How to Write an OT Functional Capacity Assessment: A Practical Guide

Writing an Occupational Therapy Functional Capacity Assessment can feel like a huge task.

You may have completed hours of assessment, spoken with the participant and their support network, reviewed previous reports, observed functional performance, considered assistive technology and home modifications, and gathered information from other professionals.

Then you sit down to write the report.

And suddenly you're looking at a blank page wondering:

Where do I actually start?

A good Functional Capacity Assessment needs to do more than describe a person's diagnosis or list their difficulties. It needs to provide a clear picture of how their disability affects their everyday function, what support they require, what they can do independently, and why particular recommendations are appropriate. You need to bring together assessment findings, functional observations, participant goals, support needs and clinical reasoning into one clear report.

What should you include?

While every assessment will be different, an OT FCA will commonly consider:

• Reason for assessment

• Relevant background and diagnosis

• Participant goals

• Formal and informal supports

• Home and community environment

• Mobility and transfers

• Personal care and domestic activities

• Communication and cognition

• Upper limb function

• Assistive technology

• Community participation

• Risks and safety

• Standardised assessments, where appropriate

The assessment should be tailored to the individual rather than simply working through a checklist.

Where does clinical reasoning come in? This is one of the most important parts of an FCA. Rather than simply documenting: "The participant has reduced balance" explain what that means functionally.

For example:

Reduced balance → difficulty completing transfers → increased reliance on assistance → recommendation for appropriate support or equipment.

Your recommendations should be clearly connected to your assessment findings and the participant's goals.

The FCA example underpinning this article demonstrates this approach by linking functional findings across areas such as mobility, upper limb function, ADLs and community access to identified support needs and recommendations.

Don't forget the participant's strengths! An FCA shouldn't only focus on what someone cannot do. Consider:

• What can they do independently?

• What are they motivated to do?

• What supports their participation?

• What skills could be maintained or developed?

This helps create a balanced picture of the person's functional capacity.

Before you finalise your FCA, ask yourself:

Have I clearly explained:

☐ What the participant can do

☐ What they have difficulty doing

☐ Why they have difficulty doing it

☐ What are the functional impacts of the impairment

☐ What support they require

☐ Why that support is appropriate

☐ How the recommendations relate to their goals

If the reader can follow the pathway from assessment → functional impact → support need → recommendation, your clinical reasoning is much easier to understand.

Need a starting point for your next FCA?

My OT Functional Capacity Assessment Template + Full Report Example provides a structured framework to help you organise your assessment findings and clinical reasoning, while still allowing you to tailor the report to each individual participant.

Templates should always be adapted to the individual participant, your clinical findings and your professional requirements.