Travel Reimbursement - Printable Version
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Travel Reimbursement - brneyedgirl40 - 06-07-2012 09:52 PM
I live in Tx.I finally located a treating doctor after having so many issues!Unfortunately I could not locate one in my area that took my insurance so I have to travel almost 3 hours away to where he is located.My question is will I get any mileage reimbursement,help with meals or possibly any help with hotel expenses if I have to stay overnight?I went for the first time last week and left at 9 am and didnt get home until 7 pm.I have a back injury and was in absolute agony being in the car that long and had to stop every 30 minutes to get out and walk around.It also cost me $70 in gas and $20 for food and drinks.Not to mention my sister lost a whole days work having to drive me.Its not an option to find a doctor closer so I have to get treatment no matter what.Has anyone else been in this situation?Any help would be appreciated!Thanks!
RE: Travel Reimbursement - 1171 - 06-07-2012 10:17 PM
§134.110. Reimbursement of Injured Employee for Travel Expenses Incurred.
(a) An injured employee may request reimbursement from the insurance carrier if the injured employee has incurred travel expenses when:
(1) medical treatment for the compensable injury is not reasonably available within 30 miles from where the injured employee lives; and
(2) the distance traveled to secure medical treatment is greater than 30 miles, one-way.
RE: Travel Reimbursement - UndercovrAngel - 06-08-2012 10:35 AM
Those are the rules1171, but don't be surprised brneyedgirl, if the work comp insurance company refuses to pay them and tries to force you to see another Dr.
Did you contact your employer in regards to if they have a list of treating Dr's ??
Did you contact the OIEC and ask them for names of workmans comp Dr's in your area ??
The IC will NOT pat for overnight stays, unless they are the ones that have sent you to see a specific Dr and they will not pay anything for your sister who accompanied you. Also, if you want reimbursed for meals, you must save your receipts and send them in with your mileage. The IC, by Texas law (unless it has changed since 2009) only reimburses up to $6.00 per meal, regardless of how long your trip is, unless, as above, it is a Dr they are sending you to that they feel is going to require an overnight stay. Then, they will calculate how many meals THEY feel you will need, and only reimburse up to a certain amount of money for each meal, for so many meals, regardless of what you eat and how many times you eat.
I learned the hard way.... and lost a lot of money stopping to eat. I had no choice as, I was generally on the road before breakfast and back on the road at lunch and had to eat regularly, as I am diabetic. I lost over $600 out of pocket buying meals that cost more than $6.00 twice a trip. They told me I should have eaten before leaving on my trip (yeah, who wants to eat at 5 in the morning) and waited til I got home to have my noonday meal. Heck, why not. Eight hours between meals as a diabetic won't hurt you. And no one ever told me I had to turn in receipts.
Don't be surprised if they deny your mileage saying Dr. SO and SO, a workcomp Dr in your area is accepting new patients so we are denyong not only your travel claim, but refusing to pay for your Dr's visit as well.
What I don't uderstand however, is you state "I finally located a treating doctor after having so many issues!Unfortunately I could not locate one in my area that took my insurance so I have to travel almost 3 hours away to where he is located."
Are you treating under work comp insurance, or private health insurance ?
RE: Travel Reimbursement - 1171 - 06-08-2012 11:05 AM
I doubt they'll force her but they may find her a doctor that is closer.
RE: Travel Reimbursement - brneyedgirl40 - 06-08-2012 05:49 PM
Angel,no I am using workers comp insurance.I have contacted my employer for a list of doctors in this area which was a couple of orthopedic doctors that dont treat back injuies.I also contacted the local wc office and the main one in Tx several times and they just stated we dont even send out a list anymore so its up to you to find one.I then called over 50 doctors locally and ones within a 120 mile radius and couldnt find one that took wc or my certain wc insurance or wouldnt take my case due to date of injury is 5 months old.As I stated in my other posts I initially had a treating doctor that was PA at a local clinic. ON one of my visits they stated this is the last time we can see you due to we have a contract with WC that we only see their patients for 3 visits only.I had exceeded that.They gave me a change of treating doctor form and sent me away.The only way I found this doctor out of town is being referred by a lawyer I spoke with that lives there.He actually used to live in my town and told me he will get on the phone with every doctor he knows here and find one to see me.After a week he called and stated that to forget it,I wont find anyone here to help me.My only option was to travel to where he lived and he had an appointment for me with a physician the next day.Sorry for the long post.Just trying to explain it all!
RE: Travel Reimbursement - UndercovrAngel - 06-08-2012 10:18 PM
Don't worry about the long explanation I, as well as many others are good at doing the same thing.
What part of TX are you in ?
The reason I ask, is I had the same problem when I had my injury back in Feb 2008. None of the WC Dr's in my area would accept me as a pt, because my employer wouldn't send them a form they required to start treating me. So my first visit to/treatment by a Dr was in the ER. I ended up hiring an attorney and she sent me to a Dr that was 2 hours from my home. I of course, had to fill out a "request to change treating Dr" so that the OIEC/Workmans Comp could approve me to be treated by a Dr out of my area. Of course, the IC didn't like that, claiming I had a Dr in my town that would/did treat me and that I should be required to continue seeing that Dr. How many of us have had any success in making follow up appointments with an emergency room Dr ?? Kind of stupid on the IC's part if you ask me.
Then, because TX has lifetime medical for an injury, after I settled my claim and asked (a year later) to receive treatment because it injury was getting worse (I originally never received any treatment, just x-rays, emg/ncs, mri and an DDE because IC denied claim until they received the IRE report and decided to settle) they allowed me 6 sessions of PT. I used them all within 2 weeks (the time period given by the IC) and my DOR then did a functional capacity test and found I was worse of than when first injured. I don't remember what he requested I have done, but the IC denied it in less than 12 hours, and then petitioned the WC court to try and force me to have to choose on of the 2 workmans comp Dr's in our town if I wanted to continue getting treatment for my injury. These are the 2 that originally refused to treat me and to this day, still refuse to do so as it is an old injury and I had a different DOR for over 2 years and they won't accept another WC Dr's patient. Or, if I so chose, I could continue going to see my DOR but they would no longer reimburse me for travel. Like they ever fully reimbursed me to begin with. I had over $1900 in travel reimbursement due me and got just a little over $440 of it. When I contacted them about it, they stated that they had lost the original copies I had sent, and by the time my attorney resubmitted them, it was outside of the 1 year I had to make a claim for reimbursement.
Our tales sound so much alike. So, to save some headaches, make sure you send in mileage reimbursement via registered/return receipt so you have proof of when the papers arrived at the IC's place of business. Give it another 24 hours after that and write that on the returned receipt when you get it back in your mail. Also, make a copy of the mileage reimbursent forms for yourself. Keep all of these in a safe place just in case your IC decides to deny your travel. Also, I would ask for a copy of the approved "Change of Doctor Form" and make sure you hold on to that as well. That way, the IC CAN'T dispute that you did things properly and try to make you change your treating Dr.
I would like to see this contract that the clinic has with workers comp to only treat 3 times before releasing from treatment. It would have to have been drawn up between the State Workmans comp office and the clinic, and I have never heard of a state requiring any such contract. Unless it was drawn up with IC the company you work for carries their insurance with.
RE: Travel Reimbursement - brneyedgirl40 - 06-09-2012 12:39 PM
Angel,I live in West Tx.I definitely wont get reimbursed for my first trip.I just received in the mail from that doctor that nothing can be done until WC approves for him to be my new treating doctor which takes about 10 to 14 days.So now everything is back on hold.I dont understand that contract with the clinic ether.I have contacted them several times to please see me so I wont lose my benefits and just get the same answer.They cant see me anymore due to I have exceeded the number of times they see WC patients.
RE: Travel Reimbursement - UndercovrAngel - 06-09-2012 02:17 PM
I live in N. Central Texas, just east of the panhandle and about 20 minutes south of the Oklahoma state line. It seems like everyone I have talked to in TX that has been injured, living on the western side of the DFW metroplex plays hell finding a competent WC Dr. I ended up having to treat with a Dr that was almost in Arlington, and did have to travel to Arlington to get my MRI and see the IRE Dr.
Your travel reimbursement should be paid at the same rate as state employees get when they use their own vehicles for travel on the job. Back in 08/09, that was .55 a mile. I don't know if it has changed since then. But please make sure you do as I suggested in sending them registered/return receipt requested, and make sure you send in receipts for meals claimed while traveling. Keep copies for yourself. That is, if you are approved for a change in treating Dr's. When you receive the signed return receipt, as well as the check for reimbursement... staple the signed receipt, as well as a copy of the check to your copies of the travel reimbursement claim. Then if there is ever a dispute, you have all your evidence in one place and can show it easily to a mediator or judge if needed. I learned the hard way.
If I had been reimbursed as I should have been, I would have prospered from my travel reimbursement instead of eating over $1500 in travel, as well as wear and tear on my car, and maintenance that had to be performed. Please learn from my mistake.
Also, if you are approved to start using this Dr for treatment, your mileage is reimburseable. Don't let anyone tell you differently. You have 1 year from date of travel to send in for reimbursement, but I would do it no less than quarterly, unless you see this Dr more than once a month. All your CA has to do is match up dates of travel to dates on notes sent in by your Dr, or call and verify you were seen in his office that day. Another way to CYA on travel, is to actually have the Dr print out/write out on his letterhead that you were seen on such and such a day, at this time in his office and sign it, giving his prescribing ID number (works real good if written out on his prescription pad). That way the CA can't say you are paying someone in the office to lie for you about being there.
And one final thing. No matter what your odometer says as far as mileage traveled, the IC will use either google maps or mapquest to find the shortest, most direct route from your residence to the Dr's office and pay you based on that mileage. In my case, it was an actual 10 mile difference, even though I drove the exact route they used to calculate my mileage. No sense in fighting them on that. You won't win.
If I can be of any help, please let me know.
RE: Travel Reimbursement - brneyedgirl40 - 06-09-2012 02:43 PM
Thanks so much for your help and tips.I will definitely use them.That is where my new doctor is located in the Ft.Worth area.I hope I do get approved for this doctor but am very concerned about making too many trips down there due to I just cant afford it.My weekly checks are the minimum amount you can receive and they barely cover the cost of one visit down there.That doctor stated I need a ortho and a neuro consult which will be in the Dallas/F.Worth area also.Hopefully I can have my PT done here.At least I can finally receive treatment and not lose my benefits so I guess I will find a way to make it down there.Thanks again for all of your help!!
(06-09-2012 02:17 PM)UndercovrAngel Wrote: Brneyedgirl,
RE: Travel Reimbursement - UndercovrAngel - 06-09-2012 03:14 PM
We must live close to one another. It is about a 2 hour drive for me into the DFW area. The DOR I was seeing for my injury, could not do any treatment for me, as my claim was denied. I was able to continue working from Feb 08 to August 08 before he pulled me out of work due to the injury getting worse because of no treatment.
But I had to go down at least once a month in order to see him so I wouldn't loose my benefits if I eventually won. In August 08, with no job, and no TIB's, it was really fun. The end of the year and through April 09 I was going to see him upwards of 3 times a month, at 292.93 miles round trip, plus trips for the MRI, a DDE, an FCE that all took place in different parts of Arlington, which were even further away. This the large chunk of change due for travel.
I sent in travel claims for Feb. 08 through July 08, August 08 through Dec. 08 and the final one was for Jan. 09 through April 09. I originally filed travel for Feb - July 08 (denied the meals portion as I failed to keep receipts) in Dec 08 and received partial payment in June of 09 after getting my attorney on them before I would settle. I never did receive any mileage after that, and once my attorney received her final payment in August of 09, she fired me as a client, but not before I had sent the mileage to her (all 14 months once again) as well as to the IC to try and get my monies. That is when she fired me and the IC claimed I filed to late for reimbursement.
Now that I am fully aware of my rights as an IW and what I can do to get the IC to make things right for me, as soon as I have healed from a soon to be done surgery on my left arm (non work related) I am filing against the IC again for more (actual treatment of my arm as it has never gotten any better) as well as going to fight them to get the monies owed for all travel (they never paid me for the 6 PT visits they awarded me in March 2010 even though I sent them the claim form the day I completed my last PT visit). I will represent myself through the whole thing instead of hiring an attorney that got more of my money than I did... and see it through a CCH, to a BRC and in front of a judge with depositions if necessary and stick it to the IC in the end if that is what it takes to get something done on my right arm, shoulder to wrist.
Good luck with your claim. I am only a key stroke away if I can be of further help.