Justification for Non-material/Non-substantive Change
ICR 1240-0006
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act (CA-278)
The Office of Workers' Compensation Programs (OWCP) administers the Federal Employees' Compensation Act (FECA), 5 U.S.C. 8147 and the War Hazards Compensation Act (WHCA), 42 U.S.C. 1701. The statutes provide for the reimbursement of payment by insurance carriers and self-insured to workers injured due to a war-risk hazard. The information collected from the CA-278 allows OWCP to consider requests filed by insurance carriers and self-insured that have paid benefits to workers injured due to a war-risk hazard to be reimbursed for such benefits out of the Employees’ Compensation Fund. Before compensation may be paid, the case file must contain medical evidence showing that the claimant's disability is causally related to the claimant's federal employment.
The program requesting one minor change in the instruction page. The room number which was previously noted is no longer active to receive mail.
Item 1 in the instructions advises the respondent to forward the completed form as follows:
Currently reads:
Mail one copy of this form with the attached supporting documents described below to
US Department of Labor - OWCP/DFELHWC
Attn: War Hazards
400 West Bay Street
Room 826
Jacksonville, FL 32202
Requested revision:
Mail one copy of this form with the attached supporting documents described below to
US Department of Labor - OWCP/DFELHWC
Attn: War Hazards
400 West Bay Street
Room 722
Jacksonville, FL 32202
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Hamai, Pamela A - OWCP |
| File Modified | 0000-00-00 |
| File Created | 2023-08-02 |