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90.2 Travel and/or accommodation costs reasonably incurred to attend treatment
Last amended: 29 November 2017
Sub section 16(6) provides for reimbursement to a person for travel and/or accommodation costs reasonably incurred in order for the person to attend treatment.
Sub section 16(8) of the SRCA provides the following list of matters which delegates should have regard to when considering journey and accommodation claims for travel to treatment:
a)the places where appropriate treatment was available to the person;
b)the means of transport available to the person for the journey;
c)the routes by which the person could have travelled; and
d)the accommodation available to the person.
Compensation can be paid for costs reasonably incurred for a journey made by a person to obtain treatment where:
- the person uses ambulance services; and
- the person's service injury or disease requires using those services.
The issue of whether a person's injury or disease requires ambulance services for transport is a matter for consideration by the delegate based on the evidence. For example, if the person has a need for care during transportation, has lost control of effective bodily systems required for travel or is bed-ridden, then the delegate should be adequately satisfied that the person requires ambulance transport.
A person should have non-emergency ambulance transport reimbursed, or paid, if the travel is related to their accepted condition/s. The person should contact the delegate prior to the travel being undertaken to obtain prior-approval for the travel and to allow the appropriate amount to be reimbursed to the claimant or paid directly to the ambulance service provider.
Where it is necessary for a person to travel to obtain treatment, compensation can also be paid for costs reasonably incurred for the journey where the person uses public transport.
Note: The definition of “public transport” for the purposes of meeting the cost of travel can be a complicated matter. For example:
- The use of taxis as a form of public transport may be acceptable. Whether a person has reasonably incurred a cost by using a taxi to travel to treatment must be considered in the light of whether there is another appropriate method of “mass” public transport available (bus, train etc), whether there is a demonstrated need for the person to use a taxi (such as evidence from the treating or referring doctor), or whether there is a family member reasonably available to assist in travel to treatment etc.
- The use of more expensive forms of “mass” public transport (such as air travel) for travel to treatment has to be considered in light of the options available to the person. Often for a person who is remote from the location where treatment is provided, the use of “mass” public transport such as air travel may be more appropriate (so the delegate considers the cost to have been reasonably incurred). This may be due to either the fact that driving may exacerbate the condition, air travel minimises time off work and provides the most direct (and therefore fastest) route, or the person is unable to drive.
No minimum distance restriction is placed on the use of either public transport or ambulance services for travel to compensable treatment. That is, the 50 km rule does not apply as per subsection 16(7)(b).
Generally, where a journey made by a person to obtain treatment is not by ambulance services or public transport, and the reasonable length of the journey (including the return part of the journey) does not exceed or is equal to 50 kilometres, compensation is not payable.
Where the length of the journey is less than or equal to 50 kilometres
Compensation can be paid for the costs reasonably incurred for a journey made by a person to obtain treatment if, having regard to the nature of the person's service injury/disease, it is reasonable for the person to use public transport or ambulance services. In this case, no distance qualification applies.
Where the length of journey is greater than 50 kilometres
Where the reasonable length of the journey (including the return part of the journey) exceeds 50 kilometres, compensation can be paid for the costs reasonably incurred for a journey made by a person to obtain treatment where the person uses means other than ambulance services or public transport. This compensation is calculated on the basis of the length of the journey considered reasonable by the delegate, using a specified rate per kilometre as prescribed by subsection 16(6).
In the situation where a person chooses to travel beyond a location where treatment is available, the shorter distance will be used for the calculation of the reimbursement amount. For example, if a person travels a 200km round trip to obtain treatment, but the same treatment is available at a location that only required a 100km round trip (and the person is made aware of this fact, but chooses to travel the extra distance), then the reimbursement would only be paid for the 100km trip equivalent.
Attendant journey and accommodation costs
Subsection 16(6) should also be interpreted to provide compensation for journey and accommodation costs reasonably incurred by an attendant who is approved by the delegate to accompany a person to obtain treatment. These costs are calculated in exactly the same manner as those for the person receiving treatment.
Note: Attendants' costs for travel to attend vocational rehabilitation or a medical review are not normally payable. However, where a medical practitioner has certified that the attendant is required attend with the client or attend separately when it is clinically recommended that they participate in a Commission approved treatment program, such as a PTSD course, and that attendance is identified as being of benefit to the client, reasonably incurred travel and accommodation costs may be approved by a delegate using the existing legislative provisions as endorsed by the Commission.
When an attendant is the partner/spouse of the person receiving the treatment shared accommodation may be considered appropriate and reasonable. However, if the person's medical practitioner certifies that there is a need for the couple to have separate rooms, the additional cost would be reasonable.
Only one travel reimbursement amount should be paid when the attendant travels by the same method as the person obtaining the treatment, if that mode of transport is self-contained (i.e. they travelled in the same car).