A critical review of functional capacity evaluations.

The role of functional capacity evaluations (FCEs) appears to be increasing as employers and insurers rely more heavily on them for decision making. To meet credibility requirements, and the American Physical Therapy Association's standards for measurement and documentation, all FCE suppliers need to validate and refine their systems. This article provides information that can be used to make informed decisions in the selection of an FCE and in functional assessment practices. Features of well-designed FCEs are discussed. Ten well-known FCE systems are analyzed according to these features and other common characteristics. Current issues such as the qualifications of the evaluators, reliability and validity, length of assessments, projection of endurance to 8-hour workdays, standards of practice, safety protocols, and behavioral assessment and management strategies are discussed.