Highlights of Noteworthy Decisions

Decision 532 20
15/05/2020
K. Jacques
  • Board Directives and Guidelines (health care) (independent living)
  • Health care (home modification)
  • Board Directives and Guidelines (health care) (home modifications)

The worker appealed an ARO decision which found that the purchase of a back-up home generator was reasonable in the worker's circumstances, but that the worker was not entitled to specific reimbursement because it would be covered under the worker's Independent Living Allowance.

The Vice-Chair found that the policy on ILA was not applicable. A generator is a device that must be installed, rather than a service akin to hiring someone to cut the grass. So a generator cannot fall under ILA policy on the basis of being a service. Devices that cost less than $250 may be covered under the ILA policy, such as a food processor. The generator cost was almost $10,000 and therefore the ILA policy could not be applicable.
The Independent Living Devices policy was considered. The purpose of a back-up home generator of emergency preparedness, ensuring the continuous operation of electrical systems of the home, did not align with assistive devices that help restore a worker's abilities such as a motorized scooter. The Vice-Chair found the policy on Independent Living Devices did not apply to the generator.
The Vice-Chair found the assessing OT's report particularly persuasive. The assessing OT was sent by the Board to the worker's home to consider home modification requirements. The resultant report identified the generator as a required home feature. The purpose of the generator is the functioning of the home and ensuring assistive devices and other powered features, continue to operate thus ensuring the continuity of health and safety measures and access to areas of the home including exterior areas. The Vice-Chair found Home Modifications was the applicable policy.
The enhancement of an injured worker's independence and dignity is an underlying principle when considering health care provisions. Denying a provision identified as required by an assessing OT, on the basis that family members or personal support workers could assist the worker in an emergency instead, is not compatible with enhancing the worker's independence.
The worker was entitled to reimbursement for the generator under the Home Modification policy.