Which body may claim drug expenses from the Fund, and what must that body have done for the claim to fall under this provision?
General information · Not legal advice
Material to check
In the practice file we read the record of the pharmacy's registration under the Pharmaceutical Affairs Act, since the claim depends on the pharmacy being of the kind through which the Fund supplies the drug, together with the record of the drug supplied to the injured worker and the claim application sent to the Fund, which shows the claim was made and to whom.
These are types of material to look for, not evidence already verified by PRO SE.
Where readings differ
One reading takes the provision as a rule about actors: only the pharmacy through which the Fund supplies a drug, that pharmacy being registered under the Pharmaceutical Affairs Act, may claim drug expenses, and it must do so by filing a claim with the Fund.
Another reading marks the limits: the provision names no other body that may claim drug expenses, and it sends the examination and decision on a claim, the method of payment and the payment procedure to be set by a Ministry of Employment and Labour ordinance, so filing the claim does not settle whether or how the amount is paid.
Your judgment
Where a registered pharmacy supplied a drug to a worker, how would the file show whether that supply was the Fund's supply referred to at the start of this provision?
PRO SE does not make this decision or keep a case record on this public site.When to reconsider
We look at this again if the provision is amended to name other bodies that may claim drug expenses, or if a Ministry of Employment and Labour ordinance under this provision sets out the examination, decision and payment procedure that shapes how a claim is read.