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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 7. EMPLOYMENT BENEFITS |
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Chapter 7-1. [DELETED] |
Section 7-125. TRANSPORTATION AND MILEAGE
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125.1The Program may provide a claimant with transportation to and from a physical examination or medical treatment that is authorized by the Program pursuant to this chapter.
125.2A claimant who needs transportation to and from a physical examination or medical treatment shall request such transportation from the Program no later than five (5) business days before the authorized physical examination or medical treatment.
125.3The Program shall authorize transportation to a routine physical examination only if the claimant provides the Program with documentation from his or her treating physician that the transportation is necessary due to medical necessity. “Medical necessity,” as used in this section, means that the claimant is not capable of driving himself or herself or using public transportation to get to the examination, due to his or her work-related injury.
125.4The Program shall authorize transportation to an AME if the examination is within a reasonable distance of the claimant’s home address, work address, or public transportation, only if the claimant provides the Program with documentation from his or her treating physician that the transportation is necessary due to medical necessity. If the AME is not within a reasonable distance of the claimant’s home address, work address, or public transportation, the Program shall provide the claimant with transportation to the examination upon the claimant’s request.
125.5The Program shall authorize transportation to an outpatient or inpatient surgical procedure upon the claimant’s request.
125.6Upon a claimant’s request, the Program may reimburse a claimant for expenses incident to the claimant’s attendance at a routine physical examination, Additional Medical Examination, or medical treatment that is authorized by the Program, including for the cost of public transportation, mileage, and parking expenses.
125.7Claimants shall be reimbursed for the cost of mileage based upon the distance from either his or her place of employment to the physician’s office or treating facility, or from his or her home to the physician’s office or treating facility. The cost per mile reimbursed by the Program shall be at the same rate as the United States General Services Administration Privately Owned Vehicle Mileage Reimbursement Rates. The cost per mile shall be included on the form required in § 125.8 and shall be posted on the ORM’s website.
125.8If a claimant requests reimbursement of expenses pursuant to § 125.6, the Program shall send the claimant a form requesting information on and documentation of the cost of the expenses. A claimant shall not be reimbursed for expenses under this section if the claimant has not returned the form and documentation as requested by the Program.
125.9In order to be reimbursed for transportation expenses pursuant to § 125.6, the claimant must submit a written request for reimbursement within ninety (90) days of the date that the claimant incurred the expense. The Program shall deny requests received after ninety (90) days of the date that the claimant incurred the expense. If the claimant’s request for reimbursement of expenses meets the requirements of this section, the Program shall reimburse the claimant within ninety (90) days of the Program’s receipt of all of the information and documentation required to make a decision on the claimant’s request.