Highlights of Noteworthy Decisions

Decision 757 19
A. Somerville
  • Health care (attendance allowance)
  • Benefits (reduction or suspension) (material change in circumstances)
  • Board Directives and Guidelines (attendance allowance) (reduction)

The worker fell in December 2014, fracturing his cervical spine, with resulting incomplete quadriplegia. The Board granted the worker a 62% NEL award. An occupational therapist assessed the worker for a personal care allowance in April 2015. Based on the recommendations of the therapist, the Board granted a monthly personal care allowance of about $2,450. The Board funded renovations to the worker's house. Then, the Board sent the same therapist to reassess the personal care allowance. The Board then reduced the personal care allowance to about $2,000 per month. The worker appealed.

Board Operational Policy Manual, Document No. 17-06-05, on personal care allowance, states that the Board only decreases the allowance if there is a significant change in the worker's work-related impairment, usually resulting in at least a 10% reduction of the allowance.
In this case, the Board found that the worker's level of impairment had not significantly changed; rather, the reason for the reassessment was the completion of the home modifications. However, the policy also provides that the Board may review a personal care allowance on notice of a material change or at the discretion of the Board. The Vice-Chair found that the home modifications were a material change and that the Board was entitled to review the worker's personal care allowance in light of those renovations.
On the evidence, the Vice-Chair increased the number of minutes for some activities from the minutes allowed in the second assessment. The appeal was allowed in part.