Special Allowances and Services For accident-Injured Workers

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1 POLICY STATEMENT The Workers Safety and Compensation Commissionn (WSCC) provides severely injured workers or their dependents special allowances or services to reduce or eliminate the effects of a severe, compensable injury. All allowances and services for severely injured workers are considered on a case by case basis. DEFINITIONS Health Care Provider: Severe Injury: a chiropractor, dentist, nurse, occupational therapist, optometrist, physical therapist, physician, psychologist or another class off persons whose qualifications to practice any of thee healing professions are accepted by the Commission; (per ss. 1(1) of the Workers Compensation Act(s)). A work related injury that limits a worker s ability to carry out the activities of daily living, such as mobility, hygiene,, self care, etc. POLICY General The WSCC recognizes that not all severely injured workers require the same support. Therefore, allowances and services are offered to assist a severely injured worker in achieving and maintaining their independence. These allowances and services terminatee when the injury effects no longer exist. The type and amount of assistance provided by the WSCC is based on medical evidence and the recommendation of an appropriate health care provider. Thesee allowances or servicess are usually paid to the injured workers. However, if the worker cannot manage their affairs, the WSCC may make payments to another person or entity according to Policy Payment of Compensation. Special equipment purchased by the WSCC for a disabled worker s long-term use is the worker s property. Page 1 of

2 Residential Modificat tion Modifications to an injured worker s residence may include special equipment, maintenance, normal inspection, repair or replacement. The WSCC may provide a one-time only grant to a severely and permanently injured worker for residential modification. The worker or dependent is responsible for insurance and regular maintenance on equipment. The WSCC only provides funds for modifying a worker-owned home. The WSCC may also provide special equipment for an injured worker s residence. Modifications and special equipment may include, but are not limited to: widening of sidewalks and laying concrete or asphalt, allowing wheelchair use; bathroom, kitchen, bedroom and hallway modifications, allowing wheelchair use; and ramp or elevator access to and within a worker s home. Residential modifications do not include: the purchase and installation of recreational equipment, air conditioning, electrical appliances and furniture; real estate fees, legal fees or moving costs; or the construction of activity or exercise rooms. The WSCC may provide a grant to assist in the purchase of a modified residence if a worker s current residence is not suitable for modification or repair. This grant cannot exceed the cost of modifying an existing residence. Vehicle Modification The WSCC may provide an injured worker with financial assistance for vehicle modification, allowing the injured worker to operate (for example, hand controls) or access (for example, wheelchair ramp) the vehicle. The age and condition of the vehicle must be such that the modification is warranted. If there is concern about the condition of the vehicle, ann inspection by a licensed automotive mechanic must be obtained by the worker. An injured worker who operates a WSCCC modified vehicle mustt provide the WSCC with a valid driver s license and proof of insurance. This includes confirmation that the insurer is aware of the worker s medical condition and that the vehicle is modified. Page 2 of

3 The worker is responsible for maintenance and insurance for the modified vehicle. The appropriate Manager, Claims Services, may approve the replacement of defective special equipment. Vehicle modifications do not include: air conditioning; CB radios; mobile phones; or vehicles financing. Vehicle Purchase An injured worker who is wheelchair mobile may require a specially-equipped vehicle to travel safely and conveniently. In addition to payingg for necessary modifications, the appropriate Manager, Claims Services, may approve a one-time only payment of up to $10,000 toward a vehicle purchase. Home Maintenance and Independent Living Allowance (HMILA) The appropriate Manager, Claims Services, may approve an allowance of $240 per month to a permanently disabled or temporarily, severely injured worker for services to assist with home maintenance and independent living. To receive HMILA, a severely injured worker must make the request in writing and must demonstrate, with supporting medical evidence, a need for home maintenance and independent living services. An injured worker who lives in a long-term care facility is not eligible for this assistance. If the spouse or dependent(s) continue to live in the family home, this allowance may be paid to the spouse or dependent. The HMILA is provided as a monthly payment, and spent at the discretion of the workerr or designate. The allowance continues until there is a change in the worker s living situation, such as, moving from home to a long-term care facility or the worker recovers. The WSCC does not require receipts for the allowance. The HMILA is intended for, but not limited to, services such as yard maintenance and housekeeping. Page 3 of

4 Independent Living Devices Independent living devices assist an injured worker ss ability to communicate, be mobile, attend to personal hygiene and prevent further injury or health complications. The WSCC provides a severely injured worker with independentt living devices based on medical evidencee and the recommendation of an appropriate health care provider. In the case of a temporarily, severely injured worker, the WSCC pays the lesser of the costs of renting or purchasing the device. Independent Living Devices include, but are not limited to: automatic page turners; speciality chairs; motorized carts; adaptive aids to help maintain activity levels; hospital bed; or Telephone Typewriters for the deaf (TTY). Independent living devices cannot be used to replacee a service that would meet the same objective as the HMILA. For example, the WSCC does not pay for a snow blower when the HMILA may be used for a snow removal service. The appropriate Manager, Claims Services, must approve any any Independent Living Devices over $2000. Clothing Allowance The WSCC may provide an annual allowance of $500 for damage to a worker s clothing as a result of wearing a WSCC supplied upper or lower limb prosthesis or appliance. The WSCC may also provide an annual allowance off $1000 for damage to a worker s clothing from the use of a WSCC supplied wheelchair. Attendant s Allowance A permanently disabled worker receiving a pension and requiring assistance from non- family members to perform daily activities may be eligible for an attendant s allowance if they live in a private residence. The WSCC may continue paying this allowance for up to two months after the worker is admitted to a long-term care facility or hospital. A worker who is severely, but not permanently, disabled may also qualify for this allowance on a temporary basis. Financial need is not a criterion. Page 4 of

5 Family members may be considered by the WSCC too act as the injured worker s attendant. This decision is based on medical confirmation of their ability to care for the injured worker and is at the discretion and approval of the appropriate Manager, Claims Services. The quality of care the injured worker is receiving from the family member is reviewed, at minimum, on an annual basis. In circumstances where an injured worker requires eight or more hours per day of attendant care, provided by a family member, respitee care may be consideredd while the family care giver is off duty or on vacation. Respite care may be given for a maximum of four weeks per year without financial penalty. The appropriate Manager, Claims Services, may consider a request over four weeks respite care on a case by case basis. Payments are made directly to the injured worker, or r at the worker s written request, to the attendant. If injured workers are not able to handle their own affairs, the allowance may be disbursedd according to Policy 04.01, Payment of Compensation. The WSCC provides three levels of Attendant s Allowances: Level 1: One to four hours per day, to a maximumm of $1,000 per month. This allowance is provided to a worker with restricted d mobility that can feed, partly clean and otherwisee care for themself but need assistance in acts off daily living. Level 2: Four to eight hours per day, to a maximum of $2,0000 per month. This allowance is provided to a worker with restricted d mobility that requires assistance in feeding, dressing and washing themselves as welll as in other aspects of personal care and acts of daily living. Level 3: Eight to twelve hours per day, to a maximum of $4,000 per month. This allowance is provided to a worker with restricted d or no mobility who requires extensive assistance in maintaining personal hygiene and in all acts of daily living. The appropriate Manager, Claim Services, approves payment of an Attendant s Allowance over Level 3 when an injured worker, who would normally residee in a longterm care facility, is able to receive the comparable care outside a facility. The Manager may approve payment up to the amount required to care for the injured worker in a suitable facility. Additional funding may also be provided in circumstances where the local market value of care is greater than the maximum quoted in each level. Page 5 of

6 Special Financial Assistance The appropriate Manager, Claims Services, may approve Speciall Financial Assistance to a severely injured worker who is anticipated to be unable to work for three months or more. This one time assistance is provided to relievee a financial burden that the worker did not have prior to the injury. Examples of this include the payment of such things as past due bills, rent and mortgage payments to retain the worker ss credit rating or relocation where the community lacks the services essential to the worker s rehabilitation. In order to receive Special Financial Assistance, the WSCC requires an estimate of the funds required by the worker. This includes a monthly budget off income and expenditures and a breakdown of how the funds are spent. LEGISLATIVE AUTHORITIES Northwest Territories Workers Compensation Act: Nunavut Workers Compensation Act: Northwest Territories Workers Compensation General Regulations: Nunavut Workers Compensation General Regulations: Sections 32; 36; 46; 4 subsection 34(1); 34(2); 34(3); 35(1) Sections 32; 36; 46; 4 subsection 34(1); 34(2); 34(3); 35(1) Section 4.3 Section 4.3 POLICY RELATED DOCUMENTS Policy Policy Payment of Compensation Payment for Medical Aid Page 6 of

7 HISTORY Policy (Mar 31/08) Policy (Sep 21/0) Policy (Jun 22/06) Policy (Dec /01) Policy (Aug 31/01) Policy (Apr 19/01) Policy (Jan 1/01) Policy (Apr 1/99) Policy (Apr 12/90) Policy (Apr 12/90) Policy (Apr 12/90) Policy (Apr 12/90) Policy (Apr 12/90) Policy (Apr 12/90) Services for Workers with Severe Injuries Services for Workers with Severe Injuries Services for Workers with Severe Injuries Services Residential Modifications Vehicle Modifications Special Financial Assistance Attendant s Allowance Independence andd Home Maintenance Chairperson Page of