Worksheets
PDF File: 1 page; Last revised March 17, 2006
Mileage Worksheet for Medical Treatment - Examination - Physical Therapy - Laboratory Test
Although not an official Commission form, we provide this worksheet to injured employees who might need such a worksheet to report mileage incurred due to workers’ compensation-related medical appointments.
[NOTE: For complete information regarding this, refer to the 
Info Packet and see also Public Act 01-33 for up-to-date mileage reimbursement rate information.]
PDF File: 1 page; Last revised July 8, 2005
Record of Employment Contacts
Although not an official Commission form, we provide this worksheet to injured employees who might need such a worksheet to report contacts with employers during a job search while the employee is out on workers’ compensation.
[NOTE: For complete information regarding this, refer to the Info Packet]
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