Reimbursement Requests in New York: Claimant’s Record of Medical and Travel Expenses (C-257)

Under New York’s Workers’ Compensation Law, the claimant is entitled to be reimbursed for any drugs or apparatus properly prescribed by the treating physician.  Additionally, the claimant is entitled to receive reimbursement for fares, mileage and other necessary expenses going to and from his or her medical appointments.

To receive proper reimbursement, the claimant must keep record of such expenses and provide the carrier with same.  The Board instructs the claimant to submit the completed C-257 form and copies of all receipt or bills to the carrier for reimbursement.  Please note that the claimant must provide a complete form and copies of all receipts or available bills.  Please note that a C-257 form, itself, is not a mandatory filing.  The claimant may keep track of his or her expenses in any formation.  However, simply submitting a C-257 form is not necessarily a sufficient record.

It should also be noted that the reimbursement is owed for round-tip mileage, rather than a flat-fee rate.  Meaning, the reimbursement is for mileage,  not taxi or bus fare.  Below is the rate of reimbursement for mileage by year:

http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp

Hypothetical:

You are handling a claim with the following set of circumstances:

The claimant submitted a C-257, with the Board  which contains multiple entries.  Every entry states “to/from doctor’s office” and lists a $50 expense was incurred as a result.  Every entry is missing the date of the medical appointment, the name of the doctor’s office, and roundtrip mileage.

Proper Procedure:

Since the claimant did not provide sufficient information in the above mentioned hypothetical, we recommend filing a written notice with the Board.  We recommend that you document that the submitted C-257 was audited timely.  Additionally, we recommend documenting that the claimant failed to provide a sufficient record of his or her medical and travel expenses.  Therefore, the carrier cannot issue proper reimbursement until the claimant provides a complete C-257 form and any bills and receipts available in connection with the traveling expenses incurred as a result of attending medical appointments.

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