When are travel expenses covered under workers’ comp?
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When are travel expenses covered under workers’ comp?

In City of Flagstaff v. Industrial Com’n of Arizona , the Court of Appeals of Arizona held that the Industrial Commission of Arizona’s award of mileage expense reimbursement to a workers’ compensation claimant was error.

Facts of the case

The case before the court involved a claimant who lived in Flagstaff and worked for the city’s wastewater treatment plant. In the course of his employment, the claimant suffered injury to his neck and back and filed a workers’ compensation claim. The claim was approved and claimant obtained medical treatment in Flagstaff from an orthopedic surgeon, neurosurgeon and pain management specialist.

After the claim had closed, the claimant’s neck pain was still a 7 or 8 on a scale of 10. Because of the ongoing pain, the claimant obtained a referral to and consultation from a neurosurgeon in Phoenix. The Phoenix neurosurgeon recommended surgery and the claimant filed a petition to reopen his case. The petition to reopen was approved, the claimant traveled to Phoenix and the recommended surgery was performed. Following the surgery, the claimant filed for a hearing to request reimbursement of expenses incurred traveling from his home in Flagstaff to Phoenix for surgery and treatment. The claim for travel expenses was initially denied, but after an Industrial Commission of Arizona (ICA) hearing on the issue, travel expense reimbursement was awarded. The workers’ comp insurance carrier requested administrative review of the ICA decision, but the administrative law judge (ALJ) summarily affirmed the reimbursement. The workers’ comp insurance carrier appealed.

Travel expenses and the Arizona Workers’ Compensation Act

The Arizona Workers’ Compensation Act does not explicitly address the matter of travel expenses, but, in general, is construed to exclude reimbursement for such expenses unless they are necessary for the claimant to obtain treatment.

In situations where a claimant’s travel expenses are incurred seeking treatment in the same metropolitan area or city, travel expenses will be denied. On the other hand, if a claimant lives in a rural area and the closest available medical treatment is several hundred miles away, travel expenses may be appropriate if the failure to award them would effectively preclude the claimant from getting the medical treatment to which he or she is entitled. In other words, if a claimant must travel to obtain medical treatment, he or she is entitled to an award of travel expenses.

In the case before the court, the claimant lived in Flagstaff. Because treatment from a neurosurgeon was available in Flagstaff, it was not necessary for the claimant to travel to Phoenix to obtain the particular surgical treatment recommended. Only if medical care had not been available in Flagstaff such that the claimant had no choice but to travel would mileage reimbursement expenses be appropriate.

Speak to a workers’ comp lawyer

If you have been injured on the job, then you may be entitled to workers’ compensation. To learn more about your options, contact a workers’ compensation attorney to schedule a consultation to discuss your case.