Organize accident expenses and missed work

Keep expenses and missed work organized

Add one row for each expense or period of missed work. Use short receipt references instead of names, account numbers or medical details. All amounts are in US dollars.

Your entries stay in this browser tab and are not sent to ALG. They disappear when you reload or close the tab. Download a progress file to continue later. Keep downloaded files private, especially on a shared device.

This worksheet adds the amounts you enter. It does not determine which amounts are legally recoverable, estimate a settlement or provide advice about your case.

Expense records

Record each amount once. Split a bill into separate rows if different people paid portions of it. Use “Not paid yet” for an outstanding amount. Do not enter the same bill again when recording its payment.

Missed-work records

Enter hours missed and your gross hourly rate before deductions. Use a separate row when the rate changes. This simple calculation does not account for taxes, overtime rules, benefits, paid leave, reimbursement or eligibility to recover lost income. Keep those records separately.

Your recorded totals

All recorded expenses

$0.00

Self-paid portion of those expenses

$0.00

Recorded missed hours × gross hourly rates

$0.00

The self-paid total is already part of all recorded expenses. Missed-work amounts are shown separately and are not included in either expense total. Each missed-work row is rounded to the nearest cent.

Keep the documents behind the numbers

Keep receipts, billing statements, reimbursement explanations, pay records and employer confirmations with your own files. This tool stores no attachments. A receipt total and a legally recoverable amount can differ.

California's court self-help guidance on preparing evidence explains the role of supporting records. This is a personal organization worksheet, not a court or insurance form.