What Does an FCE Actually Tell You? More Than Just How Much Someone Can Lift September 02 2026

When someone hears "Functional Capacity Evaluation," there is a good chance the first thing they picture is lifting.

And, to be fair, lifting is an important part of many FCEs.

But a good Functional Capacity Evaluation is about much more than finding the heaviest box a person can pick up.

An FCE is really an attempt to answer a much larger question:

What can this person reliably do, and how does that compare with the demands of work?

Strength Is Only One Piece of the Puzzle

Consider two workers who can both lift 40 pounds.

On paper, they look identical.

But imagine that Worker A can lift 40 pounds from floor to waist, carry it 50 feet, repeat the task throughout the day, and maintain appropriate body mechanics.

Worker B can lift 40 pounds once but develops significant difficulty when the task is repeated.

Those are not equivalent functional capacities.

Frequency matters.

Duration matters.

Position matters.

Recovery matters.

Consistency matters.

And the job itself matters.

The Importance of Job Demands

A functional capacity evaluation becomes much more useful when it is connected to actual occupational requirements.

A warehouse employee, construction worker, nurse, office worker, and delivery driver can all have completely different physical demands.

That is why the question shouldn't simply be:

"What can the patient lift?"

It should be:

"What does the job require, and how does the patient's demonstrated capacity compare?"

This is one of the reasons Matheson Development offers equipment and protocols designed around functional testing rather than isolated impairment measurement. Our FCE equipment ranges from portable starter configurations to comprehensive systems for established rehabilitation programs.

Consistency Is Important

Another important part of functional testing is looking at how performance behaves over time.

People don't work for ten seconds.

Most jobs require people to perform activities repeatedly, sometimes for hours.

A person's first lift of the morning may look very different from their twentieth.

That doesn't necessarily mean the first or twentieth trial is "the answer."

It means the pattern is information.

The clinician's job is to interpret that pattern in the context of the person's condition, the test protocol, and the demands of the job.

FCEs Aren't Crystal Balls

It is also important to recognize what an FCE cannot do.

An FCE cannot predict the future with absolute certainty.

It cannot guarantee that someone will never experience pain at work.

It cannot recreate every aspect of a particular job.

And it should not be interpreted as a substitute for clinical reasoning.

Instead, an FCE provides structured information about functional performance under defined conditions.

That information can then be integrated with medical records, job demands, clinical findings, patient reports, and other relevant evidence.

Technology Isn't the Point

There is sometimes a temptation to think that a better FCE means buying more equipment.

Equipment matters.

Good equipment should be safe, reliable, practical, and useful.

But equipment doesn't perform the evaluation.

The clinician does.

A $10,000 testing room with poor clinical reasoning isn't necessarily better than a thoughtfully designed evaluation performed with a smaller equipment setup.

This is why we offer multiple FCE packages at Matheson Development rather than assuming every clinic needs the same setup. A smaller practice can begin with a portable package and expand as its referral volume and services grow.

The Real Value of an FCE

The best FCE reports don't simply contain a list of numbers.

They help answer practical questions.

Can the person perform the essential functions of the job?

If not, what is limiting them?

Is additional rehabilitation appropriate?

Would workplace modification help?

Are there discrepancies between reported ability and observed performance that warrant further investigation?

Can the person safely sustain the required activity?

Those are much more useful questions than simply asking:

"How much can they lift?"

Functional capacity is multidimensional.

And that's exactly why it deserves a multidimensional evaluation.

Explore Matheson FCE Equipment

Functional Cognition: When Knowing How to Do Something Isn't Enough August 26 2026

A person can know exactly how to perform a task and still have trouble performing it.

That distinction is at the heart of functional cognition.

It is also one of the reasons cognitive rehabilitation and work rehabilitation increasingly overlap.

The American Occupational Therapy Association maintains a dedicated clinical topic area on functional cognition, reflecting the profession's longstanding interest in how cognitive abilities affect performance in everyday occupations.

For rehabilitation professionals working with individuals after traumatic brain injury, stroke, neurological illness, or other conditions affecting executive function, this distinction can be critical.

The Problem With "Can You Tell Me How?"

Imagine asking someone:

"Can you explain how you would assemble this?"

They may give you a perfect answer.

They know the steps.

They understand the instructions.

They may even perform well on a traditional cognitive test.

But then you put the materials in front of them.

Suddenly things change.

They skip a step.

They become distracted.

They don't notice an error.

They continue working even though the product is obviously incorrect.

They have difficulty changing strategies.

Or they become overwhelmed when a second task is introduced.

The problem isn't necessarily that they don't know what to do.

The problem is using what they know while actually doing it.

This Is Where Functional Assessment Becomes Important

Traditional cognitive testing can be extremely useful.

But real jobs rarely consist of sitting quietly in a room answering one question at a time.

Work involves interruptions.

Noise.

Deadlines.

Changing priorities.

Multiple instructions.

Unexpected problems.

Other people.

And sometimes a phone ringing while you're trying to finish something else.

A functional assessment can introduce some of those demands in a structured and observable way.

Product Spotlight: The Doll Chair Assembly Task

The Progressive Occupational Demand System Doll Chair Assembly Task was designed around this idea.

The task involves assembling a meaningful object while progressively adjusting occupational demands.

The DCAT includes three levels of chair complexity and allows clinicians to introduce concurrent auditory processing demands, such as transcribing telephone messages.

That combination is important.

The clinician isn't simply asking:

"Can you assemble this chair?"

The clinician can ask:

What happens when the task becomes more complicated?

What happens when attention has to be divided?

What happens when instructions change?

What happens when the person makes an error?

What happens when they have to recognize and correct that error independently?

Those observations can reveal things that a paper-and-pencil test may not.

The Importance of Error Correction

One of the most interesting parts of functional cognitive assessment is watching what happens after something goes wrong.

Everyone makes mistakes.

The question is what happens next.

Does the person recognize the mistake?

Can they figure out why it happened?

Can they change their approach?

Do they ask for help appropriately?

Do they continue repeating the same error?

Do they become frustrated and stop?

These are meaningful work behaviors.

"Just Right" Is a Useful Concept

The DCAT is part of the Progressive Occupational Demand System, which allows the clinician to grade the challenge presented to the client.

That means the task can become more demanding without simply becoming more difficult for the sake of being difficult.

The objective is to find an appropriate level of challenge and observe performance as demands increase.

That is much closer to how work actually behaves.

Why This Matters for Return to Work

A person returning to a job after a brain injury may have adequate strength, mobility, and basic knowledge of their occupation.

But if they cannot manage the cognitive demands of the workplace, returning to their old job without further evaluation may not be realistic.

Conversely, a person who demonstrates difficulties under one set of conditions may perform successfully when the demands are modified.

That information can help guide accommodations and rehabilitation.

The point isn't to "pass" or "fail" someone.

It is to understand the relationship between the person and the demands of the task.

That is what makes functional cognition such an important part of modern work rehabilitation.

Learn more about the Doll Chair Assembly Task

Product Spotlight: The MTAP and the Value of Measuring What Patients Actually Do August 19 2026

One of the recurring challenges in rehabilitation is surprisingly simple:

How do we measure function?

Strength is measurable. Range of motion is measurable. Grip strength is measurable.

But what about being able to carry groceries? Clean a house? Lift a box? Work overhead? Perform household maintenance? Handle the physical demands of a job?

Those activities are much harder to capture with a single impairment measure.

That is one of the reasons the Multidimensional Task Ability Profile (MTAP) continues to be useful in rehabilitation settings.

Function Outside the Clinic

The MTAP is designed to quantify a person's perceived ability to perform physical activities encountered in everyday life and work.

Instead of asking only about symptoms or isolated body functions, the assessment asks patients to consider actual activities.

The result is a picture of how the individual perceives their functional capacity across a range of tasks.

The MTAP includes 50 illustrated items covering activities ranging from self-care and household tasks to heavier physical activities. It can also be related to the U.S. Department of Labor's Physical Demand Characteristics of work.

That makes it particularly interesting for clinicians who are trying to connect what happens in the treatment room to what happens outside it.

Why Pictures Matter

The MTAP uses illustrations accompanied by short descriptions.

That may seem like a small design choice, but it is an important one.

A long written description can introduce unnecessary ambiguity. A simple picture of someone performing a task can make the question much more immediately understandable.

This can be especially helpful when working with individuals who have lower literacy levels or who may have difficulty processing lengthy written questions.

In other words, sometimes the simplest way to ask a functional question is to show it.

Self-Report Isn't the Same as Performance

There is an important distinction here.

The MTAP does not replace performance testing.

A patient telling us they can lift 50 pounds and a patient demonstrating that ability under controlled conditions are two different pieces of information.

That doesn't make one "right" and the other "wrong."

They answer different questions.

The comparison between perceived ability and observed performance can actually be clinically useful.

If a person reports substantial limitations but performs much better than expected, that discrepancy deserves consideration.

Likewise, if someone reports that they can perform an activity but struggles significantly when actually performing it, that tells us something important too.

The disagreement between measures can sometimes be more informative than agreement.

Tracking Change

Another advantage of a functional questionnaire is that it can be repeated.

If the patient's perceived ability to perform everyday activities improves during treatment, the clinician has another way of documenting functional change.

This is particularly useful when the ultimate goal of treatment is not simply "less pain" or "better strength."

The goal may be:

Return to work. Return to household responsibilities. Return to independence. Return to life.

Those are functional outcomes.

A Useful Companion to Performance Testing

The MTAP can be used alongside physical performance measures rather than instead of them.

For example, a clinician might use:

• MTAP to establish perceived functional capacity
• Grip or pinch testing to examine upper-extremity strength
• EPIC Lift Capacity testing to examine lifting performance
• Job analysis to understand actual workplace demands
• Clinical observation to identify movement or behavioral factors

Together, those pieces provide a much richer picture than any one test can provide by itself.

The MTAP is available as a standalone assessment as well as a comprehensive kit that includes analytics software and additional resources.

The Bigger Idea

At Matheson Development, we have always been interested in a fairly simple question:

What can the person actually do?

The MTAP approaches that question from the patient's perspective.

Performance testing approaches it from observed behavior.

Job analysis approaches it from the employer's perspective.

Good rehabilitation often happens when those three perspectives are brought together.

Learn more about the MTAP

Return to Work Is Becoming a Bigger Part of the OT Conversation August 12 2026

For a long time, return-to-work rehabilitation has lived in a somewhat unusual space in healthcare.

Everyone agrees that work matters. Employers want people back. Patients often want to get back to their jobs. Insurers want injured workers to recover and return to productive activity. Physicians write restrictions and clearances. And occupational and physical therapists are frequently the professionals who have the best understanding of what a person can actually do.

Yet the question of how someone functions at work has not always received the attention it deserves.

That may be changing.

In April 2026, the American Occupational Therapy Association participated in a U.S. Department of Labor policy forum focused specifically on Stay-at-Work and Return-to-Work programs. The discussion included the role of occupational therapy in addressing physical, cognitive, psychosocial, environmental, and ergonomic barriers to employment.

That is an important conversation for rehabilitation professionals.

"Can They Work?" Is Usually the Wrong Question

One of the problems with return-to-work decisions is that they are often reduced to a yes-or-no question:

Can this person work?

In reality, the more useful questions are:

• What does the job actually require?
• Which essential functions can the person perform?
• Which tasks are difficult?
• How much lifting, carrying, reaching, standing, sitting, or walking is required?
• Can the person sustain those activities over an entire workday?
• Are there cognitive or attention demands?
• What happens when multiple demands occur at the same time?
• Could reasonable modifications allow the person to remain productive?

Those are functional questions.

And functional questions are where rehabilitation professionals have something important to contribute.

The Workplace Is More Than a List of Restrictions

A traditional restriction might say:

No lifting over 20 pounds.

That sounds objective. But it doesn't tell us much about the actual job.

Does the worker lift 20 pounds once an hour or 20 times every five minutes?

Does the lifting occur from floor level, waist level, or overhead?

Does the worker carry the object 50 feet?

Are they simultaneously required to reach, twist, climb stairs, or maintain balance?

Does the job require sustained hand use?

Does the worker have to remember a sequence of instructions while performing the physical task?

The difference between a medical restriction and an actual job demand can be enormous.

This is one reason functional assessment remains so valuable.

OT Has a Particularly Broad View of Work

One of the things that makes occupational therapy particularly well suited to return-to-work rehabilitation is the profession's focus on the interaction between the person, the task, and the environment.

A worker may have adequate strength but struggle with the pace of the job.

Another person may demonstrate excellent physical capacity but have difficulty managing divided attention following a brain injury.

Someone else may physically be able to perform a task but need a workstation modification to do it safely and consistently.

And sometimes the solution isn't additional treatment.

Sometimes the solution is changing the task.

That distinction matters.

Where Objective Testing Fits

Functional Capacity Evaluations can provide objective information about physical performance, while tools such as the Hand Function Sort, Spinal Function Sort, and Multidimensional Task Ability Profile can help quantify perceived functional ability in everyday and work-related activities.

The goal isn't to replace clinical judgment with a score.

The goal is to give clinical judgment better information.

When objective performance, self-reported function, job demands, and clinical observations all point in the same direction, the return-to-work recommendation becomes much easier to explain.

And when they don't agree, that discrepancy may actually be the most important finding.

The Future of Return-to-Work Rehabilitation

The Department of Labor's recent attention to Stay-at-Work and Return-to-Work programs is a reminder that rehabilitation does not end when pain decreases or range of motion improves.

The ultimate question is participation.

Can the person safely and sustainably participate in the activities that matter to them—including work?

That is a question occupational and physical therapists have been answering for decades.

It may simply be getting more attention now.

At Matheson Development, we believe good functional assessment starts with that same principle: measure what matters in the real world.

Explore our Functional Capacity Evaluation and work rehabilitation equipment and resources at Matheson Development.

Method Time Measurement (MTM) in Functional Capacity Evaluations (FCEs) July 29 2026

From Disability Notes to Functional Performance: How Work Rehabilitation and Functional Capacity Evaluation Changed Clinical Practice July 14 2026

For much of modern healthcare, rehabilitation professionals have been asked one deceptively simple question:

"Can this person go back to work?"

Today, physical therapists (PTs) and occupational therapists (OTs) often answer that question using objective functional testing, job-specific analysis, and evidence-based return-to-work recommendations. Fifty years ago, however, the answer was usually based almost entirely on physician opinion.

The evolution from subjective disability certification to standardized Functional Capacity Evaluation (FCE) has transformed occupational rehabilitation and created an entirely new area of clinical practice. Understanding this history provides valuable insight into where the profession has been—and where it may be headed.

The 1970s: When Disability Was Primarily a Medical Opinion

Prior to the widespread development of occupational rehabilitation, physicians determined work status largely through clinical judgment. Typical recommendations included statements such as "off work for six weeks" or "return to light duty," often without objective measures of functional performance.

Physical and occupational therapists primarily provided treatment. Formal work capacity evaluations were uncommon, and reimbursement focused on therapeutic intervention rather than measuring work ability.

As workers' compensation costs escalated during the late 1970s and early 1980s, insurers, employers, and policymakers increasingly questioned whether disability decisions could be based on objective evidence rather than subjective opinion alone.

The Birth of Occupational Rehabilitation

This shift created an entirely new specialty.

Programs emphasizing work simulation, work conditioning, work hardening, ergonomic assessment, and job analysis began appearing throughout North America. The focus moved beyond treating pain toward preparing injured workers to safely return to employment.

For the first time, rehabilitation professionals were being asked not only to restore function, but to measure it.

The Most Influential Pioneer: Leonard Matheson

Among the many innovators who shaped occupational rehabilitation, Dr. Leonard Matheson stands out as perhaps the profession's most influential figure.

Matheson fundamentally changed how clinicians viewed work disability. Rather than asking, "What diagnosis does this person have?" he emphasized asking, "What can this person safely do?"

His work advanced several concepts that continue to define occupational rehabilitation today:

• Objective measurement of functional performance
• Job-specific evaluation rather than diagnosis alone
• Standardized testing procedures
• Functional rather than impairment-based decision making
• Integration of rehabilitation, vocational planning, and return-to-work strategies

Perhaps most importantly, Matheson helped shift rehabilitation from a disease-centered model toward a function-centered model that remains the foundation of modern occupational practice.

Other Major Contributors

While Matheson's influence was foundational, several other leaders significantly advanced the field.

Susan Isernhagen developed one of the earliest widely adopted standardized Functional Capacity Evaluation systems, emphasizing consistency and reproducibility.

Gary Harbin contributed to the development of the Blankenship FCE system, which became widely used within workers' compensation and disability evaluation.

Together, these innovators helped establish objective functional testing as an accepted component of occupational medicine.

Functional Capacity Evaluation Changes the Profession

By the 1990s, Functional Capacity Evaluations had become an essential part of workers' compensation and disability management.

Rather than relying solely on clinical impressions, therapists could objectively measure:

• Lifting capacity
• Carrying ability
• Pushing and pulling
• Positional tolerances
• Grip strength
• Endurance
• Material handling
• Functional consistency

The FCE became more than a clinical examination. It became an evidence-based communication tool connecting therapists, physicians, employers, insurers, case managers, and vocational professionals.

Reimbursement Evolves

As occupational rehabilitation matured, reimbursement evolved alongside it.

Initially, clinicians were paid primarily for office visits or therapeutic treatment. Eventually, dedicated reimbursement developed for work conditioning, work hardening, and functional testing.

Today, the primary CPT codes include:

• 97750 – Physical Performance Test or Measurement (commonly used for Functional Capacity Evaluations)
• 97545 – Work Hardening/Work Conditioning (initial two hours)
• 97546 – Work Hardening/Work Conditioning (each additional hour)

However, reimbursement has become increasingly regulated.

Insurers now commonly require:

• Prior authorization
• Documentation of medical necessity
• Standardized testing protocols
• Comprehensive written reports
• Evidence that testing will influence return-to-work or disability decisions

Many occupational rehabilitation programs now operate under employer contracts or bundled workers' compensation agreements rather than relying exclusively on fee-for-service reimbursement.

The Shift Toward Functional Outcomes

Perhaps the greatest change over the past five decades is philosophical.

Historically, rehabilitation focused primarily on reducing pain or restoring range of motion.

Today, healthcare increasingly measures success by participation:

• Can the individual safely perform essential job tasks?
• Can they sustain work over time?
• Can they return to meaningful employment?

Function—not diagnosis alone—has become one of the most important outcomes in rehabilitation.

Looking Ahead

Healthcare continues moving toward value-based care, where reimbursement increasingly reflects outcomes rather than volume of services.

This trend places rehabilitation professionals in a unique position.

Occupational and physical therapists possess the expertise to objectively measure function, match worker abilities to job demands, and guide safe return-to-work decisions.

The challenge for the next generation is not simply performing Functional Capacity Evaluations. It is continuing to refine them through better evidence, improved technology, stronger predictive models, and patient-centered approaches that recognize work as an important component of health and participation.

Product Spotlight - Multidimensional Task Ability Profile (MTAP) June 17 2026

Unlock Clearer Insights into Physical Work Capacity with the MTAP

In the world of rehabilitation and human performance, quantifying a person's physical functional status accurately is essential for effective treatment planning and job placement. The Multidimensional Task Ability Profile (MTAP) offers a safe, reliable, and rapid method to quantify a person’s physical ability to work and perform activities of daily living (ADLs).

Why Choose the MTAP?

The MTAP stands out from traditional self-report measures by moving beyond simple text item descriptions. Instead, it utilizes 50 pictorial activity task sort items—high-quality pen-and-ink drawings paired with short text descriptions—which allow for more rapid cognitive processing and less ambiguity. This design is particularly effective for patients with low literacy levels or for use in cross-cultural adaptations.

A Scientific Foundation You Can Trust

This is not just another questionnaire; it is a sophisticated assessment tool grounded in the Rasch measurement model. This model provides empirical interval calibration for each item and the rating scale, allowing for invariant proportional comparisons of the same person over time or between different individuals. Furthermore, the MTAP is the first performance-integrated measure of its kind, displaying good concurrent validity with standardized physical performance tests like the EPIC Lift Capacity (ELC) test.

Key Features and Benefits:

• PDC Alignment: The MTAP directly matches a person’s perceived abilities to the demands of work defined by the U.S. Department of Labor’s Physical Demand Characteristics (PDC) system, categorizing capacity from Sedentary to Very Heavy.
• Comprehensive ADL Assessment: It measures a wide range of essential daily tasks, including self-care, cooking, light housekeeping, and heavy home maintenance.
• Regulatory Compliance: The MTAP meets recommendations for documentation of objective functional outcome measures for Medicare, the Official Disability Guidelines (ODG), and the AMA Guides to the Evaluation of Permanent Impairment.
• Consistency Tracking: Through optional Excel-based Analytics, evaluators can identify internally inconsistent responses and screen for less than full effort using specialized "INFIT" and "OUTFIT" statistics.
  

What’s Included?

For $475.00, your clinical practice gains a practical outcome tool that extends benefits beyond the clinic walls into the patient’s home and community life. Each kit includes:

• 2 Test Booklets with 50 illustrated drawings and task descriptions.
• 1 Examiner’s Manual containing detailed instructions, reliability studies, and normative data.
• 100 Response Sheets featuring the Department of Labor PDC and normative data crosswalk. 

Enhance your communication with providers and provide quantified justification for medical necessity by integrating the MTAP into your assessment battery today.

Empower your patients and your practice with the objective data needed to recognize and develop the value in every individual.

Learn more: Multidimensional Task Ability Profile (MTAP)

Why the Box and Block Test Deserves a Place in Every Rehab Clinician’s Toolkit June 10 2026

Doll Chair Assembly Task June 03 2026

Why Clinicians Trust the Jamar Plus+ Digital Hand Dynamometer May 27 2026

Finding the Right Weight Box Solution: Matheson Lift Box as the Ideal Alternative May 20 2026

At Matheson Development, we’re always striving to provide tools that make your material handling more efficient and reliable. While our Carry-All Weight Box and Packing Carton Weight Box have served customers well in the past, they are no longer available.

For those looking for a dependable, versatile solution, the Matheson Lift Box is now the best alternative. Designed with durability and ease-of-use in mind, the Matheson Lift Box streamlines lifting, transporting, and weighing tasks—all in one sturdy package. Its innovative design ensures that your workflow remains smooth and safe, even when handling heavy or awkward loads.

Whether you previously relied on the Carry-All or Packing Carton models, the Matheson Lift Box offers comparable functionality with added efficiency, making it the smart choice for modern industrial and warehouse applications.

Explore the Matheson Lift Box today and experience the convenience of a weight box built to meet today’s demanding standards.

Learn more about the Matheson Lift Box

Now Offering Ergonomic Assessment Equipment May 14 2026

At Matheson Development, we are excited to announce the launch of our new Ergonomics section, featuring tools and equipment designed specifically for professionals performing ergonomic assessments.

For decades, we have supported clinicians and evaluators with industry-leading Functional Capacity Evaluation (FCE) resources. Expanding into ergonomics allows us to better serve occupational therapists, physical therapists, ergonomists, and other professionals working to assess workplace demands and reduce injury risk.

Our new ergonomics collection includes products that support workstation assessments, posture analysis, force measurement, and other workplace evaluation needs. We understand the importance of reliable, practical tools in delivering accurate and defensible assessment outcomes, and we are committed to providing high-quality resources that professionals can trust.

Whether you are expanding your ergonomic services or enhancing your current assessment toolkit, we invite you to explore our growing collection.

Browse the new ergonomics collection here:
Ergonomics Collection

Concussion: Return to Work and Performance-Based Testing March 03 2025

On Demand Training!

Performance-based assessment offers a solution to difficulties found in both traditional concussion assessment as well as return to work rehabilitation. Performance-based assessments address concussion deficits from an ecologically valid, functional perspective, bridging the gap between “normal” objective testing results and patient reports of day-to-day deficits.

This course presents an overview of the policies and procedures involved in return to work rehabilitation for individuals both with and without concussion. Practical components of return to work rehabilitation are emphasized, including how to interact with management or the human resources department, the role of short-term disability coverage, and how to establish the patient’s essential job functions.

Interactive examples of three performance-based assessments are demonstrated: the Behavioral Assessment of Vocational Skills, the Complex Task Performance Assessment, and the Doll Chair Assembly Task. These interactive segments will empower the learner with the knowledge, skills, and confidence to address challenging clinical scenarios.

Meet your instructors

Matthew Dodson
Dr. Matthew Dodson is an occupational therapist and an expert in evaluating objective and functional deficits from MTBI/concussion and other forms of mild brain injury in both civilian and military populations. With extensive experience at patient, supervisory, and policy levels, he specializes in designing multidisciplinary…

Read full bio

Mark Showers
Mark Showers is an Occupational Therapist specializing in cognitive rehabilitation. Graduating from Washington University in St. Louis, Mark worked five years developing Work Hardening programming for worker’s compensation cases. Following this he developed a TBI Occupational Therapy department at a VA hospital. Since 2012…

Read full bio

Introduction to Forensic Rehabilitation February 24 2025

Video: Introduction to Forensic Rehabilitation

This video introduces Dr. Kelly Deeker and Dr. Matthew Dodson, and use a case example to describe services that occupational therapists and other rehabilitation team members can provide to assist families whose child has a serious disability.

Forensic rehabilitation is an advanced set of professional services that are the natural extension of skill sets that rehabilitation professionals develop after five years to 10 years of practice.  This type of practice provides the occupational therapist, vocational evaluator, rehabilitation counselor, physical therapist, or physician the opportunity to broaden his or her purview and ability to provide advanced services.

Forensic rehabilitation is practiced in a wide variety of settings to help resolve legal issues that occur when  a disability affects a person's ability to work and earn a living.  While the largest market for these services are found in the workers' compensation and Social Security disability areas, persons with disability also engage with rehabilitation professionals in cases involving long-term disability, product liability, and personal injury litigation.

The case example in this video is of a 15-year-old boy who experienced severe burns and a traumatic brain injury in an automobile accident. We describe the evaluation model and the methods that we employ to aggregate and analyze the information obtained in work capacity evaluation using the Functional Assessment Constructs Taxonomy (FACT) system.  We describe the three major steps in determining an adolescent's loss of earning capacity.

Executive Dysfunction and Work Rehabilitation for OTs - Part 2 February 17 2025

Video: Executive Dysfunction and Work Rehabilitation for OTs - Part 2

A short demonstration is presented in the use of the Dynamic Complex Assembly Task (DCAT) Available from Matheson Development with a TBI client in an office setting.

The DCAT is a type of Progressive Occupational Demand system (PODS) used by Occupational Therapists and Vocational Evaluators and Neuropsychologists to provide demand-calibrated situational assessments to evaluate and treat executive dysfunction.  

This is Part 2 of 2 in which we explore how OTs can work with clients in neurorehabilitation practices through the use of the BRIEF and SWAGs to evaluate and treat executive dysfunction.  Additional and long-form video lessons on this topic and similar topics are available on Vimeo: Leonard Matheson.

Executive Dysfunction and Work Rehabilitation for OTs - Part 1 February 11 2025

Video: Executive Dysfunction and Work Rehabilitation for OTs - Part 1

Occupational Therapists provide crucial and unique services to clients with brain injuries. Evaluation and treatment of executive dysfunction provides a solid foundation for clients to return to full and productive lives after a TBI. 

A case study is presented in the use of the Behavior Rating Inventory of Executive Function (BRIEF) to screen for executive dysfunction prior to administering the Doll Chair Assembly Task (DCAT).

This is Part 1 of 2 in which we explore how OTs can help clients through the use of the BRIEF and SWAGs to evaluate and treat executive dysfunction. 

THE FUNCTIONAL CAPACITY EVALUATION September 17 2024

In recent years, there has been an increased emphasis on development of the scientific basis of functional capacity evaluation (FCE). This has been stimulated by a growing awareness of its utility, and supported by major investments in research by large insurance providers and by state, provincial, and federal governmental agencies such as the United States Social Security Administration. ³⁶ The most important development has been the application of a taxonomic approach to FCE to organize and focus this research. ⁷² This chapter employs this taxonomic approach, using it to organize both conceptual and applied information. The material presented in this chapter is informed by findings from a research project that was funded by the Social Security Administration 2 (SSA) to develop methods to use information about the patient's functional limitations to improve the SSA disability determination system. In order to render the task manageable within the limitations of a textbook format, this chapter is focused on FCE with persons who have musculoskeletal impairments.

Read the full chapter here!

An Introduction to Executive Dysfunction and Work Disability August 06 2024

Presenter: Len Matheson, PhD
Download slideshow

• Executive Function Definition and Description
  • Executive functions harness and direct intelligence and other cognitive processing capacities.
  • Dysfunction prevents intelligence from being applied.
• Scope of the Problem and Emerging Markets
  • Emerging technology such as magnetoencephalography and TBI biomarkers, along with increased visibility of mTBI among troops returning from war create important practice opportunities.

Age and gender normative data for lift capacity August 06 2024

Helping a Friend Avoid PTSD November 14 2018

By Dr. Matheson

I live in Chico, down the hill from Paradise, devastated by the deadliest wildfire in California history. As a psychologist treating severe trauma since 1970, I’ve been asked how to help our friends and neighbors handle the emotional impact of this disaster.

Feeling helpless during a disaster is naturally and severely traumatizing. Helplessness in the face of death and destruction challenges all of our emotional resources. Nobody is immune, even First Responders and Combat Veterans; we’re all human. We all have the same neurobiology.

Severe trauma on which we ruminate can lead to Posttraumatic Stress Disorder. So, why is it that most severely traumatized people don’t develop PTSD?

How a traumatized person’s brain handles the trauma memory makes the difference.

Knowing how your brain handles trauma memories will allow you to help others.

Here’s a simple fact about our brains:

For a few hours after a traumatic experience is shared with you, the trauma memory is slightly malleable.

In other words:

For a little while, after a trauma memory is shared with you, it can be modified.

And this cuts both ways. Every time your friend shares their trauma memory, how you handle it can make it better or make it worse. Emphasizing the terror of their trauma will increase the memory’s emotional salience, its punch in the gut.

So, how do we help our friend without making it worse?

With affirmative listening.

Affirmative listening requires you to get beyond yourself and become fully available to your friend; listening so that you can deeply hear and affirm their experience.

Affirmative listening means that you don’t have an agenda to fix your friend.

Affirmative listening means that you commit to understanding your friend, without fully understanding their trauma. You can’t unless you were there. Their trauma is their trauma. You are making your safe presence available to your friend’s traumatic past.

You are making your heart available to your friend’s heart.

As your friend shares their traumatic memory, acknowledge their experience AND affirm their current safety and security.

“Oh my goodness! I’m so sorry, and I’m glad you’re safe.”

… is how I how I respond when a trauma victim comes to me for counseling.

“I’m so sorry and I’m glad you’re safe.”

… is the kernel of their eventual recovery.

… harnesses our interpersonal neurobiology, to modify the memory’s impact.

… interrupts trauma rumination, so the memory becomes less firmly consolidated.

… helps to gradually uncouple the emotions from memory.

… helps to pull our friend’s awareness out of the past and back into now.

… is how you help your friend stop the trauma from developing into PTSD.

And here is what NOT TO DO:

Don’t one-up each other in “war stories.” If you can share your story healthfully, that’s OK, but don’t ramp-up the emotional salience of the memory; you’re there to listen and affirm your friend’s current safety.

What if my friend keeps ruminating and seems to be stuck in the trauma?

Even with affirmative listening, professional help may be necessary. Find a well-trained professional and help your friend get connected.

The American Psychological Association provides guidelines about who you should look for: https://www.apa.org/ptsd-guideline/patients-and-families/finding-good-therapist.aspx

Psychology Today offers a geographic database that you can search: https://www.psychologytoday.com/us/therapists.

Thanks for being so concerned about your friend.

Please pass this along.