A standardized assessment of physical work capacity conducted by an OT or PT using validated protocols over 4-8 hours (Genovese & Galper, 2009).
A physician-led examination and records review that provides diagnostic and causation opinions, typically in a single session (American Medical Association, 2023).
| Dimension | Functional Capacity Evaluation (FCE) | Independent Medical Examination (IME) |
|---|---|---|
| Examiner | OT or PT | Physician |
| Duration | 4-8 hours, sometimes 2 days | 30-90 minutes, typically single session |
| Primary output | Safe maximum demonstrated physical capacities | Diagnostic and causation opinion |
| Methodology | Standardized physical tests with effort/consistency measures | History, examination, record review |
| Typical use | Establish work capacity restrictions | Establish diagnosis, causation, prognosis |
Use an FCE when physical capacity must be quantified to support items in a life care plan such as attendant care hours, home modifications, or the need for adaptive equipment, or to document restrictions in a workers' compensation matter.
Use an IME when diagnostic, causation, or prognosis questions need physician-level opinion, often on behalf of the defense.
Both examine the claimant. They answer different questions: FCE quantifies physical capacity; IME addresses medical questions. In catastrophic cases, both are often performed, and the life care planner may rely on either as part of the medical foundation for the plan.
Some IME physicians perform or order functional testing, though dedicated FCEs by OTs and PTs produce more detailed and standardized physical capacity data.