In New York workers' compensation, a functional capacity evaluation is reported on the FCE-4 and may be performed only once the attending physician finds the claimant at maximum medical improvement. The practitioner records who requested it, the MMI date, the eligibility criterion that applies and the results, and certifies the report reflects their professional opinion. The back reprints the Physical Medicine Fee Schedule rules for FCEs.
The practitioner who performs the FCE completes and signs it with license number, typically a physical or occupational therapist licensed in New York or another provider qualified by scope. The attending physician must set forth in writing any restrictions relevant to the evaluation, or state there are none.
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Practitioner's Report of Functional Capacity Evaluation
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No. The fee schedule rules printed on the FCE-4 say an FCE does not require prior authorization by the carrier, although the attending physician must justify the indication if the carrier asks. It may be prescribed only by a licensed New York physician or requested by the carrier when indicated.
Only at the point of maximum medical improvement in the attending physician's opinion, and generally not before three months post-injury unless a significant documented change justifies it. One eligibility criterion must also apply: return to a previous job, a verified new job offer, or an established vocational objective.
A physical or occupational therapist currently licensed in New York, or another licensed provider qualified by scope of practice, with constant supervision by the licensed provider. Testing by licensed psychologists or psychiatrists follows the Psychology or Medicine fee schedules and is billed separately.