Medical vs. Functional Evaluation
Medical vs. Functional Evaluation

Medical vs. Functional Evaluation

Blog and Opinions Red Slashes Oct 12, 2016
By: Nabeela Ladha

There is often times confusion that occurs when talking about medical evaluations and functional evaluations. What’s the difference? Which evaluation is better for my company/needs? When should each be used? As these are some of the questions that continuously come up, we thought it would be beneficial to create a comparison chart of the two different evaluations.

  Medical Evaluation Functional Evaluation
Purpose  Identify immediate medical/health risks Identify functional ability to complete the physical tasks of a specific job
Time 45 minutes – 1 hour  1 hour – 1.5 hours 
Evaluator Registered Nurse, reviewed by physician  Physiotherapist, Occupational Therapist or Kinesiologist 

Part 1: Medical history documented.

Part 2: Comprehensive head-to-toe physical assessment performed to identify current and potential future limiting medical conditions.

Part 3: Physician reviews all clinical information to determine fitness for duty and provide interventions where required.

Part 4: The final fitness status is confidentially and securely reported to the authorized company representative.

Part 1: Health screen completed with review of heart rate, blood pressure and medical history to ensure worker safe to participate in evaluation.

Part 2: Functional evaluation completed to evaluate ability to meet physical strength, positional and endurance requirements (i.e. lifting, carrying, reaching, pulling, pushing, etc.) based on the specific demands of the job.

Part 3: Clinician determines outcome of evaluation as Fit, Fit with recommendations or Unfit.

Part 4: The final fitness status is confidentially and securely reported to the authorized company representative. 

  •  Fitness: Compatible; Report: No restrictions
  • Fitness: Compatible with restrictions; Report: Workplace restriction required
  • Fitness: Incompatible pending corrective measures; Report: Further medical testing required 
  • Fitness: Incompatible; Report: Unfit
  • Fit
  • Fit with recommendations
  • Unfit
  • Medical clearance required
When to use?

 Medical Clearance

  • Risk based
  • Compliance based (Site Req.)
  • Legislative requirement

 Functional Abilities Clearance

  • Risk based
  • Compliance based (Site Req.)

Evaluation Analysis

As seen from the table above, medical fitness evaluations are exams that help organizations operating in safety-sensitive industries promote safety by managing employee health risks. They improve overall health and wellness in the workplace. This is done by assessing whether people are medically fit for the job they are performing. In comparison, a functional fitness evaluation is a risk mitigation tool designed to ensure that the employee is physically able to perform the required duties of the position without undue risk of being injured at the workplace. It consists of a series of tests (conducted in a clinical setting) that mirror the physical demands of the specific position a candidate will be employed in.      

It’s important to note that medical fitness does not mean that a worker is physically capable of completing the physical duties of the job (i.e. lifting, carrying, pushing, pulling, etc.). Likewise, if someone is fit to do the physical duties of the job, they might still have an underlying medical condition that could pose a safety risk on the job (i.e. history of seizures, uncontrolled diabetes, etc.). Also, if the need is there to have both a medical and functional test complete, it is important to know that the results default to those listed under the medical exam portion. However, if they are deemed “unfit” for the FFE, they become unfit overall.

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