Itemized Statement Of Charges For Travel {25T}

FORM 25T - ITEMIZED STATEMENT OF CHARGES FOR TRAVEL. The use of this form Is required under the provisions of the Workers' Compensation Act. For travel beginning January 1, 2024, employees are entitled to reimbursement of $0.67, provided they travel 20 miles or more roundtrip. Special consideration will be given to employees who are totally disabled. No reimbursement is allowed for trips to purchase medications or supplies unless medically necessary. These items must be purchased on visits to medical providers (G.S. § 97-25). www.FormsWorkflow.com