title: Functional capacity evaluation: does it change the determination of the degree of work disability?
abstract: BACKGROUND
  Determining the degree of work disability following traffic accidents is very challenging. Functional capacity evaluations (FCEs) are becoming more commonly used in the process of disability assessment.
  
  
  OBJECTIVE
  This study aimed to assess the agreement of the physicians' decision regarding the degree of work disability in two conditions: 1) based solely on a medical examination 2) based on a combined medical and FCE.
  
  
  METHODS
  This is a cross-sectional study, with 123 individuals who experienced car accidents; 76 with whiplash-associated disorders and 47 with a hip fracture. All subjects underwent an FCE, filled-in questionnaires and underwent a medical examination. The medical charts of each subject were rated twice and the degree of work disability was determined by orthopedic surgeons and occupational medicine specialists; once based solely on medical files and once based on medical files that included data from the FCE. The agreement was assessed by Intra-Class Coefficients (ICC) and the dependency between the two ratings by McNemar's test.
  
  
  RESULTS
  An excellent ICC and significant dependency were found for the percent disability in the hip injury group whereas a fair ICC and a non significant dependency for the percent disability in the whiplash group.
  
  
  CONCLUSIONS
  The use of FCEs highlights the worker's capacity to perform duties that are part of the physical demands at work. The integration of FCEs into the disability assessment procedure seems to be important especially for whiplash injuries or in cases of discrepancies between the rate of disability determined by the physician to the patient's complaints and participation.
authors.affiliation: Sackler Faculty of Medicine, School of Health Professions, Department of Occupational Therapy, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel. Electronic address: navah@post.tau.ac.il.
authors.forename: Navah Z
authors.initials: NZ
authors.lastname: Ratzon
authors.affiliation: Orthopedic Department, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Amit
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Friedman
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shiri
authors.initials: S
authors.lastname: Zamir
authors.affiliation: Sackler Faculty of Medicine, School of Health Professions, Department of Occupational Therapy, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel.
authors.forename: Debbie
authors.initials: D
authors.lastname: Rand
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006620:Hip Fractures; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D010820:Physicians; D011379:Prognosis; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries; D014937:Work; D014942:Workers' Compensation; D055815:Young Adult
keywords: Hip injury; Traffic accident; Whiplash; Workability