U.S. Department of Labor - Office of Workers' Compensation Programs Forms
The U.S. Department of Labor - Office of Workers' Compensation Programs (OWCP) is responsible for administering and overseeing various compensation programs that provide benefits to employees who have been injured or become ill as a result of their employment. These programs include benefits for federal employees, energy employees, longshore and harbor workers, coal miners, and individuals with black lung disease. The OWCP ensures that eligible workers receive the appropriate benefits and compensation to help them recover and sustain their livelihoods.
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This form is used for notifying individuals about a termination, suspension, reduction, or increase in benefit payments.
This Form is used for notifying the employer about an occupational disease and filing a claim for compensation.
This Form is used for applying for a prevailing wage determination. It is used by employers who want to hire foreign workers under certain visa categories to ensure that the wages being offered are in line with the prevailing wage in the specific occupation and area of intended employment.
This form is used for notifying law enforcement officers of an injury or occupational disease that they may have suffered while on duty.
This form is used for insurance carriers to enter into an agreement and make an undertaking.
This Form is used for applying for a determination on the amount of security deposit required for a particular situation.
This Form is used for self-insured employers to complete an Agreement and Undertaking.
This form is used for submitting health insurance claims. It is commonly used by individuals to request reimbursement for medical expenses.
This form is used for reporting coverage under the Black Lung Benefits Act for insurance policies.
This form is used for reporting rehabilitation actions taken for an injured employee. It helps track the progress of the employee's rehabilitation process.
