firm can help prove your short term or long term disability claim:
We Examine Your Policy and Assess Your Claim: The Maddox Firm will review your disability policy to determine how your insurer defines disability, what evidence is required, and whether an FCE would strengthen your claim. If an FCE is recommended, we will help you understand the purpose of the evaluation and how it relates to your specific job duties.
We Handle All Communications with Your Insurance Company: Our team manages all correspondence with your insurance company, ensuring nothing is said or submitted that could undermine your claim.
We Help You Obtain Evidence to Support Your Claim: The Maddox Firm works with your medical providers to gather records, physician statements, and supporting documentation. If an FCE is part of your case, we can help you prepare for the evaluation, select a qualified and neutral provider, and obtain a detailed explanation from your doctor that connects the FCE findings to your medical condition and functional limitations.
We Handle Appeals and Litigation: If your claim is denied, The Maddox Firm will help you build a strong appeal. If necessary, we can also pursue litigation on your behalf.
A short term disability or long term disability claim can be a complicated process. If you need help during the claims process, with appealing a claim denial, or with litigating a final adverse short term or long term disability decision, The Maddox Firm can help. The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim. Our New Jersey and New York long term disability attorneys help clients nationwide.