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OhioBWC - Worker - Form:  (C-60) - Introduction


Injured Worker Statement for Reimbursement of Travel Expenses (C-60)
Introduction

The injured worker uses this form to obtain reimbursement for travel expenses incurred as a result of examinations or treatment for a work-related injury or disease. Before completing the C-60, you may want to review the Injured Worker Reimbursement Rates for Travel Expenses (C-60-A)


Required information

  • Dates corresponding to travel
  • Type of transportation for travel
  • Cost for transportation fare(s)
  • Car mileage (if traveling by car)
  • Other expenses include: parking/tolls, meals, lodging, and companion related travel

Receipts are required for parking/tolls, transportation fares, lodging, out-of-state meals and companion related travel expenses.
Note: If you have to submit receipts, you can complete the C-60 online, but you cannot submit it online. You must print the completed form, and mail it to BWC with required receipts attached.

If you have all the required information on hand, simply click the start button to begin.

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