Should housekeeping, lawn care, and snow removal services be paid for in Colorado?
Essential services must be medical in nature
For an essential service to be a compensable medical benefit, the requested service must be either medical in nature or incidental to obtaining such medical or nursing treatment. An essential service is “medical in nature” includes home services if reasonably needed to treat or cure and relieve the effects of the industrial injury. However, the essential services must directly treat the claimant’s physical condition and injury. It is the claimant’s burden to prove the essential services are reasonable and necessary to treat or cure and relieve the effects of the industrial injury and are to directly treat the injury.
Housekeeping, Lawn Care, and Snow Removal not medical
Services such as housekeeping, lawn care, and snow removal are not generally reasonable and necessary essential services. This is because these services are not necessary to treat or cure and relieve the claimant’s symptoms. Home essential services could be considered medically necessary if the care included bathing, changing bandages, administering medication, etc. The services could include some housekeeping; however, if the care is only to do household chores, it is not medically necessary. If a large portion of the care is to do housekeeping, the care may need to be evaluated to determine what costs should be paid by workers’ compensation and what portion of the services are related to the work injury.
Medical prescription for services
Even if a treating physician has written a prescription for the housekeeping, lawn care, and snow removal services, this does not make the services medical in nature. However, if a claimant is requesting essential services, a prescription from a treating physician is not required for a judge to find the services are medical in nature.
Housekeeping, lawn care, and snow removal are not generally considered a compensable medical benefit because these services are not medical in nature and not directly treating the claimant’s physical condition and injury.
For further questions on this topic, please contact one of our attorneys at 720-488-9586.