There are two broad categories of Workers’ Compensation benefits: indemnity benefits, which cover lost wages or reduced earnings; and medical benefits, including treatment, prescriptions, equipment, attendant care expenses, and mileage reimbursement.
What is a care attendant?
A lot of people don’t think about it, but attendant care can be a huge medical benefit. If someone is injured and can’t take care of themselves, somebody else will have to do it for them. This includes things like cooking, doing household chores, going grocery shopping, and taking care of personal hygiene tasks that would be impossible for someone who is stuck in bed or doesn’t have much mobility.
If your employer provides you with a registered nurse to help with your injury, then they are within the law. However, if they do not provide such services, then a family member may have to fill in. If it is a spouse or child that ends up helping out, they may be legally entitled to compensation.
How can I get the insurance company to pay my spouse or family member?
To collect money from the insurance company for the time your family member provides attendant care, you must prove that you are entitled to such attendant service.
- Your workers’ compensation doctor must indicate that you need attendant care services and that they are medically necessary.
- It must also indicate the length of time, the level of care, and the type of assistance that is required.
- Once the insurance company receives this written prescription, they are essentially on the hook for providing or paying for these services.
Can I get compensation for my spouse or family member retroactively?
Time is of the essence. There is no getting compensation for retroactively care attendance services. Thus, the sooner that you get your doctor to prescribe these services and that prescription gets submitted to the employer/carrier, the sooner their obligation to pay will start. If you have been injured on your job and your spouse or a family member has been taking care of you at home, you’ll have to take quick action.
The exception to the retroactive limitation would be if the employer/carrier failed to follow up and take action after knowing that there was a need for attendant care. They are obligated to investigate and follow through after learning of a potential need or concern that you will need attendant care. If the employer/carrier does not do anything, they cannot simply wait for the written prescription to come at a later time to delay the start of payments until that time. They cannot pretend not to know about the need for attendant care and hide behind a wall of willful ignorance to ignore paying your spouse or family member benefits.
If your doctor never gives you a written prescription for needed benefits but does inform you of the need for attendant care, or if you communicate this same information to your employer or insurance carrier (or they were already aware based on a mention in your doctor’s report), then retroactive benefits may be recognized by them since the time they get noticed of the issue up to when they received the written prescription.
How much money can my spouse or family member collect for attendant care?
Oftentimes, your spouse is forced to quit his or her job to stay home to take care of you. Your family may be down to one source of income- your workers’ compensation lost wage benefits.
Fortunately, the law provides that your spouse or family member can receive up to the same hourly rate as their former employment. Therefore, if your spouse had a good-paying job and left that job to take care of you, they may be entitled to receive the same payment for your attendant care.
However, the law has some limits that you need to consider:
- Your spouse cannot be compensated for more than 12 hours a day.
- The hourly rate of services cannot exceed the value of care for these services available in your community.
- If your spouse is providing help to you after hours and still keeping their job; then they may be entitled to the federal minimum wage per hour.
- If your spouse was not employed and is providing help to you, then they also may be entitled to the federal minimum wage per hour.
What types of services are compensable for attendant care?
Regular household duties that are normally provided by household members would not be compensable, as they would be gratuitous. Services like dusting, sweeping, vacuuming, doing the dishes, and laundry would be tasks that have to be done regardless of whether you are injured or not; and would not be compensable. Thus, any hours of providing ordinary household services would need to be separated from the caregiving services.
There are a few exceptions where your family members can be compensated for regular duties:
- If the injured worker is unable to do anything due to their injuries, which is rare.
- If the injured worker requires passive monitoring. If an injured worker needs Passive On-Call Attendant Care, meaning they need continuous supervision by a care provider for safety concerns, any household duties performed during that time would be included and compensable.
You need to take action.
If you suffer from a work-related disability, you may need help with activities of daily living while you are out of work. Your spouse or family member may be entitled to receive compensation for your attendant care.
Contact us at the LaBovick Law Group to see what benefits you may be entitled to. We provide free consultations where we will review the facts of your case to determine the right course for you. Call us today at (561) 625-8400 for your free evaluation.