Support for Personal Independence (POL-82)

Chapter:
CLAIMS

Subject:
SUPPORT FOR PERSONAL INDEPENDENCE

Effective Date:
January 24, 2002

Last Updated On:
May 14, 2026

---

PURPOSE STATEMENT

The purpose of the policy is to explain how the Workers Compensation Board (WCB) supports eligible workers with allowances for personal care, independent living and respite care.

---

REFERENCE

Workers Compensation Act, R.S.P.E.I. 1988, c W-7.1, Section 18

Workers Compensation Board Policy, POL-92, Health Care Benefits

Workers Compensation Board Policy, POL-172, Allowance and Reimbursement Rate Schedule 

---

DEFINITION

In this policy:

“Impairment” means a medically measurable, permanent 

(i) loss of physiological function, anatomical function or anatomical structure, or

(ii) abnormality of psychological function, physiological function, anatomical function or anatomical structure. 

“Level of dependence” means an accepted objective measurement of a worker’s functional ability to independently complete activities of daily living and instrumental activities of daily living. 

---

POLICY

1. As a result of a workplace injury, a worker may require assistance to maintain a level of personal independence that enables them to remain in their own home. 
2. If a workplace injury has long-term impacts on a worker’s ability to perform activities related to personal independence, they may be eligible for: 
   

   • Personal Care Allowance (PCA) - to obtain services to assist with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs): 

     ADLs include self-care, toileting, feeding, bathing, dressing, personal hygiene, ambulation, and transfers. 

     IADLs include food preparation, housekeeping, shopping, laundry, medication management, financial management, and community activities.

   • Independent Living Allowance (ILA) - to obtain services to assist with home maintenance and quality of life, such as snow removal, grass cutting, wood piling, interior house cleaning, maintenance fees, minor home repairs, social and recreational activities, fitness and communications.
   • Respite Care Allowance (RCA) - to provide rest periods for a worker’s full time informal caregiver. 

Eligibility Criteria

3. To be eligible for any of the above-mentioned allowances, all of the following criteria must be met:

   • The worker has a whole person impairment of 10% or greater, based on the 6th edition of the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, as a result of the work-related injury.

   • Objective medical information supports the need for support for personal independence as a result of a work-related injury.

Specific eligibility criteria for each of the allowances are explained in the following sections.

4. Workers who do not meet the 10% whole person impairment criteria may be considered based on the severity of the injury and objective medical information.

5. For workers who were supported under this policy prior to September 1, 2021, including those who receive a pension or were assessed with an impairment prior to 1995, entitlement to each of the allowances will be determined on a case-by-case basis, depending on the severity of the injury and the worker’s functional abilities. 

Personal Care Allowance

6. To be eligible for the PCA, objective medical information must support the need for personal care services.

7. A needs assessment may be required to assess:
   
   • The worker’s functional abilities.
   • The worker’s immediate and long-term needs.
   • The type and extent of service that is required to meet those needs.

Payment of Allowance

8. If the WCB determines that a worker requires personal care services, the WCB will provide a monthly allowance based on the worker’s level of dependence.

   

9. The PCA is payable directly to the worker who is responsible for obtaining personal care services and will continue for as long as the worker meets the eligibility criteria. Receipts are not required. 

Independent Living Allowance

ILA Eligibility

10. To be eligible for the ILA, objective medical information must demonstrate physical, psychological or functional limitations that prevent a worker from performing activities associated with independent living.

Payment of Allowance

11. The annual ILA is payable directly to the worker, at the rate set out in WCB Policy, POL-172, Allowance and Reimbursement Rate Schedule, and will continue for as long as they meet the eligibility criteria. The worker is responsible for obtaining services and receipts are not required. 

Respite Care Allowance

RCA Eligibility

12. To be eligible for the RCA, objective medical information must support the need for constant supervision to remain in the home as a result of the work-related injury. The supervision is normally provided by an informal care giver, such as a family member or friend.

Payment of Allowance

13. The annual RCA, at the rate set out in WCB Policy, POL-172, Allowance and Reimbursement Rate Schedule, is payable directly to the worker, who is responsible for obtaining respite services. Receipts are not required.

Costs for Professional Health Care Services

14. These allowances do not replace services of professional health care providers, such as a nurse or occupational therapist. WCB will continue to pay for required health care services in accordance with Workers Compensation Board (WCB) policy, POL‐92, Health Care Benefits.

Exceptional Circumstances

15. There may be exceptional circumstances where additional services are required to perform activities related to personal independence and promote quality of life and independent living. The WCB will consider these circumstances on a case-by-case basis, based upon objective medical evidence and a needs-based assessment.

Temporary Allowances 

16. If a worker does not have an impairment, but their injury has resulted in a significant temporary need for support, the WCB may approve the allowances on a temporary basis, at the rate set out in WCB Policy, POL-172, Allowance and Reimbursement Rate Schedule.

17. Eligibility on a temporary basis is based on the objective medical information, the severity of the injury, and the worker’s physical, psychological or functional limitations. 

---

HISTORY

Board of Directors Approval Date: January 24, 2002