Mileage Reimbursement During Medical Care in a Workers’ Compensation Case

Every year, thousands of people who are injured on the job turn to the workers’ compensation system to seek compensation for their injuries and losses. According to the South Carolina Workers’ Compensation Commission, workers’ compensation insurance carriers paid more than $807 million to injured workers in 2019 to cover medical bills and lost income.

While the workers’ compensation system allows workers to recover medical expenditures, lost pay, and lost earning ability, workers frequently must also claim incidental expenses associated with a claim. The right to mileage reimbursement is a frequently raised subject in a workers’ compensation case.

It is critical to be aware of your rights under the workers’ compensation system. Because the workers’ compensation process can be extremely complicated, we have compiled information regarding mileage reimbursement during medical care under South Carolina’s workers’ compensation case benefit coverage.

South Carolina Workers’ Compensation Benefits: Mileage Reimbursement

If you are injured on the job, South Carolina Regulation 67-1601 requires that you be reimbursed for the following travel expenditures to receive medical treatment:

• Mileage to and from a medical facility more than five miles from home in accordance with the mileage allowance for state employees
• The actual cost of public transportation charges
• The actual expense of adequate overnight housing and food if applicable

In order to be reimbursed, the doctor must be more than five miles away or more than 10 miles roundtrip. South Carolina determines the amount of repayment. The reimbursement rate is 54.5 cents per mile as of January 1, 2018.

Steps to Apply for Workers’ Compensation Mileage Reimbursement in South Carolina

If you must travel to medical visits in order to complete the requirements of the workers’ compensation process, you must file a claim with their employer’s insurance carrier. To qualify for reimbursement, you must not only meet the ten-mile criteria, but also produce evidence to show your spending. In general, these documents should include:

1. Your appointment’s name and address
2. The worker’s residential address
3. Record of the total distance traveled
4. A doctor’s report indicating that the worker was seen on that day and time

After gathering all of this information, a worker can submit it to their employer’s insurance provider to seek payment for their trip. For additional information about mileage reimbursement during medical treatment in a workers’ compensation case, speak with an experienced and competent attorney.

How Mileage Reimbursement Is Refunded to Injured Employee Receiving Workers’ Compensation

The claimant will be reimbursed by the employer’s representative. To receive payment, you must keep detailed records, including the date of travel, distance traveled, and treating medical providers. To calculate the distance, we recommend using Google or Mapquest. 

It is recommended that you calculate and submit your mileage reimbursement request each month. Determine the distance between your location and the treatment facility, then track and attach printouts of the Google Maps results to your documented mileage counts to help verify how far you traveled.

If you wait until your injury case is over to submit one, you may not be refunded for traveling expenses. 

Does Workers’ Compensation Reimburse Travel to a Doctor of My Choice?

Probably not. Although workers’ compensation regulations require the employer to pay for 100 percent of all medical expenses incurred as a result of the injury, the laws also allow the company to select the doctor who delivers treatment. Although it is possible that your company will choose your doctor, this is uncommon. Why?

• Since your employer’s policy has precise strategies for how your benefits will be used, you may not have many options to choose your primary physician. South Carolina mandates that following a work accident, employees see only specific doctors.
• Some doctors, who might have experience with workers’ compensation cases, may already have your employer’s pre approval. If not, they might approve a certain hospital or group, in which case you’ll have to select a doctor from a list of options made by your company.

It is best to check with your employer’s representative ahead of time to see if your travel fees to any doctor of your choice are qualified for reimbursement under your workers’ compensation benefits.

Is it Necessary to Hire an Attorney for Your Workers’ Compensation Injury Case?

In the best-case scenario, you would not need to hire an attorney to file and obtain travel reimbursement from a Workers’ Compensation claim while undergoing treatment. Unfortunately, there are far too many examples of claims being improperly refused, underpaid, or putting an injured employee’s ability to make ends meet while they recuperate.

If you have experienced a situation in which your refund is being withheld, you can find a workers’ compensation lawyer in South Carolina to review the contents of your claim and assist you in understanding your options. Sometimes a case may necessitate additional litigation or mediation to resolve but most reimbursements do not require legal help.