Home and workplace modifications

Review the claim information including the occupational therapy (OT) assessment report, if available, along with the request for home or workplace modifications. Assess whether the OT recommendations are reasonably required as a result of the compensable injury. If an OT assessment has not been completed, consider if one is needed.

Determine if previous home or workplace modifications were provided and the cumulative costs of previous modifications. This will determine the level of authority required for the proposed home or workplace modifications. 

Determine whether the need for modifications is related to the compensable injury and if the worker meets the eligibility criteria for home and/or workplace modifications. 

When the recommendations are for medical aid equipment (e.g., ergonomic equipment, etc.) and/or assistive devices that do not require modifications to the home to install, follow the 4-6 Special services and equipment procedure. 

Temporary modifications to the home or workplace may be required in order to install certain medical aids/equipment (e.g., hand/stair rails, grab bars, bidets or raised toilets, stair or porch lifts, ramps, built-in laundry pedestals, building sheds for storage of mobility devices, etc.). If these non-structural modifications are needed, follow this procedure before authorizing or arranging for delivery of the recommended equipment. 

Call the worker or employer

Call the worker to discuss the recommended home modifications or call the worker and employer to discuss workplace modifications. Explain the referrals required for the modification project. 

If the worker does not meet the eligibility criteria for home and/or workplace modifications, discuss the recommendations or explain why they are not eligible for the modification. Communicate the decision in writing. 

If the worker does meet the eligibility criteria for home and/or workplace modification, discuss the referrals required for the modification project (if applicable). 

If an occupational therapy assessment has not been completed, explain that a referralThe OT assessment (e.g., home modification, workplace modification and/or ergonomic assessment, etc.) will identify the worker's functional needs, the type of modifications required and the benefits or limitations of the modification. will be made and once the occupational therapist's recommendations are received, a referral to a contractor or consultant will be made to visit their site and determine the scope of work required.

For home modifications, confirm if the worker owns their home and ask them to submit proof of home ownership (e.g., land title, purchase agreement, property tax assessment, etc.).

If the worker is not the homeowner (e.g., either rents, leases or shares accommodations with the homeowner) explain that structural modifications cannot be completed.  Non-structural modifications (e.g., grab bars, stair lifts, exterior temporary ramps, etc.) may be considered with written agreementA written agreement is required detailing what the expectations are for the owner and what the WCB will authorize for removal and repairs, when these devices or equipment are removed.  We must have a written agreement detailing what the expectations are for the owner and what the WCB will authorize for removal and repairs, when these devices or equipment are removed.from the registered homeowner or condominium entity that outlines the permanency or equipment removal criteria for the home modification. 

For workplace modifications, confirm that the employer owns the premises and, if so, ask the employer to provide proof of ownership and written  agreement that outlines the permanency or equipment removal criteria for the workplace modification.  If the employer does not own the premises, ask them to provide written consent from the building's owner for the proposed modifications. Confirm that the workplace modifications will result in permanent accommodation.

Note: WCB provides workplace modifications (i.e. structural and/or non-structural) when the worker has permanent work restrictions and there is confirmed employment. When the worker has temporary work restrictions, non-structural aids (e.g., ergonomic chair) may be provided. Structural modifications are considered on a one-time only basis. 

Make the referral

If an OT assessment has not yet been completed, make a referral. Call the worker and/or the employer after the assessment to discuss the outcome as indicated above.

Based on the scope of the anticipated modifications and project costs, determine if a referral to the accessibility home and workplace modifications team is required. 

A case manager manages home and workplace modification projects that are anticipated to be completed within 30 days, are within Alberta and will cost less than $30,000 (e.g., grab bars, handheld shower wand, swing away hinges, chair glides, platform lifts or porch lifts, exterior ramps, threshold ramps, door handles etc.). In these circumstances, the case manager is the decision maker. They may consult with an accessibility home and workplace modification team member if they have questions or concerns with the modification (e.g., cost, time to complete the modification, etc.).  

When the project takes longer than 30 days to complete or exceeds $30, 000, the case manager collaborates with the accessibility home and workplace modification team to determine if the project should be referred to them for ongoing management.

An accessibility home and workplace modification case manager manages all other projects including:

• All out-of-province requests (including those under $30,000).
• All home and workplace modifications for triage case managers (including those under $30,000).
• All home and workplace modifications anticipated to be over $30,000 or will take over 30 days to complete.
• All grant in lieu requests being proposed in lieu of home modifications, including worker requests for reimbursement where they wish to or did hire their own contractor, or the recommendations are not to modify present home. 

The decision makerCase manager or accessibility home and workplace modification team member. completes the remaining steps in the procedure.

Send a referral for home or workplace modifications to the WCB home modifications team desk. The home modifications team desk arranges a referral to a contractor who will visit the site and determine the scope of work required based on the occupational therapist's recommendations.

The contractor provides a quotation report that includes: the scope of the work required (including drawings and photos), a breakdown of costs and an estimated timeline to complete the work. 

The decision maker reviews the quotation report and ensures all the details related to the project are included and the quote is competitive. The decision maker manages home and/or workplace modifications under $30,000 (non-structural)Examples of non-structural modifications include installing a ramp, stair lift, porch lift, hand/stair rails, grab bars, toilet, elevator, etc. .  If needed, they consult with the accessibility home and workplace modification team and/or the home modifications coordinator if there are any concerns with the scope of work required, timeline or costs (i.e., the quote is competitive or reasonable) to complete the modifications.

If the modifications quote is over $30,000 (structural)Examples of structural modifications may include widening hallways, doorways or changes that impact the foundation, floor system, perimeter outside walls, roof system or interior load bearing walls., the decision maker sends a referral to the accessibility home and workplace modifications team who reviews the contractor's report and ensures that all details related to the project are included and the quote is competitive. They also identify any concerns and collaborate with the home modifications coordinator on whether to proceed with the modifications project through the contractor or to have the project reviewed by a consultant. 

The consultant will provide a preliminary design report that outlines the scope of the work with detailed design drawings, photos and the projected costs and timeline. 

Notes:

• When the contractor or consultant accepts the referral, the home modification coordinator completes a home modification information sheet that includes details about the modification and the name of the contractor or consultant. The decision maker sends a copy to the worker. 
• The home modification coordinator may decide to accompany the consultant on site visits to the worker's home or the employer's premise.
• The contractor or consultant will contact the decision maker within three or five days of acceptance of the referral, respectively.
• Modifications for out-of-province workers follow the same referral process.

Call the worker and employer if appropriate, to discuss any non-construction related expenses. 

Additional non-construction related costs to consider may include: 

• Alternate accommodation for the worker and family on a temporary basis while the home is being modified. 
  • Consider a furnished rental suite instead of a hotel depending on the time it will take to complete the home modifications or permanent relocation. Select the most reasonable and cost-effective option(s). If the worker rents or leases the alternate accommodations, consider:
    • Costs for monthly rent and utilities for the temporary accommodation, as they will continue to pay utilities for their current home while modifications are being completed. These costs are reimbursed to the worker and may be set up monthly so that the worker is not out of pocket. 
    • Costs for packing, moving, storage and unpacking.
    • Costs that will be incurred due to early cancellation of rental or lease agreement, usually equivalent to one month's rent, subject to negotiation with the landlord.
    • Security deposit. The security deposit is returned to WCB when the worker moves out.
• If the worker must relocate as their home was not suitable for modifications and the worker owns the residence or mobile home, consider costs associated with the:
  • Sale of the worker's residence:
    • Legal and mortgage discharge fees.
    • Real estate fees, including multiple listing (MLS).
    • Moving, packing, storage fees (obtain estimates) and unpacking.
  • Move of a mobile home:
    • Early cancellation of the lot lease agreement.
    • Moving costs (obtain estimates). 

Notes:

• Secondary housing options can be limited for workers who are in a wheelchair full time or live in a rural location; therefore, an accessible hotel accommodation may be the only viable option. In this case, consider costs for a suite with a kitchen especially if a longer stay is required. 
• Meal allowance should not be required if the right accommodations are found. However, if the worker does not have a full kitchen and has difficulty making their main meal (dinner), a meal allowance may be considered. Adjustments may be made based on the worker's circumstances.
• Costs for packing, moving, storage should be paid to the worker through reimbursement. WCB should not enter into agreements with moving or storage companies as this presents a barrier when the client may need to make a claim for a damaged or lost item. 
• The rental agreement is between the worker and the landlord. 

Review the Residential/workplace modification services quotation report (C908) from the general contractor or the consultant's preliminary design report (C1315). 

Consider: 

• The scope of work required, design drawings and specifications including dated and labelled photos, a complete budget with breakdowns and travel requirements.
• The estimated project timelines including start and completion dates and supporting documents related to permits, licenses or certifications required to complete the work.
• The current condition of the residence or workplace including photos, the age and general conditions of the existing structure.
• Whether there are any issues with the property that will require correction to comply with current building code requirements or if abatement work (i.e., asbestos removal) is a possibility.

Contact the worker and contractor or consultant to discuss the proposed modifications and to reach an agreement on the work required. Provide the worker with a copy of the Quotation Report and/or Preliminary Design Report. Schedule and complete a meeting with all parties to discuss the proposed modifications and to reach a conclusion on the work that will be considered for approval. 

Note: The decision maker can expect to receive the Quotation Report within 7 business days of the contractor site visit and a Preliminary Design Report from the consultant within 14 business days of the site visit.

For home modifications, calculate the anticipated costs for the project including the estimated cost for the current modifications being considered, non-construction related costs and the costs from previously completed home modifications.

For workplace modifications, calculate the anticipated costs for the project including the estimated cost for the current modifications being considered, non-construction related costs, and the costs from previously completed workplace modifications. 

Note: Once the accumulated costs for the modification exceeds $30,000, the project is referred to the accessibility home and workplace modifications team.

Prepare a file note outlining the project plan. Include the following information: 

• A brief history of the injury, work restrictions, benefits, permanent clinical impairment (PCI), etc.
• The costs of previously approved home modifications (if the plan is for home modifications) or workplace modifications (if the plan is for workplace modifications) (refer to step 1). 
• The occupational therapist's recommendations and reason for the modification, as it relates to the worker's compensable injury and functional needs. 
• Dates of related documents on file (e.g., OT assessment, ergonomic assessment, medical consultant review, etc.).
• Description of the scope and overall costs for the home and/or workplace modification. Include any modifications for non-work-related conditions being considered. 
• The date the evidence of home ownership/business ownership and/or consent from the condominium entity was received. If the worker/employer is not the homeowner/owner of the business premises, the date written permission from homeowner/owner of the business premises was received. 
• Confirmation that written consent has been obtained from the employer for workplace modifications.
• Other non-construction costs (e.g., secondary housing, moving, storage, relocation, real estate expenses, etc.). See Step 4.  
• Details about the project's budget including the contingency plan (i.e., money put aside to cover any unforeseen costs, risks, events, or changes in scope that may affect the project's cost over the course of its life. 

If the modifications will cost less than $30,000, are not structural and will be completed within 30 days, continue to the next step. 

If the modifications will cost more than $30,000, are structural, or will be completed within 30 days, send the proposal to the home modifications coordinator to review the project including the scope of work, costs and an overall opinion on proceeding based on the information provided in the reporting. 

If the home modifications coordinator has concerns, discuss and action their recommendations. 

When the home modifications coordinator agrees to proceed with the project, send the file note to the supervisor or the appropriate approver level within 20 business days of receiving the consultant reporting.

The supervisor reviews the proposal for the home or workplace modification, decides if the project will be approved or not approved and sends the proposal to the next approval level, as appropriate. Each level of authority (i.e., supervisor, manager, director, vice president) reviews the recommendation, confirms the proposal aligns with policy and documents their decision in a file note. 

Review the supervisors (or other approvers) decision and address any concerns identified. If required, repeat the previous steps to obtain approval. 

Call the worker and/or employer (for workplace modifications) to discuss the decision to approve or not approve the modifications project. 

If the modification project is approved and under $100,000, send two copies of the authorization letter and request that the worker or employer return a signed copy.  Explain that the modification project cannot proceed until the signed agreement letter is on file. Once the signed copy from the worker and/or employer are received, send a copy to the contractor and/or consultant to review and sign. Continue to step 9.

If the modification project is approved and over $100,000, explain to the worker and/or employer that the project will be referred for tendering to obtain bids from contractors. To initiate the tendering process, continue to the next step. 

If the modification project is not approved, consider if other medical aids, equipment, assistive devices will provide support for the worker. This may include a referral for further assessments (e.g., personal care assessment). Communicate the decision in writing and end this procedure. Send an email to the contractor and/or consultant of the decision to not proceed with the modification. 

Refer the project to Contracting and Procurement Services (CAPS) to obtain bids for the project through the competitive public tendering process, in accordance with WCB procurement policy. 

Following the referral, all levels of authority must complete the bid/contract request referral form to approve the tendering process.

Once the request is approved, CAPS will initiate the bid tender process. Bids are obtained from contractors through a competitive public tendering process. Final project funding is still subject to a funding proposal with review and approval by WCB management at an appropriate level of authority.

Once the bids are received, CAPS, the consultant, the home modification coordinator and the decision maker review the information to reach an agreement on the contractor to hire for the project. The consultant will submit a report containing the bid documents, bids received, their recommendation for the most appropriate bid and a cost breakdown of the project for approval. 

When there is an increase in the construction costs, the decision maker will obtain approval from the appropriate level of authority before the project can be awarded. For example, if approval was provided for $150,000 and the favored bid came in at $175,000, approval for the increase in the project costConsulting fees are paid on a percentage of the construction costs so if these costs go up so do the consulting fees. is obtained from the appropriate level of authority. 

Call the worker and/or employer to discuss the outcome of the tendering process and the contractor selected to complete the modifications.

Notes: In rare cases, if it is not practical to modify the worker's current residence for structural or other reasons. The grant will normally be equivalent to the cost of modifying the worker’s current residence; however, the grant cannot exceed the actual costs to modify the new home (see Policy 04-07, Part II, Application 2 for additional information about these grants).  As noted above, all grants in lieu must be referred to the accessibility home and workplace modification team.

Monitor the progress of the home or workplace modifications and ensure payment of invoices until the project is completed.

The Medical Aid team reviews and processes payments for invoicing that aligns with the project plan and budget. If an invoice is not within the approved proposal, a file note is sent to the decision maker indicating the invoice exceeds the approved amount.

Review and, if appropriate, approve change requests, any unforeseen design or structural changes, or revised quotes. Consider if the additional costs can be paid within the contract price or out of the project contingency. Request approval from the appropriate level of authority, as required. 

Confirm the contractor has obtained required permits, including those applicable to any change requests. Note: The contractor is responsible for arranging all required permits, regardless of the project cost. 

Determine, communicate and document ongoing ownership of equipment and property associated with the modification. Refer to Policy 04-07, Part II, Application 2, Question 9; Mobility and step 5 in the 7-9 Tools and equipment procedure. 

For workplace modifications where the worker is still employed with the employer after one year, consider transferring the ownership and maintenance responsibility of the equipment to the employer. 

If the employment has or is likely to end, WCB retains ownership of the equipment. In these cases, WCB may have the equipment returned and made available for use by the same or a different worker in a future employment opportunity.

Once the modifications are complete, communicate the completion of the project in writing to the worker (home modification) or employer (workplace modification). Include the following information:

• The approved modifications and basis.
• The ongoing responsibilities of all parties. See step 9 of Policy 04-07, Part II-Mobility.
• Details about ownership and maintenance of the WCB-owned equipment (e.g., lifts, temporary ramps, etc.) required for the home modification.
• The employer's responsibility for maintenance of the WCB-owned equipment (e.g., lifts, temporary ramps, etc.) required for the workplace modifications.
• Review and appeal information.

Review the worker's eligibility for allowances (i.e., personal care allowance, home maintenance allowance level 1 and 2) as the worker's level of care may have changed following completion of the modifications.  

Contact the contractor to discuss any issues that need to be addressed. 

The contractor or consultant will conduct a warranty follow-up inspection to ensure any problems are resolved within the 12-month warranty period. The warranty inspection report will be sent to the decision maker, including the warranty work to be completed by the contractor(s).

Note: Any issues or concerns regarding the service provided by the contractor or consultant should be referred to the health care consultant for the residential and workplace modifications contract.