Skip main navigation

Outdated or Unsupported Browser Detected
DWD's website uses the latest technology. This makes our site faster and easier to use across all devices. Unfortunatley, your browser is out of date and is not supported. An update is not required, but it is strongly recommended to improve your browsing experience. To update Internet Explorer to Microsoft Edge visit their website.

  2. Forms Repository
  3. WKC-18613-E, Mileage Reimbursement Record

Mileage Reimbursement Record

Document Number: WKC-18613-E

Description: Complete this form to receive mileage reimbursement for travel to obtain treatment or attend vocational rehabilitation training due to a worker's compensation claim. The rate is the same as what state employees receive for business related mileage expenses.

Comments: This form can be filled out on the computer as a fillable pdf.

Content Contact: Lynn Weinberger

Document Attachment: WKC-18613-E (Electronic Version - pdf/787 KB)

Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.

Contact Information

For questions about this form, or if you need this form in an alternate format, please see the Content Contact (listed to the left)

Having trouble finding the correct form? Forms Contacts