Medical Care Scheme
Information
An insured person in Ireland who is injured at work, on an unbroken journey to/from work or who contracts a prescribed occupational disease is entitled to 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 Treatment Benefit Scheme.
The following expenses may be refunded if they are not fully met by the HSE or the Department of 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 qualified nursing at home on the instruction of a doctor
- Certain treatment prescribed by your doctor
- Certain travelling expenses usually limited to the cost of public transport.
The expenses must be reasonable and necessary. Medical Care is paid by cheque. 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 your doctor or the HSE.
Rules
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 six 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 notify your employer about the accident/disease and 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 Injury Benefit Section and ask them to send you a C1. You can also fill in a 'Notice of request for medical care form' found at the back of Department's booklet Medical Care SW34 and return it to the Injury Benefit Section, at the address below. A C1 form will then be sent to you.
Make sure you quote your PPS number (previously known as your RSI number) on any receipts you send in with the medical care claim form C1.
Where to apply
Occupational Injuries Benefit Section
Department of Social Protection
Áras Mhic Dhiarmada
Store Street
Dublin 1
Ireland
Tel:(01) 704 3018
Language
Related Documents
- Occupational Injuries Benefit Scheme - Introduction
The Occupational Injuries Benefit scheme provides a range of benefits for people injured or incapacitated by an accident at work or while travelling directly to or from work. - Injury Benefit
Injury Benefit is a weekly payment made to employees in Ireland who are unfit for work as a result of an accident at work or because they have contracted a disease due to the type of work they do. Find out more. - Disablement Benefit
Disablement benefit may be payable to you if as a result of an accident at work in Ireland or a prescribed disease contracted at work, you suffer a loss of physical or mental faculty.
Contact Us
If you have a question relating to this topic you can contact the Citizens Information Phone Service on 0761 07 4000 (Monday to Friday, 9am to 9pm) or you can visit your local Citizens Information Centre.