CVE Functional Capacity Evaluation 4 — Questions and Answers
Question 1: Which Occupational Safety and Health Administration (OSHA) guideline is MOST relevant when establishing safe lifting parameters within an FCE?
- OSHA 300 recordkeeping standards
- NIOSH revised lifting equation (Correct answer)
- OSHA lockout/tagout procedures
- OSHA ergonomic standard 1910.900
Correct answer: NIOSH revised lifting equation
The NIOSH Revised Lifting Equation provides a scientifically based formula for calculating recommended weight limits that FCE evaluators use as a reference standard.
Question 2: A client's FCE results show they can lift 35 lbs occasionally but the target job requires medium work (20-50 lbs frequently). The evaluator should conclude the client:
- Meets the job requirements because 35 lbs is within the medium range
- Does not meet the frequent lifting demand of the target position (Correct answer)
- Needs only ergonomic training to qualify for the position
- Should be reclassified as capable of heavy work
Correct answer: Does not meet the frequent lifting demand of the target position
Frequent lifting in the DOT medium category requires up to 25 lbs; the distinction between occasional and frequent capacity is critical in job matching.
Question 3: During grip strength testing in an FCE, the Rapid Exchange Grip (REG) test is used to:
- Measure bilateral grip strength simultaneously
- Detect submaximal effort through inconsistent force production patterns (Correct answer)
- Assess endurance by timing sustained maximal grip
- Establish dominant hand preference for tool use
Correct answer: Detect submaximal effort through inconsistent force production patterns
The REG test alternates rapid grip measurements between hands; individuals exerting maximal effort show consistent force patterns while those exerting submaximal effort often show inconsistencies.
Question 4: The PRIMARY purpose of including a positional tolerance assessment (sitting, standing, walking) in an FCE is to:
- Replace lifting and carrying assessments for low-demand jobs
- Quantify time-based capacity for sustained work postures required in most jobs (Correct answer)
- Satisfy insurance company documentation requirements only
- Screen for psychological factors affecting work performance
Correct answer: Quantify time-based capacity for sustained work postures required in most jobs
Positional tolerance data directly maps to the physical demand characteristics of most jobs, providing essential data for vocational placement decisions.
Question 5: When an FCE evaluator identifies a significant discrepancy between the client's claimed limitations and observed functional performance, the ethical obligation is to:
- Confront the client directly and document their denial
- Report the client to the referring insurance company as a fraudulent claimant
- Objectively document the observed discrepancies and validity indicators without drawing conclusions about intent (Correct answer)
- Discontinue the evaluation and return the referral fee
Correct answer: Objectively document the observed discrepancies and validity indicators without drawing conclusions about intent
FCE evaluators are objective observers who document findings; determining intent (malingering vs. fear-avoidance) is beyond the evaluator's scope and requires other assessment methods.
Question 6: Which factor MOST significantly reduces the predictive validity of an FCE for return-to-work outcomes?
- Using a standardized protocol rather than a customized evaluation
- Testing occurring in a clinical setting removed from actual work conditions (Correct answer)
- Including both physical and cognitive functional measures
- Conducting the evaluation over two days rather than one
Correct answer: Testing occurring in a clinical setting removed from actual work conditions
Ecological validity is reduced when FCE testing occurs in a clinical environment that does not replicate actual work conditions, tools, and environmental demands.
Question 7: For a client with a diagnosis of fibromyalgia, FCE testing should be modified to account for:
- Exclusion of all aerobic tasks due to cardiovascular contraindications
- Post-exertional malaise and increased symptom variability across test sessions (Correct answer)
- Elimination of validity testing because symptom magnification cannot occur
- Use of isometric-only testing to avoid dynamic movement
Correct answer: Post-exertional malaise and increased symptom variability across test sessions
Fibromyalgia is associated with post-exertional malaise, meaning symptom amplification after exertion is a genuine physiological response requiring protocol modification and multi-session evaluation.
CVE Functional Capacity Evaluation 4
Which Occupational Safety and Health Administration (OSHA) guideline is MOST relevant when establishing safe lifting parameters within an FCE?