Decision #22/99 - Type: Workers Compensation
An Appeal Panel review was held on January 13, 1998, following receipt of an appeal from the claimant.
Whether the claimant should be reimbursed for the labour component of the cost of repairing the roof of his residence.
That the claimant should not be reimbursed for the labour component of the cost of repairing the roof of his residence.
On September 13, 1982, the claimant sustained multiple injuries while employed as a miner when he was struck by a chunk of loose rock. The claim was accepted by the Workers Compensation Board (WCB) and the claimant received a Permanent Partial Disability award related to the left lower limb and back.
In 1998, the claimant requested reimbursement of labour costs associated with the repair of his roof and for a scooter. The claimant's request for the scooter was accepted, however, the request for the labour portion of his roof repairs was denied by the WCB.
On September 22, 1998, the claimant wrote to the Review Office outlining his reasons for disagreeing with the WCB's decision to deny the labour costs associated with his roof. The claimant stated that due to his accident, he was unable to work in a bent or kneeling position, that he was unable to climb a ladder properly and that he was unable to walk on the slope of a roof. The claimant concluded that as a direct result of his accident he was physically unable to perform the roof renovations.
On October 16, 1998, the Review Office made the determination that the claimant should not be reimbursed for the labour component of the costs associated with the roof repair of his residence. The Review Office quoted subsection 27(20) of the Workers Compensation Act (the Act) when rendering its decision. The Review Office accepted the claimant's argument that had he not been injured at work he would have repaired the roof himself. Review Office was of the opinion, however, that reimbursing the claimant for the costs he incurred for his roof since he was unable to do so would be outside of the workers' compensation envelope.
The claimant appealed the Review Office's October 16, 1998, decision on November 18, 1998, and a non-oral file review was held.
At issue in this appeal is whether the claimant should be reimbursed for the labour component of the cost of repairing the roof of his residence.
The relevant subsections of the Workers Compensation Act (the Act) in this appeal are subsections 24(1) to (5) which provide for medical aid and certain allowances and subsection 24(21) which provides for measures for rehabilitation.
Subsection 24(1) states:
Treatment in addition to compensation
24(1) In addition to the other compensation provided by this Part, the board may provide for the injured workman such medical, surgical, and hospital treatment, transportation, nursing, attendant care, medicines, crutches, and apparatus, including artificial members, as it may deem reasonably necessary at the time of the injury, and thereafter during the disability, to cure and relieve from the effects of the injury; and the board may adopt rules and regulations with respect to furnishing medical aid to injured workmen entitled thereto, and for the payment thereof.
Subsection 24(21) states:
Measures for rehabilitation.
24(21) To aid in getting injured workmen back to work and to assist in reducing or removing any handicap resulting from their injuries, the board may take such measures and make such expenditures from the accident fund as it deems necessary or expedient.
In considering this claim we reviewed the substance and intent of WCB policies: Section 43.00, Vocational Rehabilitation and Section 44.120.160, Residence Renovation Costs. The policies states in part:
A worker will receive vocational rehabilitation services if, as a result of the compensable accident the following conditions exist:
1.c. The worker requires assistance with the activities of daily living.
Specific services are based on the individual needs of a worker. Services should be reasonably required, cost-effective, and provide the potential for achieving vocational rehabilitative goals. These services are broadly defined as:
1.e. independent living - services intended to promote, enhance and maintain the worker's non-occupational quality of life.
1. In some circumstances, injured workers will be eligible for reasonable allowances to cover additional costs required because of a vocational rehabilitation program or the compensable rehabilitative needs of the injured worker. Where paid, the WCB will monitor the allowance. Available allowances include:
c. Vehicular and Residential Modifications - In order to facilitate independent living, costs associated with the modification of a vehicle or a residence required by reason of the compensable injury/condition will be paid by the WCB.
Residence Renovation Costs
The Workers Compensation Board may pay for modifications to the principal residence of a worker with quadriplegia or paraplegia as a result of a compensable accident, where the modifications will provide the worker with improved access and mobility.
The costs of any renovations accepted by the WCB will generally not exceed 50% of the value of the structure and property being renovated.
The claimant is seeking reimbursement for the costs incurred for the labour component of new roofing to his residence as he maintains that, but for his injury, he would have performed the labour himself and therefore would not have incurred those costs. The claimant also argues that he has the skills to perform roofing as he has worked in construction and that he has personally performed work on improvements to the ground floor of his single storied residence since his accident. While the claimant has been able to perform work on the ground floor of his residence, he cannot climb ladders or be on a roof since his injury as he has no left leg strength and has to wear a leg brace on his left leg on a permanent basis following his spinal injury.
The claimant has also argued that, when he moved residences, WCB paid the cost of moving because the claimant could not lift and therefore the WCB should also pay for the labour costs of re-roofing his residence.
We reviewed all the evidence on the file and note that the claimant sustained a significant injury and should be commended for his active participation in his physical rehabilitation and his return to work. We also note that the WCB has provided various rehabilitative supports to the claimant since his accident.
However, in response to the claimant's argument that the WCB paid the costs of moving his furniture, we find that this was agreed to based on the claimant's position that the new single storied residence would enhance and improve his access, mobility, and quality of life both following his accident and in the future. The claimant considered that certain features of the old residence could not be easily modified and this was confirmed by a WCB vocational rehabilitation consultant. Therefore the Board of Commissioners concurred with the claimant and authorized the payment of the moving costs.
We are of the opinion that the WCB's agreement to cover the moving cost was consistent with the intent of the above noted WCB policies for residential modifications and to enhance independent living in that the new residence provided the claimant with improved access, mobility, and quality of life.
At issue in this appeal is whether the WCB should pay for the labour portion of a new roof on the claimant's residence. The provision of rehabilitation assistance is discretionary under the Act and WCB policy and in this case we are of the view that the claimant's request exceeds the intent and spirit of the legislation and policy. It is our view that the intent of the legislation and policy would be to provide assistance to claimants to improve mobility, safety and security and to give assistance with independent daily living.
We find that the claimant's request for reimbursement for the labour costs of roofing his residence goes beyond those criteria as it would be classified as an expenditure related to necessary and general maintenance of a home and as well, represents a value added investment not related to residential modifications as a result of his injury. Therefore the claimant's appeal is denied.
D.A. Vivian, Presiding Officer
A. Finkel, Commissioner
R. Frisken, Commissioner
Recording Secretary, B. Miller
D.A. Vivian - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 29th day of January, 1999