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Track medical travel
Medical Mileage and Travel Log
Use this tool now
Enter one row per medical or medical-legal trip. Record the actual travel date, route, purpose, mileage, parking, tolls, receipt location, submission date, and payment response without hardcoding a reusable mileage rate.
How to use it
- 1.Complete a row soon after each trip.
- 2.Keep receipts and appointment proof with the log.
- 3.Use the current official form and rate for the trip date when submitting.
Log
Medical Mileage and Travel Log
| Travel dateUse the actual trip date | Starting pointAddress or place | Medical destinationProvider and address | Medical purposeTreatment or medical-legal event | Round-trip milesDo not add a rate here | ParkingKeep receipt | Tolls or transitKeep receipt | Proof savedReceipt or appointment record | SubmittedDate and recipient | Payment or responseDate and amount or explanation |
|---|---|---|---|---|---|---|---|---|---|
| Travel date, row 1 | Starting point, row 1 | Medical destination, row 1 | Medical purpose, row 1 | Round-trip miles, row 1 | Parking, row 1 | Tolls or transit, row 1 | Proof saved, row 1 | Submitted, row 1 | Payment or response, row 1 |
| Travel date, row 2 | Starting point, row 2 | Medical destination, row 2 | Medical purpose, row 2 | Round-trip miles, row 2 | Parking, row 2 | Tolls or transit, row 2 | Proof saved, row 2 | Submitted, row 2 | Payment or response, row 2 |
| Travel date, row 3 | Starting point, row 3 | Medical destination, row 3 | Medical purpose, row 3 | Round-trip miles, row 3 | Parking, row 3 | Tolls or transit, row 3 | Proof saved, row 3 | Submitted, row 3 | Payment or response, row 3 |
| Travel date, row 4 | Starting point, row 4 | Medical destination, row 4 | Medical purpose, row 4 | Round-trip miles, row 4 | Parking, row 4 | Tolls or transit, row 4 | Proof saved, row 4 | Submitted, row 4 | Payment or response, row 4 |
| Travel date, row 5 | Starting point, row 5 | Medical destination, row 5 | Medical purpose, row 5 | Round-trip miles, row 5 | Parking, row 5 | Tolls or transit, row 5 | Proof saved, row 5 | Submitted, row 5 | Payment or response, row 5 |
| Travel date, row 6 | Starting point, row 6 | Medical destination, row 6 | Medical purpose, row 6 | Round-trip miles, row 6 | Parking, row 6 | Tolls or transit, row 6 | Proof saved, row 6 | Submitted, row 6 | Payment or response, row 6 |
| Travel date, row 7 | Starting point, row 7 | Medical destination, row 7 | Medical purpose, row 7 | Round-trip miles, row 7 | Parking, row 7 | Tolls or transit, row 7 | Proof saved, row 7 | Submitted, row 7 | Payment or response, row 7 |
| Travel date, row 8 | Starting point, row 8 | Medical destination, row 8 | Medical purpose, row 8 | Round-trip miles, row 8 | Parking, row 8 | Tolls or transit, row 8 | Proof saved, row 8 | Submitted, row 8 | Payment or response, row 8 |
| Travel date, row 9 | Starting point, row 9 | Medical destination, row 9 | Medical purpose, row 9 | Round-trip miles, row 9 | Parking, row 9 | Tolls or transit, row 9 | Proof saved, row 9 | Submitted, row 9 | Payment or response, row 9 |
| Travel date, row 10 | Starting point, row 10 | Medical destination, row 10 | Medical purpose, row 10 | Round-trip miles, row 10 | Parking, row 10 | Tolls or transit, row 10 | Proof saved, row 10 | Submitted, row 10 | Payment or response, row 10 |
| Travel date, row 11 | Starting point, row 11 | Medical destination, row 11 | Medical purpose, row 11 | Round-trip miles, row 11 | Parking, row 11 | Tolls or transit, row 11 | Proof saved, row 11 | Submitted, row 11 | Payment or response, row 11 |
| Travel date, row 12 | Starting point, row 12 | Medical destination, row 12 | Medical purpose, row 12 | Round-trip miles, row 12 | Parking, row 12 | Tolls or transit, row 12 | Proof saved, row 12 | Submitted, row 12 | Payment or response, row 12 |
Avoid
- — Do not mix trips from different rate periods in an unlabeled total.
- — Do not assume every claim-related trip qualifies.
Keep with this tool
- — Appointment confirmation
- — Visit or attendance proof
- — Route record
- — Parking and toll receipts
- — Submitted form copy
- — Delivery proof
- — Payment or denial notice
Common questions
Why is there no mileage rate on the rows?
Rates can change, and the applicable rate may depend on the travel date. Check the current DWC materials when submitting.
Should parking and tolls be combined with miles?
Keep each category separate and preserve supporting receipts.
What if a trip is rescheduled or canceled?
Record only travel that occurred, and keep the cancellation or rescheduling message when it explains the record.
Read the deeper explanation
California Workers' Comp Mileage Is Now 76¢: What to TrackAuthoritative sources
Check the linked official source for current forms and rules. Updated: .
WCLG
Need help with the actual claim?
Every claim depends on its documents, medical evidence, and procedural history. WCLG offers a free consultation without promising a result.
Attorney Advertising. This educational tool provides general information about California workers' compensation. It is not legal advice and does not calculate a deadline or benefit. Using this tool or contacting WCLG does not create an attorney-client relationship; one begins only through an appropriate written agreement.