Highlights of Noteworthy Decisions

Decision 2180 13
S. Netten
  • Board Directives and Guidelines (health care) (independent living)
  • Health care (attendance allowance)
  • Health care (independent living) (severely disabled worker)

The worker suffered compensable accidents in 1991 and 2007, for which he was granted a 61% NEL award. The worker appealed a decision of the Appeals Resolution Officer regarding the amount of his personal care allowance (PCA).

The worker requested additional PCA minutes for grocery shopping, housekeeping, vehicle maintenance and transportation for non-medical activities.
Section 32 of the WSIA includes services of an attendant within the definition of health care. The plain meaning of "attendant" in this context is a person who attends another to perform a service. The attendant tends to the worker and the worker's personal needs. The Vice-Chair found that a PCA is directed toward personal needs in relation to routine and basic activities of daily living, such as eating, personal hygiene, grooming and mobility. It does not encompass every activity a person may do over the course of a day. Other activities would be encompassed within an independent living allowance (ILA).
Vehicle maintenance and driving to non-medical activities did not fall within the parameters of a PCA. Rather, they would fall within the parameters of an ILA. The worker was not entitled to additional PCA minutes for these services.
Board policy on PCAs refers to the Activities of Daily Living Scale (ADLS) form. The ADLS form itself is not part of the policy. The ADLS form has been amended by removing housekeeping from the form. Thus, while the policy itself has not been amended, the Board appears to have revised its interpretation of the parameters of the PCA by removing housekeeping from the ADLS form and thereby elimination overlap with the ILA. The Vice-Chair agreed that housekeeping is more correctly characterized as a measure to facilitate independent living. Accordingly, the worker was not entitled to additional PCA minutes for housekeeping.
Meals is a category on the ADLS form. This was a reasonable interpretation of the Board policy on PCAs, though not necessarily the only possible interpretation. The Vice-Chair was also satisfied that meals reasonably includes grocery shopping and meal preparation. The Vice-Chair concluded that the worker was entitled to additional PCA minutes for grocery shopping.
The appeal was allowed in part.