Highlights of Noteworthy Decisions

Decision 447 16
S. Netten
  • Health care (attendance allowance) (family member)

The worker suffered multiple injuries on August 14, 2013. The worker appealed a decision of the Appeals Resolution Officer denying payment for services of the worker's spouse as his attendant from August 15 to September 19, 2013.

There are only two Board policies that contemplate payment for the services of an attendant. Operational Policy Manual, Document No. 17-01-08, allows payment for escorts to appointments. The worker did receive escort fees for medical visits. Document No. 17-06-05, provides a personal care allowance for severely impaired workers. The worker received an 11% NEL award, well below the 60% that qualifies under the policy as a severe impairment. Thus, the worker did not qualify under either of these policies for services of his spouse as an attendant.
A worker may also be entitled to services of an attendant as health care under ss. 32 and 33 of the WSIA. Entitlement to the services of an attendant as a form of health care does not require exceptional circumstances warranting a departure from Board policy. There is no applicable Board policy regarding provision of attendant services for workers not meeting the severely impaired definition. Entitlement as a form of health care is governed by the statutory provisions.
Under ss. 32 and 33, a worker is entitled to health care, including services of an attendant, as may be necessary, appropriate and sufficient. In this case, the worker was given opioid medication and was instructed to wear a cervical collar during the period in question. There was no indication that the worker required constant or frequent supervision with respect to his medication, safety or mobility.
The services of an attendant, as a form of health care, may reasonably be interpreted to allow a spouse to be paid temporarily as a personal attendant only where the level of care provided is akin to employment in respect of the time and demands required for such care. A level of care not interfering with the spouse's regular employment would indicate that the services of an attendant were not necessary.
In this case, services of an attendant had not been medically recommended. The worker was mobile. The services of an attendant were not medically supported or necessary. The appeal was dismissed.