Physical Capabilities Evaluation

The Physical Capabilities Evaluation (PCE) Form is to be used with the Employee Worker Profile. The PCE breaks down the Injured Worker's job in its physical components. In reviewing the form, you will see examples of kneeling, sitting, lifting, etc. Complete this form in its entirety specifically to the job at hand. This form, along with the Employee Worker Profile, should be sent to the treating physician so he/she has a clear and accurate idea of the Injured Worker's job and the physical demands needed to complete it.

If you have any questions, please do not hesitate to contact the MCI Voc/Med Manager at 804-775-0710.

• Download the Physical Capabilities Form (PDF)

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