W.C. No. 3-804-791Industrial Claim Appeals Office.
December 30, 1997
FINAL ORDER
The pro se claimant seeks review of a final order of Administrative Law Judge Stuber (ALJ), insofar as it denied her claim for housekeeping expenses. We affirm.
The claimant sought an order requiring the respondents to pay for housekeeping services. However, the ALJ found that the claimant’s treating physician, Dr. Hall, testified that he has never prescribed home health care for the claimant, and believes that she is capable of performing most activities of daily living. The ALJ further found that an examining physician, Dr. Polanco, opined that the claimant does not require home health care. Finally, a witness familiar with the claimant’s daily activities testified that she performs routine activities around her home, though she is unable to perform heavy work.
Under these circumstances, the ALJ found that the claimant failed to prove entitlement to “home health care.” The ALJ stated that, although the claimant may need some assistance with heavier household chores, such assistance does not rise to the level of a compensable medical benefit under the circumstances of this case. The ALJ also found that the mere fact that a doctor prescribed assistance in the past did not prove that such assistance is needed at the “present time.”
On review, the claimant contends the ALJ erred in denying her request for “home care for the purposes of cleaning” her house. The claimant argues that a clean home is necessary to preservation of her health, and that the respondent voluntarily provided such services in the past. We are not persuaded.
“Housecleaning services” do not constitute a compensable medical benefit unless the evidence establishes that they are necessary to treat the claimant’s physical condition, as in the case of nursing care, or are incident to the provision of medically necessary attendant care services. Country Squire Kennels v. Tarshis, 899 P.2d 362 (Colo.App. 1995); Valdez v. Gas Stop, 857 P.2d 544 (Colo.App. 1993). In determining whether the claimant met the test for compensability of housekeeping services, we must uphold the ALJ’s findings of fact if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 1997.
Here, the claimant does not contend, nor does the record establish, that housekeeping services are medically necessary to treat her condition. Dr. Hall testified that, although the claimant may need assistance in performing “heavier activities . . . a couple of hours a day, two days a week,” she does not need home health care services. (Tr. pp. 24, 28). Further, Dr. Polanco confirmed that the claimant does not need such services.
Under these circumstances, there is substantial evidence to support the ALJ’s denial of the claim for housekeeping services. Further, as the ALJ concluded, the mere fact that such services were necessary in the past does not require a finding that they are presently reasonable and necessary.
IT IS THEREFORE ORDERED that the ALJ’s order dated May 22, 1997, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
______________________________ David Cain
______________________________ Bill Whitacre
NOTICE
This Order is final unless an action to modify or vacate the Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, Colorado 80203, by filing a petition to review with the court, with service of a copy of the petition upon the Industrial Claim Appeals Office and all other parties, within twenty (20) days after the date the Order was mailed, pursuant to §§ 8-43-301(10) and 307, C. R. S. 1997.
Copies of this decision were mailed December 30, 1997 to the following parties:
Jeanne A. Roberson, 3985 Spaatz, Monument, CO 80132
Colorado Compensation Insurance Authority, Attn: Mike Steiner, Esq. — Interagency Mail
Bruce B. McCrea, Esq., 1777 S. Harrison St., #1110, Denver, CO 80210 (For Respondents)
By: __________________________