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Use SIDN number for all correspondence and inquiries until assigned a self-insured risk number. File all requests for data and financial statements, or we will return your application as incomplete. You must file this form with: ATTN: Self-Insured Department, Bureau of Workers Compensation, 30 W. Spring St., 27th Floor, Columbus, Ohio 43215-2256. Company Information Present state-fund risk number Federal ID number Name of applicant (shown exactly as it is in the Articles of Incorpo.

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In ance with the New York State Workers' Compensation Board (Board) resolution adopted on February 20, 1990, the Board publishes the mileage rate for reimbursement to injured workers for travel by automobile on or after January 1st of each year. The rate on or after January 1, 2023, is 65.5 cents per mile.

The current mileage rate for 2023 is 65.5 cents per mile driven for business. What is the mileage rate for the previous year? The IRS mileage rate 2022 for cars (including vans, pickups, and panel trucks) was $0.585 per mile driven for business until June 30. From July 1, the IRS increased the rate to $0.625.

Mileage Rate for Medical and Medical-Legal Travel Expenses Increases Effective January 1, 2023. The Division of Workers' Compensation (DWC) is announcing the increase of the mileage rate for medical and medical-legal travel expenses by 3 cents to 65.5 cents per mile effective January 1, 2023.

The current mileage reimbursement rate is 53.5 cents and may be verified at the following link to the NYS Mileage Reimbursement Rate for personal vehicles.

The form is used to report the injury or illness to the Ohio Bureau of Workers' Compensation (BWC), and to seek medical benefits and other relief available under Ohio's workers' compensation law. The form must be completed by the injured worker, the employer, and any doctor who treated the worker.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232