4123-6-40 Payment of claimant travel expenses.  

  • Text Box: ACTION: Final Text Box: DATE: 11/02/2015 10:21 AM

     

     

     

    4123-6-40                    Payment of claimant travel expenses.

     

     

     

    (A)   A claimant's travel expenses shall be paid, upon the filing of a proper request, under the following circumstances:

     

    (1)     When the claimant has been ordered or authorized to undergo a medical examination outside of the city or community limits where he resides. The claimant shall be reimbursed for travel only if the travel distance exceeds a mileage distance as periodically determined by the bureau. The minimum mileage distance for reimbursement shall be published periodically by the bureau.

     

    (2)     When specialized treatment necessary for the allowed industrial condition cannot be obtained within the city or community where the claimant resides, and the treatment has been pre-authorized and approved. The claimant shall be reimbursed for travel only if the travel distance exceeds a mileage distance as periodically determined by the bureau. The minimum mileage distance for reimbursement shall be published periodically by the bureau.

     

    (3)   When the claimant has been requested to undergo a medical examination by a physician of the employer's choice, travel expenses incurred as a result of the examination are to be paid by the employer immediately upon the receipt of the bill. Payment of the bill shall not require an order of the bureau or commission, unless there is a dispute. The employer shall provide the claimant with a proper form to be completed by the claimant for reimbursement of traveling expenses. The minimum mileage provision of paragraphs (A)(1) and (A)(2) of this rule shall not apply for reimbursement of examinations under this paragraph of the rule. When the claimant's allowed conditions require taxicab or other special transportation for treatment or examination on account of an allowed injury or occupational disease. Taxicab or other special transportation must be pre-authorized.

     

    (4)(B) In situations described in paragraphs (A)(1) and (A)(2) of this rule, the following provisions apply:

     

    (a)(1) If the claimant is traveling by automobile, the claimant shall be entitled to a reasonable payment, as established and periodically published by the bureau, on a per mile basis if the mileage exceeds the distance established as provided under paragraph (A) of this rule, portal to portal, using the most direct and practical route.

     

    (b)(2) If the claimant is traveling by airplane, railroad or bus, the claimant shall be entitled to the actual and necessary airplane, railroad or bus fare.

     

     

     

     

    (c)(3) The reasonable cost of necessary meals, based on distance traveled, will be refunded to the claimant. It shall be paid in accordance with a schedule adopted by the bureau and periodically revised.

    (d)(4) Necessary hotel lodging bills will be paid at reasonable actual cost. Hotel accommodation Lodging must be pre-authorized.

    (5) Taxicab fares will be refunded only when the claimant's physical condition requires such transportation for treatment or examination on account of an allowed injury or occupational disease. Taxicabs or other special transportation shall be pre-authorized.

    (6) The payment rates for meals, lodging and travel shall be published periodically by the bureau.

    (C) When the claimant has been requested to undergo a medical examination by a physician of the employer's choice, travel expenses incurred as a result of the examination are to be paid by the employer immediately upon the receipt of the bill. Payment of the bill shall not require an order of the bureau or commission, unless there is a dispute. The employer shall provide the claimant with a proper form to be completed by the claimant for reimbursement of traveling expenses. The minimum mileage provision of paragraphs (A)(1) and (A)(2) of this rule shall not apply for reimbursement of examinations under this paragraph (C) of this rule.

    (B)(D) Actual payment or refund shall be made in accordance with requirements outlined in this rule. The payment rates for meals, lodging, and travel shall be published periodically by the bureau.

    (C)(E) This rule applies to all claims for industrial injuries and/or occupational diseases, regardless of whether the employer is part of the state fund, is self-insuring, is non-complying, etc.

    Effective:                                                             11/13/2015

    Five Year Review (FYR) Dates:                         08/26/2015 and 08/25/2020

    CERTIFIED ELECTRONICALLY

    Certification

    11/02/2015

    Date

    Promulgated Under:                           119.03

    Statutory Authority:                           4121.12, 4121.121, 4121.30, 4121.31, 4121.44,

    4121.441, 4123.05, 4123.66

    Rule Amplifies:                                  4121.12, 4121.121, 4121.44, 4121.441, 4123.66

    Prior Effective Dates:                         2/12/97, 10/14/02, 6/1/05

Document Information

Effective Date:
11/13/2015
File Date:
2015-11-02
Last Day in Effect:
2015-11-13
Five Year Review:
Yes
Rule File:
4123-6-40_PH_FF_A_RU_20151102_1021.pdf
Related Chapter/Rule NO.: (1)
Ill. Adm. Code 4123-6-40. Payment of claimant travel expenses