Caregiving is often performed by women and is considered women's work. It is also undervalued and unpaid. The way automobile insurers determine how care providers are (or are not) paid illustrates and perpetuates this problem.
Attendant care benefits may be available to those who have sustained injuries in a car accident, under the Statutory Accident Benefits Schedule.1 Attendant care may include tasks such as assistance with mobility and transfers; assistance with toileting and bathing; dispensing of medications; ensuring safety; changing linens; meal preparation and feeding; grooming; and mental health supervision and support.
Attendant care benefits can be payable to professionals, such as Personal Support Workers (PSWs) but non-professionals, such as family members, only receive compensation if they lose income from another source.
For professionals providing attendant care, the vast majority of whom are women,2 the maximum that will be paid for routine personal care is $14.90 per hour or for basic supervisory functions is $14.00 per hour. These hourly rates include all administration costs, overhead, and related costs, fees, expenses, charges, and surcharges. 3 As of October 1, 2021, the minimum wage in Ontario is $14.35 per hour. Accordingly, given that many providers work through agencies or care companies, the amount that the care provider receives for her work likely does not meet the current provincial minimum wage.
The circumstances are most bleak for non-professional providers. For a non-professional provider, she will only be paid a maximum of the amount of the economic loss sustained by her, "during the period while, and as a direct result of, providing the attendant care."4 Unfortunately, the governing Regulation does not define economic loss. However, the following are examples of economic loss that have arisen out of the case law:
- A leave of absence from, or a termination of, employment;
- A reduction in paid work hours;
- A specific job offer foregone; and,
- The acceptance of an offer for part-time employment, rather than full-time employment.
Not surprisingly, most non-professional attendant care providers are women, as women constitute the majority of stay-at-home parents and spouses. If a stay-at-home mom has not incurred an economic loss while providing care to a family member, she is not paid for her services. It does not matter if she is pulled away from other caregiving tasks, home maintenance tasks, meal preparation, and volunteer endeavors, or if she delays entry into the paid workforce on a general basis. And, for women who work outside of the home, her attendant care services will remain unpaid if she does not lose income from her "day job".
The insurer approach to payment of attendant care benefits, both for professional and non-professional providers, perpetuates the idea that work traditionally associated with women or women's time more generally is not valuable and not worth valuing. In addition, the added burden on women in this scheme may mean forgone paid work, changes in family structures, and changes in personal relationships between those who care and those who are cared for and about.
1 Section 19, Statutory Accident Benefits Schedule, O Reg 34/10
2 The Personal Support Worker profession remains overwhelmingly female. According to Canadian Women's Health Network (CAHN), more than 90% of PSW's are female.
4 Subsection 19(7), Statutory Accident Benefits Schedule, O Reg 34/10
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