Office of Workers' Compensation Programs Services Stakeholder Survey

OMB Control Number: 1225-0088
Expiration Date:

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 short survey should take no more
than five minutes to complete. You can also complete this survey on-line, found on our homepage (under
highlights): http://www.dol.gov/owcp/dlhwc/index.htm.
The intent of this survey is to capture your feedback on the quality of our staff services. 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, such as providing additional evidence
or appealing the decision. Contact us to find out how. http://www.dol.gov/owcp/dlhwc/lscontac.htm
If you do not wish to take the survey online, you may send your completed survey by mail to:
U.S. Department of Labor
200 Constitution Ave. N.W.
Room S3522, Attention: Customer Satisfaction Survey
Washington, DC 20210
Exit the
1. Which office within the Longshore and Harbor Workers’ Compensation (Defense Base Act)
program did you most recently contact?
Baltimore, MD

Boston, MA

Honolulu, HI

Houston, TX

Jacksonville, FL

Long Beach, CA

New Orleans, LA

New York, NY

Norfolk, VA

San Francisco, CA

Seattle, WA

Washington, DC

2. How did you contact this office?

In writing

By phone

If contact was by phone: From the date of your telephone contact with the office, how many business days
did it take to receive a return call?
Same day

One day

Two days

Three days

Four to six
d

More than six
d

3. Overall, how satisfied were you with the timeliness of the response provided to you by the
representative?
Very satisfied

Somewhat satisfied

Neutral

Very dissatisfied
Additional comments.

2

Somewhat dissatisfied

OMB Control Number: 1225-0088
Expiration Date:

4. How well does the term “Professional” describe the individual who assisted you?

Excellent

Good

Poor

Fair

Additional comments.

5. How well does the term “Courteous” describe the individual who assisted you?
Excellent

Good

Fair

Poor

Additional comments.

6. Do you agree or disagree? The individual who assisted you was knowledgeable about the subject
matter.
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Additional comments.

Exit the

7. a) Was the service provided to you helpful in answering your questions/issue?
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

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

Yes

No

c) Was the service provided to you helpful in clarifying your issue?

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

d) Was the service provided to you helpful in explaining the next steps in the process?

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

e) Was the service provided to you helpful in suggesting alternatives?

Strongly Agree

Agree

Disagree

Neutral

Strongly Disagree

f) Was the service provided to you helpful in clearly explaining the potential delays in resolving the
issues at a more formal level?

Strongly Agree

Agree

Neutral

Disagree

Additional comments.

2

Strongly Disagree

OMB Control Number: 1225-0088
Expiration Date:

8. Overall, how satisfied were you with the service provided to you?
Very satisfied

Somewhat satisfied

Neutral

Somewhat dissatisfied

Very dissatisfied

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 N-1301,
Washington, DC 20210 or email [email protected] and reference the OMB Control Number
1225-0088. Note: Please do not return the completed survey application to this address.

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