Transportation/Travel Expense Form

The Transportation/Travel Expense Form provides a clear and concise means to document travel expenses for which reimbursements may be sought. Request for travel expense reimbursement must be accompanied by a completed Transportation/Travel Expense Form and filed directly with the claim administrator.

If the claim administrator disputes reimbursement, a Claim Form can be filed with the Commission. When requesting reimbursement for transportation/travel expenses, the request must include a completed Claim Form, Transportation/Travel Expense Form, receipts for travel expenses and medical documentation to support the expenses incurred. Examples of medical documentation include, but are not limited to treatment records and/or billing statements that include dates of service. A hearing may be necessary to resolve disputed issues, if any.

Instructions: 

The Transportation/Travel Expense Form may be filed electronically through the Commission’s WebFile system at http://webfile.workcomp.virginia.gov. To file electronically, the user must have a valid and active WebFile account. This form may be filed by mail or in-person at 333 E. Franklin St., Richmond, VA 23219. This form may also be filed by fax at 804-823-6956.

For questions or assistance with completing this form, please call the Virginia Workers’ Compensation Commission’s Customer Contact Center toll-free at 877-664-2566 or email questions@workcomp.virginia.gov.