Guidelines for travel expenses related to medical and hospital services, medical reviews and return to work case conferencing.

Transcription

1 Travel Expenses Guidelines for travel expenses related to medical and hospital services, medical reviews and return to work case conferencing June 2015 The WorkSafe Agent (the Agent) can reimburse reasonable travel expenses incurred by a worker to attend medical and hospital services required as a result of a work-related injury or illness in accordance with Victorian workers compensation legislation. Travel and associated expenses incurred to attend an independent medical examination, impairment assessment, Medical Panel review or General Practitioner (GP) Return to Work Case Conference can also be reimbursed. Requests for reimbursement must be submitted within six months of the date of travel. The Agent will periodically review a worker s entitlement to travel expenses to ensure that the costs remain reasonable for the work-related injury or illness and are payable under the legislation. Definitions In this policy: travel expenses are expenses for travel by: public transport (bus, train or tram) taxi (with prior approval) road ambulance (with prior approval) air ambulance (with prior approval) air travel (with prior approval). Consideration may also be given to reimbursement of meals and accommodation expenses associated with attending an independent medical examination, impairment assessment or Medical Panel review. Road ambulance, air ambulance and air travel are not suitable for use to attend a GP Return to Work Case Conference. in determining the reasonable costs of travel, the Agent will give consideration to: the purpose of travel a worker s ability to utilise modes of transport the distance travelled, by the most direct route availability of comparable service providers in close proximity to a worker s residence the length of time between date of travel and the request for payment. Workers are expected to seek treatment from a provider within their local area. If the required treatment is available locally and a worker chooses to seek treatment from a provider outside of their local area, the Agent can only pay the reasonable equivalent travel expenses that the worker would incur from attending treatment locally. In circumstances where a worker requires treatment from a provider whose treatment modality or specialty is not available locally, the Agent can pay reasonable expenses for a worker to travel outside their local area. Guidelines Private Motor Vehicle expenses What can the Agent pay for in relation to travel by private motor vehicle to attend medical and hospital services, an independent medical examination, Medical Panel review or GP Return to Work Case Conference? for a worker using their own motor vehicle (excluding motorised wheelchairs) or being a passenger in a private motor vehicle, where the use of public transport is not practicable. Reimbursable expenses are the reasonable costs of: kilometres travelled by car parking fees tolls. examination, Medical Panel review or GP Return to Work Case Conference by private motor vehicle? Prior approval is not required for the reimbursement of private motor vehicle expenses. consider paying for private motor vehicle A worker must provide all the following details when submitting expenses for the use of a private vehicle: name of service provider/hospital attended Note: This policy is a guideline issued by WorkSafe Victoria under Victorian workers compensation legislation in respect of the reasonable costs of services and, where indicated, those services for which approval should be sought from the WorkSafe Agent or self-insurer (as the case may be) before the services are provided. WSV1432/03/05.13

2 address of departure and arrival date(s) and time(s) of travel total kilometres travelled parking or toll receipts or tickets (clearly showing dates and times). Where parking has been paid for but no parking ticket or receipt is available, parking costs of up to $15 can be reimbursed upon provision to the Agent of verification of attendance at the appointment. What fees are payable for private motor vehicle Reimbursement for kilometres can be considered at the set rate per kilometre of $0.30 for the distance of the most direct route between a worker s residence and the service provider s address. The per kilometre reimbursement rate is based on information provided to WorkSafe by the Royal Automobile Club of Victoria (RACV) on a 6 monthly basis, which calculates the average running costs and vehicle depreciation associated with travelling extra distances for defined purposes associated with a WorkSafe claim. Reimbursement for parking and tolls can be considered as per the amount on receipts or tickets. What won t the Agent pay for in relation to private motor vehicle travel The Agent will not reimburse the costs of: travel for non work-related injury or illness purposes motor vehicle hire expenses such as a deposit, petrol, hire charge and insurance traffic or parking fines. Public Transport What can the Agent pay for in relation to travel by public transport to attend medical and hospital services, an independent medical examination, Medical Panel review or GP Return to Work Case Conference? for a worker using the following forms of public transport: bus train (metropolitan or V-Line) tram. Information on the level of support that bus, train and tram services can provide can be obtained directly from the transport provider. examination, Medical Panel review or GP Return to Work Case Conference by public transport? Prior approval is not required for the reimbursement of public transport expenses. consider paying for public transport A worker does not need to provide tickets when submitting expenses for travel by public transport but the following information must be provided: name of service provider/hospital attended address of departure and arrival date(s) and time(s) of travel cost(s) of tickets. What fees are payable for public transport The Agent can pay up to the daily fare for zones or V/Line trip travelled. What won t the Agent pay for in relation to public transport travel The Agent will not reimburse the costs of: public transport fines weekly, monthly or annual tickets travel to destinations not related to medical and hospital services required as a result of a work-related injury or illness. Taxi What can the Agent pay for in relation to travel by taxi to attend medical and hospital services, an independent medical examination, Medical Panel review or GP Return to Work Case Conference? for a worker by taxi where, due to their work-related injury or illness, the worker is: unable to drive a private motor vehicle unable to travel as a passenger in a private vehicle unable to travel by public transport (train, tram or bus). Where travel by taxi has been approved by the Agent, a worker is permitted to be accompanied by another person or persons to/from appointments. Information on the level of support that taxi services can provide can be obtained directly from the transport provider. examination, Medical Panel review or GP Return to Work Case Conference? Prior approval must be obtained from the Agent before travelling by taxi. prior approval for taxi travel? The treating health practitioner must provide medical evidence that a worker s injury or illness is preventing travel by: public transport.

3 reimbursing a worker for taxi A worker must provide all the following details when submitting expenses for the use of a taxi: itemised receipts - clearly showing cost, date, time of travel, evidence of driver accreditation with the Victorian Taxi Services Commission, Australian Business Number and destination (i.e. home address and service provider address) name of service provider/hospital attended. What fees are payable for taxi Where all of the above conditions are met, the Agent can pay the reasonable taxi fares for the distance to and from the medical provider or hospital in accordance with Victorian Taxi Directorate rates. What won t the Agent pay for in relation to taxi travel The Agent will not reimburse the costs of: any expenses related to the additional use or cost of a taxi by a person other than the worker (e.g. where a taxi is shared for part of the journey by another person) commercial passenger transportation services provided by drivers who do not possess appropriate accreditation with the Victorian Taxi Services Commission taxi waiting time chauffeur driven limousines taxi fares above Victorian Taxi Directorate rates travel to destinations not related to medical services required as a result of a work-related injury or illness. For workers who have a multi purpose taxi card issued by the Victorian Taxi Directorate, this card should not be used for payment for taxi services for which reimbursement will be sought from the Agent. The Victorian Taxi Directorate guidelines state that a person is not permitted to use a multi purpose taxi card for any travel which is required for a work-related injury or illness covered by WorkSafe. Road Ambulance What can the Agent pay for in relation to travel by road ambulance to attend medical and hospital services, an independent medical examination or Medical Panel review? for a worker to attend a medical or hospital service, review by road ambulance where, due to their workrelated injury or illness, the worker is: unable to drive a private motor vehicle unable to travel as a passenger in a private vehicle unable to travel by public transport (train, tram or bus) unable to travel by taxi. examination or Medical Panel review by road ambulance? Prior approval must be obtained from the Agent before travel by road ambulance, except in emergency circumstances. prior approval for road ambulance travel? The treating health practitioner must provide medical evidence that a worker s injury or illness is preventing travel by: public transport (train, tram or bus) taxi. consider paying for road ambulance The road ambulance service provider must provide the Agent with a breakdown of all costs: flag fall type (for example, emergency/nonemergency) and charge time and duration of service, cost per minute, and total charge for this element total kilometres travelled, cost per kilometre and total charge for this element any other charges. What fees are payable for road ambulance For Victorian public road ambulance services, where all of the above conditions are met, the Agent can pay in accordance with the fee schedule arrangement the ambulance service has with the Department of Health. For private road ambulance services, where all of the above conditions are met, the Agent can pay the reasonable costs of private ambulance travel. What won t the Agent pay for in relation to road ambulance travel The Agent will not pay any charges above the standard price charged to non-compensable customers. Air Ambulance What can the Agent pay for in relation to the use of air ambulance to attend medical and hospital services, an independent medical examination or Medical Panel review? for a worker to attend a medical or hospital service, review by air ambulance where, due to their workrelated injury or illness, the worker is: unable to drive a private motor vehicle unable to travel as a passenger in a private vehicle

4 unable to travel by public transport (train, tram or bus) unable to travel by taxi unable to travel by road ambulance. examination or Medical Panel review by air ambulance? Prior approval must be obtained from the Agent before travel by air ambulance. prior approval for air ambulance travel? Approval for air ambulance travel can only be given in exceptional circumstances. The treating health practitioner must provide medical evidence that a worker s injury or illness is preventing travel by: public transport (train, tram or bus) taxi road ambulance. consider paying for air ambulance travel In order for invoices to be processed, the air ambulance service provider must provide the Agent with a breakdown of all costs: ambulance any other charges total cost for each ambulance service. What fees are payable for air ambulance travel For Victorian public air ambulance services, where all of the above conditions are met, the Agent can pay in accordance with the fee schedule arrangement it has with the Department of Health. For private air ambulance services, the Agent can pay reasonable costs, where all of the above conditions are met. What won t the Agent pay for in relation to air ambulance travel The Agent will not pay any charges above the standard prices charged to non-compensable customers. Domestic Air Travel What can the Agent pay for in relation to domestic air travel to attend medical and hospital services, an review? The Agent can reimburse the reasonable costs of domestic air travel for a worker to attend a medical or hospital service, independent medical examination or Medical Panel review where: the use of private motor vehicle, public transport and taxi are not practicable, or a worker provides information to indicate that the cost of domestic air travel is less than the cost of other forms of transport. If a worker is assessed as needing support beyond that provided by transport providers, additional travel costs can be covered with prior approval. The Civil Aviation Safety Authority (CASA) website details the level of support that airline and airport ground staff must provide to passengers with a disability. Is prior approval required for domestic air travel to medical and hospital services, an independent medical examination or Medical Panel review? Prior approval for domestic air travel must be obtained from the Agent. All prepaid, non-urgent domestic air travel must be arranged and booked by the Agent in line with the current State Government formal agreement. prior approval for domestic air travel? Approval for domestic air travel can only be given in exceptional circumstances. If a worker is requesting approval for domestic air travel because their work-related injury or illness is preventing them from travelling by private motor vehicle, public transport or taxi, then medical evidence to support this is required from the treating health practitioner. If a worker is requesting approval for domestic air travel because the cost of domestic air travel is less than the cost of other forms of travel, or because domestic air travel is the most practical form of travel for another reason, then information to support this is required from the worker. consider paying for domestic air travel A worker seeking reimbursement for domestic air travel must provide: copy of receipt from air service airport of departure and arrival name of service provider/hospital attended date(s) and time(s) of travel copy of written prior approval total invoice cost. What fees are payable for domestic air travel For domestic air travel, the Agent can pay the costs of one regular economy full-return airfare for a worker. What will the Agent not pay for in relation to domestic air travel The Agent will not pay any charges above the standard prices charged to non-compensable customers. Meals and Accommodation

5 What can the Agent pay for in relation to meals and accommodation associated with attending an review? The Agent can reimburse the reasonable costs of a worker s meals and accommodation associated with attending an independent medical examination or Medical Panel review. Meals and accommodation costs for anyone other than the worker will not be reimbursed. Is prior approval required for reimbursement of meals and accommodation associated with attending an review? Prior approval must be obtained from the Agent for the reimbursement of meals and accommodation associated with attending independent medical examinations and Medical Panel reviews and will only be provided in specific circumstances. prior approval for reimbursement of meals and accommodation Meal expenses: The Agent can reimburse the reasonable costs of a worker s meal expenses (in accordance with the WorkSafe fee schedule) where travel to the independent medical examination or Medical Panel review is more than 100km away from a worker s residence and results in a worker being away from home at meal time/s. Accommodation expenses: The Agent can reimburse the reasonable costs of a worker s accommodation expenses (in accordance with the WorkSafe fee schedule) where information has been provided that shows the work-related injury or illness prevents a worker from being able to attend the appointment and return home on the same day. expenses for anyone other than the worker. General When will the Agent respond to a request? Within 10 working days of receiving a request for prior approval or reimbursement of expenses, the Agent will advise whether: the request has been approved the request has been denied further information is required to make a decision. Where further information is required, the Agent will advise whether the travel expenses request has been approved or denied within 10 working days of receiving the additional information. Can the Agent prepay for travel The Agent can consider prepaying a worker s travel expenses if the worker requests prepayment and the distance to be travelled is greater than 100 kilometres. consider paying for meals and accommodation A worker seeking reimbursement for meals and accommodation expenses must provide the Agent with receipts for the expenses. What fees are payable for meals and accommodation Refer to the meals and accommodation fee schedule. What won t the Agent pay for in relation to meals and accommodation The following expenses will not be reimbursed: meals and accommodation expenses associated with attending medical and hospital services that are not independent medical examinations required by the Agent or Medical Panel review incidental expenses associated with accommodation such as mini-bar items, laundry, television/video hire, telephone calls and alcoholic beverages

6 Further information Contact the referring Agent, or refer to: How to Invoice WorkSafe WorkSafe s Meals and Accommodation Fee Schedule WorkSafe s Online Claims Manual (refer to Chapters and 10.5)

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