Decision #32/07 - Type: Workers Compensation

Preamble

This is an appeal by the worker of Workers Compensation Board (“WCB”) Review Office Order No. 732/2006 dated November 2, 2006 holding that the WCB should not cover the cost of a Tempur-pedic mattress. A review was held on January 25, 2007.

Issue

Whether or not the WCB should cover the cost of a Tempur-pedic mattress.

Decision

That the WCB should not cover the cost of a Tempur-pedic mattress.

Decision: Unanimous

Background

Reasons

The worker says that the WCB should pay for the purchase of a Tempur-pedic bed because he feels that this bed allows him to get a good night sleep and feel less numbness and pain in his back the next morning.

WCB medical advisors and the worker’s treating physicians have commented on the worker’s need for this bed:

  • The worker’s family physician initially prescribed the purchase of a Tempur-pedic bed in March 2005. He clarified however in a June 20, 2005 letter that he only did so at the worker’s request and that such a purchase would be beneficial for the worker’s paraspinal muscle spasms but not necessary;
  • The worker’s treating physical medicine and rehabilitation specialist commented in May 2006 that such a purchase would be reasonable if it provided the worker with relief and allowed for improved sleep;
  • Two WCB medical advisors who examined the worker’s file in March 2005 and March 2006 could not find any substantive therapeutic reason for the worker to be provided with this particular type of mattress.

The provision of medical aid is governed in part by subsection 27(1) of The Workers Compensation Act (the “Act”) and WCB Policy 44.120.10, Medical Aid.

These provisions clearly indicate that the provision of medical aid is discretionary and contingent upon being necessary to assist the worker to recover from his compensable injury or to minimize the impact of the compensable injury.

In the case before us, the medical evidence suggests that the provision of a Tempur-pedic bed is to assist the worker with his sleep and not his compensable injury. Though we accept that quality and amount of sleep can impact on the worker’s functionality, this is the case with most people. The provision of medical aid is not however designed to pay for any and all medical aid. It is only designed to pay for medical aid which will assist the worker in recovering from his compensable injury or minimize the impact of the compensable injury. In weighing the evidence, we are unable to find on a balance of probabilities that this is the case. For these reasons we find that the WCB should not cover the cost of a Tempur-pedic mattress.

Accordingly the worker’s appeal is dismissed.

Panel Members

L. Martin, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Kosc

L. Martin - Presiding Officer

Signed at Winnipeg this 7th day of March, 2007

Back