Office of Workers' Compensation Programs Services Stakeholder Survey

Introduction

Welcome!  

The Office of Workers’ Compensation Programs is committed to continuous improvement of our services with the ultimate 
goal of achieving total customer satisfaction. We would greatly appreciate if you would answer a short survey and let us 
know how well we assisted you. This survey consists of between fifteen and twenty questions depending upon your 
responses and should take no more than eight to ten minutes to complete.  

The intent of this survey is to capture your feedback on quality of service you received from our staff. Please do not 
respond on the basis of your satisfaction with the outcome of a claim. If you are not satisfied with the outcome of a claim, 
other, more effective means are available to you including providing additional information and appealing the decision 
directly with the administering Program. 

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information 
unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is 
estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, 
gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to 
respond to this collection is voluntary. Send comments regarding the burden estimate or any other aspect of this 
collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of the 
Chief Information Officer, Attention: Departmental Clearance Officer, 200 Constitution Avenue, N.W., Room N­1301, 
Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1225­0088. Note: 
Please do not return the completed survey application to this address. 

Program Contacted

*Which benefit program did you most recently contact?
j Federal Employees' Compensation
k
l
m
n
j Black Lung Benefits
k
l
m
n

j Longshore and Harbor Workers' Compensation (includes Defense Base Act)
k
l
m
n
j Energy Employees' Occupational Compensation
k
l
m
n

Federal Employees' Compensation

Which Office within the Division of Federal Employees' Compensation did you most
recently contact?
Office Locations

6

Please select one of the 
choices in the drop down 
box on the right.

Method of Contact

How did you contact this office?
j In writing
k
l
m
n

j By phone
k
l
m
n

Timeliness

Overall, how satisfied were you with the timeliness of the response provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments. 

5
6

Return Call

From the date of your telephone contact with the office, how many business days did it
take to receive a return call?
j Same day
k
l
m
n
j One day
k
l
m
n

j Two days
k
l
m
n

j Three days
k
l
m
n

j Four to six days
k
l
m
n

j More than six days
k
l
m
n

Rating About the Individual That Assisted You

How well does each of the following words describe the individual who assisted you
Excellent

Good

Fair

Poor

Professional

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Courteous

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Please add any additional comments. 

5
6

Knowledge

Do you agree or disagree? The individual who assisted you was knowledgeable about the
subject matter.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly disagree
k
l
m
n

Please add any additional comments. 

5
6

Service Provided

Was the service provided to you helpful in:
a) Answering your question/issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Answering your question/issue (continued)

If the service provided did not answer your question/issue, were you given a date when
you could expect an answer?

j Yes
k
l
m
n
j No
k
l
m
n

Service Provided (continued)

Was the service provided to you helpful in:
b) Clarifying your issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

c) Explaining next steps in the process?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

d) Suggesting alternatives?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

e) Clearly explaining the potential delays in resolving the issues at a more formal level?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Overall Satisfaction

Overall, how satisfied were you with the service provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments. 

5
6

Optional Additional Questions

Would you be willing to answer several additional questions specific to the Federal
Employees' Compensation Program?

j Yes
k
l
m
n
j No
k
l
m
n

FECA Role Connection

What is your role in connection to the FECA program?
j Claimant
k
l
m
n

j Employer
k
l
m
n

j Injury/Compensation Specialist/Treatment Provider
k
l
m
n

FECA Question/Issue

Please indicate, in general terms, what your question/issue was about?
j Acceptance/Denial
k
l
m
n

j Compensation Payments
k
l
m
n
j Bill Payment
k
l
m
n

j Medical Authorization
k
l
m
n

FECA Benefit

Has this office ever denied you a benefit?

j Yes
k
l
m
n
j No
k
l
m
n

FECA Denied Benefit

Was your contact about a denied benefit?

j Yes
k
l
m
n
j No
k
l
m
n

Black Lung Benefits

Which Office within Black Lung Benefits did you most recently contact?
Office Locations

6

Please select one of the 
choices in the drop down 
box on the right.

Black Lung Benefits: Method of Contact
How did you contact this office?
j In writing
k
l
m
n

j By phone
k
l
m
n

Black Lung Benefits: Timeliness

Overall, how satisfied were you with the timeliness of the response provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments 

5
6

Black Lung Benefits: Return Call

From the date of your telephone contact with the office, how many business days did it
take to receive a return call?
j Same day
k
l
m
n
j One day
k
l
m
n

j Two days
k
l
m
n

j Three days
k
l
m
n

j Four to six days
k
l
m
n

j More than six days
k
l
m
n

Black Lung Benefits: Rating About the Individual That Assisted You

How well does each of the following words describe the individual who assisted you
Excellent

Good

Fair

Poor

Professional

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Courteous

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Please add any additional comments 

5
6

Black Lung Benefits: Knowledge

Do you agree or disagree? The individual who assisted you was knowledgeable about the
subject matter.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly disagree
k
l
m
n

Please add any additional comments 

5
6

Black Lung Benefits: Service Provided

Was the service provided to you helpful in:
a) Answering your question/issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Black Lung Benefits: Answering your question/issue (continued)

If the service provided did not answer your question/issue, were you given a date when
you could expect an answer?

j Yes
k
l
m
n
j No
k
l
m
n

Black Lung Benefits: Service Provided (continued)
Was the service provided to you helpful in:
b) Clarifying your issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

c) Explaining next steps in the process?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

d) Suggesting alternatives?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

e) Clearly explaining the potential delays in resolving the issues at a more formal level?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Black Lung Benefits: Overall Satisfaction

Overall, how satisfied were you with the service provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments. 

5
6

Black Lung Benefits: Optional Additional Question

Would you be willing to answer one additional question specific to the Coal Mine Workers'
Compensation Program?

j Yes
k
l
m
n
j No
k
l
m
n

Black Lung Benefits: Final Question

Regardless of the status or outcome of your claim, was the staff member able to
meaningfully respond to your question(s)?

j Yes
k
l
m
n
j No
k
l
m
n

If not, please explain. 

5
6

Longshore and Harbor Workers' Compensation

Which Office within the Division of Longshore and Harbor Workers' Compensation did
you most recently contact?
Office Locations

6

Please select one of the 
choices in the drop down 
box on the right.

Longshore: Method of Contact
How did you contact this office?
j In writing
k
l
m
n

j By phone
k
l
m
n

Longshore: Timeliness

Overall, how satisfied were you with the timeliness of the response provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments 

5
6

Longshore: Return Call

From the date of your telephone contact with the office, how many business days did it
take to receive a return call?
j Same day
k
l
m
n
j One day
k
l
m
n

j Two days
k
l
m
n

j Three days
k
l
m
n

j Four to six days
k
l
m
n

j More than six days
k
l
m
n

Longshore: Rating About the Individual That Assisted You

How well does each of the following words describe the individual who assisted you
Excellent

Good

Fair

Poor

Professional

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Courteous

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Please add any additional comments 

5
6

Longshore: Knowledge

Do you agree or disagree? The individual who assisted you was knowledgeable about the
subject matter.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly disagree
k
l
m
n

Please add any additional comments 

5
6

Longshore: Service Provided

Was the service provided to you helpful in:
a) Answering your question/issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Longshore: Answering your question/issue (continued)

If the service provided did not answer your question/issue, were you given a date when
you could expect an answer?

j Yes
k
l
m
n
j No
k
l
m
n

Longshore: Service Provided (continued)
Was the service provided to you helpful in:
b) Clarifying your issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

c) Explaining next steps in the process?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

d) Suggesting alternatives?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

e) Clearly explaining the potential delays in resolving the issues at a more formal level?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Longshore: Overall Satisfaction

Overall, how satisfied were you with the service provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments. 

5
6

Longshore: Optional Additional Questions

Would you be willing to answer several additional questions specific to the Longshore
and Harbor Workers' Program (including the Defense Base Act)?

j Yes
k
l
m
n
j No
k
l
m
n

Informal/Mediation Timeliness

The Informal Conference/Mediation I participated in was scheduled and held in a timely
manner:
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

My Preparedness

For THIS Conference/Mediation, I believe I had adequate time to gather and prepare
information in support of my position.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Rediness of other parties

For THIS Conference/Mediation, the other parties involved with this session were prepared
to discuss options and authorized to make the appropriate level of decisions to resolve
this dispute.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add additional comments. 

5
6

Skillfulness and Ability of the Claims Examiner

For THIS Conference/Mediation, the Claims Examiner or District Director was helpful in
assisting the parties in:
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Clarify Issues

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Suggesting Alternative 

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Solutons
Assisting the parties in 
communication
Recommending a likely 
outcome based on facts of 
the case so far
Clearly explaining the next 
steps to the process
Clearly explaining the 
potential delays in 
resolving the issues at a 
more formal level

Overall Dispute Resolution

Overall, I believe the OWCP Informal Dispute Resolution process is helpful in resolving the
dispute issues on this claim.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Energy Employees Occupational Illness Compensation

Which Office within the Division of Energy Employees Occupational Illness Compensation
did you most recently contact?
DOL Office Locations
Please select either one of the DOL Office Locations 
"OR" one of the Resource Center Locations in the drop 
down boxes on the right, not both.

6

Resource Center Locations

6

Energy: Method of Contact

How did you contact this office?
j In writing
k
l
m
n

j By phone
k
l
m
n

Energy: Timeliness

Overall, how satisfied were you with the timeliness of the response provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments 

5
6

Energy: Return Call

From the date of your telephone contact with the office, how many business days did it
take to receive a return call?
j Same day
k
l
m
n
j One day
k
l
m
n

j Two days
k
l
m
n

j Three days
k
l
m
n

j Four to six days
k
l
m
n

j More than six days
k
l
m
n

Energy: Rating About the Individual That Assisted You

How well does each of the following words describe the individual who assisted you
Excellent

Good

Fair

Poor

Professional

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Courteous

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Please add any additional comments 

5
6

Energy: Knowledge

Do you agree or disagree? The individual who assisted you was knowledgeable about the
subject matter.
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly disagree
k
l
m
n

Please add any additional comments 

5
6

Energy: Service Provided

Was the service provided to you helpful in:
a) Answering your question/issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Energy: Answering your question/issue (continued)

If the service provided did not answer your question/issue, were you given a date when
you could expect an answer?

j Yes
k
l
m
n
j No
k
l
m
n

Energy: Service Provided (continued)
Was the service provided to you helpful in:
b) Clarifying your issue?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

c) Explaining next steps in the process?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

d) Suggesting alternatives?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

e) Clearly explaining the potential delays in resolving the issues at a more formal level?
j Strongly Agree
k
l
m
n
j Agree
k
l
m
n

j Neutral
k
l
m
n

j Disagree
k
l
m
n

j Strongly Disagree
k
l
m
n

Please add any additional comments. 

5
6

Energy: Overall Satisfaction

Overall, how satisfied were you with the service provided to you?
j Very satisfied
k
l
m
n

j Somewhat satisfied
k
l
m
n
j Neutral
k
l
m
n

j Somewhat dissatisfied
k
l
m
n
j Very dissatisfied
k
l
m
n

Please add any additional comments. 

5
6

Energy ­ Optional Additional Questions

Would you be willing to answer several additional questions specific to the Energy
Employees' Occupational Compensation Program?

j Yes
k
l
m
n
j No
k
l
m
n

Energy: Additional Questions

Did you contact the office to ask a question or resolve an issue?
j Ask a question
k
l
m
n

j Resolve an issue
k
l
m
n

Did you get the question or issue resolved?

j Yes
k
l
m
n
j No
k
l
m
n

Please indicate, in general terms, what your question/issue was about.
j Acceptance/Denial
k
l
m
n

j Compensation Payments
k
l
m
n
j Bill Payment
k
l
m
n
j Other
k
l
m
n

Other (please specify) 

Have you been issued a decision on an existing case?

j Yes
k
l
m
n
j No
k
l
m
n

Enery: Acceptance/Denial

Was the decision accepted or denied?
j Accepted
k
l
m
n
j Denied
k
l
m
n

Completed

Thank you for your feedback! Your responses will help us improve service to our claimants and other stakeholders.