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Click ‘Get Form’ to open the FUNCTIONAL CAPACITY EVALUATION (FCE) in the editor.
Begin by entering the claimant's personal information, including Name, Claim #, and Date of Injury. Ensure accuracy as this data is crucial for identification.
In the Medical Evaluator section, provide the name and specialty of the evaluator. This establishes credibility for the evaluation.
Proceed to document the dates when impairments became severe and when treatment began. This helps track the progression of the claimant's condition.
Answer questions regarding work capabilities, such as whether assistive devices are required and how many hours of competitive work can be sustained daily.
Fill out sections on physical demands like lifting, carrying, pushing, and pulling. Use checkboxes to indicate frequency and weight limits accurately.
Complete non-exertional physical demands and side effects of medication sections to provide a comprehensive view of the claimant’s functional capacity.

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