Travel Expenses for Medical Treatment

In a Rule 23 decision (not legal precedent), the Illinois Appellate Court, Worker's Compensation Division affirmed the judgment of the Circuit Court that confirmed the decision of the Illinois Workers' Compensation Commission awarding travel expenses to Petitioner for travel to and from the Petitioner's treating physician.

In this case, travel expenses totaling $1,041.60, amongst other benefits, were awarded to the Petitioner. The Illinois Workers' Compensation Commission unanimously affirmed the Arbitrator's decision. The Respondent appealed to the Circuit Court which confirmed the Commission's decision and this appeal to the Appellate Court followed. The main issue on appeal was the Respondent's assertion that the award of travel expenses was contrary to law.

As a result of repetitive trauma to her hands and elbows, the Petitioner was diagnosed with bilateral carpal tunnel syndrome and bilateral cubital tunnel syndrome. The Respondent had the Petitioner examined by an IME Physician in St. Louis, MO. The Respondent's IME physician concluded after a review of a videotaped job description, that the petitioner's job activities could potentially contribute to carpal tunnel syndrome and cubital tunnel syndrome. At arbitration the Respondent did not dispute the compensability of the petitioner's injuries nor the reasonableness and necessity of her medical treatment. The Respondent did, however, object to petitioner's mileage log of 2,880 miles to and from her treating physician. The Petitioner lived in Christopher, Illinois and sought treatment from Dr. Beatty in Edwardsville, Illinois, approximately 108 miles away. The Petitioner testified that her reason for choosing Dr. Beatty was that Dr. Beatty was a hand surgeon, with training in plastic surgery. She also testified that she knew of people who had had similar surgeries who had extensive post-operative scarring on their arms and hands. The Petitioner decided she wanted to minimize her own scarring by receiving treatment from a doctor who was also trained in plastic surgery. Although she knew of local orthopedic surgeons, she did not know of any local doctors with plastic surgery training.

The Arbitrator in this case took judicial notice of the Governor's travel board rates and found that the choice of medical treatment with Dr. Beatty was reasonable and necessary and mileage expenses are reasonable for the travel to treatment to and from the doctor. The Arbitrator Awarded the Petitioner $1041.60 in travel expenses.

The appeal of the issue of the award of travel expenses involved the element of reasonableness. The Court in this case, cited General Tire & Rubber Co. v. Industrial Comm'n, 221 Ill. App. 3d 641 (1991), where the Appellate Court found it reasonably necessary for the claimant to incur $1,588.00 in travel expenses for treatment by a doctor whose office was located 90 to 100 miles from the claimant's home. The Court applied the reasonableness standard.

In General Tire, the Petitioner lived in the Mt. Vernon area and sought treatment from Dr. Marrese who practiced first in Evansville, Indiana and then moved to Wood River, Illinois. Evansville is approximately 100 miles from the petitioner's home and Wood River is approximately 90 miles away (Id at 651). This particular doctor had been the petitioner's treating physician since 1984 when the Petitioner initially sought medical treatment on April 17, 1984 the date of his initial injury. The Petitioner was subsequently re-injured at work on July 11, 1986. The General Tire Court concluded that because Dr. Marrese had been the petitioner's treating physician since 1984, he was the doctor most familiar with the petitioner's condition and medical history. It would be reasonable for the petitioner to seek the medical care of someone he knew and trusted.

In applying the standard of reasonableness, the Appellate Court in the instant case reasoned that the reasonableness standard does not entail an independently dispositive element of necessity. "The overriding element is reasonableness; to the extent that travel expenses must be necessary, they must be reasonably so, not absolutely so." In so concluding, the Appellate Court held that the Commission did not err as a matter of law by articulating its award of travel expenses in terms of reasonableness. The Court found that the Petitioner's specifically stated reasons for choosing to treat with Dr. Beatty were reasonable, further the Court noted that the Petitioner traveled no farther to see Dr. Beatty and the Respondent required her to travel for IME visits.