By Sid Glover, Co-Founder, CEO and President of ATF Medical
Injured workers who recently experienced complex or catastrophic injuries usually need home modifications to ensure safety, mobility and independence in their homes. Also known as adaptive housing projects, these typically include door widening, ramps, lifts, and shower bars. Occasionally, the workers’ limitations call for major kitchen or bathroom remodels and room additions.
Adaptive housing projects are complicated enough when the injured worker is the homeowner. But what happens when they do not own their residence?
Approximately 36% of the US adult population rent their residences, and one in three adults between the ages of 18 and 34 live in their parents’ homes, according to U.S. Census Bureau data from 2021. An injured worker may also live in a home solely owned by a spouse, roommate or significant other.
Modifying an “Other-Owned” Home
The first step is to gain consent to the modifications from the property’s owner. Some owners try to resist home mods, but the Fair Housing Act says that a landlord cannot deny reasonable modifications to accommodate the injured person as long as the unit is restored to its pre-modified condition when the renter moves out.
The good news is the residence can be adapted; the bad news is the restoration clause. The injured worker might not move for five or 10 years, making reserves difficult to predict. Or the claim have settled. It’s best to negotiate a contract that eliminates the requirement to restore these properties.
Architectural guidelines of apartment complexes, condominium communities, and homeowner associations factor into home mods. Some will try to prohibit ramps or the reasonable, convenient placement of one. They may not want ramps, but the Fair Housing Act means they must accept ramps or another means of providing access to the injured person.
Keep in mind that the ramp, lift or other access solution cannot impede public spaces, such as sidewalks and parking lots. Working with apartment and condo complexes calls for creativity. In one case, the building had no handicapped parking space and the worker needed a ramp or some other way to get over the curb in her wheelchair. Ultimately the property manager agreed to cut out the curb to accommodate the chair.
Marriage, Divorce and Parents
Other-owner adaptive housing projects can be contentious. In one case, the injured worker wanted to discharge from a post-acute care facility, but his wife refused to approve the changes and the house was in her name alone. In cases like this, the carrier may be better off finding the worker a different home.
Separation and divorce are serious factors in adaptive housing decisions. Marriages come under considerable strain when one partner experiences a sudden and life-altering disability. The first three to five years after the injury are critical.
One study revealed the good news that 66% of patients with a traumatic brain injury remained married to the same person 10 years post injury. But the study also showed that 68% of the divorces that did occur happened within five years of the TBI. There are similar stats for patients with spinal cord injuries. Keep in mind this research was conducted with the general population. Workers’ compensation patients may face a higher risk due to the psychosocial impacts associated with the system.
Young, single injured workers often move in with their parents. In a recent claim, the parents requested an addition to their home to accommodate their son, whose injury caused him to become paraplegic. The estimate came in around $200,000. They were seeing their son in a wheelchair for life and living with them forever. But he was in his 20s and the wheelchair did not have to keep him from enjoying a full and independent life.
It’s important to educate families on the injured person’s current condition and likely future abilities. The son may find want to get a place of his own one day. Parents need to consider their own futures as well. Will they retire and want to move? What happens when they try to sell a house that has been modified for a paraplegic? Having the difficult decisions upfront will prevent problems later on.
Low-Impact Approaches
When adapting a leased or other-owned home, we should choose products that have minimal impact on the construction. Clamp-on grab bars, handrails and shower bars, along with temporary ramps and pull-tension mounted vertical poles that don’t have to be mounted are examples these.
Complex rehab and mobility equipment can eliminate the need for construction or major remodels. For example, a power chair with seat elevation or a standing chair can eliminate the need to lower kitchen cabinets. These bring additional benefits of being able to be used outside the home and preventing some medical conditions. And if the person moves, the equipment is called mobile for a reason.
It’s always a good idea for home modification and CRT specialist to collaborate on solutions for an injured worker. This becomes even more important when the injured worker is not the homeowner.
Another low-impact option is an Accessible Dwelling Unit (ADU). These are bedroom/bath units designed to accommodate wheelchairs. These dwellings roll up to the property, some to be attached to a home, others to stand alone. If the injured individual moves, the ADU can go with them. Delivered faster than an addition can be constructed, ADUs can be a smart choice for other-owned home modifications.
Phased-in Mods
While good practice for all adaptive housing programs, it’s particularly important to phase in home modifications for rentals. The first phase is making the home safe and accessible so the injured worker can discharge from the rehab facility as early as possible. Once home, the injured worker can settle in and learn what they can do and what needs to change. Injured workers adapt amazingly well.
Let’s say the initial home mod’s scope calls for lowering kitchen counters, appliances and cabinets and installing pull-outs in all of them. The idea is to make sure the injured worker can access items they need to cook. Instead of ripping up the kitchen, talk with the injured worker and family six weeks or so after they’ve been home. You could learn that they don’t cook and don’t want to! And the family solved the access problem by moving the items he used most often to the lower accessible cabinets. This happened in one case; the family was happy and the carrier saved $50,000.
In short, instead of us telling the injured worker what they need, let them tell where they are struggling. It may not be what we thought.
Simplifying the Complex
Modifying homes for seriously injured workers is complicated and made more so when the worker does not own their residence. The goal is to simplify the process by thinking through works best for this specific patient, this family and this environment and investigating the most appropriate equipment and housing modifications. This requires having CRT and adaptive housing specialists work together to collaborate to produce clinically appropriate and cost-effective solutions.
About Sid Glover
Sid Glover co-founded After the Fall, Inc. (now ATF Medical) with his partner Susan Nelson-Glover in 2001. A graduate of Ball State University, he carries RESNA’s ATP (Assistive Technology Professional) credential along with CAPS (Certified Aging in Place Specialist), C.E.A.C. (Certified Environmental access Consultant), CRTS (Certified Rehab Technology Specialist), and ECHM (Executive Certificate in Home Modification) credentials.
With a background in health and fitness, Glover started his career by selling orthopedic equipment, and mobility equipment in all payer groups. Eventually the partners refined ATF Medical’s services to align exclusively with the needs of workers’ compensation payers.
Today Glover leads a team of exceptionally caring specialists who have secured the company’s reputation as a single-source supplier of all the complex rehab and mobility equipment and home and vehicle modifications a seriously injured worker needs.
Glover prides himself on recommending and providing the most appropriate equipment for the workers’ compensation patient as well as containing costs for payers. He loves a challenge and is constantly thinking out of the box for each and every claim.
About ATF Medical
ATF Medical (After the Fall, Inc.) the premiere workers’ comp complex equipment and adaptive housing provider, supplies fully integrated mobility and accessibility solutions for workers’ compensation payers and injured workers nationally. The company specializes in complex cases and coordinates all rehabilitation and accessibility needs, including home modifications and vehicle modifications. Based in Newnan, Georgia, ATF Medical can be reached via www.atfmedical.com or by calling 877-880-4283.