When you get injured at work in Iowa, two evaluations will likely determine your financial future: the Functional Capacity Evaluation (FCE) and your permanent impairment rating. What many injured workers don't realize is that these assessments are just the beginning of a complex process, and the type of injury you sustained can mean the difference between receiving a few thousand dollars or hundreds of thousands in compensation.

What Is a Functional Capacity Evaluation and Why Does It Matter?

Your Functional Capacity Evaluation is much more than a simple physical test. It's a comprehensive assessment that can make or break your workers' compensation case. Yet most injured workers walk into the evaluation room with little understanding of what's actually at stake.

The FCE is administered after your treating physician determines you've reached maximum medical improvement (MMI). That is the point at which your condition isn't expected to improve further, even with additional treatment.

This evaluation can last up to six hours and is spread over two days, during which you'll undergo tests designed to measure your functional physical ability to perform work-related tasks.

What the FCE Actually Measures

During your evaluation, the doctor will assess several critical factors that directly impact your impairment rating and work restrictions:

Musculoskeletal Abilities: The evaluator tests how well your bones, muscles, joints, limbs, ligaments, and tendons function compared to before your injury. This includes range of motion, strength, and coordination.

Repetitive Motion Capacity: Your ability to perform the same movements repeatedly throughout a workday is carefully measured. This is particularly important for workers whose jobs require repetitive tasks.

Overall Strength: The evaluation measures your strength across different muscle groups and compares it to the normal capacity for someone of your age and physical condition.

Material Handling Frequency: You'll be tested on how often you can handle materials, whether constantly, frequently, or only occasionally. This directly impacts what type of work you can perform going forward.

Non-Material Handling Tasks: Beyond lifting and carrying, the FCE assesses your ability to perform other work-related activities like reaching, bending, climbing, and maintaining various positions.

The Critical Mistakes Injured Workers Make During FCE

Understanding what evaluators are watching for can help with your FCE. Doctors performing these evaluations receive specialized training to recognize inconsistent effort or symptom exaggeration. However, they're equally trained to spot when injured workers are pushing themselves beyond their true capabilities.

Be Honest, They Know the Difference

The single most important thing to understand about your FCE is this: be truthful about your limitations. Doctors are trained professionals who can detect when someone is exaggerating their disability. Attempting to appear more injured than you are can severely hurt your case, potentially resulting in a denial of benefits or accusations of fraud.

However, the opposite problem is equally dangerous. Many injured workers, particularly those with strong work ethics or fears about their employment, push themselves too hard during the evaluation. They lift more than they safely can, ignore pain signals, or minimize their limitations because they're worried about losing their job or appearing weak.

This tendency to overperform can result in an unfair impairment rating that doesn't accurately reflect your true functional limitations. Once that rating is established, it becomes extremely difficult to challenge, potentially costing you thousands of dollars in benefits and leaving you without appropriate work restrictions to protect your health.

You Have the Right to a Second Opinion

Many injured workers don't know if your doctor assigns you an impairment rating that you believe is unfair following your FCE, you're entitled to request an independent medical examination with a physician of your choice, at your employer's expense.

Under Iowa Code Section 85.39, you can submit Form 100A along with your chosen physician's report to your employer to request this second opinion. This is an extremely valuable right, but it must be used strategically. Not all independent medical examiners are created equal, and choosing the wrong doctor can actually harm your case rather than help it.

Understanding Impairment Ratings: The Foundation of Your Compensation

Once you've completed your FCE and reached maximum medical improvement, your treating physician will assign you a permanent impairment rating. This rating is a percentage that represents the level of permanent loss of function you've sustained because of your work injury.

The Rating Is Just the Beginning

Here's where many injured workers and even some inexperienced attorneys get it wrong: they assume the impairment rating is the final word on compensation. In reality, for many types of injuries, the impairment rating is just one factor among many that determine your benefits.

This is where understanding the difference between scheduled and unscheduled (industrial disability) injuries becomes absolutely critical.

Industrial vs. Scheduled Injuries: Why Your Body Part Matters More Than the Percentage

Imagine two Iowa workers, both receiving a 10% permanent impairment rating from their doctors. One worker receives approximately $25,000 in benefits.

The other receives more than $150,000. Both ratings are 10%. Both workers are honest, hardworking Iowans. So why the massive difference?

The answer lies in whether their injury is classified as a scheduled member injury or an industrial disability case.

Scheduled Member Injuries: Simple Math, Limited Compensation

Scheduled member injuries involve specific body parts that Iowa law has assigned a predetermined number of compensable weeks. These include:

  • Hand
  • Arm
  • Leg
  • Foot
  • Fingers
  • Toes
  • Eye
  • Hearing loss

For these injuries, the calculation is straightforward: your impairment rating percentage is multiplied by the number of weeks assigned to that body part. For example, if you sustain a 10% impairment to your leg, and the leg is assigned 220 weeks under Iowa law, you would receive 10% × 220 weeks = 22 weeks of compensation.

This calculation is relatively simple and, for scheduled member injuries, the impairment rating is often the primary and sometimes the only factor in determining your compensation.

Industrial Disability Cases: Where the Real Value Lies

Industrial disability cases involve injuries to parts of the body not covered under the scheduled member system. These are sometimes called "unscheduled" injuries and include:

For industrial disability cases, your impairment rating is only one of many factors considered when calculating compensation. Iowa law requires consideration of:

  • Your Impairment Rating: The percentage assigned by your doctor based on the AMA Guides.
  • Age: Younger workers who have more working years ahead of them may receive different consideration than workers nearing retirement.
  • Education: Your level of education and specialized training affects your ability to find alternative employment.
  • Work History: Your employment record, including the types of jobs you've held and skills you've developed.
  • Functional Limitations: The specific work restrictions your doctor has assigned, such as lifting limits, standing/sitting requirements, and activity restrictions.
  • Lost Wages: Whether you've experienced a reduction in earning capacity due to your injury.
  • Ability to Return to Your Usual Work: Whether you can perform your pre-injury job duties or must find alternative employment.
  • Ability to Perform Other Work: What types of jobs, if any, you're still capable of performing given your restrictions.

For industrial disability cases, compensation is calculated as a percentage of 500 weeks of benefits rather than the limited weeks assigned to scheduled members. This difference is substantial.

An industrial disability case might result in compensation worth hundreds of thousands of dollars, while a scheduled member case with a similar impairment rating might only be worth tens of thousands.

The Iowa Second Injury Fund: Hidden Benefits Many Workers Miss

If you sustained a scheduled member injury to one part of your body (hand, arm, foot, leg, or eye) prior to your current work injury, even if that first injury wasn't work-related, you may be entitled to receive significantly more compensation paid by the Iowa Second Injury Fund.

Many injured workers don't realize they qualify for these benefits because they assume their previous injury doesn't matter if it wasn't related to work. This is incorrect. A prior injury that results in a second scheduled member impairment can open the door to substantial additional compensation.

However, accepting certain types of settlements can permanently bar you from accessing Second Injury Fund benefits later. This is one of the many reasons why settling your case quickly without understanding all the factors at play can be a costly mistake.

The Dangers of Quick Settlements

Insurance companies know that most injured workers don't understand the difference between scheduled and industrial disability cases. They also know that workers who are struggling financially or worried about their future may be tempted to accept quick settlement offers, especially when those offers come at a vulnerable time.

It is common for something like you receiving your impairment rating, and shortly afterward, a check arrives in the mail. The insurance adjuster calls and suggests you could receive all your money at once if you just sign a few papers. It sounds tempting, cash in hand, case closed, move on with your life.

But those "few papers" are usually a full settlement and release that permanently closes your case. Once signed, you typically cannot reopen your claim, even if you discover later that you were entitled to far more compensation.

You Can Cash Your Impairment Rating Check

If you receive a check for your impairment rating, you can generally cash it without signing any settlement paperwork. If a company doctor has given you an impairment rating, the insurance company should pay you that rating amount without requiring you to sign settlement documents.

Some insurance companies try to make it seem like you must sign paperwork to receive your impairment check. This is not accurate. By cashing the check so long as you haven't signed settlement documents you're not agreeing that this is the only or correct amount of compensation you should receive. However, the check you receive may represent only a small fraction of what you're actually owed.

Don't Wait Too Long

While you shouldn't rush into a settlement, you also cannot wait forever to pursue additional benefits. Iowa law imposes strict time limits for filing workers' compensation claims and challenging impairment ratings. Waiting too long can result in losing your right to pursue additional compensation.

This is why early consultation with an experienced Iowa workers' compensation attorney is crucial. An attorney can evaluate your case type, explain what benefits you're entitled to, and ensure you take appropriate action within the required timeframes.

Choosing the Right Independent Medical Examiner

If you disagree with your impairment rating, requesting an independent medical examination under Iowa Code Section 85.39 is one of your most powerful tools. However, this right must be exercised carefully.

Not All IME Doctors Are the Same

The doctor you choose for your independent medical examination can significantly impact your case outcome. You should look for a Board Certified Independent Medical Examiner physicians who have passed specialized testing on the AMA Guides Fifth Edition, which is the reference manual used to determine permanent impairment ratings in Iowa.

Many of these doctors are also Board-Certified Occupational Health physicians whose specialty involves evaluating, treating, and making recommendations concerning work-related injuries. This specialized expertise is valuable when challenging an impairment rating.

The Insurance Industry Connection

Another critical factor to consider: some doctors who are technically qualified to perform impairment ratings work for insurance companies and employers the vast majority of the time. These physicians may have developed a reputation for consistently providing lower impairment ratings or more favorable opinions for insurance carriers.

The 2017 Legislative Changes

Injured workers should also be aware of significant changes made to Iowa's workers' compensation law in 2017. House File 518, signed by Governor Branstad, substantially reduced the rights and compensation available to injured workers.

One of these changes reduced the amount insurance companies are required to reimburse injured workers for independent medical examinations under Section 85.39. If you pursue an independent examination without legal representation, you may be surprised to find that the insurance company only agrees to pay for the rating itself not for the doctor's time reviewing medical records, conducting a thorough examination, or writing a detailed report.

This can leave you responsible for a significant portion of the examination bill, potentially costing thousands of dollars out of pocket.

Getting Legal Guidance on IME Selection

Most experienced workers' compensation attorneys in Iowa have relationships with several qualified independent medical examiners. They know which doctors specialize in particular types of injuries, which ones provide thorough and well-supported evaluations, and which ones have credibility with judges if your case proceeds to a hearing.

Before you schedule an independent medical examination on your own, it's wise to consult with an attorney even if you haven't decided whether to hire one for your entire case. At minimum, run the doctor's name by an experienced workers' comp attorney to ensure you're not choosing a physician who regularly works for insurance companies.

Knowledge Is Protection

Your Functional Capacity Evaluation and impairment rating are critical milestones in your Iowa workers' compensation case, but they're not the end of the story. The type of injury you've sustained scheduled member versus industrial disability can mean the difference between minimal compensation and fair recovery that truly reflects your losses.

Don't let the complexity of Iowa's workers' compensation system work against you. Before you accept any settlement offer, cash any checks, or sign any paperwork, take the time to understand your rights and the true value of your claim.

To help you navigate Iowa's workers' compensation system, our lawyers offer a free copy of our comprehensive book, "An Insider's Guide to Work Injuries," which includes the Injured Workers Bill of Rights, the 7 Deadly Mistakes to Avoid, and information about impairment ratings, second opinions, and much more.

We provide this resource at no cost because we've seen too many Iowans settle with insurance companies only to discover they missed out on thousands of dollars in benefits they were owed. Just because you received a check for your impairment rating doesn't mean you've been paid correctly—it's often only a small part of what you're entitled to, and there are time limits for pursuing additional benefits.

If you have questions about your claim or are facing disagreement over your impairment rating, don't delay—get your free book at Iowaworkinjury.com, call us at 641-792-3595, chat now, or contact us online to schedule a no-cost injury evaluation.

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Corey Walker
Corey Walker
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With over 28 years legal experience, Corey has been recognized for his work as an injury attorney.