SYLLABUS The costs of making structural modifications to the residence of a permanently injured employee to permit installation of equipment deemed reasonably necessary to relieve the effects of the employee's injury are not medical treatment costs subject to Minn. Stat. § 176.135 (2012), but instead are "alteration or remodeling" costs subject to the limits of Minn. Stat. § 176.137 (2012).
The opinion of the court was delivered by: Anderson, Paul H., Justice.
Workers' Compensation Court of Appeals
Anderson, Paul H., J. Dissenting, Page, J. Took no part, Wright, J.
Office of Appellate Courts
The issue presented in this case is the extent of New Dimensions Home Health's liability for structural changes necessary to the home of Tessa M. Washek in order to permit installation of a ceiling-mounted motorized lift system. A compensation judge found that the cost of making the structural changes was compensable under Minn. Stat. § 176.135 (2012) because those changes were necessary to provide Washek with reasonable and necessary medical treatment--namely, to minimize skin breakdown and reduce repetitive trauma to Washek's upper extremities. The Workers' Compensation Court of Appeals reversed the compensation judge, concluding that the changes to Washek's home necessary to permit installation of the lift system constituted "alteration or remodeling" of Washek's home and that the employer's liability was therefore limited by Minn. Stat. § 176.137 (2012). We affirm.
In 2002, relator/employee Tessa M. Washek suffered spinal cord damage and other injuries in a work-related motor vehicle accident and was rendered a paraplegic. Washek's employer, New Dimensions Home Health, and its insurer accepted liability for Washek's injuries and have paid various workers' compensation benefits, including wage loss benefits, rehabilitation, and medical treatment. In addition, New Dimensions and its insurer have paid approximately $58,000 to make Washek's home more accessible for her special needs.
The record before the compensation judge indicates that between 2002 and 2009, Washek suffered from several health problems as a consequence of her disability. For example, Washek has had multiple dermatologic issues, including an ulcer in the sacral region that required surgery in 2005. She also developed carpal tunnel syndrome in both wrists that required surgery in 2006.
In 2009, an accessibility specialist who visited Washek's home observed that the toilet in Washek's bathroom was equipped with a gel seat, but because the seat could not be securely fastened to the toilet, it often shifted as Washek slid onto it from her wheelchair. As a result of this complication, Washek stopped using the gel seat. Although Washek's home is equipped with a roll-in shower stall, Washek had difficulty transferring into and out of the shower chair, and in rolling the shower chair over the threshold to the shower stall and over the threshold between the bathroom and her bedroom. There were also concerns expressed about Washek falling out of the chair. The design of the bathroom made reconfiguration difficult.
The accessibility specialist's solution to the foregoing problems was the installation of a remote-controlled, ceiling-mounted lift system extending from Washek's bedroom to the toilet and shower stall in Washek's bathroom. With the lift system, the specialist reasoned, Washek could leave the shower chair in the shower stall itself and lower herself into the chair, thus eliminating the need to propel the shower chair over the various thresholds. In addition, the lift system would allow Washek to lower herself onto the toilet's gel seat, rather than attempting to slide onto the seat. This procedure would eliminate the "shearing" of the skin on Washek's buttocks when she would slide onto the toilet.
In June 2010, Washek filed a medical request seeking payment for the installation of the lift system. The cost of the system itself, delivered and installed, was estimated at $15,414. New Dimensions and its insurer agree that the lift system is reasonable and necessary to "cure and relieve" the effects of Washek's work-related injuries and that the cost of the lift system, installed, is a medical expense that is compensable under Minn. Stat. § 176.135.
The lift system's vendor informed Washek that installation of the lift system would require Washek to make several modifications to her home to accommodate the system. For example, installation of the track requires that the path of the track be "free from lighting fixtures, smoke/CO detectors, ceiling and bath fans, and any other obstructions on the ceiling." Installation of the track also requires "[r]ais[ing] all door headers above or flush with the ceiling level," installing "solid wood blocking above and flush to [the] drywall . . . capable of supporting 500 lbs. on the track at every point along the track where a support will be located," and "provid[ing] an ...