October 23, 2015 Article

Maine Workers' Compensation Alert: Appellate Division Rules on Compensability of Home Renovations

Section 206 of the Maine Workers’ Compensation Act provides: “An employee sustaining a personal injury arising out of and in the course of employment . . . is entitled to reasonable and proper medical, surgical and hospital services, nursing, medicines, and mechanical, surgical aids, as needed, . . ..” It also provides, under § 206(8), that “The employer shall furnish artificial limbs, eyes, teeth, eyeglasses, hearing aids, orthopedic devices and other physical aids made necessary by the injury....”

In Gray v. Prudential Insurance Co. of America, WCB App. Div. Decision No. 15-26 (October 5, 2015), the Appellate Division addressed the compensability of home modifications under 206. Craig Gray suffered an injury while working for Prudential Insurance that rendered his preexisting paraplegia condition worse. The Board ordered Prudential to pay for a variety of home modifications associated with making his home more accessible, finding the modifications fit within § 206.

Prudential appealed, contending that the modifications are neither “medical” nor “mechanical” and do not otherwise fall within the scope of § 206(8). The Appellate Division affirmed. It found the renovations to be within the confines of the employee’s home (bedroom, bathrooms, and kitchen) and that these are areas “where very basic and private activities of daily living take place.” It noted that the hearing officer “carefully reviewed how each requested modification was causally linked to, and rendered necessary” by the injury and “properly considered the reasonableness of each requested modification, accepting most of them, but also rejecting certain items as not within the statute.” The Appellate Division found the hearing officer’s decision appropriately reflects consideration of the “ultimate purpose” of section 206: “to provide reasonable relief from the effects of a work-related injury.”

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