Prostheses, Orthoses and Assistive Devices Policy 25-007 | Effective Date: July 14, 2020

Purpose

The purpose of this policy is to:

• Provide direction to staff for authorizing prostheses, orthoses, and assistive devices; and
• Communicate WorkSafeNB’s responsibility for providing prostheses, orthoses, and assistive devices that are medically effective. 

Scope

This policy applies to injured workers requiring prostheses, orthoses or assistive devices:

• For the treatment of a compensable injury; or
• To replace a device damaged as a result of a compensable injury.

Statements

Under the authority of subsection 41(1) of the WC Act, WorkSafeNB may provide medical aid that it considers necessary as a result of a worker’s work-related injury.

Using this authority, WorkSafeNB may approve prostheses, orthoses and assistive devices that directly improve functioning for return to work or activities of daily living. On a more limited basis, WorkSafeNB may provide a maximum of one device per claim that indirectly supports an injured worker’s rehabilitative goal by improving function through social or recreational activities.

WorkSafeNB approves prostheses, orthoses and assistive devices, that either directly or indirectly improve functioning, only if they are medically effective in the treatment or ongoing care of the compensable injury.

WorkSafeNB may repair or replace a worker’s pre-accident prosthesis, orthosis, or assistive device, one time only, when it is damaged during a compensable workplace injury. This repair or replacement is to a similar type and quality as the pre-accident device and the replacement must be prescribed.

Interpretation

1. Medically effective devices are ones that:

• Are prescribed by a physician or an approved healthcare provider;
• Improve functioning;
• Contribute to rehabilitative goals;
• Minimize the risk or aggravation of an injury; and
• Are appropriate given the physical characteristics of the injured worker. 

2. Before providing prostheses, orthoses or assistive devices WorkSafeNB requires that a needs assessment be completed by an approved healthcare provider with the expertise to determine:

• The injured workers' functional capacities;
• The injured worker's immediate and long term treatment needs; and
• Which prostheses, orthoses and sufficient to meet those needs.

3. WorkSafeNB determines if devices indirectly support the rehabilitative goal through social and recreational activities by considering whether the injured worker;

• Participated in a social or recreational activity before the accident and wants to resume this activity or;
• Can no longer participate in a pre-accident activity and wants to pursue a new social or recreational activity. 

4. Following approval, WorkSafeNB will reimburse prostheses, orthoses or assistive devices. Receipts are required. 
   
   
5. All components must be pre-approved. Components in excess of what reasonably meets the need, or that add significant cost without adding function are not generally approved. 
6. WorkSafeNB may approve assistive devices that require installation in the injured worker's home. When this occurs WorkSafeNB will pay the cost of installation. 
7. WorkSafeNB may approve assistive devices that require structural changes for workers who have severe long-term functional limitations. These structural changes are managed under Policy 21-403 Home Modifications to Assist with Functional Access. 
8. Injured workers are responsible for the day-to-day care of their prostheses, orthoses and assistive devices. WorkSafeNB pays for repair or replacement of devices over time due to normal wear and tear, changes in the physical condition of the injured worker and fit of the device, or damage from accidental causes. WorkSafeNB may refuse to pay for repair or replacement of a device if there is evidence that the wearer or user has wilfully damaged or destroyed it.