Travel Reimbursement Request
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
Travel Reimbursement Request (A fillable form - 173 KB PDF) |
|
| Description | Injured workers use this form to request reimbursement for travel expenses used to receive treatment, retraining and/or vocational services. These forms will be accepted by L&I. They may not be accepted by all Medical Bill Processors due to lack of a barcode. | |
| Detail | ||
| Form number | F245-145-000 | |
| Availability | Order it | |
| Keywords | doctor, espanol, injured worker, medical, most requested forms, physician, reimbursement, retraining, spanish, transportation, travel, treatment, voc rehab, vocational, vocational provider, vocational rehab | |
| Languages | English , Spanish | |
| Valid dates | 07-2008 | |
| Contact information |
Managing Injured Workers' Claims
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| Web pages | Workers' Comp Claims | |
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