The Medical Mileage Expense Reimbursement Form allows employees to request reimbursement for travel costs incurred when seeking medical treatment for a work-related injury or illness. Employees may claim mileage expenses at the current reimbursement rate ($0.67 per mile) as well as parking fees, tolls, and public transportation costs. The completed form, along with receipts, must be submitted to the insurance company for processing.
Medical Mileage Expense Reimbursement Form
File Type:
pdf
Categories:
Workers Compensation