How to Claim Self-Paid Treatment, Care and Transport Costs in Korea

Eight checks on KCOMWEL Forms 10 and 10-2

1. Choose the form before adding amounts: use Form 10 for self-paid treatment or medicine and Form 10-2 for care, transport or an assistive device. On each form, mark the specific claim type; do not place all categories into one undifferentiated total.
2. Form 10 identity and treatment: enter verified workplace-management or business number, worker identity, occupation, hiring date and accident time. List inpatient and outpatient periods with day counts, the claimed total, the medical institution or pharmacy, and a receiving account held by the eligible person.
3. Form 10 proof and duplicate-payment check: attach original receipts, itemized treatment statements, prescription or pharmacy detail and other requested records. Answer whether the employer, a third party, another law, compensation or damages already paid the same expense; list date, amount, payer and evidence when yes.
4. Form 10 reverse side: complete the extra accident narrative and medical opinion only when this treatment-cost claim substitutes for the initial medical-benefit application. The worker states date, type and detailed cause; the medical institution records diagnoses, prior disease, treatment periods and work-treatment compatibility. Otherwise do not repurpose these boxes.
5. Form 10-2 period and calculation: mark care, transport or assistive device. Enter the exact claim period, inpatient/outpatient days, a line-by-line calculation, total amount and receiving account. For care, disclose any payment under long-term care, disability-support or another law and attach the related decision.
6. Care details and medical opinion: the institution states disability status and checks the applicable care-scope condition. Record one-person or shared care, dates, inpatient/outpatient days, recovery-room or integrated-care exclusions, and each caregiver’s identity, relationship and qualification. Do not count excluded service periods twice.
7. Transport and device details: for transport, record total treatment days, actual outpatient days, each origin/destination, transport method, distance, trips and cost evidence. For an assistive device, record item/model, quantity, frequency, purchase price and medical necessity, with prescription, inspection confirmation, receipt or transaction statement as applicable.
8. Consent, authorization and result: read optional service-notice consent separately; date and sign claimant and representative fields. A medical institution may submit with authorization. Both forms list ten-day processing. Keep a complete copy, original-evidence inventory, receipt and the written decision showing approved categories and amount.

Example only — do not submit: Mei L. separates a 68,000-won clinic payment and 14,500-won prescription from taxi trips to treatment. She uses Form 10 for the clinic and pharmacy receipts, matches each itemized statement, reports no duplicate payment and names her verified account. She uses Form 10-2 only for medically supported transport, listing each date, origin, destination, distance and receipt; she does not claim care or a device. The doctor completes only the applicable transport opinion. Replace every fact, date, category and amount with verified records.