New York Worker’s Compensation – Medication and Transportation Reimbursement (C-257)

Syracuse, NY Workers' Compensation Lawyers | Medication and Transportation Reimbursement | MCV Law

For Meggesto, Crossett, and Valerino claimants with an existing New York State Workers' compensation case, Compensation Law provides for the reimbursement of certain Medical and Transportation costs that are directly related to the injury of record.

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Reimbursable expenses include mileage for transportation to and from Doctor’s visits, as well as out-of-pocket medical expenses for prescriptions and for durable medical equipment such as crutches and braces.

Below is the link to the mileage reimbursement rates.
http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp

Below is the link to our C-257 form generator, which is the form to be used for submitting Medical and Transportation expenses.
http://mcvlawblog.com/practice-areas/workers-compensation/medical-and-transportation-expense-c-257-form-generator/

This form is very straightforward. Be sure to fill in all the necessary information at the top of the form, including name, WCB case Number, Social Security number, and address. On the bottom half of the form, as well as on the second page, are spaces for you to fill in your expense information. If you are going to ask for reimbursement of both mileage and medical expenses, it is best to use separate forms in order to keep the mileage and the medical separated.

When calculating mileage, under “Nature of Expense” put the name and address of the Doctor you are visiting. In the second column goes the date of the visit, and in the third column goes the “round-trip” mileage to the Doctor and back to your place of residence. A trip to the pharmacy to pick up prescriptions is not a covered expense. Parking and toll expenses are, however, covered, with copies of original receipts. Do not try to “pad” the mileage with extra driving, because the examiner will already have an approximation of the miles involved, and discrepancies will slow or stop the reimbursement process. Be sure to inquire if your carrier offers any home deliveries on prescriptions – more and more carriers are offering such programs.

When applying for Medical reimbursement, under “Nature of Expense,” put the name of the prescription or the type of medical equipment that you are seeking reimbursement for, the date you made the purchase, and the amount spent out-of-pocket. Please note that the carrier will not reimburse for out-of-pocket copays for medication. The carrier will also not reimburse for any prescription or medical equipment without a copy of the original receipt.

When you have completed the form, forward it to your Compensation insurance carrier for reimbursement. There is no statutory time limit for the reimbursement process, and there is no penalty for late payment of medical and transportation expenses, but allow at least a window of 60-90 days to receive payment. If you have not heard anything in 60 days, contact the offices of Meggesto, Crossett, And Valerino, and we will be glad to contact the carrier on your behalf. It is important for all parties involved that you keep a copy of your submission, in the event that payment is incorrect or delayed.

Tips:

  • Make sure the form is complete.
  • Neatness counts – a sloppy or incomplete form will cause delay.
  • Try to submit no more than 6 months’ worth of expenses at a time. If you try to submit several years at once, payment will be delayed, and there is no guarantee that the insurance carrier will be able to go back and pull all the necessary records.
  • If you receive mileage and not all of it is paid, it is possible that the medical records of your visits are not yet available to the carrier. Those records must be matched with your mileage submission. No payments are made until the matching medical reports are filed.

John M. Bellinger
Paralegal
[email protected]

Mr. Bellinger is part of the Worker’s Compensation team at Meggesto, Crossett and Valerino. This entry was written by Mr. Bellinger under the direction and approval of Attorney Crossett.

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