The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") to deny his request for reimbursement of a medical report required to renew his driver's licence. A file review was held on January 15, 2015 to consider the matter.

Issue

Whether or not responsibility should be accepted for the expense associated with medical forms required for renewal of the worker's driver's licence.

Decision

That responsibility should be accepted for the expense associated with medical forms required for renewal of the worker's driver's licence.

Decision: Unanimous

Background

The worker has an accepted claim with the WCB for a right shoulder injury that occurred on May 13, 1992 and a subsequent myocardial infarction which occurred during post surgical physiotherapy treatment.

In August 2014, the worker asked the WCB to reimburse him for the costs associated with a medical form completed by his physician which was required by Manitoba Public Insurance in order to renew his driver's licence. The worker stated the medical forms were required because of his compensable heart condition and the WCB had paid for this expense in the past.

On September 3, 2014, the WCB advised the worker that the medical form was not related to his workplace injury and therefore the WCB was unable to reimburse him for the $110.00 fee. The decision was based on subsection 27(1) of The Workers Compensation Act (the "Act"). On September 9, 2014, the worker appealed the decision to Review Office.

On October 20, 2014, Review Office determined that responsibility should not be accepted for the expense associated with the medical forms for renewal of the worker's driver's licence. Review Office stated that there was no provision under the Act or WCB policy to compel the WCB to pay for such an expenditure. It was the worker's personal choice to drive and any expense associated with his transportation preference was not the WCB's responsibility. If the WCB had covered this expense before as contended by the worker, it would have been an administrative error. The worker disagreed with Review Office's decision and an appeal was filed with the Appeal Commission.

Reasons

Applicable Legislation

The Appeal Commission and its panels are bound by the Act, regulations and policies of the Board of Directors.

Under subsection 4(1) of the Act, where a worker suffers personal injury by accident arising out of and in the course of employment, compensation shall be paid to the worker by the WCB.

Subsection 27(1) provides that medical aid will be paid by the WCB for so long as is necessary to cure and provide relief from the injury.

WCB Policy 44.120.10, Medical Aid presents a comprehensive and coordinated approach to the delivery of medical-aid services to injured workers. The provision of medical aid attempts to minimize the impact of the worker's injury and to enhance an injured worker's recovery to the greatest extent possible.

WCB Policy 44.120.30, Support for Daily Living outlines the general criteria for providing injured workers with assistance to engage in the activities required for daily living and summarizes the forms of assistance the WCB may provide.

Worker’s Position

The worker was self-represented in the appeal. His Appeal of Claims Decision form stated:

WCB has denied paying medical form expenses for my drivers licence renewal. WCB has accepted responsibility for my heart condition (1993) and always paid for my medical forms to maintain my drivers licence. The last time WCB paid for my medical forms was 2009.

Analysis

In order to find that responsibility should be accepted for the expense associated with medical forms required for renewal of the worker's drivers licence, the panel must find that the Act or WCB Policy provides authority for this type of compensation to be paid to the worker. We are able to make that finding.

The panel considered WCB Policy 44.120.10, Medical Aid, but we find that it is not applicable. This policy deals only with the delivery of medical-aid services to injured workers and we find that the expense associated with the medical forms cannot be considered to be related to the provision of medical aid. The expense does not relate to any treatment or relief related to his compensable injuries.

The panel next considered WCB Policy 44.120.30, Support for Daily Living (the "Policy"). The general criteria for assistance under the Policy provides that decisions regarding the type, level and duration of assistance are made on a case by case basis. It further provides that the compensable injury must have reduced the worker's ability to engage in the activities required for daily living. The listed activities include "routine travel outside the home." The Policy states:

The assistance should compensate in the most cost-effective way possible for additional costs the worker incurs in engaging in the activities that he/she engaged in prior to the injury, where those costs arise because of the injury.

The panel notes that the Policy specifically lists "Vehicle Modifications" as a type of assistance which may be provided where a modified vehicle is required to allow an injured worker to safely operate a vehicle as part of the requirements of daily living.

The request being made by the worker in this appeal is somewhat unusual because it is not a direct vehicle modification or assistive device, but rather obtaining a medical form is a requirement that is being imposed on the worker by the drivers licensing authorities. Nevertheless, the worker is obligated to meet this requirement in order to be able to engage in routine travel outside the home. Without it, he cannot legally drive.

The reason why the worker is required to obtain the medical form is because of his previous history of myocardial infarction, which was accepted as a compensable injury. Were it not for the compensable myocardial infarction, the worker would not have to incur this cost when renewing his drivers licence. In the circumstances, the panel is satisfied that the expense associated with the medical forms is an additional cost which the worker must incur as a result of his compensable injury, and there is authority under the Policy to provide assistance to the worker for this additional expense. We therefore find that responsibility should be accepted for the expense associated with medical forms required for renewal of the worker's drivers licence.

The worker's appeal is allowed.

Panel Members

L. Choy, Presiding Officer
A. Finkel, Commissioner
P. Walker, Commissioner

Recording Secretary, B. Kosc

L. Choy - Presiding Officer

Signed at Winnipeg this 5th day of March, 2015