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RM0007 Rev. 7/14 WORKERS' COMPENSATION MILEAGE LOG Phone: 402-436-1760 Fax: 402-458-3276 Risk Management Department Lincoln Public Schools By completing this form, I understand I will need to come
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How to fill out workers39 compensation mileage log
How to fill out workers' compensation mileage log?
01
Write your name, date, and employee identification number at the top of the form.
02
Record the starting point and destination for each trip made during work hours.
03
Indicate the purpose of the trip, such as client visit, supply pickup, or medical appointment.
04
Write down the total mileage traveled for each trip.
05
Separate personal mileage from work-related mileage by clearly noting which trips were for business purposes.
06
Keep track of tolls and parking fees incurred during work-related trips and include them in the appropriate section.
07
Sign and date the mileage log to certify its accuracy.
Who needs workers' compensation mileage log?
01
Employees who are required to travel for work purposes.
02
Employers who need to keep track of their employees' mileage for reimbursement or other purposes.
03
Insurance companies and legal entities who may require documentation of an employee's travel for workers' compensation claims or legal proceedings.
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What is workers' compensation mileage log?
Workers' compensation mileage log is a record of the distance traveled by an employee for work-related purposes in order to claim reimbursement for mileage expenses.
Who is required to file workers' compensation mileage log?
Employees who are required to travel for work-related purposes and are seeking reimbursement for mileage expenses are required to file workers' compensation mileage log.
How to fill out workers' compensation mileage log?
Employees must accurately record the date, starting point, destination, and total mileage for each work-related trip on the workers' compensation mileage log form.
What is the purpose of workers' compensation mileage log?
The purpose of workers' compensation mileage log is to track and document the distance traveled by employees for work-related purposes to calculate reimbursement for mileage expenses.
What information must be reported on workers' compensation mileage log?
The workers' compensation mileage log must include the date of the trip, starting point, destination, total mileage, and a brief description of the purpose of the trip.
When is the deadline to file workers' compensation mileage log in 2023?
The deadline to file workers' compensation mileage log in 2023 is typically within 30 days of the end of the month in which the work-related trips were taken.
What is the penalty for the late filing of workers' compensation mileage log?
The penalty for the late filing of workers' compensation mileage log can vary depending on the specific policies of the employer or the workers' compensation insurance provider, but it may result in a delay or denial of reimbursement for mileage expenses.
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