Claimants: Additional Information
: Out-of-Pocket Expenses
Out-of-Pocket Expenses Instructions
Compensation for Out-of-Pocket Expenses
An Approved HCV Infected Person may
be reimbursed for his or her out-of-pocket expenses,
- incurred due to the HCV Infected Person's infection
with Hepatitis C
- were/are not recoverable under any public or
private health care plan
- attributable to seeking medical advice or generally
accepted medication or treatment
Out-of-Pocket expenses will include the following:
to establish a claim with the 86-90 Hepatitis C Claims
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
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.
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
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
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
Breakfast maximum = $14.65 CDN
Lunch maximum = $13.65 CDN
Supper maximum = $38.90 CDN
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.
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
OF LEGAL EXPENSES
Legal expenses which might be incurred to establish a claim
- Commissioner of Oaths
- Long form birth certificate
- Certified copy of the will
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
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:
The HCV Infected Person's claim has been approved
at disease level 1 or higher;
The HCV Infected Person's expenses only
include travel, hotels, meals, telephone and
other similar expenses;
Out-of-pocket expenses must be attributable
to seeking medical advice or generally accepted treatment
for the HCV Infected Person - this must be confirmed
by the physician;
The out-of-pocket expenses were incurred
due to the HCV infection;
Such expenses are not recoverable
by or on behalf of the claimant under any public or
private health care plan;
Original receipts for all costs
incurred must be delivered to the Administrator. Please
indicate your claim ID number on ALL receipts.
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
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
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.
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.