Opinion ID: 1867704
Heading Depth: 1
Heading Rank: 11

Heading: Medically-Necessary Housing

Text: Finally, Dennis argues that the trial court erred in holding that the workers' compensation statute does not require an employer to cover the cost of wheelchair-accessible housing. Erin Truckways argues that the trial court interpreted the statute correctly. The Workers' Compensation Law requires that employers furnish certain medical necessities to injured employees, providing in pertinent part: The employer or the employer's agent shall furnish free of charge to the employee such medical and surgical treatment, medicine, medical and surgical supplies, crutches, artificial members, and other apparatus, including prescription eyeglasses and eye wear, such nursing services or psychological services as ordered by the attending physician and hospitalization, including such dental work made reasonably necessary by accident as defined in this chapter, as may be reasonably required.... Tenn.Code Ann. § 50-6-204(a)(1) (2005). Dennis argues that because the Workers' Compensation Law is to be construed in favor of employees, we should broadly interpret other apparatus to include housing. Erin Truckways argues, and the trial court agreed, that such an interpretation is not supported by the statute. Although it is true that the Workers' Compensation Law is remedial in nature and is to be given a liberal and equitable construction in favor of workers, Long v. Mid-Tennessee Ford Truck Sales, Inc., 160 S.W.3d 504, 510 (Tenn. 2005), the language of the statute simply cannot sustain the analytical leap necessary to construe housing as medical apparatus. The statute includes as examples of medical apparatus such items as crutches, artificial members and prescription eyeglasses and eye wear. The statute contemplates specialized accessories and aid particularly necessary to an injured employee. It does not contemplate basic necessities of life, such as housing. In Wilhelm v. Kern's, Inc., 713 S.W.2d 67 (Tenn.1986), this Court ordered the employer to pay $1200 per month to cover the cost of housing in a halfway house where the employee had suffered a work-related mental illness. The $1200 included room, board, laundry, and supervision of the employee. The Court concluded that, because the employee was schizophrenic and his doctor had testified that it was medically necessary for him to live in a supervised environment, the cost of the halfway house was a permissible nursing service[] under the statute. Id. at 69. The Court also relied on the doctor's testimony that, in his opinion, the entire $1200 monthly fee was a medical expense because it was needed for [the employee's] proper psychiatric care and treatment. Id.; see also Squeo v. Comfort Control Corp., 99 N.J. 588, 494 A.2d 313, 322 (1985) (housing for quadriplegic employee covered where employee required extensive nursing care and suffered from severe mental depression resulting in numerous suicide attempts). In Wilhelm , unlike in this case, the evidence showed that the employee required specialized, continuous nursing supervision because of his psychiatric condition. The physician testified that the employee required institutionalization for his schizophrenic condition. Because the statute states that nursing services are covered, it was within the contemplation of the statute that the expense of the halfway housewhich was essentially placement in a supervised nursing facilitywas covered. In this case, the evidence shows that Dennis does not require continuous care and supervision. Rather, the evidence shows that he is capable of a great deal of independence and could be even more independent with the addition of modifications to make his home wheelchair-accessible. The purpose of workers' compensation is to replace lost wages. See, e.g., Van Hooser v. Mueller Co., 741 S.W.2d 329, 330 (Tenn.1987). From that compensation, it is contemplated that an injured employee will purchase the necessities of life such as food and shelter. Compensation rates are set with the assumption that the payments will be used by injured employees to cover such ordinary and necessary expenses. Requiring an employer to pay the full cost of specialized housing would be an unintended windfall for the injured employee because it would relieve that employee of the entire cost of housinga cost which the statute contemplates he will be paying with the wage-replacement he receives in the form of compensation benefits. This does not mean, however, that the employer has no responsibility under the Workers' Compensation Law to supply the modifications necessary to make housing wheelchair-accessible to an injured employee confined to a wheelchair. It is undisputed that wheelchair-accessible housing is medically necessary for Dennis. Dr. Simon testified that accessible housing was medically necessary for both Dennis' physical and psychological health. Unlike the entire cost of housing itself, in our view, modifications such as ramps, grab bars, widened doorways, and accessible cabinets and appliances are within the statute's definition of apparatus when such modifications are found to be medically necessary. If it is possible to modify the injured employee's existing home, then the employer shall bear the cost of all modifications deemed medically necessary. The proof at trial appeared to show that Dennis' mother's house cannot be modified to accommodate Dennis' wheelchair. We therefore remand to the trial court to act as a Master to determine two other alternatives: 1) the availability and cost of wheelchair-accessible housing for Dennis only; and 2) the availability and cost of non-accessible housing capable of modification, and the cost of modification to make such housing wheelchair-accessible. We reserve judgment on the question of whether the statutory phrase other apparatus as used in Tennessee Code Annotated section 50-6-204(a)(1), may be construed to require the employer to pay for any of these alternatives until the trial court makes its findings of fact. The trial court shall hold a hearing, make findings, and report to this Court within 90 days.