The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

This appeal involves a worker who was injured while at work on September 1, 2005. The worker's claim was accepted by the Workers Compensation Board (WCB). Wage loss benefits and medical treatments were authorized. The worker, who lives in a rural area, chose to be treated by a chiropractor in Winnipeg who had treated him in the past. The worker sought payment of travel expenses to his chosen chiropractor. The WCB approved travel to the nearest chiropractor and refused to pay the costs for the additional distance to Winnipeg. The worker has appealed the WCB decision. A file review was held on May 15, 2006 at the worker's request.

Issue

Whether or not the worker should be reimbursed for the full traveling distance to Winnipeg to attend his chiropractor.

Decision

That the worker should not be reimbursed for the full traveling distance to Winnipeg to attend his chiropractor.

Decision: Unanimous

Background

The worker reported injuries to his right hip and lower/mid back on September 1, 2005.

The WCB accepted the claim for compensation and wage loss benefits were paid to the worker along with chiropractic treatment costs. Following his compensable injury, the worker sought treatment from a chiropractor whom he had been seeing for a 2003 lower back injury.

In December 2005, the worker asked the WCB to provide him with an explanation as to how his mileage reimbursement was being calculated to cover the costs associated with his chiropractic treatment. It is noted that the worker lived and worked in rural Manitoba and attended a chiropractor in Winnipeg for treatment.

On December 7, 2005, the worker was advised by his case manager that he was not eligible to receive reimbursement of travel costs from his residence to Winnipeg as there was chiropractic treatment available in Portage la Prairie and this was the most cost effective alternative. WCB policy 44.120.10 was referred to in the decision. On December 7, 2005, the worker disagreed on the basis that his treating chiropractor was qualified as a chiropractic neurologist and there were no other chiropractors nearer to him with such a qualification. The worker indicated that he had been seeing this particular chiropractor continually since January 2003 and found him to be able to do the most rehabilitation for him and his injuries.

On December 23, 2005, Review Office confirmed that the worker should be reimbursed for traveling expenses based upon the distance to the nearest chiropractic facility. Based on the WCB's existing policy and practices along with the facts of the claim, Review Office found that there was no reasonable basis to reimburse the worker for traveling expenses any more than the distance to the nearest chiropractic facility. On February 23, 2006, the worker appealed Review Office's decision and a non-oral file review was arranged.

Reasons

Worker's Position

The worker has requested that the WCB reimburse him for the cost of travel to Winnipeg. The WCB has only agreed to pay for travel to the nearest chiropractic facility, in Portage la Prairie. The worker disagrees with this decision.

In his appeal form, the worker asked that the decision be overturned for the following reasons:

"On my previous claim which occurred Apr. 2003, I saw numerous doctors 7 physiotherapists and the only one able to rehabilitate me was Dr. [name]. I was covered for all traveling expenses to see him starting Jan 2004 on this claim & was never expected to only be paid for km's to portage la prairie. I was covered for travel expenses the first time, why would I not be covered the second time?"

In a December 7, 2005 letter to the WCB's Review Office the worker noted that Dr. [name] is a chiropractic neurologist and that there are no other chiropractic neurologists closer to him. He expressed the view that "continued treatment from Dr. [name] is absolutely necessary in order for me to recover from my injuries."

Applicable Policy

Payment for travel expenses is made in accordance with WCB Policy 44.120.10, Medical Aid. Subsection 3(a) (i) is applies to this appeal. It provides:

3. Expenses

a. Expenses Incurred to Attend Compensable Medical Treatment

i) The WCB will reimburse an injured worker's actual reasonable expenses related to travelling to medical treatment (wage-loss, travel, accommodations, meals and reasonable telephone charges) which are in excess of costs normally incurred by the worker while travelling to and from work.

Analysis

The issue in this appeal is whether the worker should be reimbursed for the full traveling distance to Winnipeg to attend his chiropractor. The WCB has approved reimbursement of expenses for travel to the nearest chiropractic facility.

The panel has considered the worker's request but has determined that travel expenses should be reimbursed to the nearest chiropractic facility. This is consistent with the WCB policy of reimbursing workers for reasonable expenses related to traveling.

The panel appreciates that the worker has an established relationship with this chiropractor and wishes to receive treatment from him. From the evidence on the claim file, the panel finds this to be a personal choice by the worker as there does not appear to be a valid medical reason for receiving treatment only from this specific provider. In this regard, the panel notes that Review Office consulted with a WCB chiropractic consultant. He advised that the attending chiropractor's reported specialty as a "chiropractic neurologist" is not recognized by the Manitoba Chiropractic Association. The consultant commented there is no reason to travel to Winnipeg aside from the worker's preference for treatment from this chiropractor.

In conclusion, the panel finds that the worker should be reimbursed travel expenses in accordance with WCB policy to the nearest chiropractic facility, which in this case is Portage la Prairie. The panel does not consider it reasonable for the WCB to reimburse additional travel costs without a valid medical reason.

The appeal is denied.

Panel Members

A. Scramstad, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

A. Scramstad - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 19th day of June, 2006