Functional Capacity Evaluation Mr Lawrence Turner

Claim Number: 123456

Functional Capacity Evaluation (FCE) - Summary

Name: Lawrence ‘Larry’ Turner

Test Date: 25/3/2022
DOB: 20/08/1972 (49 years old)
Date of Injury: Aug. 15, 2021
Claim Number: 123456
Gender: Male
Employer: ENERGY PROVIDER
Occupation: Power Engineer
Injury: Right Shoulder anterior labral Tear & Impingement Syndrome

Reason for Testing: To determine ability to return to work

Initial Assessment and Psychosocial Assessment completed on March 21, 2022 and attached to
Assessment. Please see for full details (please refer to Model Answers from Tasks 3 & 4).

Summary Of Mr Turner’s Engagement, Participation And Performance During FCE: Mr Turner

engaged well with assessment. His behaviour demonstrated his full cooperation, and he was willing
to give 100% effort in all test items. His patterns of movement were consistent with the nature of his
injury. His right shoulder strength and ROM limitations were as reported by his treating consultant
and Allied Health professionals.

Abilities/Strengths: Mr Turner has no limitations to his standing, walking or seated work. He was
able to demonstrate safely that he can perform tasks in kneeling, crouching, ladder climbing, sitting
or standing.

Limitations: Mr Turner has decreased endurance in his right shoulder, which is evident particularly
when completing elevated work. There were compensatory patterns of movement observed
throughout tasks involving elevated work or lifting above shoulder and head. Mr Turner has been
working with a physiotherapist post operatively and has made good gains in terms of recovery on
the right shoulder.

Job Match Table: Power Engineer

Job Demand Functional Capacity Abilities Job Match?

Ladder climb with tool belt on Ladder climb completed with Yes
waist – occasionally tool belt on waist – frequently
One-handed forward reach – One-handed forward reach – Yes
approx. 120cm occasionally approx. 125cm in standing

Two-handed forward reach – Two-handed forward reach in Yes

approx. 135m occasionally standing – approx. 140cm
and 60cm frequently occasionally and 70cm
frequently
Waist-to-shoulder lifting – 10kgs rarely & 7kgs No
15kgs occasionally occasionally

Floor-to-waist lifting 20-25kgs 18kgs rarely & 15kgs No

occasionally occasionally

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Functional Capacity Evaluation Mr Lawrence Turner
Claim Number: 123456
One-handed carry up to 50m 10kgs frequently with left Yes
with 8kgs occasionally hand over 50m; 10kgs
occasionally with right hand
over 50m
Static pull 30kgs using one Pull force of 40kgs with left Yes – if allowed to use left
hand occasionally arm and 25kgs with right arm hand

Walking and standing Walking – frequently Yes

throughout workday – Standing – frequently
frequently

Elevated work with 3kg tool Able to complete task No with right hand
occasionally frequently with left hand. Yes with left hand
Able to reach the height but
unable to sustain reach with
tool in hand.
Elevated work reaching Able to reach upwards Yes
upwards occasionally occasionally

www.wor kwell.com (866) 997-9675 [email protected]

Potential Barriers to Return to Work: A job match was done using the critical demands of the
client’s job, which were provided by the employer. The client has decreased strength in the right
shoulder, limiting his ability to do lifting and elevated work. Return to work would require
modifications or restricted duty at this time. The results of the FCE reflect the client’s current
abilities, and this job is currently not a match for his safe, maximum abilities.

Physical Return to Work Options Explored: Based on client’s current safe abilities, he is unable to
complete the job requirements for lifting and/or overhead working with a tool. Options for RTW
include modifying the three job demands he is currently unable to perform or restricted return to
work based on client’s current safe abilities, if available through employer.

Recommendations Regarding Return to Work:

Mr Turner may benefit from a work conditioning program to increase his strength and ROM in the
right shoulder in functional work-based activities. He has the potential to meet the job requirements
based on his current FCE results and the critical demands of the job and is motivated and engaged to
do so. If restricted duty or modifications are available, it is recommended he spend 3.5 hours a day
at work initially and commit to work conditioning 3.5 hours a day with an hour break, gradually
increasing work hours over a 3-4 week period or until client’s abilities meet all of the critical
demands of the job.
Summary: Mr Turner should be able to return to eight-hour workday, five days a week at the levels
indicated.

Test Results and Interpretations:

Please note that all tests are done on the assumption of normal working hours, breaks, good
ergonomics and that the tested functions do not occur more than three times in a day. If they do,
this should be performed.

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 Functional Capacity Evaluation Mr Lawrence Turner
Claim Number: 123456
Interpretations of functions in a normal working day
Frequency Observed Limitations observed % of workday
physiological effort
Never Contraindicated Not possible 0
Rarely Maximum Significant limitation 1-5%
Occasionally Heavy Some limitation 6-33%
Frequently Low Slight/No limitation 34-66%
Self-Limited Client stopped the test. 0%

Name: Lawrence Turner. Test Date: 25th March, 2022

Lifting Unable Maximum Heavy Low Limitations Recommendations

Strength Rarely Occasionally Frequently
(KGS) 1-5% 6-33% 34-66%

Waist to 18 15 10 Decreased
floor strength in
right
scapular
stabilisers
Waist to 10 7 5 Right
crown shoulder
weakness
and
decreased
endurance
observed
Front 35 30 25
carry
Right 12 10 5
carry
Left carry 15 12 10

Push-Pull (static) Force Generated (pounds)

Push static 120kgs
Pull static 115kgs
One-handed pull L = 40kgs R= 25kgs

Posture/flexibility Unable Significant Some No Limitation Recommendations

/ambulation limitation limitation limitation
Rarely Occasionally Frequently
1-5% 6-33% 34-66%
Elevated work X DECREASED Use a ladder or step for
(weighted) RIGHT work so it is completed
SHOULDER at chest height
ROM &
STRENGTH
Fwd bend Standing X
Sitting X

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 Functional Capacity Evaluation Mr Lawrence Turner
Claim Number: 123456
Standing X
Walking X
Squatting X
Stairs X
Ladder climb X
Crouching X
Kneeling X

Job Specific Testing

Job Demand Functional Capacity Abilities Limitations
Ladder Climbing with tool belt on No Limitations No limitation
waist – occasionally
One handed forward reach approx. Forward one handed reaching to No limitation
120cm – occasionally 125cm in standing posture

Two handed forward reach approx. Forward double handed forward No limitation
135m – occasionally and 60cm reach in standing posture at 140cm
frequently and 70cm frequently

Waist to shoulder lifting – 15kgs 10kgs rarely Yes – decreased strength in R

occasionally 7kgs occasionally Shoulder

Floor to waist lifting 20-25kgs 18kgs rarely Yes Decreased strength in R

occasionally 15kgs occasionally Shoulder

One handed carry up to 50m with Mr Turner able to carry 10kgs No limitation
8kgs occasionally frequently with Left hand over
50m, Mr Turner able to carry 10kgs
occasionally with right hand over
50m
Static pull 30kgs using one hand Pull force of 40kgs with left arm Does not meet the job requirement
occasionally and 25kgs with right arm with right hand

Walking and standing throughout Walking – frequently No limitation

work day – frequently Standing - frequently

Elevated work with 3kg tool Able to complete task frequently Decreased right Upper limb
occasionally with left hand strength and endurance – did not
Able to reach the height but unable meet the demands
to sustain reach with tool in hand
Elevated work reaching upwards Mr Turner able to reach upwards No limitation
occasionally occasionally

Musculoskeletal Exam
Range of Motion and Strength (NB WFL = within functional limits (NORMAL)).

Shoulder

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Functional Capacity Evaluation Mr Lawrence Turner
Claim Number: 123456
Shoulder Normal Range Range of motion Muscle Strength

RIGHT LEFT RIGHT LEFT

Forward 180 145 WFL 4 5
Flexion
Extension 60 WFL WFL 5 5
Abduction 180 140 WFL 4- 5
Internal 70 50 WFL 4 5
rotation
External 60 45 WFL 4 5
rotation

Summary:
Client presents with decreased ROM and strength in the Right shoulder consistent with diagnosis. All
other ROM and strength within normal limits. Client started testing with a pain rating of 1/10 and at
the end of testing reported 4/10 pain in the R shoulder. Client participated to his full capacity and
tests results are based on this performance.

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