Court of Appeals Addresses Notice of Claimant’s Transportation Needs

by James G. Muncie, Jr., Esq.

In the recent case of Medical Management International and Travelers Indemnity Company of America v. Jeffry, the Virginia Court of Appeals examined whether the Workers’ Compensation Commission erred when it awarded full reimbursement of the claimant’s Uber costs. 75 Va. App. 679 (2022). The Court concluded that the Act does not require the claimant to give advance notice of transportation needs or costs and the employer and insurer suffered no prejudice from the claimant’s lack of notice to them before incurring the expense.

In the Jeffry case, the claimant underwent surgery for a compensable injury and was rendered unable to drive as a result. If no one in the claimant’s family was available to take her to her medical appointments, she would use Uber as her mode of transport.

At the Deputy Commissioner level, the claimant received reimbursement according to the Commission’s standard rate per mile, amounting to $139.83 of the $881.47 sought by the claimant. The Deputy Commissioner awarded reimbursement in this fashion because they accepted the defendants’ argument that the claimant had not given notice that she needed transportation.

However, upon review by the full Commission, the Deputy Commissioner’s finding was reversed. The Commission focused on the defendants’ argument that they had been prejudiced by the lack of notice. The Commission reasoned that the lack of notice alone was not fatal to the claimant’s request for transportation costs. The Commission “divine[d] but one purpose for a notice requirement: to “allow[]the [employer] the opportunity to save money by arranging transportation by a less costly means than that chosen by the claimant.” The Commission further provided that, “if the [employers] can mitigate their costs, then notice affords them the opportunity to do so. If, however, they can’t secure less costly transportation, then they cannot claim that their interests were prejudiced merely because the claimant failed to notify them that she was securing transportation through Uber.”

The defendants in this case offered no evidence to establish that they were prejudiced by the lack of notice, such as proof that they routinely provide transportation services at a lower cost than Uber. Thus, the Commission found that the claimant’s request was not barred and awarded the claimant the full amount of her Uber charges.

The Virginia Court of Appeals affirmed the Commission’s ruling, although on different grounds. While the Commission viewed the relevant question in this matter to be one of prejudice, the Court of Appeals emphasized that there is no such notice requirement in the statute regarding transportation expenses.

Firstly, the Court reiterated that the Workers’ Compensation Act requires medical care for a compensable injury be provided free of charge, and in accordance with this principle, Commission case law has “consistently held that the employer is responsible for the reasonable and necessary transportation in connection with [a] claimant’s medical treatment.” Further, the Court highlighted that the Commission has also established precedent in which, “depending on the circumstances, reasonable and necessary costs may encompass various methods of transportation, ranging from ‘mileage reimbursement’ to ‘the cost of taxi services, ambulance [rides] or airplane [fare].’”

Secondly, the Court discussed the absence of any language in the Act to support an advance-notice or pre-authorization requirement. Pointedly, the Court stated that, “we find the omission of such a notice requirement in the text of the Act to be significant because the General Assembly knew how to create a notice requirement if it had intended one.” The Court outlined various other instances in the Act in which a notice requirement is specifically included, such as for reporting occupational disease or notice of the workplace accident, once again calling attention to the absence of a notice requirement in the Act pertaining to necessity of transportation. The Court also concluded that, “it would be inconsistent to require notice here when a claimant does not have to specifically request medical benefits in an application to the Commission to be entitled to all necessary medical benefits.”

Yet, the Court clarified that while an employee with a compensable injury is entitled to free transportation to medical appointments, that does not mean they are entitled to transportation by any method or at any cost. The transportation costs must be “reasonable and necessary.” The Court also provided that the employer and insurer may still meet its obligation by choosing which means of transportation the claimant receives, such as by contracting with a third-party to provide transportation. Further, a carrier can still contest the amount of the claimed transportation charges as “unreasonable”, particularly if the carrier has discounted fares they pay to vendors for such transportation.

If a scenario arose in which the employer offered transportation and the claimant declined and opted to use a more expensive mode of transport, then the Court said a request under such facts should be denied. But these are not the facts as presented in Jeffry, as the claimant’s employer in this case provided no particular methods for transportation to medical appointments. Therefore, absent any evidence that the Uber charges incurred by the claimant in Jeffry were excessive, it was not unreasonable for the claimant to utilize Uber to get to her appointments.