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Digraph Software 1403 Folk Rd, Suite 203A Wilmington, DE 19803Toll Free: 8662123539 Fax: 8882064952 www.medigraphsoftware.comMediGraph Functional Capacity Evaluation Sign up Form As a Digraph subscriber,
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How to fill out functional capacity evaluation

01
To fill out a functional capacity evaluation, follow these steps:
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Start by gathering all necessary forms and documents related to the evaluation.
03
Review the instructions provided with the evaluation forms to understand the purpose and requirements of each section.
04
Begin by filling out personal information, including name, date of birth, contact details, and relevant medical history.
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Move on to specific sections of the evaluation that may require you to rate your physical abilities or limitations. Provide accurate and honest information based on your current condition.
06
Use additional sheets or space provided to explain any answers in further detail if needed.
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If you are unsure about any question or section, do not hesitate to seek clarification from the evaluator or healthcare professional.
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Once you have completed all the sections, review your answers for accuracy and completeness.
09
Sign and date the evaluation form as required.
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Submit the filled-out functional capacity evaluation to the designated recipient or healthcare provider.
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Keep a copy of the evaluation for your records.

Who needs functional capacity evaluation?

01
Functional capacity evaluation may be needed by individuals in various circumstances, including:
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- Workers who have suffered an injury or illness that may affect their ability to perform job-related tasks
03
- Individuals applying for disability benefits and require an assessment of their physical capabilities
04
- Athletes or sports professionals undergoing evaluations for performance-related purposes
05
- Individuals involved in legal cases where their physical abilities are a factor
06
- Candidates for certain job positions that require a specific level of physical fitness and capabilities
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- Individuals undergoing rehabilitation or therapy and need to monitor progress and abilities over time
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Functional capacity evaluation is a comprehensive assessment conducted to determine an individual's ability to perform tasks related to their daily living and work activities.
Employers are typically required to request a functional capacity evaluation for an employee who is returning to work after an injury or illness.
A healthcare professional, such as a physical therapist or occupational therapist, will administer the evaluation and report the findings based on the individual's physical abilities.
The purpose of functional capacity evaluation is to assess an individual's physical capabilities and limitations in order to determine their ability to safely perform specific job tasks.
The evaluation typically includes information about the individual's physical abilities, restrictions, and recommendations for returning to work.
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