An occupational injury is understood as harm to health suffered by an employee while performing work duties or in direct connection therewith. Such an event may have not only health but also financial consequences — besides pain and temporary incapacity to work, the question arises as to who will bear the costs associated with medical treatment.
Treatment Costs Related to Occupational Injuries
Employees are entitled to compensation in connection with occupational injuries. The most common claims involve compensation for pain and suffering, impairment of social usability, wage compensation, and severance pay. One of the less known and often overlooked components of an injured employee’s claim are the treatment costs related to the occupational injury. This article explains what treatment expenses you may claim from your employer after a workplace injury and what conditions must be met for a successful claim.
What Are Treatment Costs Related to Occupational Injuries?
Generally, most treatment expenses are covered by health insurance. However, certain procedures, medications, or medical aids may not be covered, requiring out-of-pocket payments. The Labour Code (§ 271d) does not explicitly specify which treatment costs employees can claim. Therefore, below is a summary of commonly recognized expenses based on expert literature and case law.
Common Types of Treatment Costs Related to Occupational Injuries
Co-payments for Medications and Pharmaceuticals
Many prescribed medicines are only partially reimbursed by health insurance. Co-payments made at the pharmacy are a typical example of expenses that your employer must reimburse, provided these medicines were reasonably necessary for treating the occupational injury.
Medical Aids and Devices
Medical aids are intended to aid recovery and rehabilitation after an occupational injury. Some expenses not covered by health insurance, but considered reasonably incurred, include items such as:
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Orthoses, bandages, and other medical aids
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Crutches, walkers, or wheelchairs
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Special hygiene products related to treatment
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Compensation aids necessitated by the injury
The employer should reimburse such reasonably incurred costs as part of occupational injury compensation.
For example, if you purchase a bandage for an injured arm, with a white bandage costing 100 CZK and a pink bandage 200 CZK with the same functional properties, the employer will reimburse only the cheaper, functionally equivalent option unless a medical professional justifies the more expensive choice.
Costs of Rehabilitation and Spa Treatments
Physiotherapy, rehabilitation exercises, or spa stays not fully covered by health insurance but part of the treatment process may be reimbursed. The employer is obligated to cover spa treatment costs only if the treatment contributes to your recovery and is recommended by your attending physician.
Note: If a rehabilitation procedure is usually covered by health insurance but you paid for it yourself, reimbursement by the employer may be denied as it would not be considered a reasonably incurred cost. Similarly, if the spa treatment is not medically recommended but undertaken for personal reasons, reimbursement is not guaranteed.
Transportation Costs
Employers must reimburse transportation costs to and from medical treatment if travel by taxi, private transport, or public transport (when travel outside the place of residence is necessary) was required. The chosen mode of transport must be appropriate to your medical condition; reimbursement may be denied if a cheaper, reasonable alternative was available but not used.
Both the injured employee and close relatives traveling to provide care may claim transportation costs.
Reimbursement for Special Diet or Nutrition
If your doctor prescribes a special diet or nutritional supplements related to the treatment of your occupational injury, these additional expenses may be reimbursed.
Costs of Home Care and Nursing
If you required home care or nursing beyond standard insurance-covered care, you may claim reimbursement for these expenses.
Claiming Treatment Costs from Your Employer
You have the right to reimbursement as soon as costs are actually incurred, not only after treatment ends. Claims may be made by the employee or any person who paid the costs (e.g., a family member). Typically, claims are submitted according to the employee’s financial situation, either during treatment or after all compensation amounts are calculated.
To ensure reimbursement, you must:
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Provide proper documentation: Keep all receipts, invoices for medicines, medical aids, and services, medical reports, prescriptions, proof of payment for additional care, tickets or proof of travel to appointments.
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Demonstrate the reasonableness of expenses: Costs claimed must be medically justified and directly related to treating your occupational injury, preferably supported by a physician’s recommendation.
Procedure for Filing Treatment Cost Claims
We recommend:
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Submitting a written request to your employer
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Attaching copies of all relevant documents and receipts
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Briefly explaining how each expense relates to your occupational injury treatment
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Stating the total amount requested
Employee Responsibility
If you contributed to the injury through your own fault (e.g., by violating safety regulations), your compensation may be proportionally reduced, including treatment cost reimbursement. The degree of reduction depends on the circumstances and extent of your fault.
Know Your Rights
An occupational injury involves not only health but also financial burdens. The law provides sufficient protection, allowing employees to claim reimbursement for treatment costs related to occupational injuries.
For successful claims, maintain thorough documentation, keep receipts, and obtain medical recommendations for specialized or non-standard treatments. Employers are legally obligated to reimburse costs that are reasonably incurred and directly related to treating the occupational injury.
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