When Can Travel Reimbursement Be Limited in Oregon Workers’ Compensation?

By Kolbi E. Trebbien, Attorney at Law

Injured workers are generally entitled to reimbursement for reasonable and necessary travel expenses related to compensable medical treatment. Such reimbursement includes mileage, parking, and other related expenses. The purpose of the rule is straightforward: access to medical care should not be limited by geography or financial hardship.

However, such travel reimbursement is not unlimited. OAR 436-009-0025(4)(b) allows an insurer to limit reimbursement when a worker elects to treat with an attending physician located far from the worker’s residence, provided certain requirements are met. The rule does not permit an automatic cap on mileage. Instead, it establishes required protocol before reimbursement can be limited.

Before limiting travel costs, the insurer must provide written explanation that reimbursement may be restricted due to availability of providers closer to the worker’s residence. In addition, the insurer must provide a list of alternative attending physicians who are located closer to the worker’s residence, who practice in the same specialty, and who are willing to provide similar medical services. A provider who is not truly comparable in specialty, or who is not accepting patients, does not meet the rule’s requirements.

Importantly, the worker is not required to change physicians and may continue treatment with the chosen attending physician. The rule simply allows the insurer to limit mileage reimbursement to the distance between the worker’s residence and with one of the identified geographically closer
providers.

Please do not hesitate to me at kolbit@rwlaw.com if you have questions regarding this issue.