Rising Gas Prices Warrant Increase in Mile Reimbursement Rate in Oregon
The Oregon Workers Compensation Division issued a Revised Bulletin No. 112 and an updated Form 3921 (Request for Reimbursement of Expenses), to address increasing gas prices. Effective July 1, 2022, an injured worker is entitled to reimbursement for personal mileage expense equal to 62.5 cents per mile. This represents a four-cent increase over the mileage rate set just six months ago. Prior rate increases occurred on an annual basis. The Revised Bulletin did not adjust meal and lodging reimbursement.
There appears to be no foreseeable end to rising gas prices. The WCD is paying attention to those costs and increasing rates accordingly. As claim costs increase, it is more important than ever to scrutinize reimbursement requests to ensure they are compliant with OAR 436-009-0025. Things to consider when evaluating a request for reimbursement of claim related costs:
- Was the request for reimbursement submitted by the later of the following dates:
- Two years from the date the costs were incurred or
- Two years from the date the claim or medical condition is finally determined to be compensable? OAR 436-009-0025(2)(a).
If the request was not submitted timely, the insurer may disapprove the reimbursement request. OAR 436-009-0025(2)(b)
- Was the reimbursement request written and did it provide reasonable documentation (i.e., sales slips, receipt, etc.) to support the request? If not, the insurer can require this additional information before deciding whether reimbursement is appropriate. OAR 436-009-0025(1)(b). The request for additional information must occur within 30 days of receiving the reimbursement request. If additional information is needed, the time to obtain the information is not counted in the 30-day timeline to respond. OAR 436-009-0025(1)(c).
- For meal reimbursement, was the meal “reasonably” required by necessary travel to a claim related appointment? Reasonableness is determined on a case-by-case basis and includes factors such as travel, appointment length, etc. OAR 436-009-0025(3)(a).
- For lodging reimbursement, was there a need for an overnight stay? OAR 436-009-0025(3)(b).
- For travel reimbursement, was the request for actual and reasonable costs for travel to medical providers paid by the worker?
- Personal vehicle mileage reimbursement is based on the reasonable actual distance for the beginning and end addresses to attend an appointment.
- Public transportation or, if required, special transportation is reimbursed based on the actual cost. OAR 436-009-0025(4)(e)-(f).
- Is the injured worker traveling long distances to receive treatment?
- If yes, the insurer may be able to limit reimbursement based on practitioners that are closer to the worker. The specific criteria to limit reimbursement are outlined in OAR 436-009-0025(4)b).
The timeline to respond to reimbursement requests are quick – 30 days from the receipt of the request for accepted claims OR within 30 days of receiving the request or 14 days of claim acceptance (whichever is later) for requests received prior to claim acceptance. If you have questions regarding a reimbursement request, requirements for disapproving a request, and/or the rules outlined above, please contact me directly at 503-412-3116 or .
Posted by Courtney Kreutz.