Seriously injured workers and their families may need domiciliary care benefits.

Workers whose injuries are so serious that they require 24-hour care may receive that care from a family member.  Profoundly injured workers tend to be much happier and healthier when they live at home rather than in an assisted living facility.  However, there is a big toll on the family that takes on the care of a profoundly injured person. 

A family member who takes on 24-hour a day care of a claimant can be compensated for 8 of the 24 hours of care.  This eight hours of compensation is paid 365 days per year, and there is no compensation for overtime.  The Department of Labor and Industry (DLI) provides a maximum amount of compensation that an individual providing domiciliary care may receive.  The amount varies depending upon the part of Montana where the care is provided.  Section 39-71-1107, MCA, does not provide for respite care for the home care provider.  This means that if the family member would like a break from taking care of this person, he or she is required to pay for that assistance or find someone else willing to help.  

Domiciliary care claims can run into the hundreds of thousands of dollars.  Because so much money is at stake, insurance companies are willing to hire private investigators and subject the claimant to multiple independent medical evaluations throughout the process.  If a claimant may require domiciliary care, that claimant will almost certainly be subjected to surveillance by a private investigator.  This is particularly true of claimants who suffer a traumatic brain injury because they may look completely fine, are often able to keep a daily routine, and can occasionally leave the house.  

Insurance carriers, including the Montana State Fund will not suggest domiciliary care benefits even when it is apparent that they are needed.  You must take it upon yourself to ask whether your injured family member can qualify for these benefits.  If your family member is injured badly enough to require 24-hour per day care, you will most definitely need the help of an attorney to guide you through this very difficult process.  Please call our office if you or your family member have suffered a brain injury or other serious problem that requires help to complete daily activities.  

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