WHAT M&T EXPENSES ARE ELIGIBLE FOR REIMBURSEMENT?
Round trip mileage for medical treatment and evaluation. This includes trips for medical treatment (hospitals, doctors, physical therapists and chiropractors), trips for medical tests (such as MRIs and x-rays) and trips to the insurance company’s doctor.
Reimbursement for necessary prescription medications. Receipts are required to receive reimbursement.
Reimbursement for necessary over the counter medications. Receipts are required to receive reimbursement.
Reimbursement for necessary medical supplies (such as bandages, crutches, medical tape, etc.). Receipts are required to receive reimbursement.
Hospital parking. Receipts are required to receive reimbursement.
WHAT M&T EXPENSES ARE NOT ELIGIBLE FOR REIMBURSEMENT?
Round trip mileage to hearings.
Round trip mileage to pharmacy.
Round trip mileage for out of state medical treatment not previously approved.
Round trip mileage to ACCES-VR/VESID or any similar vocational rehabilitation program.
Anything that does NOT have a receipt for proof of payment.
Anything that is NOT causally related to your WC claim.
Doctor appointments which do NOT have corresponding medical reports to show proof of attendance.
WHEN SHOULD I SUBMIT MY M&T FOR REIMBURSEMENT?
There is no deadline or time requirement to submit your reimbursement requests. You may submit such requests at any intervals that are convenient for you (such as monthly, quarterly, yearly or at the end of the case). In our experience, it is better to submit these requests at least every few months.
HOW DO I KEEP TRACK OF MY M&T?
The best way to track your mileage is to keep a list of all of the dates of your medical appointments (referencing the specific provider including their address) along with the round trip mileage (from your home).
If you have not kept track of your appointments, you can call your medical providers and they will send you a list of all of your appointments. If you did not track your mileage, you may use the internet resource MapQuest to calculate your round trip mileage. That resource is found at http://www.mapquest.com
WHAT IS THE CURRENT RATE FOR MILEAGE REIMBURSEMENT?
The rate for mileage reimbursement is set by the Chair of the New York State Workers’ Compensation Board. For current rates please see http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp
IS THERE A FORM I AM REQUIRED TO USE TO SUBMIT MY M&T REQUESTS?
The Workers’ Compensation Board has developed a useful form (C-257) which we recommend you use for submission of your reimbursement requests. Here is the link to the form http://www.wcb.ny.gov/content/main/forms/c257.pdf
Be sure to include all of your claim information on the form such as your name, address, carrier case number and WCB case number. Failure to complete the form correctly may delay the reimbursement and may require resubmission.
WHO DO I SUBMIT MY M&T REQUESTS TO?
All M&T requests go directly to the carrier. You should keep a copy of all reimbursement requests for your records.
HOW LONG DOES IT TAKE TO GET REIMBURSED?
There is no specific deadline in the law regarding the amount of time the carrier may take to audit and pay such requests for M&T reimbursement. Typically it takes around 60 days for the carrier to audit and pay M&T requests, however, the response time varies.
WHAT IF 60 DAYS HAS PASSED AND I HAVE NOT RECEIVED PAYMENT?
Contact our office. We will need you to provide to us a copy of your original request including receipts and the date it was submitted. We will follow-up with the carrier. If we do not get a reasonable response back from the carrier we will request a hearing to seek payment.
There is NO specific penalty for the carrier’s failure to timely pay these reimbursement requests. That being said, the carrier can be penalized if the Judge orders reimbursement of M&T expenses and the carrier fails to do so.