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Will Claimants Receive Reimbursement for Travel Expenses under Pennsylvania Workers’ Compensation Laws?

Work-related injuries can cause financial distress for an employee and their family.  While workers’ compensation benefits are available, according to Pennsylvania law, they do not entirely replace the worker’s income. A Pennsylvania workers’ compensation attorney can make clear exactly how workers’ compensation benefits are structured and adjusted according to the employee’s wages.

For those employees who suffer financial hardship following a work-related injury, additional expenses required to travel to medical appointments can prove extremely challenging.  State law concerning whether the employer’s workers’ compensation insurance carrier will reimburse travel costs to medical appointments has been greatly influenced by the Commonwealth Court decision of Helen Mining Co. v. WCAB, 616 A.2d 759.

This important case changed the law concerning whether travel expenses are reimbursed for injured workers receiving workers’ compensation.  Generally, the rule is that when necessary medical treatment is not available in the location near the injured worker, in many situations, medical expenses will be reimbursed.  According to this decision, there are factors to be considered in reimbursing travel fees, and there are exceptions that exist, entitling the claimant to travel expenses.

Despite the general rule that a workers’ compensation insurer needs to reimburse claimants for travel costs, the Helen Mining Co. v. WCAB case made clear certain exceptions may apply, entitling the claimant to travel expenses.  Again, if treatment is actually locally available, the claimant will not be entitled to travel expenses, except for exceptional circumstances.  Additionally, the court made clear that when a claimant chooses to get treatment with a physician outside the local area, but local treatment is available, the claimant will not be entitled to reimbursement for his expenses for traveling. Finally, if the claimant cannot be treated locally, reimbursement may be available if they travel to a facility where others may be referred or where others are.

It should be noted that when an insurance company sends a claimant to be examined by their own medical expert, for an Independent Medical Examination, for example, they will pay for mileage.

Following the Helen Mining case, the court interpreted the travel reimbursement rule as often requiring that a claimant travel within 100 miles one way for medical treatment in order to be reimbursed.  Sometimes known as the “100-mile” rule, this is not applied in every case, but some judges may find that if the travel was within 100 miles one way, the factors from the Helen Mining case would be applied.

At Needle Law Firm, our skilled workers’ compensation attorneys provide legal guidance and representation for individuals injured at work throughout Pennsylvania. Whether you are seeking workers’ compensation benefits or are questioning whether you are eligible for travel reimbursement for medical care, we can help you understand your legal rights and advocate on your behalf.   Contact our office for a free, no-obligation consultation by calling 570-344-1266 or filling out our online form.

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