wsib medical travel expense form

Operational Policy Manual

Travel and Related Expenses

The WSIB pays all reasonable expenses incurred when, on the direction or approval of the WSIB, a worker, or another person designated by the WSIB, must travel in relation to a claim.

The purpose of this policy is to outline when the WSIB may pay for claim-related travel expenses.

The WSIB does not reimburse travel costs incurred by a worker while conducting routine job search activities; however, it reimburses the worker for transportation and related expenses incurred while attending WSIB-sponsored training-on-the-job programs.

For claims not yet allowed the WSIB must pre-authorize attendance at health care appointments for special clinical investigations or examinations. If the claim is subsequently not allowed, out-of-pocket expenses, such as travel, accommodation, and meals, will be reimbursed as an administrative cost to the WSIB. For information on reimbursement of lost wages while attending health care appointments, see  17-01-05, Wage Loss for Health Care Appointment .

Practicality, expedience, and clinical necessity are considered when determining the mode of transportation. The WSIB may consult with WSIB clinical staff regarding the nature and sufficiency of travel arrangements.

Transportation expenses are paid based on the most direct route.

The WSIB approves payment of travel expenses when a change of health professional is allowed.

Transportation

Taxis and specialized transport.

The WSIB pays taxi fares/fees incurred by persons with impairments travelling by specialized transportation when the worker is involved in a medical or return-to-work (RTW) assessment or plan:

• if the worker does not have a vehicle, or has an impairment that prevents travel by public transit, or

when a prevailing non-work-related medical condition requires this means of transportation, and travel is essential to the medical or RTW assessment or plan established for the work-related impairment.

Public transportation

Use of public transportation is fully reimbursed.

While attending an established clinical program such as physiotherapy, the worker is paid for public transportation upon verification of treatment dates.

If public transportation is available but an alternate mode is chosen, the equivalent of public transportation costs is paid.

When public transportation is not available and a personal vehicle is used, payment is made at the approved mileage rate. For the current rate, see  18-01-05, Table of Rates .

When the use of a personal vehicle is approved, actual parking fees are reimbursed.

Return to permanent residence

When a worker returns to a permanent residence, having lived and worked (and was injured) away from that residence, any additional travelling expenses incurred due to the nature of the injury is reimbursed to the party bearing the expense.

The WSIB pays the worker’s hospitalization fees while attending a WSIB-approved program, travelling expenses, usually for one trip home each month. It also considers requests for additional trips home having regard for circumstances such as maintaining family ties, humanitarian and compassionate reasons, urgent family matters, etc.

Family member

If a worker is unable to travel due to the work-related medical condition, payment of travel and related expenses is extended to enable one family member to visit the worker. Consideration for payment is according to the same criteria used for a worker returning to their residence.

Travel expenses are paid when a family member is required to travel to a treatment centre to receive instruction in the care and treatment of the worker’s condition.

Travel expenses for an escort are paid when there is a clinical necessity, or for compassionate or practical reasons, see  17-01-08, Escorts .

Accommodation

When required to lodge away from home while keeping an appointment or participating in a program authorized by the WSIB, accommodation expenses (hotel, or room and board) are paid at approved rates.

Meal allowances are paid at approved rates if workers are required by the WSIB to lodge away from home, attend scheduled appointments, out-patient health care programs, etc. For the current meal allowance rates, see  18-01-05, Table of Rates .

Application date

This policy applies to all expenses incurred on or after March 1, 2021, for all accidents.

Document History

This document replaces 17-01-09 dated February 15, 2013.

This document was previously published as: 17-01-09 dated November 3, 2008 17-01-09 dated October 12, 2004 17-01-09 dated February 20, 2004 17-01-09 dated April 6, 2001 06-01-03 dated September 30, 1992.

Legislative Authority

Workplace Safety and Insurance Act, 1997 , as amended Section 33

Workers' Compensation Act, R.S.O. 1990 , as amended Section 50

Administrative #16, March 24, 2021, Page 586  

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What Is Form 2721A?

• Preview Document
• Download Form 2721A PDF Download Form 2721A PDF

WSIB Travel Expense Form Instructions

Form 2721a travel expense form - ontario, canada.

• Canada Legal Forms
• Ontario Legal Forms
• Ontario Workplace Safety & Insurance Board

Form 2721A, Worker Travel Expense Form , is a document Ontario-based employees prepare before they travel to treat their workplace injuries and illnesses to be reimbursed for incurred expenses. The Workplace Safety and Insurance Board (WSIB) guarantees they will pay for your travel expenses after it will be confirmed you actually had a medical appointment as a result of the workplace-related injury or illness.

Alternate Name:

• WSIB Travel Expense Form.

The latest version of the document was released on March 1, 2023 , with all previous editions obsolete. You can download a fillable WSIB Travel Expense Form via the link below .

Here is how you should fill out WSIB Travel Expense Form:

• State the number of your claim - before you can submit this form, you need to prepare a claim and file it with the human resources department so that the expenses are pre-approved and the payment is not delayed.
• Write down your full name, current address, and telephone numbers . If you have a new address , check the appropriate box.
• Describe your travels - date and time , points of departure and arrival, and the reason for travel. Obtain the stamp of the treating agency or the name and signature of your physician. Indicate whether you traveled by public transit or taxi and record the amount of money you have spent.
• Enter the roundtrip distance and the sum of money you spent on parking if necessary. Provide a full breakdown of meal expenses .
• Calculate the total amount of expenses and write it down at the bottom of the form.
• Confirm the details in the document are true and complete, enter your full name, sign and date the form. Note that the statement alone is not enough - you need to attach original parking receipts, taxi receipts, and other documentation that proves you have spent the amount of money stated in the form.

Complete this document during the travel to keep track of all the payments and expenses and then mail it to 200 Front St W Toronto, Ontario, M5V 3J1. Keep a copy of the form for your own records.

Other Revision

Download form 2721a travel expense form - ontario, canada, linked topics.

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