Highlights of Noteworthy Decisions

Decision 204 22
01/03/2022
M. McLoughlin
  • Health care (appliances or apparatus) (stair lift)

The worker appealed a decision which denied entitlement to the cost of installing a stair lift in his new home. Due to his Chronic Regional Pain Syndrome (CRPS) and other conditions arising from a left knee injury, he had considerable difficulty with ambulation, particularly with ascending and descending stairs. He had previously been granted entitlement to a motorized scooter while he lived in a single level apartment. The worker had since moved into an inherited multi-story home. He requested coverage for the cost of installing a stair lift in this new residence.

The worker's appeal was denied.
The Vice-Chair stipulated that a worker is entitled to health care as may be necessary, appropriate and sufficient as a result of the injury. The worker would have to qualify as a severely impaired worker. In this case, the worker's NEL rating of less than 60% felt below the threshold, however, the Vice-Chair outlined that this was not strictly necessary in order to be eligible for an assistive device, and instead, this entitlement could flow from health care entitlement provisions such as OPM Document No. 17-01-02, which provides payment for assistive devices and home modifications. The worker was previously paid moving costs under the Home Modification policy.
The Vice-Chair acknowledged that ascending and descending stairs was problematic for the worker, and a stair lift would enhance the worker's ability to live independently. However, it would have to be determined whether the worker's need for the assistive device arose as a result of the injury. As the worker was already paid moving costs, the Vice-Chair stated it would not be unreasonable to apply the "more than once only basis" provisions of this policy in considering the worker's claim for a stair lift following his relocation. For this to occur, the Vice-Chair needed to determine whether the relocation was necessitated by circumstances beyond the worker's control.
The Vice-Chair ultimately found, based on the documentary evidence, that the relocation into a multi-story home against medical recommendations was a matter of personal choice and not necessitated by circumstances beyond the worker's control. Furthermore, the Vice-Chair concluded on a balance of probabilities that the relocation was not a necessity by reason of the worker's compensable condition.