Case Summary : Decision-Making Process

Personal care allowance

The worker contacted the Commission through his son to complain about a reduction of his Personal Care Allowance (PCA). The worker, now 80, had a workplace spinal cord injury in 1968 that left him paraplegic. His 74-year-old spouse had been his caregiver for 38 years. The worker received a PCA to cover the cost of the care provided to him in his home.

The worker believed his PCA was reduced because of the installation of an intercom security device, which the WSIB recommended. The worker understood that the WSIB paid for the service. He then learned that his PCA was reduced substantially to cover the cost of the device. This was the first time the worker’s PCA had been reduced. Previously, the PCA was increased as his condition changed.

The worker’s son told the Commission his parents were not happy with the service and had asked for its removal. The WSIB was reluctant, and the manager asked the worker to sign a letter confirming that he was refusing this safety device. The worker was feeling pressured and worried about the consequences of signing, or not signing, the letter.

The son also expressed concern about the length of time it took to get his father’s PCA reviewed and implemented. He said it took a year from the first occupational therapist (OT) review in 2005 until the WSIB sent the nurse case manager and OT to see his father in 2006.

A Commission specialist met with two directors to review a number of process issues. The WSIB agreed to do a further review of the worker’s PCA based on information from both home visits as well as WSIB past practice. After the review, the worker received a new decision letter detailing the changes to each area of his PCA. In addition, he received an apology for the delay in reviewing and implementing changes to the PCA. The WSIB also agreed to remove the security device and to adjust his PCA accordingly.

The directors said they would make sure staff are reminded to communicate clearly with workers about the effect of such services on PCA benefits. The decision letters were revised to include details of any changes and reasons for the changes.

(October 2006)