The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that she is not entitled to travel expenses to attend treatment in Winnipeg. A file review was held on September 17, 2018 to consider the worker's appeal.

Issue

Whether or not the worker is entitled to travel expenses to attend treatment in Winnipeg.

Decision

The worker is not entitled to travel expenses to attend treatment in Winnipeg

Background

The worker reported to the WCB on April 18, 2018 that she injured her right shoulder on April 3, 2018 in an incident she described as:

I was off loading our food delivery, was picking up a milk crate of cream and I felt a pop in my right shoulder while lifting the crate.

On April 16, 2018, the worker attended an appointment with her chiropractor where she reported neck, mid-back and shoulder pain with limited mobility. The chiropractor diagnosed the worker with a cervical/thoracic/shoulder sprain/strain and recommended light duties for two weeks.

In a discussion with the WCB on April 24, 2018, the worker advised that she was attending her chiropractic treatments in Winnipeg as she was already undergoing treatment for an injury unrelated to this claim with this chiropractor. The worker inquired whether she would be reimbursed for her travel expenses to attend for treatment in Winnipeg and was advised that the WCB would not cover her mileage. On April 24, 2018, the WCB followed-up their discussion with the worker with a letter formally advising that her mileage expenses to attend treatment in Winnipeg would not be covered as there were medical practitioners where she resides that could treat her. The worker requested reconsideration of the WCB's decision to Review Office on May 4, 2018. The worker argued that she was an existing patient with the chiropractor in Winnipeg and was comfortable with their treatment of her unrelated injury. She noted that she had been treated previously by practitioners where she resides and felt that the chiropractor who was treating her in Winnipeg was providing better care for her.

Review Office advised the worker on May 30, 2018 that she was not entitled to reimbursement for travel expenses to attend treatment in Winnipeg. Review Office acknowledged that the worker's arguments of being treated by the same chiropractor that she was successfully treated for an unrelated injury were valid, however, Review Office notes that they were bound by the policies of the WCB. Review Office determined that as there are treatment providers available where the worker resides, she would not be entitled to reimbursement for travel expenses.

The worker filed an appeal with the Appeal Commission on May 30, 2018. A file review was arranged.

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 relation to chiropractic treatment she received as a result of a workplace injury.

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.

Board Policy 44.120.10, 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's appeal was dealt with by way of a file review.

The worker provided a written submission dated May 30, 2018. She submitted that:

I see [chiropractor] at the [name] Clinic located at [address] in Winnipeg every 2 weeks for the last 5 years due to [another injury], so I chose to continue to seek treatment from him for my shoulder injury vs going to see a new chiropractor locally. [Chiropractor] has extensive history treating shoulder injuries as they relate to sports type injuries. I felt that given my previous history with chiropractors that I have seen in the [town] and their inability to treat my [other injury] that they would not be able to treat my shoulder condition as well as [chiropractor] nor with the speed at with (sic) he has managed to treat me. I chose to see him as I trust him to treat me the right way without further injuring me.

In a letter to the Review Office dated May 4, 2018 the worker wrote:

On April 3rd, 2018, I injured my shoulder while working, I see [chiropractor K] at [clinic] located at [address] in Winnipeg every 2 weeks due to [another injury], so I chose to continue to seek treatment from him for my shoulder injury vs going to see a new chiropractor located in the city that I live in. I have in the past seen 2 of the local chiropractors, [chiropractor N] and [chiropractor A], with little to no results in regards to my existing condition. ….so yes, I chose to drive [distance] each way to seek treatment for my shoulder injury form (sic) [chiropractor K]. I chose to drive this as I trust him to treat me the right way without further injuring me, he has been my primary chiropractor for over 5 years and knows how to treat me and how much pressure he can use on me. [Chiropractor K] has extensive history treating shoulder injuries as they relate to sports type injuries…Instead of staying at home and treating my injury while Workers Compensation paid my wages, I have not missed a day of work, nor have I had any wages paid to me from workers compensation. It is my understanding that workers compensation is there for the workers when they are injured while working, I should not have to go thru (sic) this process in order to get compensation for my mileage that I deserve as we should be able to see the Doctors that we are comfortable with vs. ones that are convenient in regards to where we live…

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 mileage expenses for attendance at a chiropractor whose clinic is in a different community from where the worker resides and works. 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.

In addressing this appeal, the panel makes the following findings:

• the worker was injured at work on April 3, 2018

• the worker's residence and place of employment is in a community outside Winnipeg

• the worker elected to attend a chiropractor in Winnipeg

• there are several chiropractors, qualified to provide treatment, in the community where the worker resides and works.

• the worker chose to attend the chiropractor in Winnipeg, as opposed to attending a chiropractor in the community that she resides and works, for personal reasons as she was seeing this chiropractor for another condition

The panel notes that the Policy establishes criteria for when travel expenses will be paid by the WCB for a worker to attend compensable medical treatments. This provision is intended to provide payment of expenses where a worker has to travel a greater distance for medical treatment than the distance the worker had to travel for work. This provision limits the reimbursement to the expenses which are greater than the worker would have normally had if she been working.

Based upon the above facts and in compliance with the Policy, the panel finds that the worker is not entitled to reimbursement of her travel expenses. It finds that these expenses arose solely out of her personal decision to travel to Winnipeg notwithstanding that services were available in her community.

The worker's appeal is dismissed.

Panel Members

A. Scramstad, Presiding Officer
J. MacKay, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, J. Lee

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

Signed at Winnipeg this 25th day of October, 2018