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 for travel expenses. A file review was held on November 20, 2017 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to reimbursement for travel expenses.

Decision

That the worker is not entitled to reimbursement for travel expenses.

Background

The worker filed a claim in November 2009 for noise induced hearing loss that he attributed to long term noise exposure at his workplace. After investigation by the WCB, the worker's claim was accepted, with a 1988 accident date established.

A May 3, 2010 letter from Compensation Services advised the worker that his claim had been accepted and that after a review by the WCB's ear, nose, and throat specialist, two hearing aids were approved for the worker. The WCB would provide full coverage of all hearing aids ordered from the WCB Approved List, and would be accepting responsibility for the purchase of batteries and any ongoing maintenance of the hearing aids, with prior approval.

File information indicates that the worker did purchase hearing aids and that he was in regular contact with WCB in the years following regarding various hearing aid maintenance issues.

In July 2013, the worker advised his case manager that he would be moving from his home in Thompson, Manitoba to Newfoundland. On December 13, 2013, the worker provided a new address in Newfoundland and asked if he was eligible for mileage, as he now had to make a trip to another community in order to service his hearing aids. (Information later provided by the worker on February 10, 2017 indicated that the distance to and from the second community is 210 km).

In a decision letter dated December 13, 2013, Compensation Services advised the worker that the WCB was unable to cover mileage costs. The decision cited WCB Policy 44.120.10, and stated that there was a hearing centre in Thompson which was where he resided when his occupational exposure had occurred, and therefore there would be no mileage in excess what he would have travelled to work.

The worker appealed this decision to Review Office on January 9, 2014. He stated that he had retired from work on January 27, 2012 for medical reasons, and had relocated to a community in Newfoundland in order to get treatment for his hearing loss. He now had to travel to another community for treatment and felt that he should not be penalized for his relocation in order to improve his medical condition. He felt he should be reimbursed for all travelling costs associated with his hearing loss.

On March 3, 2014, Review Office denied the worker's request for reimbursement of his travel expenses in Newfoundland. The decision referred to WCB Policy 44.120.10 Medical Aid ("the Policy"), and stated that the worker had relocated from Manitoba to Newfoundland due to personal reasons unrelated to attending for treatment or services related to his hearing loss. Review Office found that the worker's travel between the two Newfoundland communities was not related to the compensable hearing loss claim, and determined that there was no entitlement to reimbursement of travel expenses.

On May 5, 2017, the worker appealed Review Office's decision to the Appeal Commission and a file review was held on November 20, 2017.

Reasons

Applicable Legislation and Policy

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 is seeking reimbursement of mileage expenses in order to maintain his hearing aids.

The payment of compensation for medical expenses falls under the heading of Medical Aid. The Act empowers the board to provide such medical aid as it deems necessary:

Provision of medical aid

27(1) The board may provide a worker with such medical aid as the board considers necessary to cure and provide relief from an injury resulting from an accident.

Medical aid to be under supervision of board

27(10) Medical aid furnished or provided under any of the preceding subsections of this section shall at all times be subject to the supervision and control of the board; and the board may contract with health care providers, hospitals or other health care facilities for any medical aid required, and agree on a scale of fees or remuneration for any such medical aid.

The Policy addresses the subject of medical aid, and more specifically, reimbursement of expenses to attend compensable medical treatment. Section 3(a) of the Policy provides, in part:

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. … iii) All travel reimbursements should be based on the most cost-effective alternative and take account of the injured worker's medical functioning level.

Worker's Position

The worker provided a written submission dated May 5, 2017. The worker advised that he retired from his Manitoba employer on January 27, 2012 because of medical reasons, and relocated to Newfoundland because of his health and to continue to receive treatment for his hearing loss. In his current location, he has to travel to another community in order to get treatment for his hearing loss in the form of examinations and new hearing aids.

Employer's Position

The employer did not participate in the appeal.

Analysis The issue before the panel is whether the worker is entitled to reimbursement of mileage expenses following his move to a new community in Newfoundland. For the worker's appeal to be successful, the panel must find that the requested travel expenses satisfy the requirements of the Policy. The panel was not able to make this finding, based on the following findings: • The Policy establishes a base line for when travel expenses can be paid by the WCB for a worker to attend compensable medical treatments (which in this case would include the worker's attendance for ear examinations and hearing aid maintenance). The base line is set as the worker's travel distance to and from work prior to his accident. • 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 the distance he had to travel for work. This provision limits the reimbursement to the expenses which are greater than the worker would have normally had, had he been working. 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. • From 2010 to 2013, the worker was able to access a hearing centre in Thompson, and as the travel distance was closer than his original travel distance to work, the worker was not entitled to travel expenses while he continued to live in his Manitoba community. The panel finds that this was the most cost effective alternative, as required by the Policy. • Once the worker moved to Newfoundland, he now lived 105 km away (210 km return) from the nearest hearing centre, in another community. • The worker also advised in his notice of appeal that he moved to Newfoundland in order to seek hearing treatment. The panel finds, however, that the worker's relocation to Newfoundland following his retirement was not related to his workplace injury. In particular, there is no indication on file that the hearing centre in his Manitoba community was unable to meet his needs at the time of his relocation. • The panel therefore finds that the worker's move to Newfoundland, almost two years post-retirement, was done for personal reasons. As the worker lived in Thompson and had been employed in that community at the time of his workplace injury, this would be the basis for calculation of his ongoing travel expense entitlements. While in Thompson, the worker was not entitled to the payment of travel expenses in respect of his hearing aids. As such, the worker is not entitled to reimbursement of his additional travel expenses which arose solely out of his personal decision to move to a community that did not have a nearby hearing centre. The panel finds that the worker is not entitled to reimbursement of travel. Therefore, the worker's appeal is dismissed.

Panel Members

M. L. Harrison, Presiding Officer
A. Finkel, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, B. Kosc

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

Signed at Winnipeg this 30th day of November, 2017