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Human Capital Services

Workers' Compensation Mileage Reimbursement Form

Fill out the Workers' Compensation Mileage Reimbursement Form (pdf)

For authorized medical care, you will be entitled to mileage when you drive your personal vehicle if the distance is more than 5 miles round trip.

Related KSU Policy and Procedures Manual Chapter:  4820.100 Insurance Programs-Worker's Compensation Program