Pennsylvania Workers Compensation and travel expenses to doctor

Either way you look at it, a work injury can be financially disturbing for many.  Many injured workers have their injury denied, meaning they are receiving no income while they litigate their claim.  Others have an accepted claim, but for medical benefits only, which again means, no wage loss benefits while the claim is being litigated.  Others may be receiving benefits, but at a reduced rate from their regular, average weekly wages.  Often, it causes financial hardship.

Regardless, work injuries often times require significant medical treatment.  That means trips back and forth to the doctors, to pain management, to physical therapy, and to the pharmacy.  Unfortunately, there is a misperception out there that an injured worker is entitled to reimbursement of travel expenses back and forth for their treatment.    The injury isn’t my fault, why should I have to pay for my own gas to and from treatment.  Great argument.  And I agree wholeheartedly.  However, in Pennsylvania, it is not a reality. 

The controlling case on the matter was Helen Mining Co. V. WCAB, 616 A.2d 759.  The Court substantially narrowed the travel reimbursement in a workers compensation matter.

We have interpreted “reasonable” to include travel expenses incurred for long distance travel if necessary to obtain medical care.

To summarize, Harbison-Walker requires that if treatment is available locally, and claimant seeks the proscribed treatment locally, other than in exceptional circumstances,[5] any travel expenses incurred going back and forth to the physician or treatment center are not reimbursable. If claimant chooses a physician outside the local area, travel expenses are not reimbursable because claimant has not been prevented from receiving the necessary treatment merely because of travel restrictions. If, however, the necessary treatment is not available locally, Claimant is entitled to be reimbursed for travel expenses as long as it is to a facility where others are or would be referred so that he is not prevented from receiving the treatment he requires.[6]

If necessary medical treatment is not available in your area, and you can prove that it’s absolutely necessary to travel out of the state for treatment, there’s a good chance that your expenses should be reimbursed.

So what does that mean?  It means that the medical provider can’t be local and that a local provider otherwise is not available to treat you.  It is a narrow application of the law.  The Court has since narrowed the travel reimbursement rule to oftentimes requiring that am injured worker travel within 100 miles one way for medical treatment in order to be reimbursed.  It is not a hard fast rule, but is generally applicable.

If the insurance carrier asks you to attend an ‘independent medical examination’ the insurance carrier can and will provide transportation for you or they will reimburse your travel expenses for that appointment.  You are entitled for reimbursement for IME purposes.

If you have been injured at work, do not hesitate to call Mooney & Associates today!  We have 14 offices throughout Central Pennsylvania and stand ready to assist you.  We offer our clients FREE consultations.  Call us today at 717-200-HELP or 1-877-632-4656.

Mark Buterbaugh

Attorney representing injured workers and Social Security Disability clients in Pennsylvania and Maryland.