Division of Federal Employees' Compensation (DFEC)
Information for Injured Workers and their Representatives
How do I submit correspondence (other than reimbursement claims and claim forms)?
Case specific correspondence other than reimbursement claims and claim forms may either be mailed to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY 40742-8300 or uploaded to the case electronically on the ECOMP website. To upload documents, such as routine correspondence, medical reports or other documentation, you must enter the case number and the claimant's last name, date of birth and date of injury. A tutorial with detailed instructions on uploading documents is available in the Help section of the ECOMP home page.
Medical bills should be submitted to OWCP directly by the medical provider who performed the service. Detailed instructions on submission of bills by medical providers is available.
I just found out you won't authorize or pay for treatment/medication my doctor prescribed. What do I do now?
The Federal Employees' Compensation Act mandates that OWCP furnish an injured worker with services, appliances, and supplies prescribed by a qualified physician which OWCP deems likely "to cure, give relief, reduce the degree or the period of disability, or aid in lessening the amount of monthly compensation." When a request for medical authorization is received, the requested treatment or medication is reviewed to determine if it is normally appropriate to treat the diagnosis that has been accepted as work related. Some medical services may be approved routinely, while others require review by a claims examiner.
If a requested medical procedure, device or medication is not allowable for the accepted work-related diagnosis, but an injured worker's physician believes it is necessary to treat the injured worker, the provider should submit medical documentation for review by the claims examiner. As is the case with anything sent to OWCP, please be sure to include the injured worker's claim/case number on every page. Documentation may be mailed to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY 40742-8300 or uploaded to the case electronically via ECOMP.
How do I learn the status of a medical authorization request, bill, or claim for reimbursement?
Injured Workers, Providers, and Employing Agencies can check on the status of bills and reimbursements on the OWCP Web Bill Processing Portal. Claimant eligibility, bill status, and medical authorization inquiry functionality is also available 24 hours a day via our Interactive Voice Response (IVR) system. To access the IVR, please dial 866-335-8319. To speak with a Customer Service Representative regarding a bill or reimbursement, you may call 844-493-1966, toll free. This number is available Monday – Friday, 8am – 8pm, EST.
How do I do find out what conditions OWCP has accepted on my claim?
While your initial acceptance letter includes this information, claims are often updated to include other conditions. This information is also available on the OWCP Web Bill Processing Portal. You can log in by clicking FECA/Claimant. From there you will enter your case number, date of birth, and date of injury. Once logged in, you can click on the "Eligibility and Accepted Conditions" link to access a list of accepted conditions. You can help your provider by giving her/him the list of accepted conditions for your claim and by telling your provider how to access this information online.
While logged into the Portal, you may access the Claimant Query System (CQS) by clicking the link "CQS," which also allows you to view the accepted conditions for your case, as well as information on case status and compensation payments and claim tracking.
I think that other diagnoses need to be added as accepted conditions on my claim. What should I do?
If you believe that additional or different conditions warrant acceptance on your claim, please provide OWCP with medical documentation supporting the claim's expansion for review by the claims examiner. As is the case with anything sent to OWCP, this medical documentation must include the claim/case number on every page and may be mailed to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY 20742-8300 or uploaded to the case electronically via ECOMP.
What form do I submit to get reimbursed for traveling to and from my medical appointments?
Complete the OWCP-957 "Medical Travel Refund Request" form to request reimbursement for your transportation/mileage expenses. This form is available on the OWCP Web Bill Processing Portal. Click on the "Forms and Links" link. Write your OWCP claim number on the top right side of the form. You may record 3 trips on each form. The section requiring a Doctor's signature for each trip does not apply to OWCP claimants.
Mail the completed OWCP-957 to:
U.S. Department of Labor
DFEC Central Mailroom
PO Box 8300
London, KY 40742-8300
How do I get reimbursed for out of pocket expenses I've paid for authorized treatments, pharmacy expenses/medications, medical appliances, or medical supplies for a work-related injury?
Reimbursement for pharmacy expenses/medications, medical appliances and supplies, and medical, surgical, and dental services can be claimed using Form OWCP-915 "Claimant Medical Reimbursement Form". This form is available on the OWCP Web Bill Processing Portal. Click on the "Forms and Links" link. Put each date of service on a separate line. If you are requesting reimbursement for a co-pay, write "Co-Pay" in the "Description of Charge" field. Use a separate form for each provider you paid. Don't mix prescriptions and office visits on the same form.
A reimbursement claim for medical services, surgical services, medical appliances, or medical supplies must be accompanied by a copy of the OWCP-1500/HCFA-1500 "Health Insurance Claim Form" showing individual charges and signed by the medical Provider.
A reimbursement claim for pharmacy expenses/medications must be accompanied by a copy of the Universal Claim Form or other pharmacy statement showing the name of the drug, NDC code, quantity provided, cost, prescribing physician, and date the prescription was filled.
All reimbursement requests must be accompanied by proof of payment – a cash receipt, cancelled check, or credit card receipt.
Mail the completed OWCP-915 and related documentation to:
U.S. Department of Labor
DFEC Central Mailroom
PO Box 8300
London, KY 40742-8300
Be sure to include your claim number on EVERY page you send.
If OWCP does not pay my provider's bill in full, am I required to pay my provider the difference between what was billed and what OWCP paid?
If a provider's bill is reduced by OWCP in accordance with its fee schedule or other tests of reasonableness, the provider is not allowed to charge you as a claimant for the remainder of the bill. If an authorized service has been rendered for your accepted work-related condition, you are not responsible for charges over the maximum allowed in the OWCP fee schedule. 20 C.F.R. §10.801 (d) provides that by submitting a bill and/or accepting payment, the provider signifies that the service for which reimbursement is sought was performed as described and was necessary. In addition, the provider thereby agrees to comply with all regulations concerning the rendering of treatment and/or the process for seeking reimbursement for medical services, including the fee schedule's limitation imposed on the amount to be paid for such services. See also 20 CFR §10.813.
I think I might need some help in using the web portal. Do you have some instructions or a user manual?
Yes. Go to the OWCP Web Bill Processing Portal and click on the Help link (on the right side, above the yellow box). This will open a User Guide.