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MEDICAL TRAVEL EXPENSE FORM - Maryland Workers

MEDICAL TRAVEL EXPENSE FORM - Maryland Workers 2025

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The document is a Medical Travel Expense Form that allows claimants to request reimbursement for travel expenses related to medical treatment due to an industrial injury. It requires details such as the claimant's information, dates, and travel specifics, along with supporting receipts for expenses like parking and tolls. The form emphasizes that mileage for trips to pharmacies or attorneys is not reimbursable.

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Click ‘Get Form’ to open the MEDICAL TRAVEL EXPENSE FORM in the editor.
Begin by entering your Claim Number at the top of the form. This is essential for tracking your reimbursement request.
Fill in the Date of Injury, Claimant’s Name, and Claimant’s Address, including City, State & Zip. Ensure all information is accurate to avoid delays.
Next, provide your Employer’s Name and Today’s Date. This helps in identifying your employer's records.
In the 'Traveled From' section, include your starting address (e.g., home or work). In 'Traveled To', specify the name and address of your medical provider.
Record the round trip mileage in the designated field. Be sure to calculate this accurately based on your travel.
List any parking fees, public transportation costs, or bridge tolls in their respective sections. Attach receipts as required for reimbursement verification.
Finally, sign and date the form at the bottom before submitting it along with any supporting documents.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a travel expense form?

Expense claim forms help companies monitor and record business expenses incurred by staff. Such forms help to tally all the money an individual spends on meals, training, travel, entertainment, and any other incidentals that may have been purchased using their own money as opposed to a previously provided per diem.

What travel expenses are not deductible?

Travel expenses must be ordinary and necessary. They cant be lavish, extravagant or for personal purposes. Employers can deduct travel expenses paid or incurred during a temporary work assignment if the assignment length does not exceed one year.

What expenses are not allowed as deductible medical expenses?

You typically cant deduct the cost of nonprescription drugs (except insulin) or other purchases for general health, such as toothpaste, health club dues, vitamins, diet food and nonprescription nicotine products. You also cant deduct medical expenses paid in a different year.

Is medical travel expenses deductible?

All documented transportation to and from the medical destination allowable lodging expenses during treatment and recovery and hospital and physician costs would then be deductible. Any additional costs of a vacation or pleasure nature would not be deductible.

Can I deduct mileage for taking my mother to the doctor?

Correct. You cannot deduct the mileage for your mothers appointments, even though you are her POA and attend them with her. The medical mileage deduction is strictly for transportation expenses related to your own medical care.

Are travel expenses for medical care deductible?

The IRS allows you to deduct mileage for medical care if the transportation costs are mainly for and essential to the medical care. Actual expenses youve allocated to the use of the vehicle for medical transportation: Parking fees. Tolls.