The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that he was not entitled to reimbursement of travel expenses related to his hearing loss claim. A file review was held on September 23, 2013 to consider the matter.

Issue

Whether or not the worker is entitled to reimbursement of travel expenses after March 20, 2013.

Decision

That the worker is not entitled to reimbursement of travel expenses after March 20, 2013.

Decision: Unanimous

Background

The worker has an accepted claim with the WCB for noise induced hearing loss. He is presently retired and living out of the Winnipeg area. The WCB has provided the worker with travel expenses in the past to attend hearing centers from his current home to the Winnipeg area which was later amended to the hearing center closest to his current address.

In 2013, the worker asked the WCB to provide him with travel expenses to attend a medical appointment at the hearing facility that was closest to his home. On March 20, 2013, the worker was advised that he was not entitled to travel expenses based on the following rationale:

The WCB will reimburse an injured worker's actual reasonable expenses related to travelling to the closest facility for medical treatment which are in excess of costs normally incurred by the worker while travelling to and from work.

Information on file indicates you were employed with [employer] in Winnipeg, and resided in Winnipeg. You relocated to [name] after your retirement. Hearing services are available in Winnipeg. Based on this, the WCB is unable to reimburse you for travel expenses.

On April 19, 2013, the worker appealed the above decision to Review Office. The worker noted that prior to March 20, 2013, he had been in receipt of mileage for over a decade and asked that he still be provided with mileage to attend the closet medical facility to his home.

On May 21, 2013, Review Office upheld the decision that the worker was not entitled to mileage expenses. Review Office acknowledged that the WCB had previously compensated the worker for actual mileage incurred from his current residence to his appointments. The mileage expenses paid to the worker prior to March 20, 2013 was not an issue before Review Office.

Review Office referred to WCB Policy 44.120.10 - Medical Aid in its decision. Review Office noted that the worker is limited to reimbursement of travel expenses in excess of the typical costs he would have incurred when travelling to and from work. It was felt by Review Office that the worker's decision to relocate following retirement was a personal decision made on his own accord and was unrelated to his injury stating: "The services required to maintain his hearing loss devices are available in Winnipeg, where he initially resided and worked. The worker is therefore limited to reimbursement of travel expenses beyond typical travelling costs to and from work based on his residence at the time of the injury." On June 21, 2013, the worker appealed Review Office's decision to the Appeal Commission and a file review was arranged.

Reasons

Applicable Legislation

The Appeal Commission and its panels are bound by The Workers Compensation Act (the “Act”), regulations and policies of the Board of Directors.

The worker has an accepted claim for hearing loss and the WCB has purchased hearing devices for the worker. He is asking the WCB to reimburse travel expenses for appointments related to the fitting, repair and maintenance of his hearing devices.

Subsection 27(1) empowers the WCB to provide such medical aid as the WCB considers necessary to cure and provide relief from an injury. The WCB Board of Directors has established WCB Policy 44.120.10, Medical Aid, which is intended to present a comprehensive and coordinated approach to delivery of medical aid.

Worker's Position

The worker wrote to the WCB outlining his concerns. He submitted that:

"The situation is very straightforward nothing stays the same forever I went on disability, the company moved to Edmonton, I retired and moved out to a place where I wanted to retire that I had owned for over 40 years….I am asking for that whatever the closest facility is to me I'd be entitled to that mileage…This has been in effect with me for close to a decade now and I feel it should stay in place whether it has to fall under a grandfather's clause or being that his claim has been in place for a number of years…"

Employer's Position

The employer did not participate in this appeal.

Analysis

The issue before the panel is whether the worker is entitled to reimbursement of travel expenses after March 20, 2013. For the worker's appeal to be successful, the panel must find that the travel expenses satisfy the requirements of the WCB's Medical Aid Policy. The panel was not able to make this finding. The panel finds that the worker is not entitled to reimbursement of travel expenses.

In addressing this appeal, the panel is bound by the WCB Medical Aid Policy. Paragraph 3 (a) i) of this policy deals with expenses incurred to attend medical appointments. It provides that:

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.

The panel's understanding is that the intention of this provision is to provide payment of expenses where a worker has to travel a greater distance for medical treatment than he had to travel for work. This provision restricts the reimbursement to expenses which were greater than the worker would have normally had. In a case where a worker relocates for personal reasons after an injury, the policy prevents the worker from obtaining reimbursement for the additional expenses which arise from the extra travel to and from the new residence.

The panel notes that the worker's relocation to rural Manitoba following his retirement was not related to his workplace injury. The panel also notes that services related to his hearing device continue to be available in Winnipeg where he resided and worked at the time of the injury and that additional travel expenses would not be required to be paid to the worker at that time. The panel finds that because the worker lived in Winnipeg and was employed in Winnipeg at the time of the injury, this would be the basis for calculation of his travel expense entitlements. As such, the worker is not entitled to the additional travel expenses he incurs from his current residence to Winnipeg or to other centres.

The panel notes that prior to March 20, 2013 the worker was reimbursed by the WCB for travel expenses he incurred for travel from his home in rural Manitoba to Winnipeg (and other centers) for the purpose of fitting, repair and maintenance of his hearing devices. In March 2013, the WCB reviewed the worker's file and claims for reimbursement and determined that it had erred in reimbursing the worker's travel expenses. As noted earlier, the Appeal Commission is bound by the Act and the WCB policy on Medical Aid. This policy sets out clear rules on travel expenses. The panel cannot authorize the continuation of expenses which are not authorized by WCB Policy.

The panel finds that the worker is not entitled to mileage reimbursement.

The appeal is dismissed.

Panel Members

A. Scramstad, Presiding Officer
A. Finkel, Commissioner
P. Walker, Commissioner

Recording Secretary, B. Kosc

A. Scramstad - Presiding Officer

Signed at Winnipeg this 25th day of September, 2013