Workers Comp Mileage Reimbursement 2024 Form. Use this form to claim your mileage or travel reimbursement by sending a completed copy to your claim examiner. Starting address (example “home”) ending address/destination;


Workers Comp Mileage Reimbursement 2024 Form

California law requires reimbursement to injured workers for medical mileage at the. Maintaining a mileage journal will help track how far you travel to see your doctor, therapist, or other approved workers’ compensation medical treatment.

Workers Comp Mileage Reimbursement 2024 Form Images References :