An injured worker is entitled to reimbursement for mileage expenses when traveling to and from related medical appointments. But, is that employee also entitled to receive wage loss benefits for the time missed from work while attending related medical appointments? That answer is not as easy.
It is certainly reasonable to expect, and even require the injured employee to schedule medical appointments around his work schedule so as to avoid disrupting the workday . Of course, health care providers often have the same “work hours” as the rest of us. Thus, there will inevitably arise instances when a worker must miss work to attend medical appointments. However, before compensating him for this missed time, there are some questions that should be asked and answered.
A claimant does not have the unfettered right to schedule a medical appointment during work time. The Commission requires proof that the claimant reasonably had to miss work in order to attend the medical appointment. In so finding, the Commission has ruled that a claimant who schedules a required medical appointment on a workday, or during work time, may receive temporary total or partial benefits if it is shown
(1) that the medical condition required the appointment during work hours;
(2) that scheduling the appointment at a non-work time would interfere with obtaining favorable work assignments; or
(3) that scheduling the appointment at a non-work time would cause substantial hardship.
The burden is on the claimant to show why his appointment could not have been scheduled on a non-work day or time. Generally, the Commission will find the burden met where there is evidence that the worker tried, unsuccessfully, to schedule appointments around work, the provider has limited office hours available, and/or there is significant travel time involved.
So, before agreeing to compensate workers for attending medical appointment, be sure to confirm the facts. Advise the worker that he must put forth a good faith effort to avoid missing work to attend medical appointments; advise the employer to try to accommodate medical appointments by adjusting work schedules if feasible. If it appears to be a recurring problem with a particular claimant, ask him to make the required showing or effort and necessity before agreeing to pay compensation. Often, this will prompt the worker to miraculously obtain appointments outside of work time without any undue hardship.