Wyoming Administrative Code
Agency 053 - Workforce Services, Department of
Sub-Agency 0021 - Workers' Compensation Division
Chapter 7 - BENEFITS
Section 7-3 - Medical and Hospital Care
Universal Citation: WY Code of Rules 7-3
Current through September 21, 2024
(a) Health Care Benefits.
(i) Workers with injuries
compensable under the Act shall be provided reasonable and necessary health
care benefits as a result of such injuries.
(ii) Change of Health Care Provider. A worker
wishing to change treating health care providers while under treatment shall
file a written request with the Division, stating all reasons for the change
and the name of the intended new treating health-care provider. The Division
shall send notice of the change to the employer, the worker, and the current
and intended new treating health care providers.
(iii) Medical Reimbursement to Injured
Worker. Requests for reimbursement may be submitted to the Division by an
injured worker for expense paid out-of-pocket for medical service(s) deemed
reasonable, necessary and directly related to his work-related injury on a form
provided by the Division.
(A) Requests for
reimbursement will be considered only if the original receipt, which must be
itemized, displays the transaction date, and substantiates proof of payment, is
submitted with the Division's form.
(B) The Division may reimburse an injured
worker 100% for the initial expense including taxes, paid out-of-pocket for
prescribed medical service, prescribed drug or supply required to treat a
compensable injury, when the service, drug or supply had been provided prior to
the Division's notifying the injured worker of the case number assigned to his
reported injury. The Division will not reimburse an injured worker for
insurance co-pays or deductibles.
(C) Expenses incurred by an injured worker
for over-the-counter (OTC) medication or medical supplies prescribed or
recommended by the treating health care provider will be reimbursed at 100% of
the purchase price, including taxes.
(iv) Travel Reimbursement. Reimbursement for
travel necessary to obtain the closest available medical or hospital care
needed by the employee will be payable at the rates provided for state
employees in the rules and regulations of the State Auditor. W.S. § 27
14-401(d)(iii).
(A) Reimbursement for mileage
will be based on map mileage from address to address and travel within the
community of residence will only be paid if the distance exceeds ten miles one
way.
(B) Requests for reimbursement
of meal, lodging, bus, air travel, cab, train, parking, and other travel
expenses must be accompanied by the original receipt. Reimbursement will not be
paid for car rental expenses under any circumstances.
(C) Reimbursement for meals shall be paid as
provided for state employees in the rules and regulations of the State
Auditor.
(D) Unless medically
necessary, there shall be no reimbursement for the travel and associated
expenses incurred by other persons or for phone charges incurred during such
travel. Necessity for accompanied travel should be reflected in the
documentation provided from the health care provider.
(E) Reimbursement for travel will be
considered only if filed on the appropriate form provided by the
Division.
(F) Claims for
reimbursement shall be submitted to the Division within one (1) year from the
date travel or other expenses were in
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