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Injured_IL_Worker

Illinois Work Comp Medical Insurer/Expenses to Cover Service Dogs?

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I severely injured my back and after a ruling I am on Permanent Total Disability for life, the case has not settled, and the medical is open and still being paid by the insurer.  My doctor just wrote a letter for a Service Dog to be trained to perform three tasks, bracing, retrieving, and carrying.  I presume this is covered as there are probably injured workers who became blind and needed a seeing eye dog, as their service dog.  However, the only case I was able to find online is one in Arkansas St. Paul Fire & Marine v. Stonesifer Court of Appeals of Arkansas, Division Four 1998 Ark. App Lexis 264; 1998 WL 171076 that held the insurer responsible for the service dog as a medical expense as the result of the injury sustained while at work for the employer, as well as ALL the care and maintenance of the dog while the injured worker returned to college as some sort of vocational rehabilitation. 

 

Therefore, I am trying to track down or locate any instances in Illinois or other states that would support my case at hand.  If anyone has an example or case in which an insurer paid for a service dog and ongoing care and maintenance I would appreciate it, as a young person with a permanent disability, I will likely need a total of 4-5 service dogs in my lifetime (assuming service dogs are placed at age 2 and work until age 10-12 depending on life expectancy of the breed of the service dog).  I know service dogs are a qualified medical expense under the IRS for medical deductions (see below), but if there is no case on point, perhaps there is other information that supports service dogs as a qualified medical expense.

 

IRS 2017 publication 502 -"Guide Dog or Other Service Animal - You can include in medical expenses the costs of buying, training, and maintaining a guide dog or other service animal to assist a visually impaired or hearing disabled person, or a person with other physical disabilities. In general, this includes any costs, such as food, grooming, and veterinary care, incurred in maintaining the health and vitality of the service animal so that it may perform its duties."
 
The goal of asking for your help is to provide as much possible information in support before submitting the claim and expenses to the WC carrier so they will agree to it, and not challenge the expenses.

 

Thanks,

Injured IL Worker

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Only other case I have found thus far is Village of Southampton, 2010 NY Wrk. Comp Lexis 6380 held that claimant with permanently totally disabled that the service dog is medically necessary, and carrier is liable to reimburse claimant for the expenses related to the service dog.  Reasoning that the entirety of Workers' Compensation Law is to be liberally construed to accomplish the economic and humanitarian goals of the act.

 

Also, the VA defines service dogs under 38 C.F.R. Section 17.148 and the VA will provide an insurance policy for the service dog, which includes the premiums, co-payments, and deductibles, as well as hardware needed for the service dog to perform its tasks (harness, leash, brace) including necessary travel expenses.

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Retired in VA- that is really insulting!

 

It is clear that if you read the post, that I am asking for help in identifying any cases, legal precedent or positions that will support my claim. I found two cases but from different jurisdictions-more than any help the “experts” provided to the post from the woman in Florida! With all the legal “experts” on here one would presume that those “experts” had prior case experience with this matter or more knowledge on running specific legal queeries that I might not have tried or thought of. 

 

The entire purpose of virtual online communities is to help others and share knowledge and information. 

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13 hours ago, Injured_IL_Worker said:

My doctor just wrote a letter for a Service Dog to be trained to perform three tasks, bracing, retrieving, and carrying. 

 

What did the WC claim rep say when you presented that letter and asked for the animal?

 

If you haven't asked, I suggest you do so and then come back with the answer.

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I have not any good experience with the the employer being self-insured and the outside firm they hired to manage the medical.  Often times just getting a prescription approved and filled is a time consuming fight, even though it is the same medication.  The real world of being an injured worker is that WC insurance companies do not want to part with any money for even legitimate expenses.  The WC industry and field is very toxic, especially in Illinois.  Therefore, I am anticipating another lengthy dispute. 

 

Additionally, I am hoping to find more supporting documentation, so that I know everything I can submit as a related expense upfront and not piece-meal.  Given my life expectancy and the number of service dogs I will need, I want to have my ducks in a row so to speak.  Given the limited information from my novice searches at the local library, and not finding anything on internet searches, I decided to reach out to this forum for counsel/guidance/assistance.  Thank you in advance for any brainstorming ideas that might help.

 

 

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Wouldn't it make more sense to see what kind of response you get when you submit the letter to your claim representative before you get yourself all bent out of shape looking for cases that may or may not have any relation to your situation?

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