Information
If you are insured and you are injured at work, on an unbroken journey
to/from work or you contract a prescribed occupational disease you may get
benefits under the Occupational Injuries
Scheme. One of these benefits is Medical Care. The Medical Care Scheme
allows you to get a refund of the costs of medical care and attention that are
not paid by the Health Service
Executive (HSE) or covered by the Treatment Benefit Scheme.
Rules
The following expenses may be refunded if they are not fully met by the HSE
or the Department of Employment Affairs and Social Protection's Treatment Benefit Scheme:
- Doctors' visits
- Doctors' prescriptions
- Certain medical or surgical appliances and the repair and replacement of
these (for example, artificial limbs or hearing aids)
- Certain dental and optical treatment
- Certain treatment prescribed by your doctor excluding treatment available
under the Health Acts (for example, physiotherapy, scans (MRI) and
consultant consultations)
- Certain travelling expenses, usually limited to the cost of public
transport.
The expenses must be reasonable and necessary.
Medical Care is paid by Electronic Fund Transfer (EFT). Normally, only one
payment is made but if the treatment is ongoing, payment may be made in a few
instalments. Payment is usually made to the person who claims, but may be made
to the HSE.
To qualify for a refund of medical costs you must satisfy the following
conditions:
- Your injury must have been caused by an accident at work or as a result
of your work you must have contracted a prescribed
occupational disease and
- You must notify the Department of your intention to claim medical care
within 6 weeks of the start of medical treatment. This is normally 6 weeks
from the date of the accident or the development of the disease and you
must be in employment insurable at PRSI class A, B, D, J or M.
All work accidents or occupational diseases may not result immediately in
illness or disablement. If you are not immediately incapacitated but wish to
safeguard your future right to benefit, you should tell your
employer about the accident/disease. You should apply for a
declaration that your accident/disease was an occupational one. This
should be done without delay.
How to apply
To apply, fill in a Medical Care form C1 (pdf). If
you don't have a C1 form, you can phone the Medical Care Section and ask them
to send you a C1 (see address below). You can get more information on the
scheme in the leaflet Medical Care
SW34.
Make sure you quote your PPS
number on any receipts you send in with the medical care claim form C1.
Note that only original receipts are accepted, payment will not issue for a
claim based on photocopied receipts.
Where to apply
Occupational Injuries Benefit Section
Department of Employment Affairs and Social Protection
Áras Mhic Dhiarmada
Store Street
Dublin 1
Ireland
Tel:(01) 704 3300
Locall:1890 928 400