FCA/FCE

• FCA is a battery of standardised tests used to assess a worker’s capacity to perform their work duties.

  • Provides performance-based measures of the worker’s physical capacity to predict return to pre-injury or suitable work duties, along with rehabilitation recommendations
  • Administered with utmost consideration for worker safety and wellbeing
  • Should ALWAYS follow BPS
• Contraindications to undertaking a FCA

  • No medical clearance by NTD or insurer
  • Further information required (medical history, current work duties)
  • Unstable medical conditions or recent surgery
  • Psychiatric or behavioural issues / evidence of substance abuse
  • Communication barriers
  • Recently completed FCA / No informed consent
• Method

  1. Ensure you have received approval from the NTD
  2. Explain the FCA to the worker - complete PAR-Q and informed consent
  3. Ensure screening questionnaire is completed (stop here if contraindicated)
  4. Resting measures - explain RPE, take HR and BP
  5. Perform physical assessment
  6. Commence functional work-related assessments
  7. Debrief worker once assessments complete
  8. Follow-up in 24 hours

  NB: Make sure you note EVERYTHING down - results, data, measures of HR, BP
• Data collection:

  • BPS assessment and history taking
  • Work-related functional activities
  • Musculoskeletal assessment (e.g. ROM, posture, MMT, grip strength)
  • Postural tolerances (e.g. kneeling, crouching, sitting, etc.)
  • Measures of intensity, pain, etc. (e.g. VAS, HR, RPE, BP)
  • Movement quality + safe manual handling score
• Reporting

  NB: Reports are marketing tools where good reports generate referrals

  1. Start with executive summary detailing primary findings and recommendations (max. 2 pages)
  2. Follow with raw data:
  3. Age/gender norms
  4. Screening questionnaire scorings
  5. Clinical significance of all results
  6. Ensure detailed references
  7. Include AEP details
  8. Referral link at end
• NB: You need a REGISTERED SIRA provider no. for Worker’s Comp

  • Vocational rehab via Disability Employment Services”:
  • Workplace assessment
  • Workplace modifications or special equipment
  • Workplace support to help manage injury
• Definition and Requirements

  Workplace assessment - on-site assessment of worker performing pre-injury duties / suitable work options with the employer to:

  • Identify tasks within the worker’s current capacity
  • Design recover at work plan precisely matches to workers current capacity
  • Upgrade tasks safely to improve work capacity
• Pre-assessment requirements

  • Receipt of referral
  • Approval to conduct assessment
  • Discussion of objectives with referrer (i.e. NTD)
  • Review other relevant documents
  • Plan assessment protocol and collect necessary equipment
  • Clearly explain objectives of assessment to worker
  • Complete any relevant screening questionnaires
• SUMMARY OF FCA REPORT

  1. Executive summary (Succinct summary of FCA findings + reason for referral)

  • Results of FCA
  • Recommendations concerning RTW based on FCA data
  • Needs for further training, physical rehabilitation or other strategies to reduce risk of further injury

  1. Assessment Objective
  2. Worker’s self-report
  3. Function
  4. Recommendations
• • Self-reported pain and disability assessments
  • VAS
  • Orebro Musculoskeletal Pain Screening Questionnaire
  • Roland Morris Disability Questionnaire
  • Pain Self-efficacy Questionnaire
• • Work-related ROM
  • Trunk flexion
  • Trunk rotation
  • Trunk extension
  • Trunk lateral flexion
• • Functional Performance Assessment
  • Walking self-paced test
  • Forward lean / seating / standing capacity
  • Push / pull / carry capacity
  • Squat / climb / kneeling capacity
• When invoicing the FCA you will include hours for travel, FCA report and testing
• A worker will need to access their FCA report through their insurer
• Copies of an FCA report should be kept for 7 years
• In the worker’s self-report section of the FCA report, a Roland Morris Disability score of 2 from 18 would be reported as Casper perceiving his injury having little impact on his daily function
• Recommendations for manual handling training is valid based on a safe manual handling score of 65%