Types of Small Reimbursements in Workers’ Compensation Cases

Posted on Friday, April 5th, 2019 at 3:06 pm    

The bulk of the payments in a North Carolina or Virginia workers’ compensation claim are the wage loss benefits and the medical expenses. Wage loss benefits are generally paid at the rate of 2/3rds of the worker’s average weekly wages (prior to the accident) – up to preset maximums. The wages are paid until the employee can return to work. Additional payments may be made if the worker has a full or partial permanent disability.  Adjustments to the pay are usually made if the employee can return to work but at a lower paying salary.

Medical payments cover surgeries, doctor visits, psychological counseling, and a variety of different therapies. The payments are made by the employer’s insurance company as long as the treatments are helping the worker get better. Even when an employee has reached maximum medical improvement (no additional medical care will improve his/her condition), the worker is still entitled to have the medical bills paid so that the condition doesn’t worsen. In other words, the worker is entitled to medical coverage to maintain his/her health.

Vocational rehabilitation

Some workers may not be able to return to their prior work because of the severity of their injuries. North Carolina and Virginia allow these workers to explore the option of vocational retraining. The employer may be required to pay the cost of training the worker or helping the worker get an education – up to certain limitations. Helping workers acquire new schools often means they can work in new jobs at somewhat similar pay. Speak with a skilled North Carolina or Virginia workers’ compensation lawyer to learn if you are entitled to vocational rehabilitation expenses.

Mileage reimbursement to the doctors

Workers often need to treat with many different doctors. Additionally, they may be required to see a doctor or health provider multiple times. Many workers, for example, can see their physical therapist several times a week for months at a time.

The cost to get these doctors can add up quickly. In North Carolina and Virginia, workers are entitled to be reimbursed for the cost to see their own doctors, to travel to an independent medical examination when requested, and for vocational rehabilitation support and schooling. The mileage reimbursement expenses continue for health care even if the worker has returned to the job – provided the worker needs the medical treatments to stay healthy.

The mileage expenses are calculated as follows:

In North Carolina, workers can claim mileage reimbursement if the round trip to the doctor or therapist is 20 miles or more. The amount the worker will receive is generally set by the North Carolina Industrial Commission. The NCIC, in turn, sets its rates based on the Standard Mileage Rate that is annually prepared by the IRS.

According to the NCIC, the mileage reimbursement rates are as follows:

“If employees travel 20 miles or more round-trip for medical treatment in workers’ compensation cases, they are entitled to collect for mileage at the rate of 25 cents a mile for travel prior to June 1, 2000;

  • 31 cents a mile for travel between June 1, 2000 and January 17, 2006;
  • 44.5 cents a mile for travel between January 18 and December 31, 2006;
  • 48.5 cents a mile for travel between January 1 and December 31, 2007;
  • 50.5 cents a mile for travel between January 1 and June 30, 2008;
  • 58.5 cents a mile for travel between July 1 and December 31, 2008;
  • 55 cents a mile for travel during 2009;
  • 50 cents a mile for travel during 2010; 51 cents a mile for travel between January 1 and June 30, 2011;
  • 55.5 cents a mile for travel between July 1, 2011 and December 31, 2012;
  • 56.5 cents a mile for travel between January 1 and December 31, 2013;
  • 56 cents a mile for travel between January 1 and December 31, 2014;
  • 57.5 cents a mile for travel between January 1 and December 31, 2015;
  • 54 cents a mile for travel on or after January 1, 2016.”

According to the IRS, the rates for 2017 are 53.5 cents per mile and for 2018, the reimbursement rate is 54.5 cents per mile.

The costs are meant to cover expenses for gasoline as well as wear and tear on the vehicle.

“The Industrial Commission has given the self-insurers and insurance carriers permission to pay drug and travel expenses directly to the employee without approval from the Commission.” This means that, normally, the worker will keep a record of the mileage and then submit the record to the employer’s insurance company. The record should include the date of the visit to the health provider, the identity and location of the healthcare provided, and the total distance traveled. North Carolina actually provides a form, called a Form 25T, upon which the worker should submit his or her mileage information to the employer.  It’s generally a good idea to mark down the odometer amount before the trip starts and at the end of the return home. The distance from your home to the health care provider can also be tracked by using Google Maps.

Generally, workers should be reimbursed within a few weeks from the time they submit their form but unfortunately there is no rule that sets for the time frame by which the employer/insurance carrier are required to reimburse the employee. Unfortunately, some carriers are delinquent in this regard and we sometimes have to file a motion with the Commission if an unreasonable amount of time has passed before payment has been received by the injured worker.  Depending on the amount of medical and/or vocational travel you are engaging in, it’s a good idea to submit mileage reimbursement requests on a monthly basis

Workers who take public transportation are generally allowed to be reimbursed for the cost of the public transportation. Workers who use their car to see their health care provider should also add in the cost of parking – if there is any.

The mileage reimbursement rates in Virginia are based on the same principles.  Virginia likes workers to:

  • Indicate the dates traveled and the addresses (the workers and the health care providers)
  • Attach a MapQuest or Google Maps printout of the directions and mileage
  • List any parking, bridge tolls, or public transportation costs. This can include the cost of a taxi.
  • In Virginia, mileage is reimbursed at 55.5 cents per mile.

 

Reimbursement includes the mileage reimbursement and the other miscellaneous costs – tolls, public transportation, and taxi. Workers should also include a statement from the healthcare provider to confirm they were at the appointment on the scheduled dates. Virginia does not have the 20-mile round requirement that North Carolina does.

At the North Carolina and Virginia Law office of Joe Miller Esq., we’ve been fighting for injured workers for more than 25 years. We fight to get our clients every amount they deserve – large and small. We’ll fight to get you approved for worker’s compensation benefits and explain which forms you need to complete to get paid. To speak with an experienced work injury lawyer, phone 1-(888) 694-7994 or fill out my contact form to schedule a free appointment.