We recently attended a Rehabilitation Conference with a client at the State Board of Workers’ Compensation.
A Rehabilitation Conference is a conference scheduled with the Rehabilitation Division of the State Board in catastrophic cases. A catastrophic case entitles injured workers to lifetime income benefits and medical and rehabilitation services not offered in other cases.
The purpose of these conferences is to resolve issues related to medical or rehabilitation services in the claim without litigation. In our case, three issues took precedence for the conference:
- vehicle modifications
- provision of reasonable and necessary housing modifications
- attendant care.
These issues are prevalent in catastrophic claims as these items are critical in order for a severely injured worker to get proper care, obtain modified housing and receive a vehicle that meets his or her needs.
Rehabilitation Conference Results
When an injured worker uses reasonable and necessary medical devices, including power wheelchairs, the Employer/Insurer has a duty to provide modifications to the current vehicle or a new vehicle that allows the injured worker to move from place to place with the motorized wheelchair. These wheelchairs are very large and require special vehicles that can accommodate their size. Modifications include a lift on the back of the vehicle or an electric lift for the wheelchair to fit inside. Many times it is more cost-effective for the insurance company to purchase a new vehicle rather than modify the vehicle. In our case, the purchase of a new van adequately accommodated the motorized wheelchair.
Housing is a major issue in catastrophic claims. A pre-injury residence may not be suitable for an injured worker’s needs. The injured worker’s home may need to be modified with ramps, handicap grab bars, a seated shower, a stair chair lift, and wider hallways to accommodate wheelchairs.
In our case, the current home needed a shower-equipped bathroom on the level of the home where the injured worker resided. The options included building out a new bathroom on the main level, installing a chair lift to get her from the main level to the second floor for bathing, or purchasing a new home that would accommodate the bedroom and bathroom needs. This client moved her bedroom to the main level to accommodate her and her husband and avoid stairs. It is a misconception that the insurance company is responsible to purchase an entirely new residence. In fact, the insurance company is only liable for the difference between the cost of the current home and the cost of the modified or handicap-accessible home. These issues are negotiated or discussed at the rehabilitation conference. The hope is that the parties can agree on a fair resolution to housing issues.
The final issue for our rehabilitation conference was attendant care. Our client requires 24-hour per-day attendant care not only because she is unable to perform activities of daily living, but also because she requires some specialized care to be performed by her caregivers during the day. The attendants will assist our client with dressing, cooking, and cleaning, as well as help with any medical issues that may arise. In this case, our client’s husband also provides care for some evening and overnight shifts. Family caregivers are an option if the client does not require 24-hour per-day specialized care. There is a set rate for family caregivers.
Choose Your Workers’ Compensation Attorney Carefully
A Rehabilitation Conference is an excellent avenue to resolve many issues in catastrophic claims. The rehabilitation coordinator will make determinations if the parties can not agree on certain items. If one party is dissatisfied with the recommendations or decisions, they may appeal the decision to be litigated before an Administrative Law Judge. These conferences require expertise in catastrophic claims and our attorneys are skilled in handling these complex legal issues.
Sadow & Froy solely represents seriously injured workers in workers’ compensation cases. The highly respected lead attorneys are on several “Best of” lists including Atlanta Magazine’s Super Lawyer lists. Both attorneys have received numerous industry awards. To see if your case qualifies for workers’ compensation benefits, visit our website for a free evaluation.