Cognitive Functional Capacity Evaluation

Cognitive Functional Capacity Evaluations are typically recommended by your lawyer, but may come from other professionals including your doctor or medical specialist, or your insurance adjustor. The referral is usually made to gain an in-depth understanding of your current functional abilities. The COG FCE will be used to address questions posed by the referral source, and may include identifying potential limitations with tasks in the home or at work, assessing the likelihood of returning to pre-accident job duties, and developing realistic recommendations to optimize rehabilitation.

To conduct a Cognitive Functional Capacity Evaluation, your evaluator must be a qualified therapist with prior FCE certification and experience, and specialized training in COG FCE. Your COG FCE evaluator will be a skilled Occupational Therapist, often with courtroom experience.

To become a licensed Occupational Therapist, OTs complete six years of post-secondary education, including a two-year Master’s degree in Occupational Therapy, and must successfully pass the National Occupational Therapy Certification Examination (NOTCE). All Occupational Therapists in BC are licensed under the College of Occupational Therapists of British Columbia.

At your COG FCE evaluation, your evaluator will assess both your cognitive and physical abilities. During the evaluation, the COG FCE evaluator will maintain neutrality through objective measurements and observation, but with a client-centred focus on achieving positive outcomes. To facilitate this process, it is important that you complete each part of the assessment to the best of your ability, as inconsistency of effort may impact the results of your COG FCE.

COG FCEs are typically performed in a clinic-based environment. Special considerations may result in an in-home evaluation. The COG FCE will first include an in-depth interview so the evaluator may learn of your medical and social history, how you perceive your current abilities, and information regarding your job demands.

The next step of the COG FCE consists of your evaluator conducting a series of standardized assessments related to your job demands and individual challenges, targeting both physical and cognitive aspects. The assessments will be chosen by your evaluator based on questions posed by your referral source, and information gained during the interview stage. For example, if your job requires sustained attention and you have reported difficulty focusing on tasks, then an assessment may be used to objectively identify your current abilities and challenges in these areas. Other areas of cognition that may be assessed include your ability to remember information, follow instructions, or ignore distractions; the speed and accuracy of decision-making or problem solving; or simulations of common activities present in your day to day and work environment. Throughout the one to two day process, your evaluator will be looking to see how your current abilities and assessment results compare to your work demands, and take into consideration your symptoms and fatigue level.

A comprehensive report based on the results of this process will be completed by your COG FCE evaluator. The evaluator will interpret the results from the evaluation to determine what job demands may be safely performed, and to inform recommendations for an individualized rehabilitation program. The report will include a detailed summary of your history, your job demands, and results from the functional assessments. A comparison between your current abilities and the demands of your job will be made to assess if these areas match. Finally, the report will conclude with relevant recommendations aimed to address the questions posed by your referral source.