Claimants: Additional Information : Out-of-Pocket Expenses

Out-of-Pocket Expenses Instructions

• Compensation for Out-of-Pocket Expenses
• Approval Criteria
• Receipts and Maximum Amounts Payable
• Subsequent Claims for Compensation
• How to File a Claim
• Appeals

Compensation for Out-of-Pocket Expenses

Out-of-Pocket expenses will include the following:

AND

The amount that the Administrator may reimburse shall not exceed the guidelines for the reimbursement of out-of-pocket travel expenses taken from the Financial Administration Act of Canada (FAA), more specifically the Treasury Board of Canada Secretariat Travel Directive. The amounts outlined in the FAA are reviewed and revised, where necessary, by the Treasury Board on a semi-annual basis.


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REIMBURSEMENT OF TRAVEL EXPENSES

You may be reimbursed for mileage travelled on a kilometre basis using only the most direct road routes. We will reimburse mileage claims only for distances necessarily driven from home to the location of the appointment and return. Travel expenses are only reimbursed to attend a confirmed HCV related visit. These visits may include attending:

• a laboratory for testing
• a clinic or hospital for ultrasound testing
• a clinic or hospital for a liver biopsy
• other HCV related testing

Such expenses will be reimbursed only if the visits are related to the HCV Infected Person's infection with Hepatitis C.

Costs incurred for road, ferry, bridge and tunnel tolls plus parking charges that were necessary shall be reimbursed if they were associated with an HCV related visit. Original receipts are required.

Original receipts are required for all taxi service where overnight accommodation was not used and the taxi service was necessary for an HCV related visit.
Taxi receipts are not required when you travelled by taxi on an overnight trip for which the cost is less than $8.00.

In situations where you wish to be reimbursed for travel costs other than mileage expenses, you must provide proof that the alternative mode of transportation that was used was more economical or practical than a car.

Hotel expenses shall be reimbursed up to a maximum of $155/night. You must submit proof of the hotel expense being associated with an HCV related visit coupled with the original hotel receipt.

For travel that lasted less than one day (for example when a round-trip journey generally takes place on the same calendar day), the appropriate meal expenses will be paid only where the HCV Infected Person was actually in a position to incur restaurant meal expenses and did not make other arrangements.

The following maximum amounts will be reimbursed if the travel was necessary and related to an HCV visit. Original receipts are required.

Claims for the reimbursement of telephone calls must be supported by statements as to who was called.

Original invoices/receipts are required.

Other similar expenses may include administrative fees such as photocopies, faxes, postage, child care (the amount that the Administrator may reimburse shall not exceed the guidelines for the reimbursement of child care expenses taken from the Financial Administrative Act of Canada), etc.


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REIMBURSEMENT OF MEDICAL EXPENSES

Medical Expenses which might be incurred to establish a claim could include:

• Physician fees for filling out the Tran 2 / Hemo 2 form - maximum as per BCMA guidelines
  
  
• Medical death certificate
  
  
• Autopsy report
  
  
• Fees to obtain medical / health records
  

REIMBURSEMENT OF LEGAL EXPENSES

Legal expenses which might be incurred to establish a claim could include:

• Commissioner of Oaths
  
  
• Long form birth certificate
  
  
• Certified copy of the will

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Approval Criteria

Section 4.07 of Schedule A (Transfused Plan) and section 4.07 of Schedule B (Hemophiliac Plan) of the 1986-1990 Hepatitis C Settlement Agreement coupled with the Court Approved Protocol "Uninsured Medical Expenses and Out-of-Pockets Expenses" provide that the Administrator may reimburse out-of-pocket expenses if ALL of the criteria listed below are met:

Receipts and Maximum Amounts Payable

• If receipts cannot be provided in the course of your first application, the Administrator will nevertheless process your claim for reimbursement. In cases where no receipts are delivered to the Administrator, the amount payable by the Administrator cannot exceed the amounts outlined in the Financial Administration Act of Canada (FAA), more specifically the Treasury Board of Canada Secretariat Travel Directive.
  
  
• In cases where the amount claimed exceeds the amounts outlined in the FAA, the Administrator shall not pay more than what is outlined in the FAA.
  
  
• Where receipts are provided, please indicate your claim ID number on all receipts.
  
  

Subsequent Claims for Compensation by the Same Claimant

After completing your initial claim for out-of-pocket expenses, you are entitled to claim again. Subsequent claims will be processed only after the Approved HCV Infected Person has incurred expenses amounting to $250.00 or more. The Administrator will require a valid receipt for every expense claim.

How to File a Claim

Please complete, sign and date the GEN 3 Form. Be sure to attach all original receipts and indicate your claim ID number on all receipts.

In the future, use our log sheet at section C of the Gen 3 Form to list the dates of every visit to the hospital, clinic, or laboratory attributable to seeking medical advice or treatment for your HCV infection.

Please ensure that your visits are HCV related by obtaining proof from the physician who referred you byway of a signature from a physician / nursing staff / a clinic or a hospital stamp OR a copy of the consult OR a copy of the lab result.

Appeals

The Administrator may determine that your claim for out-of-pocket must be rejected. If you disagree with the Administrator's determination, you must submit a letter to the Centre explaining your objections to the Administrator's decision.The Administrator will then mail a letter about this determination to you and further advise that you have the opportunity to appeal its decision by completing and returning a Request for Review Form. This will entitle you to submit your argument and evidence to an independent arbitrator or referee for final determination.

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