GQ Corner

Q. I have a claimant who is submitting DWC-48s to me for travel reimbursement, but many of the dates of travel are beyond one year. Am I able to deny them?

A. A claimant is entitled to travel reimbursement for medical treatment if medical treatment is not reasonably available within 30 miles of where he lives and he travels a distance of greater than 30 miles one-way. But, even so,  he must submit DWC-48s to the carrier within one year of his date of travel.

Q. Do I have to pay a claimant for medical treatment that he has paid for even though I have told him to have his doctor bill the carrier?

A. You are required to take action on the claimant’s request within 45 days of receiving his request.  He must submit a request that is legible and provide evidence of the amount he paid. The response can be on an EOB or in letter form, but it must respond to each specific item being requested.