South Carolina Workers' Compensation for Out of Pocket Expenses

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After a work related injury, you expect workers’ compensation to address your medical expenses, rehabilitation, and lost wages. But what about your out of pocket expenses? Does workers’ compensation cover these? In many instances the answer to that question is a fortunate “yes,” although it is not always as simple as seeking coverage for lost wages and medical care. Injured workers should be aware of what is covered by South Carolina workers’ compensation insurance and how to obtain the compensation and coverage that you need for your out of pocket expenses.
For this reason, we’re going to address the most common questions that we hear concerning out of pocket expenses and South Carolina workers’ compensation coverage at the law offices of David R. Price, Jr. P.A. Specifically, we will address the following:

  • What types of out of pocket expenses does workers’ compensation cover?
  • What do you do to get out of pocket expenses compensated?
  • What about reimbursement for mileage?
  • Should you talk to a South Carolina workers’ compensation attorney?

What Types of Out of Pocket Expenses Does Workers’ Compensation Cover in SC?

Any out of pocket expenses that are connected to doctor recommendations should be covered by workers’ compensation insurance. For example, there might be specific medical devices, equipment, or other items to improve your health and wellness after a work related injury. If it is deemed medically necessary for you to purchase any of these things over the counter or through a prescription with money out of your own pocket, then workers’ compensation will cover it. Having said that, you have got to know how to get those expenses compensated.

What Do You Do To Get Out of Pocket Expenses Compensated by Workers’ Comp?

In order to get your out of pocket expenses compensated by South Carolina workers’ compensation insurance, you need to submit a claim to the insurance provider. When you do this, you will write a cover letter to explain what you are seeking compensation for and why. You will also present valid documentation of what you purchased, how much it cost you, and why you needed to purchase it. This documentation should include your bills and receipts. You should also keep copies of the cover letter and the documentation that you sent, so that you have them in your own records.
Once you’ve collected your documentation, made copies for yourself, and composed your cover letter, you will send the information to the workers’ compensation insurance provider in a certified letter with “return receipt requested.” You will get a mail receipt for this, which should also be saved with your own records.
Then, you will wait for a short period of time for a response. If the insurance company takes too long to respond, then they may face penalties, so it should not be long before you receive the response. The response will either include the reimbursement that you requested, or it will explain why they have denied your request.

What About Reimbursement for Mileage?

Your mileage to and from doctor’s appointments is also considered to be an out of pocket expenses. However, this is only covered by workers’ compensation if the round trip distance is greater than 20 miles. If this is true of your commute to and from appointments, then you can request coverage of your mileage from the workers’ compensation insurance provider. You will then be compensated at the same rate as government employees who are compensated for mileage.
To get compensation for your mileage, you will have to prove that it is owed. You will do this by providing documentation of the name and address of the appointment locations, documentation showing the round trip distance, and reports or letters from the doctor(s).
Again, you should also keep copies of this documentation for your own records. You will follow the same procedure to send your request that you follow for other out of pocket expenses, by sending it in a certified letter with “return receipt requested,” and also keep the mail receipt.

Should You Talk to a South Carolina Workers’ Compensation Attorney?

If you have any questions about your workers’ compensation claim and getting reimbursed for out of pocket expenses, or if your request for out of pocket expenses and mileage is denied by the insurance provider, then you would be wise to contact a skilled South Carolina workers’ compensation attorney for further guidance and advice. Call the lawyers at David R. Price, Jr. P.A. for a free consultation to address your concerns and determine whether you need an attorney to assist you in seeking the compensation that you are owed.


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