Medical Mileage Expense Form - California (English / Spanish)

Medical Mileage Expense Form is a legal document that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California.

Form Details:

• Released on January 1, 2023;
• The latest edition currently provided by the California Department of Industrial Relations - Division of Workers' Compensation;
• Ready to use and print;
• Easy to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.