Functional capacity evaluation: an important yet neglected topic

Abstract

Functional Capacity Evaluation (FCE) is an important tool in occupational medicine for assessing an individual's actual ability to perform job-related tasks safely and effectively. Despite its potential role in protecting workers' health, preventing occupational injuries, and supporting employment continuity, occupational health assessments remain largely focused on disease diagnosis and the identification of medical restrictions, with insufficient attention to workers' actual capacity to meet job demands. Functional capacity extends beyond physical health and encompasses the interaction between an individual's health status, physical and cognitive abilities, psychological conditions, job characteristics, and workplace environmental factors. Consequently, the use of generic assessments that are not aligned with actual job requirements may lead to misleading findings and inappropriate fitness-for-work decisions. Furthermore, the limitations in the validity and predictive ability of functional tests, as well as the influence of psychosocial factors, should be carefully considered when interpreting assessment results. Occupational physicians are uniquely positioned to integrate medical findings with job demands and actual workplace conditions, thereby playing a central role in developing and implementing job-specific functional assessments.