M&T Reimbursement

Under the New York Workers’ Compensation Law, you have a right to be reimbursed for some expenses that you incur related to your work illness or injury. The most common expenses are when you travel for medical treatment. We refer to this as M&T (Medical and Transportation) expenses.

WHO DO I SUBMIT MY M&T REQUESTS TO?

You should submit all M&T requests directly to the carrier. This is the ONLY communication we allow you to send directly to the carrier. You should keep a copy of all reimbursement requests for your records (because the carrier often loses submissions).

You should also mail a copy of the reimbursement request to the Workers’ Compensation Board directly by email at wcbclaimsfiling@wcb.ny.gov OR regular mail to:

NYS Workers’ Compensation Board
Centralized Mailing
P.O. Box 5205
Binghamton, NY 13902-5205

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 see the insurance company’s doctor.

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 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’s appointments that do NOT have corresponding medical reports to show proof of attendance.

WHEN SHOULD I SUBMIT MY M&T FOR REIMBURSEMENT?

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 quarterly (because it is easier for the Carrier to process and pay you faster).

Do NOT submit your next reimbursement request until the prior request has been paid.

HOW DO I KEEP TRACK OF MY M&T?

The best way to track your mileage is to keep a list of the dates of your medical appointments (referencing the specific provider and 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 your appointments. If you did not track your mileage, you may use the internet resource MapQuest to calculate your round trip mileage.

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, click here.

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) that MUST be used for submission of your reimbursement requests. You can find that form by clicking here.

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.

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 give 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 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; however, the carrier can be penalized if the Judge orders reimbursement of M&T expenses and the carrier fails to do so.