Reimbursement of Expenses (Universal Bodily Injury Compensation) Regulation

Reimbursement of Expenses (Universal Bodily Injury Compensation) Regulation, M.R. 40/94 The Manitoba Public Insurance Corporation Act , C.C.S.M. c. P215 Regulation 40/94 Registered February 10, 1994 bilingual version (HTML) Table of Contents Section PART 1 INTRODUCTORY PROVISIONS 1 Reimbursement is subject to Schedules 1.1 Definitions 1.2 Service provider agreements PART 2 REIMBURSEMENT OF EXPENSES 2 Definition 3 Adjustment of indemnity for part-time earner or non-earner who cares for other person 4 Adjustment of expenses of victim who cares for other person 5 Medical or paramedical care 6 Out of province care 7 Hospital care 8 Massage therapy 9 Dental care, chiropractic treatment and physiotherapy 9.1 Counselling for survivors of deceased victim 9.2 Definitions 10 Rehabilitation expenses 10.1 Leisure and recreational activities 11 Prosthesis and orthosis 12 Eyeglasses or ocular prosthesis not worn before accident 13 Contact lenses not worn before accident 14 Hairpiece not worn before accident 15 Dentures not worn before accident 16 Repair, replacement, fitting or adjustment of prosthesis or orthosis 17 Prosthesis or orthosis worn before accident 18 Cost of repair not to exceed 80% of purchase price 19 Travel and accommodation 20 Expenses beyond 100 km from victim's residence 21 Ambulance 22 Bus or train 23 Private vehicle 24 Parking and tolls while using private vehicle 25 Transportation by air 26 Emergency transportation 27 Meals 28 Accommodation away from residence 29 Travel and accomodation for person accompanying victim 30-32 Repealed 32.1 Clothing of volunteer giving emergency assistance 33 Shoes 34 Prescribed appliance, medical equipment, clothing 34.1 Clothing allowance 35 Where victim did not wear or use object before accident 36 Where victim wore or used object before accident 37 Where cost of repair does not exceed 80% of purchase price 38 Medication, dressings and other medical supplies 39 Guardian, trustee or legal counsel 40 Loss of earnings 40.1 Reimbursement of tuition fees 41 Long-distance telephone calls 42 Long-distance telephone call for medical reason 43 Reimbursement for medical reports PART 3 ENHANCED REIMBURSEMENT FOR CATASTROPHICALLY INJURED VICTIMS 43.1 Extraordinary cost defined 43.2 Consent of corporation required 43.3 Adaptation of principal residence when circumstances change 43.4 Adaptation of secondary residence 43.5 Extraordinary travel costs 43.6 Attendant care for employment 43.7 Acquisition of motor vehicle by catastrophically injured victim PART 4 COMING INTO FORCE 44 Coming into force Schedule A Repealed B Reimbursement of Expenses C Personal Care Assistance Assessment Tool D Personal Care Assistance Scoring Template PART 1 INTRODUCTORY PROVISIONS Reimbursement is subject to Schedules 1 An expense that the corporation is required under this regulation to reimburse is subject to a determination by the corporation of the amount payable in accordance with the Act, regulations under the Act, and the Schedules to this regulation. Definitions 1.1 The following definitions apply in this regulation. "Act" means The Manitoba Public Insurance Corporation Act . («  Loi  ») "clinical assistant" has the same meaning as in the College of Physicians and Surgeons of Manitoba General Regulation , Manitoba Regulation 163/2018. (« assistant médical ») "nurse practitioner" has the same meaning as in the College of Registered Nurses of Manitoba General Regulation , Manitoba Regulation 114/2017. (« infirmière praticienne ») "physician assistant" has the same meaning as in the College of Physicians and Surgeons of Manitoba General Regulation . (« auxiliaire médical ») M.R. 125/2010 ; 21/2023 Service provider agreements 1.2(1) The corporation may enter into an agreement with one or more service providers, or an agent or representative of the service providers, to establish fair and reasonable terms, including prices, on which the service providers will provide goods and services for which payment is made under the Act or this regulation. 1.2(2) In this section, "service provider" means a person who provides goods or services relating to the treatment, care or rehabilitation of persons injured in motor vehicle accidents. M.R. 71/2013 PART 2 REIMBURSEMENT OF EXPENSES PERSONAL HOME ASSISTANCE EXPENSES Definition 2(1) In this section, "personal care assistance" means assistance with an activity where (a) the activity is described in Schedule C and, in accordance with that Schedule, (i) it applies to the victim, (ii) it is appropriate for the victim's age, and (iii) the victim had the capacity to perform it at the time of the accident; and (b) the assistance (i) is provided directly to and solely for the benefit of a victim, and (ii) has been evaluated in accordance with Schedule D. (« aide personnelle ») Interpretation — section 131 of Act 2(2) For the purposes of section 131 of the Act, qualifying personal care assistance is personal home assistance. Reimbursement for personal care assistance under Schedules C and D 2(3) Subject to the maximum amount set under section 131 of the Act, the corporation shall reimburse a victim for the actual and proven expenses of personal care assistance in accordance with Schedules C and D if (a) the personal care assistance meets the minimum score prescribed in Schedule D; (b) the personal care assistance expenses are the direct result of the victim's bodily injury caused by an automobile for which compensation is provided under Part 2 of the Act; and (c) the personal care assistance expenses are not covered under The Health Services Insurance Act or any other Act. M.R. 190/2004 ADJUSTMENT OF THE INDEMNITY FOR CARE EXPENSES Adjustment of indemnity for part-time earner or non-earner who cares for other person 3 The corporation shall adjust the indemnity provided under section 132 of the Act in the following circumstances: (a) the addition of a child under 16 years of age as a resident in the victim's residence; (b) the addition of a person who is regularly incapable for any reason to hold any employment as a resident in the victim's residence; (c) the death of a person referred to in clause (a) or (b); (d) the 16th birthday of a child residing in the victim's residence unless, on that day, he or she is regularly unable for any reason to hold any employment; (e) where the person referred to in clause (b) becomes regularly able to hold employment; (f) the absence from the victim's residence of a person referred to in clause (a) or (b) for not less than 28 consecutive days, if the absence is not owing to the victim's accident; (g) the return to the victim's residence of a person referred to in clause (f) for at least 14 consecutive days. Adjustment of expenses of victim who cares for other person 4 Subject to the maximum amounts set out in subsection 134(2) of the Act, the corporation shall adjust the expenses to which a victim is entitled under section 134 of the Act in the following circumstances: (a) the addition of a child under 16 years of age as a resident in the victim's residence; (b) the addition of a person who is regularly incapable for any reason to hold any employment as a resident in the victim's residence; (c) the death of a person referred to in clause (a) or (b); (d) the 16th birthday of a child residing in the victim's residence unless, on that day, he or she is regularly incapable for any reason to hold any employment; (e) where the person referred to in clause (b) becomes regularly able to hold employment; (f) the absence from the victim's residence of a person referred to in clause (a) or (b) for not less than 28 consecutive days, if the absence is not owing to the victim's accident; (g) the return to the victim's residence of a person referred to in clause (f) for at least 14 consecutive days. MEDICAL OR PARAMEDlCAL CARE Medical or paramedical care 5 Subject to sections 6 to 9, the corporation shall pay an expense incurred by a victim, to the extent that the victim is not entitled to be reimbursed for the expense under The Health Services Insurance Act or any other Act, for the purpose of receiving medical or paramedical care in the following circumstances: (a) when care is medically required and is dispensed in the province by a physician, nurse practitioner, clinical assistant, physician assistant, paramedic, dentist, optometrist, chiropractor, physiotherapist, registered psychologist or athletic therapist, or is prescribed by a physician, nurse practitioner, clinical assistant, or physician assistant; (b) when care is medically required and dispensed outside the province by a person authorized by the law of the place in which the care is dispensed, if the cost of the care would be reimbursed under The Health Services Insurance Act if the care were dispensed in Manitoba. M.R. 125/2010 Maximum expense payable for out of province care 6 An expense payable under clause 5(b) is subject to a maximum of such amount as the corporation considers reasonable and proper for the care. Hospital care 7 The corporation shall pay expenses incurred by a victim for a private room, semi-private room or private nursing care in a hospital if it is medically necessary. Massage therapy 8 The corporation shall not pay an expense incurred by a victim for massage therapy unless the massage therapy is dispensed by a physician, chiropractor, physiotherapist, athletic therapist or nurse practitioner. M.R. 125/2010 Dental care, chiropractic treatment and physiotherapy 9 The expenses payable by the corporation for dental care, chiropractic treatment and physiotherapy provided to a victim shall be fixed by the corporation in such amount as the corporation considers reasonable and proper for the service provided. Definitions 9.1(1) In this section, "deceased victim" means a deceased victim in respect of whom death benefits are paid or payable under sections 120 to 123 of the Act; (« victime décédée ») "eligible survivor" means a person, other than a person who is a victim as defined in Part 2 of the Act, who is, in relation to a deceased victim, (a) a parent, grandparent, spouse, common-law partner, sibling, dependant or another person who can demonstrate a similarly familiar relationship to the deceased victim, or (b) a child, by blood or adoption or to whom the deceased victim stood in loco parentis at the time of the accident; (« survivant admissible ») "psychiatrist" means a psychiatrist as defined in section 1 of The Mental Health Act . (« psychiatre ») Counselling for survivors of deceased victim 9.1(2) Subject to subjection (3), the corporation shall reimburse an eligible survivor for required grief counselling services. Conditions for payment of counselling 9.1(3) For the purposes of subsection (2), (a) grief counselling services are considered to be required only if prescribed by a physician, nurse practitioner, clinical assistant, physician assistant, psychiatrist or clinical psychologist, and dispensed by a psychiatrist, clinical psychologist, registered social worker or an ordained member of the clergy; (b) the amount payable for grief counselling (i) is the actual cost of the grief counselling services, if that amount is considered reasonable by the corporation, and (ii) must not exceed $3,295; (c) the corporation may pay travel, accommodation and meal expenses incurred by an eligible survivor in obtaining grief counselling if (i) the eligible survivor must travel more than 50 km from his or her home community to attend grief counselling, and (ii) travel has been approved in advance by the corporation; and (d) the amount payable under clause (c) (i) shall be the actual cost for transportation by bus or train and the amount payable for travel by automobile, meals and accommodation under clauses (b), (c), (d) and (e) of Schedule B, and (ii) must not exceed $3,295. 9.1(4) The amounts referred to in subclauses (3)⁠(b)⁠(ii) and (d)⁠(ii) shall, on April 1 of each year, be adjusted in accordance with sections 166 and 167 of the Act as if the amounts were amounts referred to in subsection 165(3) of the Act. An adjusted amount shall apply only to eligible survivors of victims who died after the date of the adjustment. M.R. 36/2003 ; 125/2010 ; 71/2013 ; 114/2021 Definitions 9.2(1) In this section, "eligible person" means a person, other than a person who is a victim as defined in Part 2 of the Act, who is a parent, grandparent, guardian, spouse, common-law partner, fiancé, fiancée, adult child or sibling of a victim requiring critical care; (« personne admissible ») "victim requiring critical care" means a victim who is admitted to and required to remain in hospital as a result of bodily injury caused by an automobile for which compensation is provided under Part 2 of the Act and who (a) is under the age of 16, or (b) as a result of the bodily injury, (i) is in intensive care, (ii) is recommended to undergo or has undergone a surgical procedure requiring general anaesthesia or an invasive or high-risk examination, (iii) is in a life-threatening condition, or (iv) is in imminent danger of death. (« victime nécessitant des soins critiques ») General provision 9.2(2) Subject to this section, the corporation shall reimburse up to two eligible persons for expenses incurred by one or both of them in attending a victim requiring critical care if the corporation considers their attendance reasonably necessary or advisable for (a) authorizing treatment on behalf of the victim; (b) assisting the victim in deciding whether to undergo a surgical procedure requiring general anaesthesia or an invasive or high-risk examination; (c) assisting in administering treatment to the victim; or (d) assisting the victim on any other medical or compassionate grounds, at the sole discretion of the corporation. Qualifying expenses and limits 9.2(3) The expenses reimbursed under this section are limited to the actual, proven expenses (a) to a total aggregate amount not exceeding $4,470 for all eligible persons in respect of a victim requiring critical care; (b) that are incurred within 21 days from the date of the accident; (c) that are incurred for the following: (i) transportation, parking and tolls, up to the maximum amounts prescribed in sections 22 to 26 and Schedule B, (ii) accommodation, up to the maximum amounts prescribed in section 28 and Schedule B, (iii) meals, up to the maximum per person, per diem amounts prescribed in section 27 and Schedule B, (iv) extraordinary expenses for child care, as provided for in section 134 of the Act and as indexed annually under Division 9 of the Act, (v) loss of net income, as defined in Division 2 of Part 2 of the Act and the Determination of Income and Employment (Universal Bodily Injury Compensation) Regulation , Manitoba Regulation 39/94, to a maximum of 90% of any proven loss; and (d) that are not otherwise eligible for reimbursement under (i) the Act or another regulation made under the Act, (ii) any other Act, including The Health Services Insurance Act , or a similar Act in another jurisdiction, or (iii) any other policy of insurance, social assistance plan, sick leave plan, compassionate leave agreement or any other collateral source, including a gratuitous payment by an employer or a payment made by an employer under a collective bargaining agreement or a contract of employment. Annual adjustment 9.2(4) The amount payable under this section for expenses incurred in attending to a victim requiring critical care shall be adjusted on April 1 of each year in accordance with sections 166 and 167 of the Act, which apply in respect of the adjustment with necessary changes. M.R. 190/2004 ; 41/2015 ; 114/2021 REHABILITATION EXPENSES Rehabilitation expenses 10(1) Where the corporation considers it necessary or advisable for the rehabilitation of a victim, the corporation may provide the victim with any one or more of the following: (a) funds for an extraordinary cost required to adapt one or more motor vehicles for the use of the victim as a driver or passenger; (a.1) funds for an extraordinary cost required to adapt a motor vehicle for the use of a victim in employment, if the corporation is satisfied that payment of the cost will have the effect of reducing the total amount payable to the victim or on the victim's behalf under Part 2 of the Act; (b) funds for an extraordinary cost required (i) where the victim owns his or her principal residence, to alter the residence or, where alteration is not practical or feasible, to relocate the victim, (ii) where the victim does not own his or her principal residence, to relocate the victim or, where relocation is not practical or feasible, to alter the victim's residence, or (iii) to alter the plans for or construction of a residence to be built for the victim; (c) funds for an extraordinary cost required to alter the victim's primary residence, where the victim is moving in order to accommodate an approved academic or vocational rehabilitation plan, or the victim was a minor or dependant at the time of the accident who is moving from the family home; (d) reimbursement of the victim at the sole discretion of the corporation for (i) wheelchairs and accessories, (ii) mobility aides and accessories, (iii) medically required beds, equipment and accessories, (iv) specialized medical supplies, (v) communication and learning aides, (vi) specialized bath and hygiene equipment, (vii) specialized kitchen and homemaking aides, and (viii) cognitive therapy devices; (e) funds for occupational, educational or vocational rehabilitation that is consistent with the victim's occupation before the accident and his or her skills and abilities after the accident, and that could return the victim as nearly as practicable to his or her condition before the accident or improve his or her earning capacity and level of independence. Consent of corporation required 10(2) Unless the victim first obtains the consent of the corporation prior to incurring a cost under subsection (1), the corporation is not liable for paying it. Corporation may require information 10(3) Before making any payment under subsection (1), the corporation may require the victim to provide the corporation with any information that the corporation reasonably requires for the purpose of this section, and the victim must provide that information. M.R. 36/2003 ; 133/2011 LEISURE AND RECREATIONAL ACTIVITIES Leisure and recreational activities 10.1(1) When a permanently impaired victim engages in leisure or recreational activities, the corporation may reimburse (a) the extraordinary costs incurred by the victim; and (b) if the victim requires attendant care, the costs necessarily incurred on account of the attendant. Maximum reimbursement 10.1(2) The maximum amount the corporation may reimburse a victim under this section is (a) in the case of a victim who is catastrophically injured, $4,000 every two years; (b) in the case of a victim who is permanently impaired, as follows: (i) $2,000 every two years, if the victim's permanent impairment rating is 70% or greater, (ii) $1,000 every two years, if the victim's permanent impairment rating is 50% or greater but less than 70%, (iii) $500 every two years, if the victim's permanent impairment rating is 20% or greater but less than 50%, (iv) zero, in any other case. Degree of permanent impairment 10.1(3) For the purposes of this section, a victim's permanent impairment rating is as determined in accordance with the Permanent Impairments (Universal Bodily Injury Compensation) Regulation , Manitoba Regulation 41/94, excluding impairments related to scarring, musculotendinous disruptions, ligaments and cartilage. Medically appropriate activities 10.1(4) Before making a payment under this section, the corporation may require the victim to provide written confirmation from a physician, nurse practitioner, clinical assistant, physician assistant, psychiatrist or clinical psychologist that a leisure or recreational activity is medically appropriate for the victim. Extraordinary cost defined 10.1(5) In subsection (1), "extraordinary cost" means a cost attributable to the victim's injuries resulting from the accident. Annual adjustment 10.1(6) The maximum amount provided in subsection (2) shall be adjusted on April 1 of each year in accordance with sections 166 and 167 of the Act, which apply in respect of the adjustment with necessary changes. M.R. 133/2011 ; 21/2023 PROSTHESIS AND ORTHOSIS Prosthesis and orthosis 11 Subject to sections 12 to 18, the corporation shall pay any expense that the corporation considers reasonable and proper and that the victim incurs for the purchase, rental, repair, replacement, fitting or adjustment of a prosthesis or orthosis if the prosthesis or orthosis is medically required and prescribed by a physician, dentist, optometrist, chiropractor, physiotherapist, registered psychologist, athletic therapist, nurse practitioner, clinical assistant, physician assistant or occupational therapist. M.R. 125/2010 Eyeglasses or ocular prosthesis not worn before accident 12 Where a victim did not wear eyeglasses or an ocular prosthesis before the accident, the corporation shall pay any expense incurred by the victim for the purchase, fitting or adjustment of eyeglasses or an ocular prosthesis. Contact lenses not worn before accident 13 Where a victim did not wear contact lenses before the accident, the corporation shall pay any expense incurred by the victim for the purchase, fitting and adjustment of contact lenses. Hairpiece not worn before accident 14 Where a victim did not wear a hairpiece before the accident, the corporation shall pay expenses incurred by the victim for the purchase, fitting and adjustment of a hairpiece. M.R. 92/95 Dentures not worn before accident 15(1) Subject to subsection (2), where a victim did not have a denture before the accident, the corporation shall pay expenses incurred by the victim for the purchase, fitting and adjustment of a denture. Fixed prosthesis resting on implant 15(2) The corporation shall pay expenses incurred for the purchase, fitting and adjustment of a fixed prosthesis resting on an implant only where a fixed prosthesis not resting on an implant would not be medically effective. Repair, replacement, fitting or adjustment of prosthesis or orthosis 16 The corporation shall pay expenses incurred by a victim for the repair, replacement, fitting or adjustment of a prosthesis or orthosis that the victim did not wear before the accident where the expenses are incurred (a) owing to a changing condition resulting from the accident; (b) owing to ordinary usage of the prosthesis or orthosis; or (c) to enhance the performance of the prosthesis or orthosis. Prosthesis or orthosis worn before accident 17 The corporation shall pay any expenses incurred by a victim for the repair, replacement, fitting or adjustment of a prosthesis or orthosis that the victim wore before the accident but, after those expenses are paid, the corporation shall not pay any further expense incurred unless the expense relates to a change in a condition resulting from the accident. Cost of repair not to exceed 80% of purchase price 18 Notwithstanding sections 16 and 17, the corporation shall not pay an expense incurred by a victim for the repair of a prosthesis or orthosis to the extent that the cost exceeds 80% of the price that was paid for the prosthesis or orthosis. TRAVEL AND ACCOMMODATION Travel and accommodation 19 Subject to sections 20 to 29 and Schedule B, the corporation shall pay travel or accommodation expenses incurred by a victim for the purpose of receiving care. Expenses beyond 100 km from victim's residence 20(1) Where a victim incurs an expense for travel or accommodation for the purpose of receiving care at a distance of more than 100 km from the victim's residence when the care is available within 100 km of the victim's residence, the corporation shall pay only the expenses for travel or accommodation that would have been incurred by the victim if the care had been received within the 100 km. Application of subsection (1) 20(2) Subsection (1) does not apply to an expense incurred by a victim for transportation from the scene of the accident to a hospital. Ambulance 21 Where a physician, nurse practitioner, clinical assistant or physician assistant requires that a victim be transported by ambulance for the purpose of receiving care, the corporation shall pay the expense incurred by the victim for the transportation. M.R. 125/2010 Bus or train 22 The corporation shall pay an expense incurred by a victim for transportation by bus or train. Private vehicle 23 Subject to Schedule B, the corporation shall pay an expense incurred by a victim for transportation by private vehicle. M.R. 39/2006 Parking and tolls while using private vehicle 24 The corporation shall pay an expense incurred by a victim for parking or tolls if the expense is incurred while the victim is using a private vehicle for which the expense is payable by the corporation under section 23. M.R. 92/95; 39/2006 Transportation by air 25 The corporation shall pay an expense incurred by the victim for air transportation if (a) other available means of transportation are inadequate or dangerous because of travel time or road or weather conditions; or (b) air transportation is less expensive than other available means of transportation. Emergency transportation 26 The corporation shall pay an expense incurred by a victim for expenses incurred for emergency transportation when circumstances warrant its use. Meals 27(1) The corporation shall pay an expense incurred by a victim for a meal in accordance with Schedule B. Adjustment of meal allowance rates for C.P.I. 27(2) An amount payable under this section shall be adjusted on April 1 of each year. How adjustment made 27(3) The adjustment shall be made in accordance with sections 166 and 167 of the Act, with necessary changes, except (a) subsections 166(2) (determination of C.P.I. for a year) and 166(5) (rounding of adjusted amount to the nearest dollar) do not apply; (b) the consumer price index for a year for the purpose of a calculation under subsection 166(1) is the average of the "food purchased from restaurants" Consumer Price Index for Manitoba published by Statistics Canada for each of the 12 months preceding January 1 of the year; and (c) for any period for which Statistics Canada does not publish the "food purchased from restaurants" Consumer Price Index for Manitoba, the consumer price index shall be calculated using a Consumer Price Index published by Statistics Canada which in the opinion of the corporation most closely represents the consumer price index for food purchased in restaurants in Manitoba. M.R. 133/2011 ; 114/2021 Accommodation away from residence 28 The corporation shall pay an expense incurred by a victim for accommodation away from the victim's residence (a) when the distance between the place where the victim must receive care and the residence so warrants; or (b) when the victim's state of health so warrants. Travel and accomodation for person accompanying victim 29 The corporation shall pay travel and accommodation expenses covered by sections 137 (person accompanying victim) and 145 (expenses relating to medical examination) of the Act as provided in sections 19 to 28, with necessary modifications. 30 to 32 [Repealed] M.R. 36/2003 CLOTHING OF VOLUNTEER GIVING EMERGENCY ASSISTANCE Clothing of volunteer giving emergency assistance 32.1(1) The corporation shall pay an expense incurred by a person who voluntarily and without expectation of compensation renders emergency first aid assistance or other assistance to a victim for cleaning, repairing or replacing clothing damaged as a result of rendering the assistance, and for any other necessary expense incurred by the person as a result of rendering the assistance. Replacement of clothing 32.1(2) The corporation shall only pay for the replacement of clothing referred to in subsection (1) if (a) the clothing cannot be adequately repaired or cleaned; or (b) the cost of replacement of the clothing is less than the cost of repair. M.R. 36/2003 OTHER EXPENSES Shoes 33 The corporation shall pay an expense incurred for the purchase, manufacture, alteration, repair or replacement of shoes that are prescribed by a physician, nurse practitioner, clinical assistant or physician assistant. M.R. 125/2010 Prescribed appliance, medical equipment, clothing 34 Subject to sections 35 to 37 and Schedule B, the corporation shall pay an expense incurred for the purchase, rental, repair, replacement, fitting or adjustment of clothing or a medical appliance or medical equipment if the expense is incurred for a medical reason related to the accident, and on the prescription of a physician, dentist, optometrist, chiropractor, physiotherapist, registered psychologist, athletic therapist, nurse practitioner, clinical assistant or physician assistant. M.R. 125/2010 Clothing allowance 34.1(1) Subject to sections 35 and 36 and Schedule B, the corporation may, in its sole discretion, pay an annual allowance for excess wear or alteration of clothing directly resulting from an accident, to a victim who is (a) confined permanently to a wheelchair; or (b) required (i) to wear a prosthesis, or (ii) to make use of an orthotic device, including a splint, brace, cast or crutches. Annual reassessment 34.1(2) Each year, on the anniversary of the day of the accident, the corporation shall reassess whether it is necessary or advisable to continue paying to the victim the annual allowance provided in subsection (1). Annual adjustment 34.1(3) The annual allowance provided in subsection (1) shall be adjusted on April 1 of each year in accordance with sections 166 and 167 of the Act, which apply in respect of the adjustment with necessary changes. M.R. 39/2006 ; 41/2015 ; 114/2021 Where victim did not wear or use object before accident 35 Where an expense is incurred under section 34 or 34.1 for an object the victim did not wear or use before the accident, the corporation shall not pay the expense unless it is incurred (a) owing to a changing condition resulting from the accident; (b) owing to ordinary usage of the object; (c) in order to enhance the performance of the object. M.R. 39/2006 Where victim wore or used object before accident 36 Where an expense is incurred under section 34 or 34.1 for an object the victim wore or used before the accident, the corporation shall pay the expense only once, unless an expense is incurred owing to a change in a condition that results from the accident, in which case the corporation shall pay the expense. M.R. 39/2006 Where cost of repair does not exceed 80% of purchase price 37 Notwithstanding sections 35 and 36, the corporation shall not pay an expense incurred by a victim for the repair of an object referred to in section 34 to the extent that the expense exceeds 80% of the price that was paid for the object. Medication, dressings and other medical supplies 38 The corporation shall pay an expense incurred by a victim for the purchase of medication, dressings and other medical supplies required for a medical reason resulting from the accident. Guardian, trustee or legal counsel 39 The corporation shall pay an expense incurred by a victim for the appointment of a guardian, trustee or committee for the victim (a) where he or she is required by law to have a guardian, trustee or committee; and (b) where the victim does not have one at the time of the accident. Loss of earnings 40 The corporation shall pay any loss of earnings incurred by a victim in order to undergo a medical examination under section 144 of the Act. Definition 40.1(1) In this section "current studies" means current studies as defined in section 87 of the Act. Reimbursement of tuition fees 40.1(2) The corporation shall pay an expense incurred for tuition fees paid for a course (a) that is part of the current studies of a victim who is a student; and (b) for which the victim is unable to obtain credit as a result of the accident. Exception 40.1(3) A person who receives a lump sum indemnity under section 88 of the Act shall not be entitled to reimbursement of tuition fees under subsection (2). M.R. 92/95 Long-distance telephone calls 41 Expenses incurred for long-distance telephone calls made by a hospitalized victim qualify for reimbursement to a maximum amount of $50 for each 30 day period. Long-distance telephone call for medical reason 42 The corporation shall pay an expense incurred by a victim for a long-distance telephone call made by the victim to make an appointment to undergo a medical examination required under section 144 of the Act. REIMBURSEMENT OF MEDICAL ASSESSMENT FEES Reimbursement for medical reports 43(1) For the purpose of section 148 of the Act, the maximum amount the corporation will reimburse a person for the cost of a medical report is $373. Limit 43(2) A person's entitlement to reimbursement for medical reports is limited to a maximum of (a) three medical reports, each prepared by a different practitioner who examined the person, filed in support of his or her application for a review; and (b) three medical reports, each prepared by a different practitioner who examined the person, filed in support of his or her appeal. If reports of same medical practitioner are filed at review and appeal 43(3) If the cost of a medical report filed in support of an application for review is reimbursed by the corporation then no additional reimbursement is payable if the same report is filed in support of the appeal. But if a report of a practitioner is filed in support of an application for review and a different medical report by the same practitioner is filed in support of an appeal, then both reports are eligible for reimbursement under this section. Annual adjustment 43(4) The maximum amount provided in subsection (1) shall be adjusted on April 1 of each year in accordance with sections 166 and 167 of the Act, which apply in respect of the adjustment with necessary changes. M.R. 41/2015 ; 114/2021 PART 3 ENHANCED REIMBURSEMENT FOR CATASTROPHICALLY INJURED VICTIMS Extraordinary cost defined 43.1 In this Part, "extraordinary" , in relation to a cost, means a cost attributable to the victim's injuries resulting from the accident. M.R. 133/2011 Consent of corporation required 43.2(1) Unless the victim obtains the corporation's consent before incurring a cost under this Part, the corporation is not liable for paying it. Corporation may require information 43.2(2) Before making a payment under this Part, the corporation may require the victim to provide any information the corporation reasonably requires, and the victim must provide the information. M.R. 133/2011 RESIDENCE ADAPTATION Adaptation of principal residence when circumstances change 43.3 If a catastrophically injured victim is required by a change in health or family circumstances to relocate or alter his or her principal residence, the corporation may pay an extraordinary cost of the relocation or alteration. M.R. 133/2011 Adaptation of secondary residence 43.4 The corporation may provide a catastrophically injured victim with one or more of the following: (a) funds for an extraordinary cost required to alter a secondary residence owned by the victim or his or her spouse and used regularly by the victim or, if alteration is not practical or feasible, an extraordinary cost to relocate the victim to another secondary residence; (b) funds for an extraordinary cost required to alter the plans for or construction of a secondary residence to be used regularly by the victim; (c) funds for an extraordinary cost required to alter a secondary residence owned by the parents of a victim or by a parent who has sole or joint custody of the victim, if the victim is a minor who regularly uses the secondary residence; (d) funds for an extraordinary cost required to alter the principal residence of a parent of the victim, if the victim is a minor who regularly resides at the residence even if the residence is not the victim's principal residence; (e) funds for an extraordinary cost required to alter a temporary residence required by an approved academic or vocational rehabilitation plan. M.R. 133/2011 TRAVEL AND ACCOMMODATION Extraordinary travel costs 43.5 If a catastrophically injured victim engages in travel activities consistent in type and frequency with his or her pre-accident travel activities, the corporation may pay (a) the extraordinary travel and accommodation costs incurred by the victim; and (b) if the victim requires attendant care, the travel and accommodation costs necessarily incurred by the attendant. M.R. 133/2011 ADDITIONAL ATTENDANT CARE FOR EMPLOYMENT Attendant care for employment 43.6(1) The corporation may pay for attendant care required by a catastrophically injured victim to engage in employment if the corporation is satisfied that doing so will have the effect of reducing the total amount payable to the victim or on the victim's behalf under Part 2 of the Act. Additional to section 131 43.6(2) Amounts paid under this section are in addition to amounts paid under section 131 of the Act. M.R. 133/2011 MOTOR VEHICLE ACQUISITION Acquisition of motor vehicle by catastrophically injured victim 43.7(1) The corporation may provide funds to acquire a motor vehicle adapted for use by a catastrophically injured victim, if satisfied that (a) the motor vehicle is for the regular use of the victim, as driver or passenger; and (b) the motor vehicle is classified by its manufacturer as a passenger car, a passenger van with seating capacity not exceeding eight persons including the driver, or a truck with a body style of crew cab, extended cab or pickup. Maximum payment by corporation 43.7(2) Funds provided to acquire a vehicle under subsection (1) must not exceed $50,000. Annual adjustment 43.7(2.1) The maximum amount provided under subsection (2) shall be adjusted on April 1 of each year in accordance with sections 166 and 167 of the Act, which apply in respect of the adjustment with necessary changes. Replacement of vehicle 43.7(3) No more than once every five years, the corporation may provide a victim with funds to replace a vehicle for which funds were provided under subsection (1). Replacement of vehicle on total loss 43.7(4) As an exception to subsection (3), the corporation may provide funds more than once every five years if a victim's vehicle is rendered a total loss under a contract of insurance. Amount provided for replacement 43.7(5) When the corporation provides funds to replace a vehicle, the amount paid shall be the difference between the cost of the new vehicle or the maximum amount provided under subsection (2), whichever is less, and the residual value of the vehicle being replaced. Amount provided for replacement when total loss 43.7(6) When the corporation provides funds to replace a vehicle which has been rendered a total loss, the residual value of the vehicle being replaced is the actual cash value of the vehicle with proper deduction for depreciation. M.R. 133/2011 ; 21/2023 PART 4 COMING INTO FORCE Coming into force 44 This regulation comes into force on March 1, 1994. SCHEDULE A [Repealed] M.R. 92/95; 190/2004 SCHEDULE B (Sections 19, 27, 34 and 34.1) Reimbursement of Expenses The corporation shall pay the following expenses incurred by a victim, in the following amounts: (a) ambulance costs: as billed; (b) travel by automobile: 37.4 cents per km, the rate to be increased in such amount and at such interval as the corporation may, in its sole discretion, decide; (c) meals: (i) breakfast: $7.92, (ii) lunch: $11.61, (iii) dinner: $17.41, to a maximum of $36.94 per day; (d) commercial accommodation: all reasonable expenses; (e) private accommodation: $25 per day; (f) excess wear or alteration of clothing to a maximum of $1,038 per calendar year as follows: (i) where due to the use of a prosthesis or the use of an orthotic device, including a splint, brace, cast or crutches, for a period of six months or more: (A) $346 for clothing worn on the upper body (trunk and arms), (B) $692 for clothing worn on the lower body (pelvis and legs), (ii) where due to permanent confinement to a wheelchair: $1,038, (iii) where due to the use of an orthotic device, including a splint, brace, cast or crutches, for a period of less than six months: $115. M.R. 39/2006 ; 133/2011 ; 41/2015 SCHEDULE C Personal Care Assistance Assessment Tool SCHEDULE D Personal Care Assistance Scoring Template