Page 9 - 1 One Simple Question

One Simple Question - Four Complex Answers

The Home Modification Survey

Part 3: Obtaining an accurate scope of work

The survey was one simple question; What is the most challenging part of the home

modification process? The second most frequent answer: Obtaining an accurate scope of work.

An accurate scope of work is the foundation by which a successful home modification project is
completed. When the scope is accurate, the contractor has clear instructions, the estimate is
more likely to be reasonable, and the results are in line with the intended outcomes. When the
scope is undefined, the contractor has no clarity, the pricing reflects the unrestricted bias of

personal opinion, and the results fall out of line with the intended outcomes.

To have an accurate scope you first need to know what one is, and then, you need to know how
to develop one.

In workers’ compensation, home modifications are considered a medical benefit, and therefore
must be considered “medically necessary”. The medical necessity definition is a bit vague, but

most definitions have three similarities. For something to be medically necessary it must be; 1.
Related to the compensable, work related injury 2. It must be considered a commonly accepted
course of treatment for the injury and 3. It shouldn’t be provided solely on the convenience, or

desire of the injured worker or their family.

Something that is medically necessary, is directly related the physical injury, requires medical
intervention, and it has a physical or medically related outcome. However, the vast majority of

home modifications are not a medical treatment, not directed toward a physical injury, and there
is not a medical or physically related outcome. The reality is that home modifications are seldom,
truly, medically necessary.

When it comes to home modifications, the frame of reference is based more on functional
outcomes than medical outcomes. Therefore, home modifications are more accurately defined as

being functionally necessary. For home modifications to be considered necessary, functionally
necessary, they should be; 1. Related to the functional loss resulting from the compensable, work

related injury 2. Must be consistent with common construction practices, 3. Should not be based

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