Why do an FCE?

The purpose of the Functional Assessment is to determine the extent of a claimant’s physical capabilities.

Functional Testing

Functional testing is performed on the individual in a controlled clinic environment. The Functional Capacity Evaluation protocol is used for this assessment unless the client requires the development of specific functional tests that reproduce the critical physical demands of a specific job or task. If required, a Physical Demands Analysis can be used as a guideline for the evaluator to focus the evaluation on specific or job related tasks. Functional testing is intended to identify tasks that may be difficult or unsafe for the individual to perform without professional supervision.

The protocol requires the client’s participation in a graded and consecutive series of measured physical tasks that provide impartial, reproducible results in detail so determined as to make a meaningful analysis of the client’s real-life capabilities.


What is the definition of "Catastrophic"?

Physical Criteria:

  1. paraplegia or quadriplegia
  2. amputation or other impairment causing the total and permanent loss of use of both arms
  3. amputation or other impairment causing the total and permanent loss of use of both an arm and a leg
  4. total loss of vision in both eyes
  5. brain impairment that, in respect of an accident, results in
    1. a score of 9 or less on the Glasgow Coma Scale, as published in Jennett, B. and Teasdale, G., Management of Head Injuries, Contemporary Neurology Series, Volume 20, F.A. Davis Company, Philadelphia, 1981, according to a test administered within a reasonable period of time after the accident by a person trained for that purpose, or;
    2. a score of 2 (vegetative) or 3 (severe disability) on the Glasgow Outcome Scale, as published in Jennett, B. and Bond, M., Assessment of Outcome After Severe Brain Damage, Lancet i:480, 1975, according to a test administered more than six months after the accident by a person trained for that purpose.
  6. subject to subsections (2) and (3), any impairment or combination of impairments.

Functional Criteria:

In accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th edition, 1993, results in 55 percent or more impairment of the whole person, or;

(g) subject to subsections (2) and (3), any impairment that, in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th edition, 1993, results in a class 4 impairment (marked impairment) or class 5 impairment (extreme impairment) due to mental or behavioural disorder;”

Stabilization Criteria:

Also, according to SABS Subsection 2 (2):
“Clauses (f) and (g) of the definition of “catastrophic impairment” in subsection (1) do not apply in respect of an insured person who sustains an impairment as a result of an accident unless,

(a) the insured person’s health practitioner states in writing that the insured person’s condition has stabilized and is not likely to improve with treatment; or

(b) three years have elapsed since the accident.”

Unlisted but Analogous Criteria:

And SABS Subsection 2 (3):
“For the purpose of clauses (f) and (g) of the definition of “catastrophic impairment” in subsection (1), an impairment that is sustained by an insured person but is not listed in the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th edition, 1993 shall be deemed to be the impairment that is listed in that document and that is most analogous to the impairment sustained by the insured person.”

NB: CAT Determinations are directed to specific clauses of the SABS catastrophic impairment criteria that restrict rendering a decision until certain conditions are met.

Application of Criteria

e) Glasgow Outcome Scale (GOS) is subject to the condition that the test be administered “more than six months after the accident.”

f) 55% Whole Person,

g) Mental and Behavioural Disorders, can only be applied if the “insured person’s condition has stabilized and is not likely to improve with treatment” or “three years have elapsed since the accident.” Assessors should note that these conditions do not apply to any of the other catastrophic impairment criteria.


Who can sign off on a treatment plan?

Members of a health profession who are members of Colleges as defined in the Regulated Health Professions Act, 1991 :

  1. Audiology and Speech-Language Pathology
  2. Chiropody
  3. Chiropractic
  4. Dental Hygiene
  5. Dental Technology
  6. Dentistry
  7. Denturism
  8. Dietetics
  9. Massage Therapy
  10. Medical Laboratory Technology
  11. Medical Radiation Technology
  12. Medicine
  13. Midwifery
  14. Nursing
  15. Occupational Therapy
  16. Opticianry
  17. Optometry
  18. Pharmacy
  19. Physiotherapy
  20. Psychology
  21. Respiratory Therapy

Late cancellation no show policies

Our policy on late cancellations and no-shows is based upon our need to recover administrative expenses including minimum-time fees charged to us by the clinicians who have committed to this case.

For practical purposes our consultants find it essential to allow five business days (5) or more before the appointment for re-scheduling. In order to avoid any misunderstanding respecting time and date of receipt, we require an original letter of cancellation. For this purpose, we request certified delivery such as same day courier or registered mail. A “fax” cannot be accepted for this purpose. Late cancellation fees will be assessed at 70% of the estimated cost.

Our assessors work on a tight schedule. If your client is more than 15 minutes late for the scheduled appointment, they may still be able to complete the assessment, but if they are unable by reason of your client’s tardiness so to do, we will still be obliged to bill you for the time.


What are the ground rules for examinations at MDAC?

We believe that our clients are entitled to the best determination of which we are capable, and for that purpose we must focus our attention only on the issues we are asked to address. We need to focus our examinations on the issues to be resolved by them, and we need to isolate the examination process from the dispute that gave rise to it. For that purpose, we request our clients to abide by the following ground rules:

  1. We cannot permit the Client's family members or friends to be present during the assessment of mentally capable adults. You are advised to make arrangements for childcare where necessary to allow the parents to attend without the children. We have no childcare facilities.
  2. No recording devices are permitted.
  3. The client should bring all pill bottles and relevant x-rays to the assessment.
  4. Clients should wear comfortable clothes to the assessment to allow movement - shorts, T-shirt, and running shoes.
  5. All clients are required to sign an authorization to release of information to the referring party prior to the interview and assessment.
  6. We do not carry out spinal or maximal functional capacity assessments on pregnant women.
  7. Children, under 16 years of age, must be accompanied by their legal guardian.