Justification for No material/Nonsubstantive Change CA-12

Justifiction - CA-12.docx

Claim for Continuance of Compensation (CA-12)

Justification for No material/Nonsubstantive Change CA-12

OMB: 1240-0015

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Justification for No material/Nonsubstantive Change

Claim for Continuance of Compensation Under the Federal Employees’ Compensation Act (CA-12)

The Department of Labor’s Office of Workers’ Compensation Programs (OWCP) is the agency responsible for administration of the Federal Employees’ Compensation Act (FECA), 5 U.S.C. 8101 et. seq., the Black Lung Benefits Act (BLBA), 30 U.S.C. 901 et. seq. and the Energy Employees’ Occupational Illness Compensation Program Act of 2000 (EEOICPA), 42 U.S.C. 7384 et. seq.  These statutes require OWCP to pay for appropriate medical and vocational rehabilitation services provided to beneficiaries. OWCP is requesting an address change to OWCP billing form Claim for Continuance of Compensation Under the Federal Employees’ Compensation Act (CA-12) in order for the new OWCP medical bill processor to receive and reimburse medical bills to medical providers.

Approval of this request is needed by April 17, 2020 for posting of the form on the new medical bill processors web portal. This will allow ample time for the new bill processor’s assumption of operations on April 27, 2020.  Any approval date beyond would necessitate a delay in operations go-live until the request is approved.



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