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HI'
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STEPHANIE B | Workers Comp and mileage? |
Is my workers compensation insurance suppose to cover my mileage to my doctors/PT visits if they are out side of the town I reside in and are they suppose to cover my prescriptions cost.
Also my lawyer has said that the lawyer for the insurance company is denying my mileage reimburesement due to the employers general denial of the accident. What the heck...
I am confused, I went to the visits which meant I had to drive there to get there and that was 25.00 a trip at three times a week and I paid for my prescriptions and sent a letter to my lawyer with all the info to be reimbursed for my cost and this is what he tells me. I am just wondering if anyone else has had this problem Additional Details My injury claim has NOT been denied. Obviously I said I have been to see the Dr & then went through PT, I am at the end of my recovery and I turned in my mileage/prescriptions cost and the lawyer said the emploeyr is DENYING the mileage/prescription cost. I assume because it is such a large amount and I was seeing a PT in my local area but then the Insurance carrier wanted me to go to a PT in the city that had more advanced technology and so on....
The lawyer said the employer is denying my claim for mileage/prescriptions. NOT my injury claim. |
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A decent answer
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Ah the mileage reimbursement question...I like mbcraz knowledge of insurance and I enjoy reading her responses. Her responses in work comp are generally close to what I got, great minds think alike, but this time she's a little bit off the chart on this one...sorry mb!
If your claim has been ACCEPTED than yes, normally states* will reimburse your mileage to the doctor and PT. Normally it's like $0.358 cents or $0.554 cents per mile. A smart adjuster will look for the shortest route from point A to point B. So if the trip you took is only 10 miles (20 miles round trip) than you get paid for 20 miles, but if you drove from point A to point B but you stopped to get groceries and drove 55 miles, you'll get credit for 20 miles.
If your claim is DENIED, than you'll have to keep track just in case you win at your hearing or until it's accepted. It will be expensive since it's been denied but if you don't go to your appointments than you could get in trouble for not attending at all. So keep track of those miles, if the insurance company doesn't appeal it than submit them in as well as your Rx.
Remember each state is different, some states will allow reimbursements while others just cover for Rx. If you can't get a hold your attorney regarding this question than I suggest call the work comp board or the state's ombudsman or manager regarding this question. Also if you filled up gas and it cost your $50.00 and you bought a Snickers bar as well, don't expect to be reimbursed for that, that's why mileage is paid, to cover the cost of your driving.
*states are different, check with your WC department regarding this. You might be entitled, you might not be.
--------------------------------------...
With this new information...well it's likely somewhere in the state rules is that the adjuster feels that it's unreasonable for you to drive "x" amount of miles to go to PT where there is a PT facility that is just as good that is less miles. So if you drove 200 miles round trip to PT but there is a PT facility that is only 4 miles away than why not go there? State rules give the adjuster some power as there are some people that do this. I suggest that you ask your attorney about requesting a hearing regarding this kind of situation. Your attorney than can tell you if you have a case on this or not. |
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Soozie Q
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As a PT, I've seen many worker's comp claims, but I have never heard of anyone getting reimbursed for mileage. Is there a PT clinic any closer than the one you're going to? If they are denying the accident at all, I'm guessing you haven't reached a settlement yet. I do know however that in regards to worker's comp, if they are paying the bill for the doctor and the physical therapy treatments, then your employer gets to choose which doctor you see and which physical therapy clinic you go to. Of course, you can go to anyone you want, but they won't pay for it. And I doubt your insurance would either since this is a worker's comp claim. I guess I just would like to know if you are receiving workman's compensation, they have acknowledged you were hurt at work, and they are sending you to their dr, who then is sending you to PT. Or are you just trying to get workman's comp and seeing a dr and going to PT on your own? If you have already reached a settlement with your employer and they are paying for your dr visits and PT visits, it would be in the legal paperwork if they have to reimburse you for prescriptions and mileage. If its not in the contract, then no, they don't have to pay for it. |
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src50
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If the employer or its WC carrier is denying the claim, then that is your major issue. You've already hired a lawyer, so listen to him. |
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Peace Warrior
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In florida it is 0.29 cents per mile and your attorney makes nothing from it, but since you are represented, I would follow his/her advice. |
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***~***
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It's not normal to pay for mileage reimbursement. |
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mbrcatz
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No, they don't cover your milage.
They cover prescription costs, if the prescription is for the injury.
Of course, if the whole INJURY is being denied, the entire CLAIM is being denied, and they won't cover the prescriptions, either.
I don't understand why you think you should get coverage when the claim as a whole, is being denied. That's what denied means.
If your lawyer overturns it, you'll get related prescriptions reimbursed. But not milage.
Your problem is with your lawyer. He's not doing a good job explaining things to you. |
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vicky dewitt
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I live in CA.What is the pay for medical miles in 2008-09-10-11. |
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