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Form CA-278 Claims for Reimbursement of Benefit Payments and Claims
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
CA-278 rev 2023
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
OMB: 1240-0006
OMB.report
DOL/OWCP
OMB 1240-0006
ICR 202301-1240-008
IC 13940
Form CA-278 Claims for Reimbursement of Benefit Payments and Claims
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0006 can be found here:
2023-05-01 - Extension without change of a currently approved collection
2023-02-22 - No material or nonsubstantive change to a currently approved collection
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