DOL Form CA-278

View OWCP-DFEC's Form CA-278 Online htm

Agency:

OWCP-DFEC

Title:

DFEC CA-278, Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act

Form Description:

DFEC CA-278, Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act: This form is used to claim reimbursement of benefit payments and claims expense under the War Hazards Compensation Act.

OMB Control Number:

1215-0202