Justification for 1240-0037

Justification - 1240-0037 OWCP-957.docx

Medical Travel Refund Request

Justification for 1240-0037

OMB: 1240-0037

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Justification for No material/Nonsubstantive Change

Medical Travel Refund Request (OWCP-957)



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 the OWCP billing form Medical Travel Refund Request (OWCP-957) as the OWCP medical bill processor has a different PO Box for bill submission via mail for the FECA Program.

Approval of this request is needed by April 1, 2022 for posting of the form on the medical bill processors web portal.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSuggs, Anjanette C - OWCP
File Modified0000-00-00
File Created2022-06-13

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