About

A home modification is a permanent structural change required to meet an eligible worker's needs for safety, mobility, or activities of daily living. Equipment and appliances may also be considered as part of the modification.

Workers who have a job-related catastrophic injury resulting in permanent physical impairment may be eligible for a home modification. Catastrophic injuries may include:

• Severe brain injury,
• Spinal cord injury,
• Extremity amputation,
• Severe burn or crush, or
• Occupational diseases which substantially limit the worker's activities of daily living or may be terminal.

Temporary medical conditions do not qualify for this benefit.

A worker must have an open workers' compensation claim or have been determined to be permanently and totally disabled (on a pension).

If the claim has been closed and the closure is final, a written application to reopen the claim must be filed. A claim cannot be reopened solely for a home modification.

A home modification request can be made by the worker, the worker's representative or others on the worker's behalf by contacting the claim manager. For self-insured claims, contact the worker's employer or the claims management representative.

Note: For the purposes of this benefit, the term "crime victim" is interchangeable with worker.

Billing L&I

Home modification consultants and contractors must have an L&I provider account number to bill for services. To apply, do 1 of the following:

• Go to Becoming an L&I Provider site.
• Contact your local L&I office.
• Call Provider Hotline 800-848-0811.

Authorization requirements

Billing form

Use the Statement for Miscellaneous Services (F245‑072‑000) form.

Self Insured: Contact the self-insured employer or their representative directly.

Billing codes and fees

Resources for providers use

Fact sheets

• Home Modification for Workers with Catastrophic Injuries fact sheet (252-060-000).
• Questions and Answers for Contractors (Home Modification for Workers with Catastrophic Injuries) fact sheet (F252-061-000).

Forms

• Home Modification Acknowledgement of Responsibilities form (F247-003-000).
• Statement for Miscellaneous Services form (F245-072-000).

Laws (RCW) and Rules (WAC)

• RCW 50.04.355 - Annual average wage.
• RCW 51.36.020(7) - Modification to residences or motor vehicles.
• RCW 51.36.022 - Residence modification assistance.
• WAC 296-14-6200 - What is a residence modification?
• WAC 296-14-6202 - What is the residence modification benefit?
• WAC 296-14-6204 - Which workers may be eligible to receive benefits for residence modifications?
• WAC 296-14-6206 - Which residences may be eligible to be modified?
• WAC 296-14-6208 - When may the worker request residence modification benefits?
• WAC 296-14-6210 - What is the maximum amount of the residence modification benefit?
• WAC 296-14-6212 - Can the worker receive additional modification benefits for the same residence?
• WAC 296-14-6214 - Can a worker receive residence modification benefits for more than one house?
• WAC 296-14-6216 - How can a worker begin the process of requesting residence modification benefits?
• WAC 296-14-6218 - How does the department or self-insured employer determine the worker's residence for purposes of residence modification?
• WAC 296-14-6220 - What type of residence may the department or self-insured employer modify?
• WAC 296-14-6222 - What is a residence modification consultant, and how are they involved in the process of residence modification?
• WAC 296-14-6223 - Will the department pay for professional services needed to design a residence modification?
• WAC 296-14-6224 - What must the worker submit to the department in a completed request for a residence modification?
• WAC 296-14-6226 - What other information must be submitted to the department in a completed application for a residence modification?
• WAC 296-14-6228 - Who will approve or deny a request for residence modification?
• WAC 296-14-6230 - What will the supervisor consider when approving or denying a residence modification request?
• WAC 296-14-6232 - What happens if the residence modification costs exceed the maximum benefit?
• WAC 296-14-6234 - Can a worker apply the residence modification benefit to the cost of building a new residence?
• WAC 296-14-6236 - How is a worker advised that the supervisor has approved or denied the request for residence modification benefits?
• WAC 296-14-6238 - Who receives payment from the department?

Questions/Answers

Questions and answers about home modifications.

• What kind of home can be modified?
  The home may be a:

  • House,
  • Duplex,
  • Apartment,
  • Condominium,
  • Manufactured or mobile home.

  If local government allows a recreational park trailer or recreational vehicle to be used as a permanent residence, then they can be modified. Commercial coaches do not qualify for this benefit.
  
  The worker does not have to own the home, but must consider the home their permanent residence. If someone else owns the home, the worker must submit the home owner's proof of ownership and written permission before a modification is considered.
  
  The home must be structurally sound and meet state safety requirements.
• Can the benefit be applied toward the construction of a new home?
  For new-home construction, only the cost difference between the construction of a standard home (without modification) and a modified home may be considered.
  
  The modifications must be approved prior to construction. The new construction modification costs cannot exceed the statutory limits for modification approval.
• What modifications may be paid for?
  Only reasonable and necessary modifications to help maintain the worker's basic safety, mobility, and activities of daily living can be paid. Examples may include widening doorways, modifying the primary bathroom, lowering countertops, and installing ramps. The benefit may also be applied to:

  • Detached structure such as a garage, fence, walkway, and driveway.
  • Home durable medical equipment and equipment that is bolted on.
  • Air conditioners or purifiers when medically necessary.
  • Household appliances under unique circumstances.
• How much money is available to modify a home?
  Benefits can be paid up to the state's average annual wage in effect on the date a request for modification is approved. The amount is adjusted yearly and is determined by the Washington State Department of Employment Security. To find out the exact amount available, contact L&I's Therapy Services Coordinator at 360-902-4480 or Claim Manager.
  If the cost of the modification exceeds the maximum benefit, the request must be adjusted by the worker to stay within the available amount or show proof of funding to cover the additional cost.
• How many homes can be modified?
  Only 1 home can be modified.
  
  If a worker has received a permanent home modification and moves, the worker is responsible for all modifications to any new residence.
• Can a home be modified more than once?
  Yes. Additional modification for the same home may be considered if the worker has a change in medical condition or a prior modification needs to be repaired, updated, or replaced.
  
  The modification cost may not exceed the maximum benefit in effect at the time each modification request is approved.
• Can temporary modifications be authorized?
  Payment for durable medical equipment may be considered, if a catastrophically injured worker needs equipment before a permanent home modification.
• What are the responsibilities of the home modification consultant?
  The modification consultant identifies all reasonable and necessary modifications needed by the worker. The modification consultant determines if structural changes are required or if the worker's needs can be met with a reorganization of tasks and/or durable medical equipment. An example would be moving food and dishes from top cabinets to lower ones for a paraplegic rather than lowering the upper cabinets.
• Who can perform home modification consultations?
  The home modification consultant must:

  • Be a licensed nurse, occupational therapist, or physical therapist, and
  • Have training or experience in both rehabilitation of catastrophic injuries and modifying homes.
• What is included in a home modification consultation report?
  Prior to the modification of a home, the modification consultant must do an on-site assessment and submit a report. The report is used as the basis for contractor bids.
  
  The initial report must include the following:

  • Worker's name.
  • Date of injury.
  • Date of birth.
  • Claim number.
  • Who requested the consultation.
  • Diagnosis and description of physical limitations.
  • Description of home environment and impact of injury on abilities to do activities of daily living.
  • Description of home and structural factors inside and outside the home that affect worker's safety, mobility and activities of daily living
  • List of all modifications needed to meet the worker's safety, mobility and activities of daily living.
  • When indicated, provides a second list of modifications that the worker can give to contractors.
  • Recommendations with short explanations of how it will meet the worker's needs.
  • Pictures or drawings of the areas to be modified.
  • The worker's preferences.

  If a final on-site consultation report is requested, it must include:

  • A list and pictures of completed modifications.
  • A list of any modifications identified in the consultation report or construction phase that were not completed.
• Who may be involved in a home modification?
  • The worker,
  • Healthcare provider,
  • Home modification consultant.
  • Contractor and
  • L&I or self-insured employer,
• What is the role of the worker?
  Requests to have their home modified. If eligible:

  • Works with the modification consultant to identify reasonable and necessary modifications.
  • Obtains 2 bids from contractors to be submitted for consideration.
  • Signs the Home Modification Acknowledgement of Responsibilities form (F247-003-000).

  If the bid is approved:

  • Signs contract with the contractor.
  • Makes final inspection with the contractor when construction is completed and
  • Signs a letter of satisfaction so the contractor can receive final payment.
• What is the role of the healthcare provider?
  Provides medical documentation about the worker's allowed catastrophic injury.
  Provides opinion regarding worker's ability to live in the home after the modification.
• What is the role of the home modification consultant?
  • Goes to the worker's home to evaluate:
  • Safety,
  • Mobility and activities of daily living, and
  • Submits a written report with pictures.
  • If needed, assists the worker and contractor during the planning and construction phases.
  • When authorized, does a final evaluation and sends a report.
• What is the role of the contractor (licensed, bonded and registered)?
  • Prepares a detailed bid for the worker.
  • Signs the Home Modification Acknowledgement of Responsibilities form (F247-003-000).

  If the bid is approved:

  • Obtains a provider number, signs a contract with the worker and obtains all required construction permits.
  • Construction must start within 6 months of bid approval.
  • Upon completion, participates in a final inspection with the worker and obtains a letter of satisfaction to submit with final billing.

  If volunteers (including family members) perform the labor, the worker can request payment for materials, building permits, and required inspections. A bid for the costs and prior authorization of the modification is still required.
• What is the role of the insurer?
  For L&I State Fund claims and Crime Victims' Compensation:
  Receives the request for home modification and determines eligibility. If eligible:

  • Authorizes a modification consultant to do an on-site evaluation.
  • Verifies that all required information is received.
  • Notifies the parties of the decision.

  If approved:

  • Maintains contact with the worker and contractor during construction.
  • Authorizes payment once requested documentation is received.

  For self-insured claims:

  Contact the self-insured employer or their claims management representative.