Carrier doesn't have to build addition on claimant's home

In Florida, unless there is a specific reason that the employee's existing home is not suited for modifications, the carrier should have the option of modifying the existing residence to conform with the medically necessary requirements rather than building additional rooms.

Case name: April v. Gevity HR, 16 FLWCLB 158 (Fla. JCC, West Palm Beach 2009).

Ruling: A Florida judge of compensation claims granted in part and denied in part an injured worker's request that her employer modify her home to make it handicap accessible.

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What it means: In Florida, unless there is a specific reason that the employee's existing home is not suited for modifications such as a chair lift and the alteration of bathrooms, the carrier should have the option of modifying the existing residence to conform with the medically necessary requirements rather than building additional rooms.

Summary: The employee had limited mobility. She resided in a three-bedroom home owned by her daughter and son-in-law. The employee's two young grandchildren also lived in the house. The bedrooms were on the second floor. The carrier agreed to modify the existing bathrooms on the first and second floors and provide an electric stair lift. However, the employee claimed that the best solution for the family's living arrangements was to build a new bedroom and bathroom on the first floor. The employee's daughter explained that her main concern was having separate bedrooms for her children as they got older. The judge of compensation claims found that the employee did not met her burden of proving that a first-floor bedroom and bathroom were medically necessary. The authorized treating doctor performed a home evaluation and determined that a walk-in shower with chair, grab bars, a handheld shower, and a handicap toilet with bars were medically necessary. He recommended a stair lift to transport the employee up and down stairs. The JCC found that the modifications recommended by the treating doctor were reasonable and medically necessary and ordered the carrier to authorize them.

While the JCC recognized the employee's daughter's concerns regarding her children's privacy, those concerns cannot override the responsibility of the carrier to provide what is medically necessary. The JCC concluded that the responsibility for a treatment plan and all that goes with it rests with the authorized physician.

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December 14, 2009

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