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California Functional Capacity Protocol

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What is it?

The Cal-FCP is a 90-minute to 120-minute 12-step process that includes a battery of tests to quantify three important aspects of soft tissue injury: pain; self-perceived physical limits; and functional capacity. Subsequent multi-site reliability and validity studies have been presented at scientific meetings and published in peer-reviewed medical journals. Because it is so time-efficient, the Cal-FCP is often used several times during a rehabilitation program. An example of its use in this manner is provided.

Who uses it?

Adopted by the IFCAN network, the Cal-FCP is a cost-effective approach to providing performance data that can be used for disability rating. Because it is inexpensive, it also is administered serially to guide a managed care treatment program for rehabilitation from painful soft-tissue injuries.

Sample Reports

This set of three reports (PDF) describes the case of a young woman who was injured while working as a flight attendant for a major airline company. Her physician sought authorization from the insurance claimsperson for a six-week physical reconditioning program.The Claimsperson agreed, authorizing three Cal-FCP functional capacity evaluations; the first to set a baseline and the next two to measure her progress. The claimsperson authorized the full series of services as long as she was making progress. Immediately after each evaluation, the report was faxed to her physician, who saw the client soon thereafter with the report in hand.In this way, tight case management was placed in the physician’s hands.

This type of report is easily word-processed, requiring no more than 15 minutes for a clerical person to complete, using the two-page Cal-FCP evaluation record to supply the information.

Note that the reports do not describe the functional capacity evaluation as a “Cal-FCP.” Because this was provided at the Washington University School of Medicine in St. Louis, Missouri, we elected to present it as a generic functional capacity evaluation.In fact, it follows the Cal-FCP protocol exactly.

Necessary Equipment

Although some of the materials necessary to perform the Cal-FCP are in the Cal-FCP Examiner’s Manual, various pieces of commercially available testing equipment also are necessary.

Necessary Equipment
Task Equipment
Structured Intake Interview EPIC Structured Interview *
Health Questionnaire EPIC Health Questionnaire *
Perceived Function EpicRehab Spinal Function Sort
Perceived Function EpicRehab Hand Function Sort
Pain and Sensation Drawing EPIC P & S Drawing / VAS *
Medical Stability MS Screening
Finger Strength B&L Pinch Gage
Hand Strength JAMAR Hand Dynamometer
Stoop, Kneel & Crouch Cal-FCP Whole Body Protocol *
Lift Capacity EPIC 1
Carry Capacity EPIC 1
Stair Climb EPIC 1
* Indicates test included in Cal-FCP Examiner’s Manual.

Background

Occupational disability is the effect of medical impairment on the individual’s ability to function in work-relevant tasks. Until recently there has been no standardized method to quantify occupational disability, providing a percent disability rating. Additionally, the matching of the impaired person’s residual functional capacity to a job’s demands has been both expensive and time consuming.

In 1993, Vert Mooney, MD, and Leonard Matheson, PhD, undertook a project for the State of California Division of Industrial Accidents to quantify the functional consequences of soft tissue musculoskeletal injury. This work resulted in a standardized method to quantify occupational disability with a percent disability rating, the California Functional Capacity Protocol, also known as the Cal-FCP.

Bibliographic References

  1. Matheson, LN. Relationships among age, body weight, resting heart rate and performance in a new test of lift capacity. Journal of Occupational Rehabilitation. 1996;6(4):225–237.
  2. Matheson, LN, Mooney, V, Grant J, Leggett S, Kenny K. Standardized evaluation of work capacity. Journal of Back and Musculoskeletal Rehabilitation. 1996;(6): 249–264.
  3. Matheson, LN, Mooney, V, Holmes, D, Leggett, S, Grant, J, Negri, S, Holmes, B. A test to measure lift capacity of physically impaired adults: Part II — Reactivity in a patient sample. Spine, 1995;20(19): 2130–2134.
  4. Matheson, LN, Mooney, V, Grant, J, Affleck, M, Hall, H, Melles, T, Lichter, R, McIntosh, G. A test to measure lift capacity of physically impaired adults: Part I — Development and reliability testing. Spine, 1995;20(19): 2119–2129.
  5. Matheson, LN, Matheson, ML, Grant, J. Development of a measure of perceived functional ability. Journal of Occupational Rehabilitation, 1993;3(1), 15–30.

Additional reading