Tag Archives: reimbursement

The High Price of Gas – Mileage Reimbursement for Injured Workers

     Injured workers who are are dependent on time loss compensation payments of only 60-75% of their wages unfortunately are well used to the enormous financial losses and constraints this wage loss puts on their family budgets.  With budget cuts being made by the Department of Labor & Industries which place additional burdens on workers by reducing reimbursements for the additional costs incurred as a result of an injury, it is important to be aware of what you can be reimbursed for, and what some relatively new regulations do not cover.  The current mileage reimbursement rate is now 56.5 cents per mile.

When money is tight, making sure you receive everything you are entitled to under your claim is important!

     Injured workers are always entitled to receive travel and/or wage reimbursement if they are asked to attend an IME (Independent Medical Exam).  However, we have noted that more recently both the Department and self-insured employers are failing to provide workers with the form necessary to be reimbursed gas mileage for what are often not insignificant distances.   Many workers are unaware they can have their wages reimbursed as well if they miss time from work.  The form can be found online here.  When self-insured employers do not provide our clients with a reimbursement form when sending out IME notices, we will send out the Department’s standard form.

     More difficult to decipher are the rules allowing for travel reimbursement for medical treatment or vocational services.  A different form must be filed to obtain reimbursement for these expenses.  At Causey Law Firm, we insure that our clients are reimbursed for travel for vocational meetings which take place in our office.  Parking is expensive in Seattle, and that cost can be reimbursed to you directly.  Some law firms charge a fee on travel reimbursement expenses, but we do not.

     While injured workers have the right to treat with their own preferred provider, travel reimbursement is only paid for regular treatment visits if there is no adequate treatment provider within 15 miles of their home AND if the claims manager has pre-authorized the travel.  Travel reimbursement is now limited for regular medical treatment visits by the so-called “15 mile rule”.  Thus, if your pre-authorized provider is 30 miles from your home, reimbursement will only be provided for the last 15 miles each way of that trip.  As with medical appointments, regular visits to meet with a vocational counselor are only covered after that 15 mile threshold has been reached.  If you are approved for a formal vocational retraining plan, however, mileage may be fully reimbursable through your plan with necessary signatures and paperwork submitted through a vocational rehabilitation counselor.

      Many workers are unaware of their right to apply for reimbursements, which can be submitted to the Department for a period up to one year of the date of travel.  The Department’s general guidelines can be seen here.  When money is tight, making sure you receive everything you are entitled to under your claim is important!

 Photo credit: Eric Fischer / Foter / CC BY

Medical Bills After an On-The-Job Injury – Do I Have to Pay Them? (PART 2)

Last week we shared a post about dealing with medical bills after an on-the-job injury. Our quick answer was that you most likely do not have to pay these bills, depending on your specific circumstances, which we discussed. So, let’s say that you don’t actually have to pay these bills, but you’ve already paid some of them. Here are a few more questions and answers.

What About Everything I Have Already Paid? Can I Be Reimbursed??

Question: My private insurance has covered the cost of my medical care while my workers’ compensation claim was in dispute. I have been making payments to my doctor’s office, too, for co-pay and other charges. Can I be reimbursed? What about my prescription costs?

Answer: Yes, you can be reimbursed for your expenses!

You can be reimbursed for medical expenses, prescription costs, travel expenses (when appropriate) and other costs once your workers’ compensation claim has been approved. In Washington State, though, the Department of Labor and Industries will only make payment to medical providers directly for services rendered, so you cannot receive direct reimbursement for payments to your doctor, physical therapist, chiropractor, etc… These providers will need to submit bills for services under the allowed claim, receive payment for those services, and then issue refunds to you and your private insurance carrier for payments previously made. This can be a difficult process, though, as the medical providers have already been paid, often at a higher rate than what is allowed under a workers’ compensation claim, so they often would prefer to not go to the hassle of rebilling for services they have already been paid for and then make refunds to you and/or your insurance carrier in excess of the workers’ compensation payments.

Prescription costs are easier to have reimbursed. If you have receipts, you can submit a Statement for Pharmacy Services form to request reimbursement. If you do not have your receipts, you can submit this form with a printout from your pharmacy of all filled prescriptions related to the claim. The printout and the form must be signed by the pharmacist to certify that you have paid for the claimed prescriptions. Reimbursement for pharmacy expenses will be paid to you directly.

Similarly, travel expenses can be claimed under certain circumstances. If the travel was at the request of the Department of Labor and Industries, or if travel greater than 30 miles round-trip was needed to see the closest appropriate medical provider, then you can request reimbursement of mileage at the State’s rate and some extra expenses, such as ferry fares, parking charges or meal expenses. The Travel Reimbursement Request form must be submitted using the appropriate code for the type of expense incurred and receipts must be provided to support the reimbursement request. As with pharmacy reimbursements, travel reimbursements are paid to you directly.