We last visited the issue of travel expenses to obtain medical treatment in our Summer 2012 issue of the TR&C Pennsylvania Workers’ Compensation Bulletin. In that issue, we advised that travel expenses are reimbursable when the travel is considered “long distance,” i.e., is not available locally. Nothing has changed since that issue. We set forth some guidelines in that issue for analysis of whether travel is reimbursable, which are:
- Determine if the claimant is travelling more than 100 miles one way. If so, the travel is per se “long distance,” and therefore, reimbursable (providing the same treatment cannot be garnered somewhere locally).
- If the same treatment is available locally, but claimant is travelling to obtain it, advise claimant of the locally available option and refuse reimbursement of the travel expense.
- If the treatment is available locally, and claimant is availing himself of the local treatment, then the travel is not reimbursable (absent some exigent circumstance, such as a bed-ridden claimant who requires assisted transport), as it is local travel.
- If the claimant is receiving treatment outside of his locale, then determine if other people in the claimant’s locale would routinely have to travel to that same location to receive the treatment claimant is receiving. If so, then the travel is to be considered local and, therefore, not reimbursable (absent some exigent circumstance). Note: It may be difficult to prove the travel is local in such a situation.
- If the treatment at issue is not available locally, and other people in claimant’s locale do not routinely travel to the treatment location, then the treatment is “long distance.” However, you must still consider whether the travel is for reasonable treatment under Harbison-Walker Refractories v. WCAB (Huntsman), 99 Pa. Commonwealth 382, 513 A.2d 566 (1986) before paying that expense.
Once you have determined that a travel expense is reimbursable, the next issue you may face is: what expenses must you reimburse? Clearly, you would have to reimburse the claimant for mileage, tolls and parking expenses.¹ The tolls and parking expenses are easily determined by what is actually paid by the claimant, but the rate you pay for mileage may be debatable. In the past, the Commonwealth Court has held that an employer is required to reimburse mileage to obtain medical treatment in accordance with the Internal Revenue Code Standard Mileage Rate (IRCSMR) unless there is evidence that the employee’s expenses differ from that rate. Barnyock v. WCAB (Garden State Tanning), 664 A.2d 683 (Pa. Cmwlth. 1995), and Williamette Industries v. WCAB (Lockett), 647 A.2d 665 (Pa. Cmwlth. 1994). A reading of both of those cases reveals that the Commonwealth Court was never asked to analyze the applicable IRCSMR. The Court in both cases apparently assumed the IRCSMR applicable would be the commonly used rate for reimbursement of business travel. However, the Internal Revenue Service (IRS) has established different travel reimbursement rates for different types of travel. The IRS, at Revenue Procedure 2010-51, has set forth rules for taking deductions for travel mileage based upon the costs of operating an automobile for business, charitable, medical, or moving expenses purposes. Those rates are NOT universal. For instance, the current rate is 57.5 cents per mile for business use of an automobile; while the rate for use of a vehicle to obtain medical care is 23 cents per mile (see IRS Notice 2014-79). Undoubtedly, the reimbursement rate for a claimant who is attending an IME at the employer’s request should be 57.5 cents per mile, as the examination is obtained at the employer’s request for a primarily business-related purpose. However, one could reasonably argue that a claimant who seeks medical care for a work injury, who must use his vehicle to obtain that care, should not be able to seek reimbursement at a higher rate than a non-work related patient that needs such care. If a claimant were to forego the mileage reimbursement from the employer/carrier, and instead seek to deduct the travel expense for tax purposes, he could not deduct that travel at the business use rate. Instead, his deduction would be limited to the lower IRCSMR for medical care. Why should a workers’ compensation claimant seeking medical care be entitled to such a windfall? ² At the time of this publication, this author has not seen a precedential case on point that deals with this issue, but it certainly warrants consideration. Perhaps the amounts generally at issue in these matters have not yet generated a case worth appellate pursuit. Taking this stance in the future is certainly recommended should a client want to test the waters.
For a confidential analysis of your workers’ compensation issues, or questions about TRC’s Workers’ Compensation practice area, please contact Harry W. Rosensteel, Esquire at (412) 316-8686 or [email protected].
Important Notice: This information is intended for general guidance only, and should not be used as a substitute for specific legal advice. For specific legal advice applicable to your situation, you should consult an attorney of your choice. Although believed to be accurate when written, no guarantee of completeness or accuracy to your particular circumstances should be implied. Laws, regulations, and court decisions in this area change frequently, and you should consult the attorney of your choice for up-to-date information.
¹This author has also seen frequent requests for meals. Meals could arguably be a legitimate expense, but only in a situation where the travel absolutely necessitated a claimant being on the road for substantially the entire day. Absent such circumstance, it does not seem reasonable to this author that meals are a viable travel expense.
²This author could anticipate that a counter argument to this position would be that IRS reimbursement for medical travel in a non-workers’ compensation matter seeks to ease the burden that obtaining medical care has on taxpayers in general; while the purpose of reimbursement in a workers’ compensation case would be to make the claimant whole. That is to say, were it not for the work injury, such expense would not be necessary.