By Melissa McGarry, Director, Product Implementation, Coventry & Apricus
When a 33-year-old man was grievously injured at work, the last thing he might have expected he would need as part of his recovery was a real estate agent.
But that’s exactly what the father of two required after falling from a second-story balcony on the job and becoming a paraplegic. Following the accident, our team at Apricus was tasked with finding a new house for the man, whom we’ll call Bill, so that he could continue raising his son and daughter.
Bill’s challenges and the steps needed to help him get closer to the life he led before his injury illustrate the invaluable benefits that can arise from home modifications following workplace injuries. Bill’s situation also underscores how broad-based specialty networks that offer a range of services can meet the sometimes extraordinary needs of those who get hurt on the job.
Home modifications, which involve everything from installing railings, ramps, and high-seat toilets to widening doorways to accommodate wheelchairs, are just one aspect of the services a specialty network can deliver. Last week, we looked at some of the intricacies of providing transportation for injured workers. Both home modifications and transportation demonstrate the diversity yet indispensability of services that fall under specialty networks. Indeed, this range highlights how important it is that injured workers have access to any number of services that could prove instrumental to their recoveries.
Understanding injured workers’ needs helps solve problems
After Bill’s devastating fall from a height of about 15 feet, the landlord of the three-bedroom house Bill had been renting wouldn’t allow renovations that could have enabled him to use a wheelchair more easily at home. He would have to move. Bill’s employer agreed to purchase a house that could be modified to meet his needs. This is the type of assignment that can fall to specialty networks.
While the particulars of Bill’s case are unique, the steps taken to address his challenges shed light on the kinds of questions that can come up when undertaking home modifications. First, it’s wise to gather some high-level information to begin understanding a worker’s needs. In this case, considerations included the budget for the home purchase, the desired location of the property, and the proposed timeline. For any home modification, there are fundamentals:
- What are the injured worker’s needs for managing the activities of daily living?
- What types of modifications might allow for those needs to be met?
- If more than one adaptation might work, which would be superior given other considerations (i.e., a wheelchair ramp versus a lift)?
It’s also important to be able to draw on the right expertise. An occupational therapist often plays a critical role in helping identify the injured worker’s needs and mapping out what interventions are most likely to be successful in meeting those requirements. In Bill’s case, an occupational therapist helped the real estate agent understand what factors might make a home well-suited to modifications. The agent sifted through available properties to identify promising houses. The occupational therapist then reviewed the selected homes—sometimes initially through a video tour and sometimes in person—to determine whether the property was indeed a good candidate for a retrofit.
As with any home-modification process, seeing a house helped answer numerous questions. These included inquiries about the width of various doorways, the size of bathrooms, and, more broadly, how well Bill might be able to move from room to room and live comfortably.
Keeping the focus on individuals is key
There are so many practical considerations around home modifications that it might be easy to lose sight of the injured worker. But it’s essential that the individual’s needs and desires are taken into account. In Bill’s situation, he was concerned with finding a home within the school district in which his children were enrolled to minimize disruption to them. The team handling his case worked to find a house that was both within the proper school district and was a property Bill found desirable. After all, if he didn’t like the house, it was less likely Bill would achieve his goals of regaining as much independence as possible and providing an ideal environment in which to raise his children, ages 8 and 14.
Another aspect of keeping the focus on the injured worker involves setting expectations about how life in a modified home is likely to unfold. Changes and adaptations to a home can make it possible for an injured worker to thrive, yet it’s also likely that life will remain different for the worker than it was before the injury, at least for a time. Showing understanding about an injured worker’s emotional needs throughout the modification process can help make the process less taxing for the individual.
Even with diligent preparation, challenges can arise
Amid all the decision-making about railings, cabinetry access, and roll-in bathtubs, there will often be unexpected complications that emerge. That’s why it’s a best practice to do as much digging as possible into the injured worker’s needs before beginning a home modification. This approach can help sidestep at least some potential pitfalls.
Sometimes, of course, the challenges are beyond anyone’s control. Like in much of the U.S., the housing market where Bill lives has been red hot. Eager buyers have been snapping up homes within a few days of their listing. Acting decisively is key. In this case, that meant gathering input in short order from the real estate agent, the occupational therapist, the employer making the all-cash purchase, and from Bill himself. It also meant having a process for disseminating information. After all, it wouldn’t have made sense to show Bill a potential house that the occupational therapist hadn’t signed off on as being viable for modification.
There were other hurdles as well that offer broader lessons. Many of the existing homes for sale weren’t suitable for the alterations necessary to allow Bill to move about with relative ease. Even new construction, with the ability to allow for adaptations from the start, didn’t present a good option because waiting for a home to be built risked adding months to the process. And among new houses that were nearer completion, builders erecting spec homes declined to make changes to their standard layouts.
The difficulties that accompanied the search for Bill’s new house make clear that successful home modifications often demand adaptability borne of experience. This flexibility in problem solving can help ensure that an injured worker’s needs are best met.
The challenges that can arise with home modifications will naturally often be unique to a particular property or to an injured worker’s circumstances. Yet there are foundational principles that researchers note should guide home modifications in general, even beyond those for injured workers. These broad goals include:
- Preventing falls and improving safety
- Seeking improved function and independence
- Promoting physical health and wellbeing
Always review how well modifications are working
An essential component of a home-modification effort is evaluation. After all, if a change wasn’t effective in assisting an injured worker, the modification was a waste of time and money and, most important, a potential source of frustration for the injured worker. It makes intuitive sense that including the person on behalf of whom the interventions are being made helps drive satisfaction with the modifications themselves. Those who feel a part of the process are more likely to believe the resulting alterations enable their activities of daily living. That confidence and the resulting sense of self-sufficiency can, in turn, help drive better injury outcomes.
Relying on a network capable of executing home modifications is important because while there is great need—in large part due to an aging society—it can be difficult to identify reputable occupational therapists and other experts within a region who can determine which modifications are necessary. One study, for example, found a lack of centralized databases for occupational therapists was contributing to fewer home modifications being completed than is necessary to meet demand. Having vendors that are experienced and regularly evaluated in performing such work can help ensure changes to an injured worker’s living environment are done correctly and in a timely manner.
The needs of injured workers who require home modifications vary and can be complex. But what remains universal is the goal of improving an injured worker’s day-to-day ability to function. For Bill, success is being able to move about his new home with greater ease than in his prior house—and being able to raise his children in an environment where he can focus on being a good father.
About Melissa McGarry
Melissa McGarry has been with Coventry & Apricus for more than 10 years and oversees multiple network products including its Outcomes-based Network Program, Exclusive Provider Program, Specialty Networks, Telemedicine Networks and Auto Network. She has more than 30 years’ experience in the health care industry with deep knowledge of networks, network products, utilization management, and behavioral health. Melissa holds a B.A. in Psychology from The University of Texas at Austin and a Master’s in Educational Psychology from the University of North Texas.
Apricus is the combination of two industry-leading specialty networks offering durable medical equipment, diagnostic imaging, physical medicine, home health, transportation and translation and more for the casualty insurance market. www.apricusinc.com
Coventry & Apricus are WorkCompWire ad partners.
This is NOT a paid placement.