- Health care (vehicle modification)
- Permanent disability
- Health care (vehicle purchase)
The issue under appeal was whether the worker was entitled to health care benefits in the form of a Roadtrek E-Trek XL Edition. The worker was recognized as having a total PD award of 83%.
The appeal was denied.The Vice-Chair considered the applicability of the identified policy, OPM Document No. 17-06-07 "Vehicle Modification", to the worker's request, since the worker was not interested in modifying the vehicle he owned at all relevant times, a 2017 Toyota Highlander.Firstly, the Vice-Chair noted that the policy does not preclude a finding that the purchase of a vehicle may be a "service as may be necessary as a result of the injury" in light of a worker's level of disability. The entitlement pursuant to section 52 is not limited and section (6) grants broad discretion in the scope of health care. The policy document merely addresses the most common situation: the modification of a vehicle already owned by the injured worker. There may be special circumstances in which the purchase of a specialized vehicle is more cost-effective than the modification of an existing vehicle. Second, although OPM Document No. 17-06-07 does not act as a bar to a "necessary" mobility device, the Vice-Chair found that it provides useful guidance with respect to the general criteria for entitlement to a road-worthy vehicle as a mobility device, and with respect to various pre-conditions (such as insurance) which should be met prior to authorization of the expenses.The vehicle in question, the Roadtrek E-Trek XL Edition, may be more commonly referred to as a recreational vehicle or a motorhome. It includes a kitchenette, washroom, and bed, among other features. The worker provided a written quote from a retailer for a particular motorhome with the features he asserted were necessary. The quote was for a total cost of $230,520.00. It was indicated that the worker travelled often, and he was required to bring many assistive devices with him when he visited family, which made him "feel like a burden." It was submitted that having this motorhome would facilitate these visits and restore his independence.The Vice-Chair concluded that the evidence did not support a finding that a Roadtrek E-Trek XL Edition, or any similar recreational vehicle or motorhome, constituted a "service […] necessary as a result of the injury" pursuant to section 52.In support of this finding, the Vice-Chair noted that the worker was able to operate his 2017 Toyota Highlander. That vehicle enabled him to have mobility within his community and to socialize with family and friends. While owning the motorhome would make it easier for him to travel, it was not necessary. The worker submitted that the motorhome would enable him to attend religious and social events of the Métis community outside the province. The Vice-Chair noted that no persuasive argument had been presented to suggest that the purchase of a motorhome was the only, or even the most reasonable, means of transportation to attend such events. The worker indicated that he would like to have a motorhome so as to travel to the United States and Canada "because he is getting old and it's now or never." The Vice-Chair recognized that travel for personal pleasure is intrinsically not "necessary", and consequently, cannot be considered health care under the meaning of section 52.Furthermore, the Vice-Chair noted that the medical reports, including the occupational therapist's report, clearly indicated that even prior to the provision of the worker's electric scooter, the worker was able to maintain social contacts. In addition, the worker had indicated that the Toyota Highlander was comfortable and met his needs. The evidence also indicated that the Roadtrek E-Trek XL Edition did not qualify as a "necessary" health care device, and contained information which was consistent with the prior evidence of the worker's social interactions and of the worker's mobility capacity.