As a miner who has been awarded benefits under the Federal Black Lung Benefits Act, you are entitled to medical benefits for the treatment of your black lung disease and related disability.
Your medical benefits include payments to medical providers for doctor appointments, hospitalizations, medical appliances, supplies, and prescription medications. Additionally, mileage costs for travel to obtain medical treatment for your lung condition may also be reimbursed.
Effective February 17, 2024, you must use and complete the new Medical Travel Refund Request- Expenses, OWCP-957B form, to obtain reimbursement for mileage cost, and other expenses for travel related to medical treatment for your covered Black Lung condition.
The format of the new Medical Travel Refund Request –Expenses form (OWCP-957B) has been redesigned for a more user-friendly experience. Effective March 31,2024, the old OWCP-957 (Medical Travel Refund Request) form will no longer be accepted for processing. If the old OWCP-957 form is used after this date, it will be returned to you, requesting that you complete the new OWCP-957B form and resubmit. We regret any inconvenience this may cause.
The medical provider or an authorized representative must complete and sign the “Care Rendered” area of the form for each visit.
Please mail the completed Medical Travel Refund Request – Expenses (OWCP-957B) form to:
U.S. Department of Labor OWCP/DCMWC
P.O.BOX 8302
London, KY 40742-8302
NOTE: Overnight travel, related meals, and lodging that include mileage that exceeds 100 miles one-way, and/or 200 miles round trip, will require special prior approval from the DCMWC District Office. You can reach the District Office by calling the toll-free number on business days, 9:00 a.m. – 4:00 p.m. (ET): 1-800-347-2502.