Right to coverage of expenses for healthcare services in the event of occupational injury

In the event of occupational injury or illness, Helfo can cover essential expenses for the following healthcare services under Section 5-25 of the National Insurance Act: 

• medical care
• outpatient clinics
• X-rays
• dental care
• physiotherapy
• medicines
• food products
• medical supplies
• bandages
• creams, ointments, gels and oils
• glasses/lenses

If you need other aids as a result of your occupational injury or illness, Nav will assess any coverage. 

On the Nav website, you can read more about the conditions for getting an injury or illness approved as an occupational injury.

Once Nav has approved your injury or illness as an occupational injury, you will receive a decision on this from Nav. The decision describes the injury or illness that has been approved. You can then apply to Helfo for coverage of healthcare costs relating to your occupational injury or illness. You can find the application form further down the page.

You can apply for coverage of expenses for travel to and from treatment. 

Read mot about reimbursement of travel expenses at Pasientreiser (Patient travel).

In order to have your expenses covered in full under the rules concerning occupational injuries, it is a requirement that the need for the healthcare service is primarily or largely due to the occupational injury/illness. 

Occupational injury does not entitle you to reimbursement of expenses for chiropractor treatment, speech therapy treatment or treatment by a psychologist.  

When you send Helfo receipts for expenses for treatment, you must enclose a copy of the approval decision from Nav.

See the other sections for what you need to do to get your expenses covered in connection with your occupational injury.

You must then apply to Helfo for coverage once you have received your occupational injury decision from Nav. See "Submitting applications to Helfo " further down the page.

Helfo covers user fees and supplies according to fixed rates.

If you need treatment from a doctor, outpatient clinic or X-rays, you must take the decision letter with you to the treatment centre. The doctor will consider whether the treatment is necessary as a result of your occupational injury or illness. In this case, you will not have to pay a user fee.

The treatment provider must have a GP agreement with the municipality. The outpatient clinic or X-ray institute must have an operating subsidy agreement with the regional health trust. 

You must attach a statement from the physiotherapist if you are to seek reimbursement for treatment you have received before the approval decision was made. 

See “Submitting applications to Helfo” further down the page.

Helfo covers user fees according to fixed rates.

If you have received the decision from NAV and need physiotherapy treatment as a result of your occupational injury or illness, you must take the decision with you when you go to the physiotherapist/manual therapist. The treatment provider will consider whether the treatment is necessary as a result of and in accordance with the approved occupational injury from NAV. In this case, you will not have to pay a user fee.

You do not need a referral. 

In order for you to be entitled to coverage of expenses, the physiotherapist must have an operating subsidy agreement with the municipality, and a direct settlement agreement with Helfo.

Your dentist must assess whether you meet the conditions for coverage under the occupational injury rules. If the conditions are met, you will not have to pay a user fee. The treatment is intended to restore the condition that existed before the accident occurred.

Please note that the dentist's fees may be higher than the National Insurance scheme's rates. This means that you must expect to pay the difference between what Helfo covers and what the dentist charges. 

If you need dental treatment before you have received Nav's approval decision, the dentist must consider whether you meet the conditions for coverage according to point 13a, extensive dental injury in the event of an accident, in the explanatory circular to Section 5-6, Section 5-6 a and Section 5-25 of the National Insurance Act.

If you have already paid the user fee when you receive the decision from Nav, you can take the decision to the dentist and ask the dentist to reconsider the terms, and possibly refund the user fee to you.

It is a requirement that your treatment provider has an arrangement with Helfo regarding direct settlement in order for you to receive allowance for dental treatments.

If you need any of these things for more than three months after the date of injury (acute phase), the doctor must provide a statement detailing your needs.

In the application/statement, the doctor must confirm that your needs are due to the approved occupational injury or illness. It must also be specified what medicines, food products and medical supplies you need as a result of your occupational injury or illness.

As a general rule, GPs can apply for a subsidy for an approved occupational injury or illness. 

Your GP, another doctor at the GP’s surgery or a doctor at a multidisciplinary pain clinic can apply for an individual subsidy for you for medicines that contain opioids. If you intend taking pregabalin (Lyrica) to treat neuropathic pain or trigeminal neuralgia, the same requirements apply to who can apply, but the application can also come from a specialist in neurology. If you need a higher daily dose of opioids than 100 mg oral morphine equivalents, the application must come from a doctor at a multidisciplinary pain clinic.

When your doctor sends the application to Helfo, you should forward a copy of the occupational injury or illness decision. 

See “Submitting applications to Helfo” further down the page.

If you receive a decision concerning a subsidy to cover your expenses, you can collect medicines, food products or medical supplies from your local pharmacy or medical supplies store. You must then take the decision from Helfo with you. When you present the decision from Helfo, you do not have to pay user fees. 

If you need any of these things for more than three months after the date of injury, the doctor must provide a statement detailing your needs.

In the medical statement, the doctor must certify that your needs are due to the approved occupational injury or illness. Your doctor must specify which products you need as a result of your occupational injury or illness. 

You must send this statement, along with a copy of the decision from Nav approving your occupational injury, to Helfo. See “Submitting applications to Helfo” further down the page.

You must pay for the purchases yourself and send itemised receipts to Helfo for reimbursement. Bandages, medical supplies and over-the-counter medications must be purchased at a pharmacy or medical supplies store. 

If you are receiving wound care from the municipality’s health and care services, it is the municipality that is responsible for covering the expenses for bandages and medical supplies as well as over-the-counter drugs.

In the medical statement, the doctor must certify that your needs are due to the approved occupational injury or illness. The doctor must state the approximate total quantities of creams, ointments and oils that you will need per year.

You must send this statement, along with a copy of the decision from Nav approving your occupational injury, to Helfo. See “Submitting your application to Helfo” further down the page.

You must pay for the purchases yourself and send itemised receipts to Helfo for reimbursement. 

There is no requirement for the products to be purchased at a pharmacy or medical supplies store.

If you are treated by the municipality’s health and care services, the municipality is responsible for covering the expenses of creams, ointments, gels and oils.

Helfo will cover the cost of frames up to NOK 1,500 and essential lenses. If, for medical reasons, you cannot wear glasses because of your occupational injury or illness, you may be able to have the cost of contact lenses covered.

The cost of an eyesight test by an optician will not be covered.

The first time you apply to Helfo for reimbursement for glasses, you must have a statement from an ophthalmologist confirming that the visual impairment has a direct connection with the occupational injury, and that the injury necessitates the need for the glasses. If you need new glasses, every three years you must attach a statement from an ophthalmologist or optician confirming that the occupational injury is still the reason for the need for the glasses. 

If you have had a lens inserted due to an eye injury, documentation from an ophthalmologist is sufficient the first time you apply for reimbursement. Due to the permanent nature of the damage, you do not need documentation for subsequent applications.

Send the statement, a copy of the decision on approved occupational injury from Nav and the itemised receipt to Helfo. See “Submitting applications to Helfo” below.

In order to be entitled to reimbursement, Nav must have approved your occupational injury or illness.

You will need to attach the following:

• approval decision from Nav
• itemised receipts stating 
  • patient name
  • product name
  • price of the product
  • date of purchase
  • name of the treatment provider

You will also need to check the sections above to see whether you need to attach a medical statement to your application.

If you incurred expenses due to your occupational injury before Nav approved it, the deadline for submitting receipts is six months after the occupational injury was approved.

Retrospectively, the deadline is six months from the date on which you incurred each individual expense.

Paper form

You must send the form together with the original, itemised receipts and other relevant information to Helfo, Postboks 2415, 3104 Tønsberg

PS: If you are completing the form on behalf of a child under 16, it is the child's details that you need to enter. However, the form must be signed by the parent/guardian. 

Read more about how you can arrange power of attorney over Helfo communications.

Please use the following procedure to submit documentation after logging in to Altinn:

• Select “Tilleggsopplysninger til søknad/fullmakt” from the drop-down menu under “Hva gjelder innsending”/”Innsendingen gjelder”.
• Select “Etterspurt dokumentasjon” under “Tilleggsopplysninger”.
• Make sure to enter the reference number relating to your existing case. This will allow us to consider your case more quickly. The reference number will have the following format: “22/0000”.