U.S. Department of Labor - Office of Workers' Compensation Programs Forms

This Form is used for filing a claim for medical reimbursement from the Office of Workers' Compensation Programs (OWCP). It is used by individuals seeking compensation for their medical expenses related to a work-related injury or illness.

This Form is used for submitting claims for medical services provided to injured federal employees. It helps standardize billing and ensures proper reimbursement.

This form is used for reporting the issuance of insurance policies by carriers. It is important for carriers to accurately report policy issuances for record-keeping purposes.

This form is used for filing a claim for survivor benefits under the Federal Employees' Compensation Act Section 8102a Death Gratuity.

This form is used for addressing overpayment recovery questions related to the Office of Workers' Compensation Programs (OWCP).

This form is used for requesting earnings information. It is typically used by individuals who need to provide proof of their income.

This Form is used for requesting a waiver of service by registered or certified mail for claimants and authorized representatives.

This form is used for employers to claim reimbursement under the Assisted Reemployment (AR) Program.

This form is used for requesting leave buy back and includes a worksheet and certification and election section.

This form is used for providing detailed information about the time spent by an employee on work-related activities. It helps track the hours worked, breaks, and any additional time off, such as holidays or leave.

This Form is used for applying for special fund relief. It is used to request financial assistance from a special fund.

This form is used for requesting approval for attorney fees in legal matters.

This Form is used for applying for commutation, which is the reduction of a sentence or penalty.

This form is used for requesting intervention in a legal proceeding. It is typically filed by parties involved in a case to request the court's involvement or assistance.

This form is used for requesting approval for settlement in Section 8(I) cases.